Nailing Your Residency Interview

Written by Pamela Skillings, top interview coach — named “a guru in the world of job interviews” by The Wall Street Journal.

Congratulations on making it this far in your medical career!

You’ve already worked incredibly hard making your way through medical school, completing your rotations, and passing your exams.

Now comes the next hurdle in your path; the Residency Interview.

To really launch your career, you are faced with the task of having to match with incredibly competitive residency programs. Considering many graduating medical students have little to no experience interviewing, this can be a daunting prospect.

In 2022, 42,549 residents applied to residency programs. Only 80.1% matched. This means that 19.9% don’t.

Do not fear! This is where we can help.

This guide will help you start preparing right away.

It’s chock-full of useful information you can directly apply to your interview prep, regardless of your circumstances or where you are in the process.

If there’s a particular component of the resident interview you are worrying about, feel free to look at the Table of Contents and jump to where you would like to go.

CHAPTER 1

What Makes You Stand Out?

That’s the million-dollar question you should be able to answer with your interview.

You may wonder why you should invest your time and other resources to prepare for your residency interviews.

Simply put, everyone who is invited to an interview is technically qualified. You all look good on paper and meet the requirements.

This is your opportunity to show–with your stories, body language, personality, and experiences–that you are absolutely the best candidate and should be their #1 pick.

There’s a lot of information out there about how to prepare for interviews. Don’t be misled by the well-meaning advice to just “be yourself” and “not overthink it.”

You do, of course, want to be yourself, but a more polished, confident, and prepared version of yourself.

And of course, overthinking and causing yourself anxiety isn’t helpful.

But thorough, mindful preparation makes the difference between being #1 and having to settle for something that isn’t quite what you were hoping for.

Some of The Challenges You’re Facing May Include:

  • Low test scores
  • Limited experience in the U.S.
  • Struggles with nerves or low self-confidence
  • Past failures to match
  • Gaps after medical school

This is true for many candidates and, unfortunately, why almost 20% fail to match each season. However, with careful preparation and practice, you can overcome these challenges and succeed in your residency goals.

You don’t have to tackle this alone. We can help you knock it out of the park, just like we’ve done for hundreds of other residents over the last ten years. So read on!

CHAPTER 2

How To Predict What Questions You’ll Be Asked

While you can’t predict the exact questions you’ll be asked, there are some common questions and topics you can anticipate.

You can (and should!) prepare for the majority of the most common questions.
So what are these common questions?

There are about 5 different categories of questions you can expect in your residency interviews:

1. Conversation Starters

These are the preliminary questions at the start of the interview. They usually begin with some variation of “tell me about yourself.”

Some examples of these are:

“Who was your childhood hero?”

“What’s the last thing you learned outside of work?”

Or, the ultimate conversation starter, “What do you love about what you do?”
This question gets the conversation flowing and gives a basic blueprint of who you are and what your background is.

2. Experience and Background

Here they will ask you about your professional background. This usually includes questions about why you chose your medical school, your specialty, and your favorite and least favorite rotations.

This is also an area where answering may become tricky if you have a gap since medical school, or any other abnormality that may set you apart.

(We have a whole chapter on answering tricky questions, so feel free to skip ahead to Chapter 8 if you want some advice on how to handle them the most effectively.)

3. Behavioral and Situational

Behavioral questions are those that begin with “tell me about a time,” or “give me an example of…”

For example, “Tell me about a time you had to think on your feet.”

Or,

“Give me an example of a time when you mediated a conflict between two people.”

Their primary purpose is to see how you handled a situation in the past in hopes of predicting how you may behave in the future.

They work well for the interviewer because they draw out details about your key accomplishments and how you approach work.

Situational questions are more hypothetical.

They are about, “what would you do if…” scenarios. Such as, “What would you do if you made a mistake that caused harm to a patient?” or “What would you do if you disagreed with a decision made by your attending?”

Situational questions are not as common as behavioral questions and can be a little harder to prepare for.

We have dedicated several chapters to going in depth with some of the most common behavioral questions, so keep reading for the drill-down into the nitty-gritty details.

4. Personality

These are the get-to-know you questions.

The interviewer doesn’t just want to know who you are on paper. After all, everyone who’s been called in for an interview is qualified.

They want to get a sense of who you are.

They may do this by asking you about things like your hobbies and interests.

It may even come as a straightforward question like, “What do you enjoy doing outside of work?” or ?“What’s the last show you binged on Netflix?”

They may throw in a really quirky question or two to see how you respond under pressure and get an even more detailed look at your personality. Something like, “How many unread emails are in your inbox?”

5. Medical

Lastly, you may encounter technical or philosophical questions about medicine.

For instance, you may be asked about your thoughts on the future of medicine, your specialty, or a current issue in your field. Something like, “What do you think will be the next breakthrough in this field?”

For international students, it’s not unlikely you will be asked to compare your experience with practicing medicine in your home country versus the American healthcare system.

They may dig into your research or a recent rotation. Or, something general, like, “What role does research play in a physician’s career?”

We know this is a lot to take in, but we’re here to walk you through every step.

In the next chapters we’ll be drilling down and examining some of these questions in detail and showing you how to prepare to knock it out of the park.

CHAPTER 3

Mastering a Great First Impressions With “Tell Me About Yourself”

Some variation of this question is nearly guaranteed to come up in any interview, whether for residency or otherwise.

Interviewers can phrase it in different ways, like “Take me through your resume.” or “Tell me more about your background.” But it all means the same thing – they’re asking you to tell them more about you and how you ended up in that interview.

This is such a popular opener for most interviewers because it’s an easy way to start the conversation and get you talking.

Ultimately, they are looking for the highlights of your background. Your highlights should primarily focus on your professional life, but some personal details are also okay to include (especially if they are relevant to your professional growth or accomplishments).

Different interviewers will have different interests in this question, however.

Some view this time as an opportunity to get to know you more personally. Others want to hear your elevator pitch of professional accomplishments.

It’s a little tricky for candidates because, being open-ended, the question lends itself to a rambling answer if you’re unprepared.

It is very difficult to find the balance between confidence and arrogance, professional vs. personal, and focused vs. rambling.

However, if you prepare well, this question is an excellent opportunity to start the interview strong.

Embracing this question and answering it well sets the tone for your whole interview. It gives you some power over the direction the conversation takes.

This can help your confidence level tremendously so that you don’t feel at the mercy of your interviewer.

Answering Strong

Think about your answer as your elevator pitch-a focused overview that’s so concise you can deliver it in a short elevator ride.

Your pitch should include the highlights of your professional life:

  • Your education
  • Your research
  • Clinical experience
  • Other accomplishments

Your delivery should be natural and spontaneous while remaining succinct and on point.

We’ll outline our 3-Step Approach on how to accomplish this in the next section, but first we want to point out that we do not recommend a scripted approach.

We strongly suggest using bullet points to guide your answers instead of writing out a script and memorizing it.

Scripted answers can sound stiff and artificial, making the interviewer feel like they’re not getting to know the real you.

With bullet points, you will still cover all the necessary information but will be free to speak from the organic energy of the moment in a truly authentic way.

Your answer will be a little different each time, but that’s 100% okay.‍

The goal is to let them get to know you while still being informative. You don’t need a rote answer to do that to the best of your ability.

Our Proven 3-Step Approach

Let’s dive into outlining your elevator pitch with our proven 3-Step Approach.

1. Who You Are

The first component is a compelling, confident statement about who you are as a professional.

A common mistake here is to start at the beginning of your resume and attempt to go through your whole life story chronologically and in too much detail.

One of the pitfalls of this–other than losing your way and rambling out an answer–is that you are starting with the weakest parts of your work history.

What you actually want to do is grab their attention right away and then continue with the details.

You have to tell them how you want them to see you.

For residency interviews, the opening statement usually begins with your medical school training and any other accomplishments or details that set you apart.

Example: “I’m currently completing my studies at Medical School X and have also devoted the last 6 months to gaining hands-on experience in psychiatry with my volunteer work with the Northern County Jail substance abuse program and the Central City transitional housing program…”
“I’m finishing up my coursework at Medical School X and have spent the last 5 months volunteering at the Shady Oaks Nursing Center with their hospice program to gain hands-on experience…”

Why we like it

This answer starts the interview strong by highlighting extensive, hands-on psychiatry experience outside rotations.

2. Why You’re Qualified

This is the meat in the “tell me about yourself” sandwich.

You want to cover 3-5 of your most impressive accomplishments and qualifications.

It’s also okay to weave in a few personal details here to make it more interesting. You want to be informative, personable, and most of all, you want them to remember you.

Below is an example of a step (b) with a personal detail before going into your education and other details.

Example: “I actually come from a family of physicians, so I kind of always knew I would pursue medicine in some form, then had the chance to volunteer at my dad’s hospital as a teen and realized that pediatrics was the path for me…”
“My brother had cancer when we were kids and he passed away. His battle made me want to become a doctor so I could help other sick kids in ways that my brother’s doctors couldn’t.”

You can also include some of the following topics in your answer:

  • Research experience
  • Relevant rotations
  • Relevant volunteer experience
  • Awards and recognition
  • Experience at that facility

Example: “During my volunteer experience at the children’s hospital in Houston, TX, I was able to speak with some of the top pediatric cardiologists in the country. Not only was it an honor and a privilege, but I also learned their unique perspectives on what it takes to practice pediatric medicine in a top-ranked hospital.””

By weaving your personal experience into the narrative of your professional account, you can better emphasize your strengths and qualifications.

3. Why You’re There

You want to wrap up your answer with a strong statement about your interest in this particular program.

You don’t have to give too many details here because you’ll almost certainly be asked a follow-up question about it.

For the purposes of the “tell me about yourself” question, you can stick to something short and sweet like:

Example: “This program feels like a great fit for me based on my research — and particularly the patient population, which aligns with my interest in community medicine…”

This response is succinct but still gives specific details about why the candidate is interested in that specific program.

Tying It All Together

Now that you have the 3 parts to build your answer, you can outline your bullet points using these guidelines.

Who You Are

  • A confident, compelling statement about who you are as a professional

Why You’re Qualified

  • 3-5 of your most impressive accomplishments and qualifications;
  • include some of the following topics in your answer:
    • Research experience
    • Relevant rotations
    • Relevant volunteer experience
    • Awards and recognition
    • Experience at a facility

Why You’re There

  • wrap up your answer with a strong statement about your interest in this particular program

Your entire answer should not go over two minutes. Keep in mind that PRACTICING your interview is how you master the art of answering questions smoothly and in a timely fashion.

Once you outline your answer, practice aloud, first using your notes, and eventually getting to where you can answer freely and spontaneously without them.

CHAPTER 4

Nailing the FIT – “Why Your Speciality?”

Some version of this question will come up in every single interview. And for good reason.

It’s an important question.

Your interviewer may ask you about your specialty specifically:
“Why pediatrics?” or “Why orthopedics?”

Or the question may be phrased slightly differently, “Why did you choose this specialty?”

Ultimately, what your interviewer is looking for here is:

  • Your commitment to your specialty
  • How good of a fit you are for their program and the specialty

You may be incredibly passionate about your specialty and have likely given it a ton of thought.

However, none of that will help you if you can’t articulate that passion aloud in a clear, informative way.‍

This is especially true if your background doesn’t exactly align with the specialty you’ve chosen.

Maybe you switched specialties, or it took you a while to decide.

Whatever the case may be, understanding and eloquently communicating your choice will be essential.

What Interviewers Want

Frequently, Program Directors emphasize ‌they are looking for FIT in the ideal candidate.

What does “fit” mean?

Primarily, it means having values and interests that align with those of the program.

They want to bring people in who truly want to be there. People who will be dedicated, focused, and go the extra mile through the grueling experience of residency.

Part of what will determine your success is your feelings about your specialty.‍

It may be hard to express just why you’ve chosen the specialty that you have.

It’s probably a mix of factors, including what you enjoy, what you’re good at, what you were exposed to during medical school, what you value, and perhaps even some family influence.

Because this question is so common, a general answer will not work well for you. Your interviewer has already heard every shallow answer hundreds of times. What sets you apart?

As you did for the “tell me about yourself” question, you’re going to want to outline a few bullet points for yourself.

You may find your words flow naturally, or you may find you have trouble putting words to the journey that led you to your specialty.

Either way, don’t leave this question to chance.

After you’ve outlined your answer, practice out loud. First with your notes in front of you, and then without them as you grow more and more confident in what you want to say.

Here’s an example to help you get started:

Question: Why Family Medicine?‍

“I have always been drawn to family medicine. I think it’s because I have experienced first-hand how lives can be saved when serious conditions are identified early on and managed by a knowledgeable and caring physician.‍

Medical advances in type I diabetes extended the life of my grandfather by almost 50 years, and now help my diabetic father manage his illness

In medical school, I only became more focused on family medicine. I love the variety and the continuity of care found in family medicine.‍

I like having the opportunity to work with patients of all ages and I truly appreciate the wide range of practice options available to family medicine physicians.”

Why We Like It

While succinct, this is a very sincere answer that clearly outlines the candidate’s values and understanding of the impact family medicine has on patients. The personal details also give the interviewer a better view of what’s motivating their interest in the specialty, and helps to set them apart.

CHAPTER 5

Answering the #1 Consideration of Program Directors – “Why This Program?”

Just as with questions about your specialty, “why this program?” is also a question you’re likely to get in every residency interview.

We’ve already talked about how important “fit” is to company directors.

But to drive it home, we want to mention that the Accreditation Council for Graduate Medical Education (or ACGME) conducts a survey of residency program directors in the U.S. every year, asking them about their residency interview approaches and priorities.

In the most recent survey of 1,454 residency program directors, “fit with program culture” was identified as the #1 consideration.

So consider this question your opportunity to convey what an excellent fit you are.

The fact of the matter is, medical residency is much more challenging than your average job. You will work very long hours, be faced with many tough decisions, work with difficult people, and have to operate at your highest level while under extreme pressure.

Considering how tough it’s going to be, your chances of success are far greater if you’re in a program that suits you and you’re motivated to be there.

How to Tackle This Question

The first thing you’re going to want to do is research.

You want to be able to speak in detail about what excites you about the program and why you think you’re an excellent fit.

Researching programs does take a lot of time, but it is well worth it.

It’s easy to get caught up in the business of interview season and neglect to prepare your talking points.

Don’t fall into this trap.

Outline and practice your bullet-points like we’ve talked about doing above.

Remember, your answer to this question is conveying your priorities to the interviewer. This will definitely factor into their decision about your fit.

Lead with what jumps out at you about the value of the training offered and how it aligns with your goals.

Maybe that will be research opportunities, fellowship options, patient population, or academic curriculum.

Example

“Well, first of all, I was drawn to the program based on its reputation for providing both breadth and depth of training with a variety of subspecialty and research opportunities.

I also like the fact that it is a teaching hospital that serves a diverse patient population — this is in line with my top priority of gaining great clinical experience.

Through speaking with current residents, I know that the environment is collaborative and the attendings here are very approachable. These are also big pluses for me.”

You want to be as specific as you can about each program, so read up on them, see which of their values align with yours, and use this to outline your answers.
Your tone, overall demeanor, and details of your answer will also be communicating how enthusiastic you are about each program.

Of course, it’s much easier to be enthusiastic about your top picks.

For programs that you don’t know as much about, or aren’t at the top of your list, you may need to think more about what aspects of the program are most interesting.

If you’re going to go through the trouble and expense of going to the interview, it’s well worth the extra effort it takes to think through this.

If you come across as half-hearted or apathetic, you won’t make it to the top of their list.

On the other hand, if you are incredibly enthusiastic about a program but are unable to articulate that excitement, it will translate as disinterest.

This is yet another reason to practice and prepare.

Geography Is a Factor

It’s very possible that one of the reasons a particular program appeals to you is because of where it’s located.

Maybe you have family or friends in the city, love the climate, or simply have always wanted to live there.

If you are interviewing from out of town, your interviewer will likely try to gauge how excited you are about coming to their city.

Location is a big part of your “fit.”

As important as your work is to you, it is just one part of your life, and if you’re miserable in the city you’re living in, it will begin to show up in your enthusiasm about your workplace.

For this reason, if you have a particular attachment to the area of your potential residency, mention it.

This will help clear up any doubts your interviewer may have about how well you will do in a particular city.

For example:

“I am excited about the prospect of relocating to the Dallas area. My wife is actually from Texas and has lots of family nearby. We have visited the area several times and really like it and would welcome the opportunity to be close to family as well.”

However, be careful not to make it sound as if geography is the primary reason you are interested in a program.

Your emphasis should be on the value of medical training, not the nearness to Mom or to great beaches.

CHAPTER 6

Answering the Dreaded Strengths and Weaknesses Questions

The interviewer asks about strengths because they are really looking for what sets you apart.

And they’re rooting for you here–if you are a stellar candidate, their job becomes much easier. They want you to be the one that sticks out from the crowd.

If you are the perfect fit, their job is one step closer to being done.

On the face of it, “tell me about your strengths” or some variation thereof should be a straightforward question, right?

After all, at this stage in your career, you should have a pretty good idea of the things you’re good at.

Even if you do know what you’re good at, there are a couple of ways a lot of candidates go wrong:

1. Too General‍

Because it’s easy (and all too common) to think that this question will be a breeze to answer, many interviewees don’t spend much time thinking about it.

When the moment comes, they blurt out a generality like, “I am a people person,” or “I am a team player.”

But these answers won’t actually help you. In fact, they may even hurt you.

Firstly, they don’t actually answer the question. Answers that are this vague lack any specific details about what being a team player means in action in the workplace.

And secondly, remember how we said the whole reason this question is asked is to identify what sets you apart?

Well, you guessed it, with general answers, absolutely nothing jumps out as different or even interesting.

Do not waste this opportunity on a general, no-thought answer.

You may be costing yourself the chance to land your dream residency program.‍

2. Too Modest

We’ve seen some incredibly gifted people over the years who were so humble about their accomplishments, the interviewer never knew how great they were.

It makes sense that you may be a little reluctant to talk yourself up. We’re taught that it is rude and unbecoming to discuss our accomplishments and we usually don’t go around talking about how great we are. To get comfortable answering this question, start by listing at least 5 of your greatest professional strengths.

These can be classics like creativity and attention to detail, softer skills like communication or problem-solving, or areas of hands-on expertise and experience.

Once you have your list, write a brief proof point for each strength.‍

A proof point can be a single example that shows the strength in action or it can be a more general, but still detailed, overview of how you’ve displayed that strength over time.

Here is an example of how you might answer a question about your strengths:

Example: Team Skills‍

My background has helped me to develop strong interpersonal skills and the ability to work well as a team member.
For example, when I was a research volunteer for a pediatric psychologist at Hospital X, I facilitated cultural competency training workshops for resident physicians. I assisted in the debriefing and reinforcement of effective engagement and communication strategies.

Example: Team Skills

My background has helped me to develop strong interpersonal skills and the ability to work well as a team member.

For example, when I was a research volunteer for a pediatric psychologist at Hospital X, I facilitated cultural competency training workshops for resident physicians. I assisted in the debriefing and reinforcement of effective engagement and communication strategies.

Weaknesses

Just as with strengths, questions about your weaknesses are a bit awkward.

After all, no one likes to spend time thinking about their flaws, let alone speaking about them casually to a stranger in an interview setting.

Interviewers like this question because it makes them seem thorough and “hard-hitting.”

Indeed, asking this question will probably result in seeing how well a candidate does under pressure.

So make sure you remain unruffled by being prepared if asked about your weaknesses.

How to Answer ‘What is Your Greatest Weakness?’

A good weakness answer has two important parts:

  1. Your weakness
  2. How you are working to address it

You’ll want to choose a “good” weakness to discuss. This can be something obvious, like poor test scores, a gap in your resume, or poor performance reports.‍

If you don’t have a potential red flag on your application, you should take a more standard approach and discuss a real weakness, but do so tactfully.

You should keep a few things in mind when discussing your weaknesses.

1. Be Authentic

Don’t choose a weakness because it sounds good. Often, candidates do this because they are taking the oft-cited advice of “turning a negative into a positive.”

They give answers like, “I work too hard sometimes,” or “I am too much of a perfectionist.”

This sounds like a good idea, but it’s not.‍

Your interviewer has likely already heard every “negative-to-positive” in the book, and it may even cause them to think you are hiding something.

You will get much further with sincerity.

However, be careful not to go overboard and be too candid.

Never, ever lie in an interview, but be diplomatic about the weakness you share, being careful not to raise any doubts about your ability to thrive in the program.

You should answer with a genuine weakness that isn’t a deal breaker and that you’ve taken steps, or are willing to improve. Read on for examples.

2. Pick an “Acceptable” Weakness‍

If you’re applying to a program with a heavy emphasis on patient interaction, don’t cite poor communication skills as your weakness.

Be mindful of the desired skills and competencies of the program and choose your weakness accordingly.

Example: Being too direct

“Sometimes I can be a bit too honest when I provide feedback to coworkers. My personality is naturally very straightforward and to the point, and most of my colleagues really value that, but I have learned that there are times on the job when more diplomacy is required.

I took a training class on conflict management and it really opened my eyes to the need to communicate differently with different people. So now I am much better at providing constructive feedback, even if it doesn’t always come naturally.”

This works well because the candidate notes that, although being too direct is a weakness, they recognize it as such and have taken concrete steps to make improvements.

3. Choose a “Fixable” Weakness‍

The language you choose to describe your weakness should convey that it is “fixable.”

For instance, you could say:

“I have a hard time speaking in front of large groups.”‍

This is something that can be improved with practice and new skills as opposed to:

“I am very shy and often have trouble speaking up in meetings.”‍

Both of these statements describe the same weakness. And while there is nothing wrong with being shy, the second example could leave the interviewer worried that you may not be able to collaborate in a team environment or could leave something of high importance un-said due to fear of speaking up.

4. Describe Your Weakness Concisely and Tactfully

Always be honest, but don’t feel like you have to go into great detail. Be brief. And most importantly, avoid sounding defensive. Negativity is often translated as unprofessional, so keep it positive.

CHAPTER 7

One Foolproof Formula to ANY Behavioral Interview Question

Behavioral questions have become very common in all interviews. You may not get them in all residency and fellowship interviews, but you will get them in some.
A behavioral question is one that starts with, “tell me about a time…” or “give me an example of…”
They are meant to test your skill in different competencies (leadership, teamwork, problem solving, etc.) and predict how you will respond to a situation in the future based on how you handled things in the past.

Most Common Behavioral Questions for Residents

In a recent survey by the Accreditation Council for Graduate Medical Education (ACGME), residency program directors said that the top qualities they are looking for are:

  • professionalism
  • integrity
  • interpersonal and communication skills
  • reliability and dependability.

Not surprisingly, the most common behavioral questions for residents have to do with these desired competencies.

You can expect some questions about the following:

Patient Stories

These examples will give them a sense of your clinical experience, your approach to patient care, and your interpersonal and communication skills.

Teamwork Stories

What you’re like to work with will be very important for your interviewer to know. Asking about teamwork will give them an idea of how you approach collaboration, how you get on with different personalities, and whether or not you will make a good teammate.

How Well You Handle Pressure

Your residency will be demanding. They will want to know how well you’ll be able to handle working under that kind of pressure.

Your Commitment Level

These questions will usually come in the form of asking about a failure.

The most important aspect of answering questions about failure is demonstrating how you handled it and what you learned from it.

Seeing how you handled a failure will help them gauge how resilient you are and what level of commitment you have when it comes to seeing things through.

Your Integrity

It’s difficult to get a grasp of someone’s code of ethics during such a brief time as an interview, but your interviewer may try to dig a bit deeper with questions like:

“Tell me about a time your integrity was tested.”

Or…

“Tell me about a difficult ethical decision you’ve had to make.”

Ideally, your answer should reflect your values in a story where you feel you made the right decision and stand by your choice.

It doesn’t have to be a dramatic example, but it should reflect your ethics and values as a medical professional.

How to Answer Behavioral Questions

As humans, we tend to absorb and remember information best when it is presented to us in a story.

The answers you give to behavioral questions are stories. True stories from your work history that illustrate your key competencies in a way that will stick with the interviewer.

At Big Interview, we promote the STAR format/approach.

STAR stands for

Situation/Task, Action, and Results.

The STAR method has been around for a long time and it WORKS.

We have seen it time and again with thousands of interviewees. Crafting your best stories with this simple approach keeps you succinct and informative while impressing your interviewer.

So let’s break it down.

Writing Your Interview Stories

Situation/Task

Spend some time thinking back on your work experiences.

Brainstorm situations you were in where you had to use your problem solving, leadership, communication, or any other skills.

Once you have a few good stories, you’ll want to flesh them out using the STAR approach.

Naturally, you’ll start with Part 1, S/T, which is all about the Situation/Task.

The idea here is to give the interviewer some context and some background. Just what they need to know to make the rest of the story make sense.

Resist the temptation to go into too much detail. This is where it’s easy to get bogged down with irrelevant information and veer your question off course.

You only need to clarify your role and ensure an understanding of the challenge’s difficulty, complexity, and/or size.

You are providing a foundation, so the rest of the story makes sense. What were you trying to achieve and why?

Action

The A–Action– part of your story is where you describe the actions you took to complete the task, solve the problem, address the issue, or improve the situation.

Why did you do what you did? What was the strategy behind it?

This will help show what you’re like on the job, how you approach things, and how you think.

In this section, you’ll want to mention relevant skills used and competencies demonstrated, because this can really help to underline your abilities and your strengths.

Again, stay focused on key details and avoid going off on tangents.

Results

The final part of your answer is your results. Every good story has a happy ending. You need to emphasize a positive outcome for this story.

This not only shows that you’re results-oriented, but it also ends your answer in a nice, crisp, confident way.

If you have tangible results, mention those first.

These could be patients treated, problems solved, efficiency increased–or anything that you can talk about that is tangible.

If you don’t have tangible results, anecdotal results are just as effective. Not every story comes with measurable outcomes.

You can also cite positive feedback from the attending or from a patient, experiences gained, skills learned, or relationships that were improved.

Don’t sell yourself short when it comes to your results. Outlining your stories, especially defining your R, will help ensure you’re highlighting your experience and accomplishments to your best advantage.

Now that you have a nice, tight STAR story that shows you in your best light, you need to define which competencies were demonstrated in each example.

This will help you categorize your stories and know when to use which examples when asked a behavioral question.

Example Answer for “Tell me about a time when you had to make a tough decision.”:

“During the time I volunteered with the jail substance abuse recovery unit, I discovered that one of the patients with whom I had become pretty close had relapsed but was lying about it. Honesty and transparency is a requirement for participation in the program. It was only a matter of time before he was discovered as a result of a failed drug test. I spoke with him and tried to convince him to come clean, talk with the other doctors in the program, and resume his recovery. Unfortunately, he refused.

I felt compelled to speak with the lead doctor since this patient’s relapse was a risk to the other recovering patients. The lead doctor confronted him and confirmed his relapse with a drug test. He was expelled from the program.

It was a difficult decision and really hard to watch him go, but ultimately, he made his choice. I had to make the decision that was for the greater good of the program and the rest of the patients who were working to get better. I don’t regret my decision. Fortunately, the rest of the patients made excellent recoveries and moved through their programs successfully.”

It is great to have stories that are multipurpose, but you have to know which stories are the best fit for each competency area.

We have a whole section devoted to Behavioral Questions in our Residency Curriculum. Click here to find out more.

CHAPTER 8

Don’t Get Tripped Up! Answering “Tricky” Questions in the Residency Interview

Sometimes life doesn’t go exactly as we plan. We may end up taking a more roundabout way towards reaching our goals than the standard ideal.

This could be for a plethora of reasons.

Family or personal concerns, lack of focus when you were younger, or immigrating to a new country are just some of the things that can delay- and sometimes jeopardize- your medical career.

There’s no need to panic, however.

Interviewers understand that life happens. They will undoubtedly ask about something odd on your application, but with thorough preparation and the right approach, there’s no need to worry.

In this chapter, we’re going to take a look at some of the more common application abnormalities we’ve come across and help you prepare for any tricky question you might get tossed as a result of your circumstances.

Gaps

In the U.S., the typical trajectory is to go straight from medical school to residency. As we talked about above, that may not always be possible for some applicants.

Unfortunately, many interviewers will see a gap in time between med school and residency as a red flag.

They may be afraid that your skills are not up to date, or that you lack commitment and resilience.

If you’ve gotten the invitation to the interview, it means your gap is not a dealbreaker.

However, you need to be prepared to talk about it because you will certainly be asked to explain any abnormalities on your application.‍

The residency interview process is very competitive and you will be going up against candidates who do not have a gap.

So, even though you have probably addressed the gap in your personal statement, you must make sure that it isn’t seen as a red flag once you are in the interview.

The key to addressing your gap is to think strategically about how to address it positively.‍

The best way to discuss your gap is to weave it into your “tell me about yourself” answer at the start of your interview.

This gets it out of the way from the get-go and keeps you in control over the tone the rest of the interview takes.

Example:

“I’m sure you noticed the six-month gap between my graduation from Medical School X and when I began volunteering at the children’s hospital in Houston, TX. I’d like to address any concerns you might have about that. The reason I was out for six months was because my mother needed my help in caring for my father as he was going through cancer treatments. She has no other family close by and I’m an only child, so it was my responsibility to help.”

A clear, concise explanation like this works well because it displays a sense of responsibility and honesty. Of course, always be honest in your answers and explanations.

Low Test Scores

Just as with gaps, if you’ve gotten an interview, your low test scores haven’t taken you out of the running.

This is very good news. You now have the chance to blow them out of the water.

Of course, they realize your test scores could have been higher, and so the topic becomes the elephant in the room.

The best way to approach this is just to tackle it head-on.

The key is to redirect the attention from the low scores and shine the spotlight on how much you have improved and how dedicated you are.

For example, you can give an answer like:

“I know that my Step 1 scores could be higher. In retrospect, I realize I didn’t prepare as well as I could have due to a family issue that came up during that time frame. Although I did reasonably well, I knew my score was not truly representative of my knowledge. So I buckled down in my preparation for Step 2. And as you can see from my Step 2 scores, my improved study approach was much more successful…”

This answer takes responsibility for the initial low test scores, gives a reason without divulging too much detail, and redirects the focus to a positive outcome.

“Positive” is the key word here. You never want to come across as defensive or negative while explaining your low scores.

International Medical Graduates (IMGs)

As an international medical graduate, you bring many strengths and positive qualities to the table. However, your application’s potential cultural differences, language barriers, and time gaps may be seen as red flags.

As an IMG, you’ll want to get up to speed on U.S. interviewing practices.
Some things that may trip you up are:

  • Self-promotion
  • Interviewing when English is not your first language
  • Heavy accents
  • Body language and nonverbal communication

There’s a lot to say here. So much, in fact, we’ve developed three entire lessons devoted to IMGs in our Residency Curriculum to make sure we cover as much ground as possible.

We will also go into detail about some advice for IMGs in Chapter 10 of this page, so keep reading or feel free to skip ahead.‍

CHAPTER 9

Don’t Get Tripped Up! Answering “Tricky” Interview Questions

So far, we’ve talked a lot about technical and career-related questions.

But there’s another group of questions you should be prepared for.

These are the “get to know you” questions.

Ideally, these are supposed to be ice breakers. They are meant to get you talking about yourself, your interests, and things you enjoy.

They are trying to see what you are about, what your personality is like, and what you might be like to work with.

While talking about your hobbies or answering other personal questions may seem straightforward, it’s worth taking the time to prepare.

As with any other question you’ll be asked, once you hear yourself talking aloud in the moment, you can start to feel awkward, lose your way, draw a blank, or raise a red flag without meaning to.

You don’t have to stress too much about personality questions. They are not technical like some questions you’ll get and don’t rely on training or credentials to be impressive.

If you are nervous about being able to show your true personality while under pressure, spend some time thinking through and outlining your answers, just as you have with the other questions you have prepared for.

Here are a few personality questions you are likely to get:

Outside Interests

What do you like to do when not working? What are your hobbies?

These are probably the most common personality questions, and there is no wrong way to answer them.

They truly are just trying to get to know you. Your answer can also be an excellent opportunity to connect.

If you have an interest in kind with your interviewer, you both may feel like you’re talking to a kindred spirit and be more at ease.

If you have an interesting or unique hobby, it can also spark interest and discussion, causing more connection and something about you that will stand out to them later and help them remember you.

Describing Yourself

Some interviewers like to ask you to describe yourself. Usually, by asking something like:

Give three words that best describe your personality.

Or

How would your friends and family describe you?‍

It’s incredibly difficult to articulate the complex essence that is you to a stranger in an interview.

And if that wasn’t enough, tossing out describing words about yourself feels very awkward.

As with most things during your interview process (and in life!), authenticity is the best path to take.

Brainstorm three adjectives that you feel truly describe you.

If you’re having difficulty thinking of some, we’ve found the ABC approach works well.

Pick adjectives that start with A, B, and C and they’ll be easier to remember.

Try to pick positive descriptors that aren’t over-the-top arrogant-sounding. For instance, here are some good ones just to get you thinking:

  • Adaptable, adventurous, ambitious
  • Balanced, big-hearted, bold
  • Caring, capable, confident

You don’t have to stop with A, B, and C. Think further in to the alphabet with words like

Enthusiastic

Flexible,

Generous,

Hardworking, etc.

until you feel you’ve found three words that suit you.

Your Influences / Inspiration

This question could be asked in a straightforward way or with something zanier like, “if you could have dinner with any famous figure, who would you choose?”

Again, spend some time thinking about this before the interview, just so you won’t get tripped up.

No doubt there have been many people who have inspired you while pursuing your medical career, so pick three and be prepared to give a sentence or two on why they stick out to you.

CHAPTER 10

Special Advice for IMGs (International Medical Graduates)

We’ve talked a bit about being an International Medical Graduate in Chapter 7: Tricky Questions, but we want to take a little time and delve into some ‌challenges surrounding IMGs.

Self-promotion

Self-promotion doesn’t come naturally to many people. Some are more shy or have more introverted personalities than others.

It can also be especially difficult for those from other cultures to sell themselves.

High-Context Cultures include many countries in Asia, the Middle East, and South America (among others). In these countries, there is more of a collective focus.

The emphasis is put on the family or group. As a result, people who talk about themselves a lot are not perceived favorably.

In Low-Context Cultures, there is more emphasis on the individual and a favorable response to people who “talk a good game” and strive to “get ahead” for personal success. Examples of low-context cultures include the U.S., the U.K., Germany, and Australia.

As you can imagine, coming from a high-context culture and interviewing for a medical residency in America can cause some things to get lost in translation socially and verbally.

While it’s completely understandable to have the self-expression you learned in your home culture, you don’t want it to work against you in your interview.

In low-context cultures, you must know how to articulate your value out loud.

The interviewer wants to see what sets you apart from all the other candidates, and this is much easier to do if you tell them why you’re an excellent candidate.

Employing all the advice we’ve given you here will help you build confidence in talking yourself up. Hone your speaking points by staying on task using STAR, outline your answer, and practice, practice, practice!

The more you hear yourself speak about your accomplishments, the more comfortable you will become.

Then, you won’t feel bashful on interview day, and words will come easy.

Language Barriers

Some candidates worry they will encounter a word they don’t know or understand in the interview.

To help relieve anxiety about this, study up on common interview terms.

Reviewing lessons like this is a great way to prepare by learning what types of questions you’ll be asked and how to answer them.

You can also simply be honest. If your interviewer uses an English term you are not familiar with, simply ask for clarity.

Accents

Some candidates worry a great deal about their accents.

They worry so much, in fact, they become overly self-conscious and struggle to perform as well as they could in interviews.

If you’re a candidate with an accent, it may not be as big a problem as you think.

Make sure you are speaking slowly and clearly.

As interview nerves creep in, it’s easy to begin speaking quickly and make your accent more pronounced and your words more jumbled.

There are accent neutralization resources out there, but we have found that clear, slow, repeated practice is the best remedy.

You can record as many answers as you like with our Big Interview Practice Tool and get honest feedback on your accent from someone you trust, as well as evaluate it for yourself.

Whew, if you’ve made it this far, you’re a rockstar!

We hope all of this helps you in your preparation for your big day. If you would like to delve further into any of these topics, feel free to check out our Residency Curriculum designed for future leaders in medicine like you.

Good luck and let us know how it goes!

All of us at Big Interview are rooting for you!