For most residency applicants, the arrival of November marks the beginning of the interview season. This often brings back memories of the medical school admission interview, with the ubiquitous “Why do you want to be a doctor?” question.

Four years later, you find yourself in a similar situation – this time, hoping to land a position in the specialty and residency program of your choice. “Why do you want to be a doctor?” is now replaced with “Why do you want to go into [this specialty]?” and “Why are you interested in our residency program?” While the questions will differ to some extent, you may be experiencing the same gamut of emotions – uncertainty, nervousness, and perhaps even fear.

Given the highly evaluative nature of the interview process and its importance in the residency selection process, this anxiety is well-placed. Over the years, many surveys of program directors have inquired about the importance of the interview. Recently, the National Resident Match Program surveyed 1,840 program directors representing the nineteen largest specialties to determine the factors used for ranking applicants.¹ Ranked number one, even higher than clerkship grades and USMLE scores, was the residency interview. A number of previous studies substantiate this finding. In one study done at the Children’s Hospital of Pennsylvania, interview scores were found to be the most important tool for the ranking of applicants.² In a survey of family medicine and obstetrics/gynecology residency program directors, the residency interview was found to be most valuable in the ranking of applicants.³ Program directors of internal medicine residency programs have also rated the interview as most useful for ranking decisions, with 96% of respondents reporting the interview to be highly or moderately useful.⁴

While receiving an interview invitation is an honor, simply being interviewed does not guarantee a place on a program’s rank list. In a study of emergency medicine residency programs, with data obtained from 3,800 individual interviews, a total of 14% of interviews resulted in unranked applicants.⁵ In another study, one third of applicants were actually ranked less favorably following the interview.⁶ Dr. Reilly, former program director of the University of Texas medical school at Houston psychiatry residency program, states that a “good interview can save someone with the less than perfect application. A bad interview cannot always be salvaged by a paper record.”⁷ The conclusion here is that the interview is critical to your chances of a successful outcome.

Recognizing the importance of the interview, we have devoted four chapters and nearly fifty rules to the interview process in our book, The Successful Match: 200 Rules to Succeed in the Residency Match. In this column, we discuss three of the most important rules for interview success.

Dig deep

The primary goal of an interview is to impress upon the decision-makers that your unique qualifications are exactly what they seek.  Many decision-makers refer to this as “fit.” Will your strengths and aspirations help the program achieve its own goals? Are your proven qualities the type necessary to achieve success as a resident in their program? In order to convey this message, you need to know yourself, and you need to know the program, and you need to be able to convey this knowledge during the interview.

Conveying this message starts with demonstrating a strong and sincere interest in this particular residency program. One of the easiest ways to impress an interviewer is to arrive well prepared, having thoroughly researched the residency program. Start with the program’s website. What is the program’s philosophy? Is the program known to produce academicians? Is it recognized for its contributions to community service? Is research an area of key emphasis in the department? What is the program looking for in a resident?  With this knowledge in hand, you will be better prepared to demonstrate to the program that you are precisely the type of individual they seek. Equally important, the information that you gain will help you decide if this is a program where you would like to train.

While most applicants will review the program’s website, too often the research begins and ends there. We recommend that you dig deeper. Perform an internet search to learn more about the program, its faculty, the hospital, and the city. Well before your interview, contact graduates of your medical school who are residents or faculty at the program. Locate physicians in your area who trained at that program. These individuals can provide valuable information about the program, which you, in turn, can refer to during the interview. For example, “Dr. Ran, the chairman at my medical school, was recently a visiting professor in your department. In speaking with him, I learned about how your program really pioneered human simulation training as a teaching tool. I’ve been looking forward to learning more about that during this interview.” Candidates who make the effort to take these steps can convincingly demonstrate that they are truly interested in the program.

Many applicants do an excellent job in researching a program in advance. Unfortunately, many don’t know how to, or don’t feel comfortable, demonstrating this knowledge. They may end up making no reference to the specific information that they have read or learned about the program, or they may ask the type of basic questions that could have been asked by any other applicant.  The end result is a generic interview, and a lost opportunity to demonstrate your strong interest in the program.

First impressions can make or break you

Multiple studies have shown that creating a favorable first impression is critical to interview success.  In one study done by Thomas Dougherty, chair of business and economics at the University of Missouri, a favorable first impression led to an easier and more successful interview. Interviewers who are more favorably impressed by interviewees during the first few minutes went on to treat those applicants more positively. They spoke with a more positive vocal style, engaged in more active recruiting of the applicant, and asked less questions.⁸ Although this study was in another field, medical faculty interviewers are not unlike those in other fields. The impressions they form of you through your first interactions will play a pivotal role in your interview success, or lack thereof.

The obvious measures in managing first impressions remain critical. One should arrive early and be well-dressed and impeccably groomed. The ability to maintain appropriate eye contact and shake hands properly are little discussed in medicine, yet are no less important. One article in the Lancet found a strong correlation “between a firm handshake – as evidenced by strength, vigor, duration, completeness of grip, and eye contact – and a good first impression.”⁹ It is important to be able to walk into a room and project self-confidence through your body language, facial expressions, and tone. In addition, the ability to engage in small talk is more important than many applicants realize. Dr. Jamie Collings, program director of the emergency residency program at Northwestern University, states that “whether the topic is the weather, current events, or sports, you’re expected to participate.”¹⁰ She encourages applicants to get “up to date on current events, see a movie, read a non-medical book, and read the paper regularly.”

Dr. Ziegelstein, associate program director of the internal medicine residency at Johns Hopkins Bayview Medical Center, states that “individuals who interview and judge others for a living (e.g., program directors) often form very strong first impressions. Typically, those individuals are flexible and those impressions are changeable, but those first impressions are nevertheless important.”¹¹ In our experience helping applicants prepare for interviews, we know that applicants spend considerable time preparing for anticipated questions. Unfortunately, most applicants then give little or no thought to the factors involved in a favorable first impression. Preparing for the subjective factors involved in first impressions is just as important as preparing for the typical interview questions. If you’re uncomfortable with small talk, practice with others. Mock interviews with friends, colleagues, and mentors may highlight weaknesses, and are an important tool in interview preparation. Make sure you’ve received honest feedback on your interview performance.

Stand out from the rest of the crowd

You are competing with, perhaps, hundreds of other applicants. It is critical that you ask yourself “What is it that sets me apart from the other candidates?” Through our own experiences interviewing applicants, and through discussions we have had with other faculty interviewers, we know that few applicants make a concerted effort to stand out from the rest of the pack. We agree with Dr. Krogh, former faculty member of the department of family practice and community medicine at the University of Minnesota, who reminds applicants that “programs interview hundreds of applicants, many of whom are compatible with the program. Make yourself noticeable enough. How you do it is up to you but many unfortunately do not even try to do it.”¹²

We understand that you may not consider yourself unique. In fact, parts of your background and qualifications are likely to be similar to other applicants – good grades, solid USMLE score, and good medical school. Is there anything truly unique about this package? Not on the face of it. But there can be. Many applicants have remarkable accomplishments, but fail to recognize or discuss them. Others have unique strengths or particularly strong qualities that they fail to emphasize in their application materials and interview.

Did you have a fantastic overseas international health experience during medical school? Were you involved in cutting edge research? Do you have a special or unusual talent? Have you gone out of your way on clinical rotations to emphasize patient education and the provision of patient educational materials? Do you have an aptitude for teaching, and have you demonstrated that through your activities in medical school? Were you the founder of your medical school’s pathology club or the president of AMSA? If so, the interview represents a wonderful opportunity to highlight these accomplishments.

We’ve spoken to applicants who brainstorm, and don’t feel as though they can discuss anything remarkable or unique about themselves. While that’s hardly ever the case, you can still utilize additional ways to stand out. Impress your interviewers with your level of preparation. Showcase your strong communication skills. Answer each question by taking it one step further than most applicants. For example, applicants often answer the question “What are your strengths?” with a short list of qualities. “My strengths include my attention to detail, interpersonal skills, and ability to persevere.” Most applicants stop there. The few that continue with an example that highlights their strengths succeed in leaving a memorable impression. “My ability to persevere has been central to my success. The pathology interest club that I wanted to set up at my medical school was initially applauded, but my cofounder and I hit many obstacles. Even though I started during first year, the club didn’t come into existence until my third year, and it was my perseverance that kept me going and dealing with all the roadblocks.”

Asking insightful questions is yet another way to distinguish yourself. These can highlight your individual qualities, as well as your interest in the individual program. Dr. Ksiazek, program director of the Pritzker School of Medicine ophthalmology program at the University of Chicago, states that “You do not want to blend into a sea of other applicants by asking the same old questions.”¹³ As interviewers, we’ve all heard the typical “What do you consider to be the weaknesses of the program?” Contrast that with: “In medical school, I have had several international health experiences which I have found very fulfilling. That’s why I was particularly excited to learn about the global health track your residency offers in Kenya. What kind of impact has the global health track had on residents in your program?”

And finally…

As you approach your interviews, focus on how far you’ve come.  By offering you an interview, the program has essentially informed you that you are a competitive candidate. Given that programs routinely receive hundreds or even thousands of applications, an interview invitation is a real honor. Programs only extend these invitations to candidates who are being seriously considered for a residency position. Having come so far, it is essential now that you devote the effort, time, and preparation necessary to sell yourself effectively and convincingly to programs.

References

¹Results of the 2008 NRMP Program Director Survey. Available at http://www.nrmp.org/data/programresultsbyspecialty.pdf.  Accessed on October 26, 2009.

²SwansonWS, Harris MC, Master C, Gallagher PR, Maruo AE, Ludwig S. The impact of the interview in pediatric residency selection. Amb Pediatr 2005; 5 (4): 216-220.

³Taylor CA, Weinstein L, Mayhew HE. The process of resident selection: a view from the residency director’s desk. Obstet Gynecol 1995; 85 (2): 299-303.

⁴Adams LJ, Brandenburg S, Blake M. Factors influencing internal medicine program directors decisions about applicants. Acad Med 2000; 75: 542-543.

⁵Martin-Lee L, Park H, Overton DT. Does interview date affect match list position in the emergency medicine national residency matching program match? Acad Emerg Med 2000; 7 (9): 1022-1026.

⁶Gong H, Parker NH, Agar FA, Shank C. Influence of the interview on ranking in the residency selection process. Med Educ 1984; 18 (5): 366-369.

⁷Reilly E. Career counseling: psychiatry. Available at www.uth.tmc.edu/med/administration/student/ms4/2003CCC.htm.  Accessed October 22, 2008.

⁸Dougherty TW, Turban DB, Callender JC. Confirming first impressions in the employment interview: A field study of interviewer behavior. Journal of Applied Psychology 1994; 79: 659-665.

⁹Larkin M. Getting a grip on handshakes. Lancet 2000; 356: 227.

¹⁰Available at www.saem.org/…/0/…/MSS_CollingsTheInterview2009SAEM.doc.  Accessed on October 22, 2009.

¹¹Ziegelstein RC. “Rocking the match”: applying and getting into residency. J Natl Med Assoc. 2007; 99: 994-999.

¹²Krogh C, Vorheis C, Abbott G. The residency interview: advice from the interviewer. The New Physician 1984; 8.

¹³Ksiazek S, Taylor TL. Pritzker residency process guide: ophthalmology. Available at http://pritzker.uchicago.edu/current/students/ResidencyProcessGuide.pdf.  Accessed on October 22, 2009.

As the current residency application cycle is winding down, the next wave of applicants is getting ready to apply for the 2009/2010 season.  As you begin thinking about your residency application, you should consider who will be writing your letters of recommendation (LORs), how you will talk about your path to residency at your interview, and how you should contact programs and follow up with them (and if this really makes a difference in outcome).

This article serves as a follow-up to the article, “Getting Into Residency: Part 1,” which was published on the Student Doctor Network in October 2008.

Letters of Recommendation

I encourage medical students to treat every attending as though he or she will one day write them a letter. Why? I believe this helps the student perform well and also creates a safety net of sorts. Since you don’t know whom you will meet in the future, it may well be that a good LOR could come from the internal medicine attending from your third year rotation or a preceptor from an introduction to medicine course during your first year.

If you have identified someone with whom you have rapport and who thinks highly of you anytime during your medical education, don’t wait to ask that person if he or she would be willing to write you a strong letter of reference in the future. Then be sure to keep in touch with the attending from time to time. Keep the attending updated on your progress and achievements so, when it comes time to write your letter, the attending won’t have to play catch up, which will make the letter more sincere.

While writing a letter of reference is extra “work” for an attending, it is also flattering since it indicates that you respect and think well of that individual. Writing excellent letters for my stellar students that I knew would help them get to the next level of their education and training was one of my greatest joys in academic medicine.

Which letters have the most impact when it comes to residency? It depends. If you are applying for orthopaedic surgery, for example, you don’t want to have three letters from non-orthopaedic faculty. ERAS allows you to select four letters to be sent to each program so, for a very competitive specialty, you want at least two of these letters to be from attendings within the specialty to which you are applying. When applying to residency, titles matter; a letter from a community doctor will carry less weight than a letter from the chair at a major academic center.

A survey sent to directors of all programs participating in the 2008 match by the National Residency Matching Program (NRMP) addressed this issue. Most important, the survey showed, are letters from clerkship directors, colleagues and chairs within the specialty. Letters from “other faculty,” while still important, have the least weight.

Writing a good LOR takes skill and experience. Sometimes junior faculty don’t know what constitutes a good letter, another reason why it is sometimes “safer” to have letters written by more senior faculty. A more experienced faculty member, who has read and written hundreds of letters of reference, understands the essential elements and “buzz words” that make a great LOR.

Keep in mind that the smaller the specialty, the more likely everyone is to know each other. When I reviewed residency applications, it was comforting to read a letter from someone whom I knew and trusted. At the same time, letter writers get “reputations.” I remember a clerkship director who wrote outstanding letters for every single applicant who rotated in her department. As a result, I questioned whether I could trust this individual’s evaluation. As an applicant, you have no way of knowing who writes good letters and who doesn’t, but it is important to understand that some attendings are talented in this area while others aren’t.

How do you go about asking someone to write a letter? To some degree this depends on your relationship with the individual.  If an attending offers to write a letter on your behalf and you have had an open dialogue about this, then simply ask him if he would like any supporting documentation.

Otherwise, it is best to schedule an appointment to meet with the attending.  It is fair to ask this person openly if she would be willing to write a strong letter on your behalf. You must hope that you will get an honest reply.

Your job is to make the letter writer’s job as easy as possible. Arrive at the meeting with a folder in hand that has a copy of your CV, your personal statement (if you have already written it) and any information she may need, such as your AAMC number and where the letters should be sent. ERAS has downloadable cover letters that you can fill out for your letter writers for both US students and IMGs. Remember to give your letter writers plenty of time to write your letter (at least one month), and understand that you may need to “nudge” or remind them more than once.

The Interview

Your most recent interview probably was for medical school. The emphasis for residency interviews is different, so don’t think that you will be telling the same story all over again. It is important to think about the path you have taken since you started medical school. What has motivated you, who has inspired you and what determined the choices you have made?  Applicants are judged most on the following during the interview:

• Commitment to the specialty to which you applying
• Understanding of what it means to practice this specialty
• Interpersonal skills
• Interactions with faculty, residents and staff
• Professionalism
• Maturity
• Leadership ability
• Overall “fit” with the program
• Red flags, explanation for gaps in time, psychopathology

I encourage applicants to review their written applications before interviews so they can remember what they have written. Anything on your application is “fair game” for discussion so be prepared to discuss everything in detail.  Don’t be afraid to try and guide your interview. The interviewer isn’t the only one in control here and you should try to make segues to topics that you would like to discuss.

The ideal interview is an open conversation – a back and forth dialogue. While everyone has their own interview style, most (skilled) interviewers know they will get the best idea of who you are if you are at ease and comfortable. In my experience, it is the less experienced interviewer who tends to “shoot questions” at you.  And remember, you aren’t going to be tested on your medical knowledge. Non-US citizen IMGs are often asked to discuss an interesting case to make sure they can communicate effectively about medical issues, however.

Also remember that feedback from current residents and support staff (such as the residency coordinator) plays a role in resident selection. Residency is intense and, especially for small residency programs, being a good “fit” for a program is important. This is why your behavior and interactions with the residency staff, during tours of the facilities and during dinners and lunches with the residents, is vitally important.

When I was in residency leadership, if my residency coordinator identified someone as rude or disrespectful, I listened. Residency leadership teams are small and a negative interaction with one member of that team is likely to negatively affect your ranking. Along the same lines, if a resident thought highly of an applicant and believed she would mesh well with our program, I also listened.

A few questions you should be prepared to respond to on residency interviews:

• Tell me about yourself
• Why do you want to go into XXX?
• When did your interest in XXX begin?
• What strengths would you bring to the program?
• Tell me about your research
• Tell me about (any flaw in your application).
• How do you feel about moving to our city/town?
• Where do you see yourself in 10 years?
• Why do you want to attend our program?
• Do you have any questions for me?

Follow up with Programs

I always encourage applicants to contact the program directors where they interviewed early in the season. While some programs rank as the season moves along, others hold a “ranking day” in late January/early February when they rank applicants. From experience, I can tell you that it was very difficult to remember applicants who interviewed early in the season. That said, the research done on this topic indicates that the timing of your interview does not affect your ranking.

Interestingly, the NRMP survey results indicate that program directors do not place much importance on second looks or visits or that postinterview contact affects ranking. Nonetheless, I believe that you should send a thank you note just “to play it safe,” and demonstrate respect and because doing so is just good manners. Also, sending a letter of intent to your first choice program is wise. The worst thing that can happen to a program is not to fill its positions, forcing the program to enter the scramble. It also “looks good” for a program director to boast, “We got our top three applicants!” If a program knows you are ranking it #1 and it doesn’t want to “go too far down on their list,” your letter of intent may influence your ranking.

As match day approaches, good luck to everyone and match well. For 2009/2010 applicants, start thinking about your strategy for next season.

While this article (and Part 1 of this series) addresses some of the concerns related to the residency match, keep in mind that many nuances affect the process and this varies from applicant to applicant.

Jessica Freedman, MD, a former medical admissions officer, is president of MedEdits (www.MedEdits.com), a medical school, residency and fellowship admissions consulting firm. She is also the author of the MedEdits blog, a useful resource for applicants: (www.MedEdits.blogspot.com).

Meet Dr. Freedman at the American Medical Student’s Association Meeting in March in Arlington, Virginia.

“Man’s mind, once stretched by a new idea, never regains its original dimensions.”
Oliver Wendell Holmes (1809 – 1894)

I’ve been most successful in life when I’ve stopped to see the situation from another person’s point of view. This is good to have in mind when facing a medical school interview. There are certain salient concepts an applicant must understand to communicate more successfully during the interview. This column will discuss some behind the scenes dynamics, which will give you the edge during your interviews.

The Tired Interviewer

The following dramatization is intended to provide a common base of understanding to begin our discussion. As you read this short story, try to picture the scene. Take on the roll of the interviewer and imagine what you might be feeling.

You have been on call and working all night. It was not the busiest night you have had but it was not slow. There were several sick patients on your service and your pager would not stop beeping. You had a very difficult time putting in a central line in an elderly patient requiring vasopressor medications. You are frustrated and your back hurts because you were hunched over for more than an hour. You hurry to finish your rounds so that you are not late for the day’s interviews with the medical school applicants.

You really like being on the admissions committee and have participated for several years now. You like to talk to the young students and care a great deal for the University, as you are a graduate of its medical school. While you do like this position, it is extra work for which you are not getting paid and it is towards the end of the interviewing season. You have completed at least 12 of these interview days already. You are tired and have been up for 30 hours now. You walk into the admissions office, say hello to the secretary and ask for the applications of the students you will be interviewing today. She hands them to you and you quickly pour through the first applicant’s personal statement, grades, MCAT scores and letters of recommendation while drinking your coffee.

You call in the applicant, smile and shake her hand. The interview takes place. You thank the applicant, shake her hand and send her back to the waiting room. You close the door to the interview room and turn to fill out the University’s standard post-encounter evaluation form. You realize there are four more interviews to go and that 38 hours will have passed before you get to sleep. What happens next?

Subliminal Questions

I believe there are several questions being asked by an interviewer, often on a subconscious level. A wise applicant will be aware of these and present his or her information in such a way as to help the interviewer answer them. Three of the more important questions are:

• What is going to make my job easier as I fill out the evaluation?
• Did the applicant give me anything of substance or am I going to have to pull items from the interview to fill out the evaluation?
• What is different about this applicant compared to the others?

When you put yourself in the interviewer’s shoes it’s not hard to see why she would be asking such questions. Let’s look at each one in more detail to gain an understanding of the requirements necessary to answer the question.

Easy Does It

Prepare your responses in such a way as to make it easy for the interviewer to complete the interview evaluation. This is done, in part, by providing complete answers, maintaining a positive attitude and painting a picture. Here is an example using a simple question:

“What do you like to do in your free time?”

Answer #1: “Well, I don’t have a lot of free time because I’m always studying and trying to get good grades. I do like to do logic puzzles and go running if I have the chance.”

Notice, this person only partially answered the question. He started off with a negative comment about not having much free time. He gave the impression that he struggles to get good grades. He did manage to say he likes puzzles and running. As an interviewer it would be a stretch to see this individual as truly confident, happy or even much fun.

Answer #2: “Free time is a precious commodity so I use it wisely. I am eager to hit the books but I also know how important recuperating is for balance. I enjoy doing those Sudoku number puzzles; they’re addictive. I also love to run. I’m not exactly ‘marathon man’ but I have a great time just pounding the pavement and exploring my neighborhood.”

This person has done a great job of painting a picture. The second answer conveys the same information as the first, but in a much better way. As an interviewer, I may not necessarily know what a “logic puzzle” is but I have heard of Sudoku. It is easy for me to visualize this college guy running in the city, making a loop around the local park. Maybe he ends his run with a pit stop in the neighborhood coffee shop to work on a Sudoku puzzle. The second candidate’s interview has left a more vivid picture, more color and more I can use.

Give Them Something to Remember

Jermiah Fleenor, MD, MBA

Recall that the interviewer in our scenario was not getting paid. This is a common occurrence in reality. Few admissions committee members are compensated for their role. Take this to heart. Don’t make them have to work to fill out your evaluation. Do the work for them.

One way this can be accomplished is by giving them several memorable catch phrases. Examples from the second answer would be “marathon man,” Sudoku, and pounding the pavement. In practice, an interviewer may not remember the exact details of each exchange in a given interview. In fact, they may conduct several interviews before filling out the evaluation forms. As the interviewer thinks back, mentally replaying the highlights of the interview, the term “marathon man” is more memorable than “I like running,” as is Sudoku, compared to logic puzzles.

Remember, as the interviewer is filling out your evaluation they are creating an original work of sorts. It is a tremendous help to have been given good material as opposed to generating it on your own. This will make the process more easy and enjoyable for everyone.

Compare and Contrast

Humans learn and remember by focusing on differences. For example, it is easier to remember a person at a funeral wearing a colored outfit as opposed to a black suit. In like fashion, it will be easier for the interviewer to remember you if you present the talents and traits that are unique to you.

Start this process by building a mental image of a typical applicant. Then give serious thought to your unique talents and traits. The goal is to stand out as someone who will be an excellent physician. Spend time talking to other medical school applicants at your university and find out what they bring to the table. Ask your advisor about the skills, talents and past experiences of most applicants. Decide how you stand out, and be prepared to present yourself accordingly in interviews.

For example, you may have significant work experience in the medical field or you may have traveled extensively. Draw from these experiences to identify unique strengths. I recall a woman in my medical school class who had had her own successful business as an interior designer. She was older, refined and very professional. She focused on these areas as they were unique to her and it greatly aided her in gaining acceptance into medical school.

Summary

Taking the time to see things from the interviewer’s point of view is important for success. It requires extra work, but facilitates the preparation process and gives a context in which to deliver information during the interview. Keep these ideas in mind as you interview and watch your chances of success increase.

Please email any medical school interview questions to Dr. Fleenor at jdfleenor -at- gmail.com.

Dr. Fleenor is author of The Medical School Interview: Secrets and a System for Success

Visit Kaptest.com for more information and
SDN Member discounts on Kaplan Courses and Materials.

By Janani Krishnaswami, M.D.
Kaplan Admissions Consultant

The school interview inspires anxiety and anticipation in many applicants. A test of poise and communication skills, the interview is a key component of the school application package.

The process inherently benefits those who are:

• Relaxed
• Sincere
• Articulate
• Aware – of both their own motivations for seeking medicine (i.e., self-awareness) and “externally” aware (i.e., current events, salient healthcare issues)
• Able to comfortably carry on a conversation covering a wide range of topics (which stems from all of the above).

Just as the applicant has tirelessly worked to tackle challenging courses, study for the admissions test, and polish a personal statement, work needs to be done to prepare for the interview.  While school interviews are largely casual and friendly affairs (a far cry from, say, “stress” interviews held in some areas of finance and consulting) it is entirely possible to “tank” the interview by adopting a laissez-faire approach.

The following myths should be dispelled by the informed applicant at once:

• Interviews are mostly a formality; once you are offered an interview you’re at least guaranteed a spot on the wait list.
• Interviews are biased toward extroverts and native English speakers. It’s much harder to get a good score if you’ve got a thick accent, speak softly, or are quiet.
• There is no real way to prepare for medical school interviews, since you won’t know in advance what questions will be asked.

Schools vary regarding how much importance they place on the interview versus the paper application. In general, top-tier schools will lend more importance to the interview – especially as a deciding factor between two exceptional candidates.  Sifting through an abundance of stellar-on-paper applicants, they often turn to the interview to assess honesty, enthusiasm, sincerity and the intangible qualities of personal rapport that come across in the interview.

Getting an Interview

What does receiving the offer of an interview mean?  This, of course, is a complex question varying from school to school. In brief, receiving an interview means one of two things:

1. Based on your grades, test scores and secondary applications, you have passed the initial hurdles of score screening and essay review, making either a numbers-based cutoff process or passing an individual committee member’s screen.
2. Your application was perhaps sub-par or borderline in terms of scores, academic performance, etc., but the committee is intrigued by other aspects of your application and wants to evaluate further via an in-person interview.

The linking factor between scenarios 1 and 2, as the astute applicant might have gathered, is that the interview-invited candidate has an advantage in both cases.   In either case, the applicant has impressed the committee to the point where they would like to know more, where they see a potential fit, a potential acceptance.  In that sense, receiving an interview acceptance represents a very positive development in the applications process – more so than, for example, receiving a secondary.  Drawing from this reality, the conclusion that follows is very important:

Once you have received an interview, the goal of getting an acceptance is within striking distance.

The corollary is that under preparing, underperforming or otherwise botching an interview can essentially lower a stellar “on-paper” candidate to the point where he/she is wait-listed or rejected.   I have reviewed the files of high-scoring MCAT/GPA candidates with a very impressive paper application who were out right rejected by the committee – after painful interviews showed them to be uncertain, haughty or passionless.  Thus, the final conclusion, and the one that applicants should take home:

Acing an interview – and earning an acceptance – is almost entirely within the applicant’s control.

Preparing for the Interview

With that said, here are the top strategies for preparing for a medical school interview:

1. Know thyself. You must have a very clear, convincing, and sincere knowledge of a) why you want to attend school more than anything else and b) what you have done – activities, volunteering, research, etc. – that supports your reasons as evidence.  You get a discrete block of time – 2-3 minutes – to answer the question, “So why do you want to go to (medical, dental, pharmacy…) school?” This is one of the most important questions of the interview. Within that time, you should be able to articulate your true reasons and come across as honest, logical, convincing and real.  Having interviewed hundreds of insincere candidates, admissions committees are quickly able to spot a half-hearted, passionless, or – worst of all – dishonest answer, rendering the applicant to the bottom of the admissions pile.
2. Know why School X is the best place for you. Not surprisingly, admissions committees want to accept candidates who would be likely to accept the acceptance. It looks better for the school and the school’s rankings if, say, 90% of candidates offered acceptances decide to matriculate. Thus, if you come across as someone likely to take that spot if offered, your chances of admissions will increase.  Caution: As in #1, schools will quickly identify candidates who are more hot air than genuine substance.  “Substance”-qualifying reasons include: working with researcher X who is a specialist at the school, curriculum-specific initiatives that are only seen at school X, wanting to pursue a career in an area where school X is renowned or offers unusual opportunities.  Coming up with reasons for attending a school leads to #3:
3. Research the school thoroughly, backwards and forwards. This is more than just a quick glance through the website.  Understand latest developments in the curriculum. What areas were recently changed? How has the school revamped or made innovations in its program recently? What are some of the accomplishments of graduates and current students? What are some areas of ongoing research? The questions are numerous and will be tailored to each applicant’s interest (i.e. service outreach, basic science lab opportunities, international relief efforts, clinical training and simulation, to name a few) . But the key is to spend several hours (yes, hours) analyzing and understanding information to answer them in full.
4. Above all, be humble and sincere. This does not mean downplay your significant accomplishments.  But always remember where they’ve come from: it is rare that a stellar applicant has reached his or her heights without help. Often, there is a mentor, a teacher, a volunteering experience, a parent or patient that has paved the way. It is perfectly fine to describe your outstanding achievements, awards, discoveries, cutting-edge research, critical acclaim, etc. But add that “I-remember-where-I’ve-come-from” angle: how you are thankful to Mentor X or Professor Y for their tireless help, how you are inspired to give back to the community (only if you are, of course!), how you hope to be like Doctor Z, etc.
5. Do. Not. Lie. Under ANY circumstances. Often, the truth has a funny way of revealing itself. And if it is ever found that the applicant lied under any circumstances: it is automatic rejection and a firmly closed door on the application process.

Visit Kaptest.com for more information and discounts on Kaplan Courses and Materials.

by Jeremiah Fleenor, MD, MBA

Another summer is upon us. As you enjoy the warm days and break from classes, let’s consider another commonly encountered interview question. This one is almost certain to pop up during your interview conversation.

What would you do if you couldn’t be a doctor?

I’ve seen this question take many an applicant aback. When asked this question during my interviews I recall being confused and wondering whether there was a hidden meaning. Here’s what would go through my mind: “Why do they want to know what I’d do if I wasn’t able to be a doctor? Are they somehow trying to see if I’m really serious about my career choice? Is it appropriate to say there is no other option and that becoming a physician is the only reality for me?”

Perhaps you’ve already faced this question. If you hesitated or felt uncomfortable don’t feel badly –most of us have been there! In this article we will discuss how to give the interviewer a succinct, informative answer.

The Question Behind the Question

Often times an interviewer is looking for specific information but will ask the question in such a way that is not necessarily obvious. There is a question behind the question. Think of these questions as “fronts” for something else. Some common examples are listed below:

• What symbol or object describes you?
• If you could invite one person, living or dead, to dinner, who would it be, and what would you discuss?
• If I were the president of my town’s chamber of commerce and you were a new doctor here, why should I recommend you?

These “front” questions can be completely hypothetical, physically impossible and seemingly unrelated to medicine. These characteristics can make them easier to spot. The key to these questions is to determine what information the interviewer is trying to “get at” and answer accordingly.

For example, the interviewer asking the second question in the list does not really care whether you choose to have dinner with Albert Einstein or Madonna. She doesn’t necessarily care if you talk about the theory of relativity or the perks of being a rock star. What she wants to know is what characteristics you posses (likely typified in the person you select) and what aspects of this person you find most interesting. It’s a question about character and values.

“What would you do if you couldn’t be a doctor?” is a classic “front” question. I think the two items of focus behind this question are:

• What are your interests outside of medicine?
• What are your personal drivers? (What motivate you?)

Outside Interests

Your outside interests are more than casual hobbies. They may be indicators of your passions. Perhaps you volunteer time to a specific organization or there is a business venture you’d like to pursue. Or perhaps you assist in an area of research that you find captivating. Although volunteer jobs may not necessarily relate to being a doctor they are important to you. They help to show the admissions committee who you truly are … the depth you possess.

Motives

More important to the interviewer are your personal drivers. What is it that causes you to get out of bed every morning? Maybe you’ve never thought about this but it’s an important question to ask.

The answer to “What would you do if you couldn’t be a doctor?” is a clever way to determine what drives you. Simply put, your motives shouldn’t change just because your career does.

Sometimes it can be tricky to determine what motivates us. These questions may help in your discovery.

• If you had the day off and didn’t have any responsibilities to attend to, what would you do?
• What activity would you choose to do, even if you weren’t going to be paid?
• What discussion topic really gets you fired up?
• Is there a particular injustice that is very upsetting to you? If so, why?

For example, I know someone who loves to build. Furthermore, he loves to incorporate new technology into his projects. With or without a paycheck he would choose to design buildings. He loves investigating new, better materials and construction techniques. He is constantly interested in ways to be more environmentally friendly. If he had his way he would devote the majority of his time to this area of interest because it’s what drives him.

What drives you? This is important for you to know and equally important to convey to the admissions committee.

The Approach

Once you know the information the interviewer is actually trying to obtain it becomes much easier to answer the question. Try this three-step approach as you prepare:

1. Express sadness over the possibility of not being able to practice medicine.
2. Share the things that motivate you and would make you a good physician.
3. Answer the question in the context of an important outside interest.

Express Sadness

Remember, the interviewer just took away what you believe is your life-long goal and passion. It would be inappropriate to say, “That’s cool. I’d just go work at my dad’s warehouse until something else popped up.” The goal is to play along, but to also convey your conviction that medicine is the best place for you.

Motivation

Discover for yourself those things which motivate you and would make you a good physician. Character traits and values such as compassion, discovery, strong work ethic, diligence, creativity or social justice are good examples. In an interview these would be expressed in the context of certain activities ( e.g. building a new house, volunteering, research, etc.).

Outside Interests

This allows the interviewer to get to know more about you and to remember you long after the interview. It is a great opportunity to demonstrate the depth and breadth of your character. Your passions and the time you devote to them are important to admissions committees. They make you unique and memorable and are glimpses into your inner person.

In Action

A sample answer might look like this:

“Wow, I’d be pretty upset not to be able to practice medicine, because I really believe it’s the best profession for my talents and personality. However, if I couldn’t be a doctor, I would probably go into R&D (research and development) at a biotech company. I love to figure things out. New discoveries excite my imagination. During a summer internship at _____ I really enjoyed the analytical, research component of the work. It was very demanding and required a high level of commitment, but my enthusiasm stayed. I felt excited about my work. Also it was nice to know we were working on projects that would eventually help people.

This would likely satisfy my passion for science, but I would still feel something missing. I really need meaningful human interaction. I’d likely do volunteer work abroad. Some of my travels have opened my eyes to the extreme hardships people face in other countries. [Perhaps tell a quick story of a personal experience]. It’s important for me to stay close to people in need and to develop strong, meaningful interactions.”

From what this applicant said I see that she would be saddened by not being able to practice medicine. She is analytical, diligent and likes to solve problems. This is someone who has a strong need to connect with people on a fundamental level, in order to help them. To an interviewer, that’s valuable information.

Summary

Don’t be thrown by the question, “What would you do if you couldn’t be a doctor?”. Now that you know what the interviewer has in mind you can take advantage of this opportunity. Use this question as an excellent way to demonstrate important aspects of your character and personality, as well as your drive to become a physician.

Please email your medical school questions to Dr. Fleenor at: jdfleenor@gmail.com

by Jeremiah Fleenor, MD, MBA

“It is better to know some of the questions than all of the answers.”
James Thurber (1894 -1961)

As the second half of the interview season begins, I want to provide some insight into one of the most common, but deceptively tricky, questions asked during an interview. This question was posed to me in every one of my interviews, and I suspect that many of you will also face this potentially silent killer: “So, can you tell me a little about yourself?”  

It appears to be so simple and apparently innocuous. But don’t be fooled! Beneath these few words, and plain veneer, lies a myriad of pitfalls. This is unfortunate, because this question affords an interviewee with one of the best opportunities to impress the interviewer and guide the session towards success.

Let’s look at some of the pitfalls, how to avoid them, and how to use this question as a spring-board to propel yourself into the status of a top-notch applicant.

The Bad

The most devious aspect of this question is the element of surprise – it often comes before the applicant even thinks the interview has begun. But be forewarned! As the lights come on, the show is underway. The “thumbnail biography” question may well be asked as you and the interviewer casually walk down the hallway toward the interview room. It seems like small talk – even an ice-breaker. While this may be true in part, you must not treat it as such. Be aware that there is significantly much more going on than informal chit-chat.

Another difficulty for medical school interviewees is that this question lacks a right or wrong answer. This is a recurrent theme in medical school interviews, and many questions fit into this category. But as scientists, we live in a world dominated by the concept of correct and incorrect. The steps of mitosis are ordered, well established and fixed, and there’s not a lot of room for interpretation as to the correct order of anaphase and telophase. As such, applicants tend to struggle with questions that lack correct, fixed answers.

The Ugly

The one-two punch of informality and lack of a set or correct answer often leads the applicant to stumble. The common response by unprepared applicants is to ramble on at length. Not only is rambling inefficient, the outcome is deleterious. Time is a precious interview commodity, and you must not waste it. You only have a set amount of time in which to convince your interviewer that you would make a great physician, and equally importantly, that you are the best fit for their school. An overly long response many actually detract from the interviewer’s first impression of you and frustrate them. By droning on, you may actually limit the interviewer’s efforts to come to a good decision. But you must not squander the opportunity to convey the important items which distinguish you from other applicants, and demonstrate that you are an excellent match for the school.

The problems above have an even greater impact because they prevent you from gaining yet another important advantage. As the next section will detail, this is quite simply the perfect opening to take control of the interview.

The Good

A biographical question offers an ideal opportunity to provide a selective overview of what you’d like to discuss during the interview. It is a perfect vehicle to help steer the interview into a positive direction, and to distinguish yourself from the masses of other applicants. The question is intentionally open-ended, designed to see where you choose to take it. With this in mind, be sure to lead the interviewer down a well prepared path that casts your application in the best possible light.

Before we see what a good answer might look like, there is another important concept I’d like to convey. This is one of my favorite analogies, and like all good physician analogies, it involves food. I view the response to “Tell me about yourself” like a tray of hors d’oeuvres. I present the interviewer with a tasty selection of potential topics of discussion, and allow them to choose which they would like to talk about. In so doing, I accomplish several things:

1. I set the menu with items I’m best prepared to discuss.
2. I increase my ability to guide the interview, as the interviewer is more likely to ask questions about these subjects than about other, random subjects.
3. I reduce the stress for all parties by providing the topics for discussion, thereby, decreasing the likelihood of being blindsided by an unanticipated question.

In order to take advantage of this opportunity, you will need to work off of the body of information you have developed in preparation for interviews. Basically, you will offer the information in outline form, allowing the interviewer to then choose which topics they would like you to elaborate on. While this column doesn’t comprehensively cover the detailed components of that information, it will provide some guidance. But keep in mind that the goal is to communicate your strengths, the life experiences that have contributed to these strengths, and the personal attributes you feel will demonstrate your ability to be both an outstanding medical student and future physician. Based on my personal experience, it is good to include a few other facts in order to help the interviewer relate to you as a person. For example, I would always state my age and where I was from, but a variety of other personalizing facts may be offered.

Here is a list of possible categories to help structure your body of information:

• Age
• City of origin (could be your city of birth or current residence)
• Important work experiences (you can include research and volunteer activities)
• Passions
• Personal characteristics (kind, compassionate, energetic, etc.)
• Hobbies

Here is what an applicant’s list of topics they would like to mention might look like:

• 23 years old.
• Live in Boston.
• Compassionate, diligent and determined.
• Passionate about cancer research; spent two years assisting in the investigation of a new medication.
• Aunt is a breast cancer survivor – spent a lot of time with her during the course of her illness and recovery.
• Enjoy traveling in Central America, sailing and other water sports.

Let’s look at all of this in action. Here is a sample answer to the question utilizing the information above:

“Can you tell me a little bit about yourself?”

“Well, I’m 23 and currently living in Boston. I spend a good portion of my time working on a research project with my university investigating a new cancer treatment medicine. It’s easy for me to devote time to this project as my aunt is a breast cancer survivor, and I learned a lot as she went through this process. I’d like to be part of a team, helping others to beat cancer. It’s not all work for me, though. To relax, I love to sail, and Boston is a great city for this hobby. I also like traveling, to Central America in particular. I’ve found some great volunteer opportunities in these countries as well, and met some amazing people along the way. These trips are always fantastic experiences, and really feed my compassionate side.”

This basic outline can be offered with ease in less than 45 seconds, and it gives the interviewer a feast of potential items to discuss. Perhaps he or she went to school in Boston, or knows someone who teaches in the city. Maybe your interviewer speaks Spanish or has traveled to Central America. It would be easy for an interviewer to ask what life lessons you’ve learned on your travels to these foreign countries. Or maybe she will ask whether helping your aunt get through breast cancer was the hardest time in your life, and what you learned in the process. Perhaps the interviewer also does pharmaceutical research. The possibilities are endless, and enables the interviewer to follow up on topics that are of more interest, while at the same time helping to keep the conversation within your comfort zone – at least for awhile.

Summary

The applicant who is aware of, and prepares to deal with, the perils latent in the biographical question, can turn the tables on a trick and make it into a treat. The hors d’oeuvres concept allows the applicant to subtly outline the body of the interview, and control the main topics of discussion. In the end, using these simple methods can ease the discomfort of an open-ended ice breaker, and really give you the opportunity to shine.

Please email your medical school questions to Dr. Fleenor at jdfleenor@gmail.com.

by Jeremiah Fleenor, MD,

“That which we persist in doing becomes easier, not that the task itself has become easier, but that our ability to perform it has improved.”
Ralph Waldo Emerson (1803 – 1882)

Part 1 of this series dealt with how to gather and organize the personal information you want to convey during interviews. Now that you have collected that information, you’re ready to practice delivering it in a smooth, professional way.

An interview is without doubt a pressure-cooker setting. You may know exactly what you want to say before the interview, but in that high stress environment, it is not surprising to suffer brain-freeze and respond in a completely unanticipated way. One of the few remedies to counter this awkward effect is preparation – lots of it. Interviewing is a skill; like riding a bike or throwing a baseball, so it naturally takes practice and effort. Let’s look at some of the ways in which you can give your interviewing muscles a good work out.

Mirror, Mirror on the Wall….

One simple but good exercise is to spend some quality time in front of a mirror. Ideally you can find a mirror to sit in front of, to mimic how you will appear across the table from your interviewer, but a smaller mirror will do for some of these exercises as well. The purpose is to see yourself from your interviewer’s perspective. Focus on your facial expressions, body language and delivery. To start with, practice some of the fundamental mechanics that are vital to a great interview: smiling, eye contact, hand position and body language.

1) Begin simply by sitting in front of a mirror and smiling. In particular, get comfortable smiling for extended periods of time. It’s not about perfect teeth or minty fresh breath. The purpose is to be able to maintain a natural and unstrained smile for a longer period of time than you would normally.

2) Once you’ve mastered the art of smiling, spend some time making good eye contact with your reflection. You’re not trying to win a staring contest. Rather, the goal is to become comfortable with long periods of maintaining eye contact in a relaxed and natural way.

3) Next, find a few comfortable sitting positions. This is important because interviews aren’t conducted standing up. And the seating that you’re offered can range from hard-back chairs to soft couches that are easy to get lost in. You’d be surprised how much sitting in an unaccustomed position can make you feel uncomfortable and effect how you portray yourself. Do you feel more comfortable with your legs crossed or side by side? Do you like to lean back or sit forward? The key is to assess how you look and feel in different sitting positions and how that enables you to best deliver your message.

4) The following exercises require a larger mirror. Once you are seated before the mirror, practice delivering the “gold nuggets” you have gathered about yourself, demonstrating your potential for becoming a highly effective medical student and future physician. This is best accomplished through questions and answers. Pose hypothetical interview questions to yourself and answer them as you would during a real interview.

5) While you practice answering questions, pay special attention to your hands. Try to find a balanced way of using them to communicate, and find a comfortable position of rest. You may choose to fold them in your lap or rest them on your legs.

6) Be sure that you continue to smile, make good eye contact and be engaging. Pretend that this is the real deal. While going through these drills carefully watch yourself and ask yourself the following questions:

• Do I believe what I’m saying?
• Do my facial expressions and body language communicate the same message as my words?
• Do I look comfortable?
• Do I appear to be having fun?
• Do I look and sound like a prospective medical student and future physician?

7) Take these mirror sessions as far as you’d like. You may even want to dress up in interview attire if you feel uncomfortable or unused to wearing a suit. By practicing for interviews in a suit you will become more accustomed to wearing one, and will look less uncomfortable or awkward. Alternatively, you could practice in sweats or pajamas. Just find whatever works best for the skills you need to develop.

While you might feel silly sitting in front of a mirror, in a suit, while talking to yourself, this is nevertheless a cheap, easy and practical way to work through some of the basics of interviewing. Once you master these fundamentals, you will get a lot more mileage out of the next activity.

Mock Interviews

Most universities have career counseling centers that provide free interview preparation services. Sometimes they are geared more towards general job interviews. Often, however, there are staff members trained in conducting mock graduate school interviews, even medical school interviews specifically if your school has a pre-health advising office. Given that you’re almost certainly paying for this service in the form of school fees, feel free to take advantage of this excellent opportunity.

Mock interviews are usually set in a formal environment and are intended to be as real as possible. Most ask “candidates” to come dressed as they would for real interviews. The interviewer asks you questions, ideally relevant to medical school admissions. This is your opportunity to deliver the responses you have prepared. Afterward, the interviewer will evaluate your performance and provide constructive feedback.

If your career center has the ability to videotape the interview, ask to have it taped. This is a highly useful technique despite how painful it may be to watch yourself on video. You will be able to see the nervous tics, count the “umms,” listen to your overall delivery and evaluate your credibility. Furthermore, you will be able to see how you responded to tough questions. Pay special attention to these. Make a note of any “bad habits” that came out under this stress, and then focus on eliminating them during future preparation. Also make a note of which questions gave you the most trouble, and spend more time practicing your responses to those questions in particular.

Practically speaking, mock interviews accomplish the same ends as the mirror sessions, but they offer certain advantages:

• They are more realistic.
• They offer a level of uncertainty for you, as the ‘candidate.’
  • Candidates cannot anticipate the questions.
  • Candidates do not know in advance how the room and seating will be arranged.
  • Candidates cannot predict the temperament or pace of the interview.
• They provide direct feedback from a skilled observer (e.g. the interviewer).
• They illustrate the areas in which you were or were not prepared.
• A videotape displays how you respond in frightening detail, which allows for tremendous improvement.

Conclusion

The amount of time and effort that you dedicate to your interview preparation will directly impact the ease and professionalism of your delivery. If you have mastered these skills, you will be able to more efficiently and effectively use the limited time during an interview to show who you are, and to drive home why you would be an excellent addition to their medical school.

Although good interview skills come more naturally to some than others, the basic skills and exercises described above can open the door to interview success for people who are not naturally gifted in this area. Nevertheless, regardless of your current level of interviewing skill, I hope that some of the exercises and suggestions in this article will improve your delivery and help you sail through interviews.

Please email your medical school interview questions to Dr. Fleenor at jdfleenor@gmail.com.

By Jeremiah Fleenor

When I look around, everything tells me fall is in the air: school is back in session, the weather is becoming slightly cooler and the smell of OChem lab lingers on my clothes. If you’re half the dork I am, the smell of a new textbook is a welcome aroma. It represents a fresh start and being one step closer to becoming a physician.

All of these indicate there is another interview season upon us. Accordingly, this two-part series is dedicated to helping prospective medical students prepare for upcoming interviews.

Do I really need to prepare?

This is a fair question. We all have multiple demands placed on us and we must make wise decisions as to where we allocate our most precious resource: time. Is it really appropriate to dedicate time to something that is months away and is seemingly just a “conversation?” After all, I have to maintain a stellar GPA, gain work experience, balance my personal life and try not to go crazy in the process. As the title of this column indicates, the answer is yes.

While the interview is, in many ways, just a “conversation,” it only becomes so once you have put in the work required to build a solid foundation. If this foundation is lacking it will be difficult to have a productive interview. There are numerous time constraints and nuances that make the medical school interview very challenging.

For some of you, this may be the first real interview you have encountered. It would be a mistake to think of it like an interview for a job at a fast food restaurant or a coffee shop. Nor is it like an undergraduate entrance interview. It is much more akin to a job interview for a highly paid professional position. After all, you are seeking admittance into a program that, once completed, will allow you to hold one of the most respected positions in our society. It’s a big deal.

At the risk of sounding paternal, this is not the time to try and “wing it.” It is incredibly difficult to get to the interview stage. You will be best served by being as prepared as possible, so you can realize your goal of getting into medical school.

Here is the bottom line: interviewing is a skill. It’s just like riding a bike, making new friends or succeeding in a class. There are certain unique concepts that are important to success and utilizing these concepts takes practice.

As you see one more thing added to your plate, please don’t lose hope. General preparation for your interview might not be as hard as you think.

Gathering Information

One of the most important initial preparations is discovering what you bring to the table. What qualities will carry you through medical school and contribute to your becoming an excellent physician? In essence, this is the material you will convey during the interview. It is the information you are using to substantiate your candidacy. I view each relevant experience or characteristic as a piece of gold. Gathering usable information is like mining. It requires spending time to take an inventory of who you are and what you’ve done in life. Once you’ve collected this information, sift through it and single out the most relevant and important facts. These will best demonstrate how and why you will make an amazing medical student and future physician.

Unfortunately, there is far more detail on the subject of gathering your personal information than this forum allows. Nevertheless, here are a few categories to help you get started in your quest for gold:

* List your strengths and weaknesses
* List the reasons why you want to be a doctor
* List your travels and the important things you learned from them
* List the challenging times in your life, how you dealt with them and what you learned
* List your hobbies or extracurricular activities
* List the positive things that make you unique

Organize It

One of the most daunting facts we face during the interview process is the realization that an interviewer could ask almost any question. Can you imagine trying to prepare for a million different questions? It’s as overwhelming as it is impossible. Fortunately, you don’t have to attempt this feat. It is true that a million different questions can be asked, but they all condense quite nicely into a few broad categories. It is the formation of these categories that allows you to handle the sea of variability encountered during an interview.

Categories are simply mental constructs for grouping similar pieces of the personal information you collected from your past (the gold). The reason for grouping personal information is to make it easy to access during the fast pace of an actual interview. For example, here are some real medical school interview questions to help demonstrate the point.

* Who is a person you would invite to dinner and why?
* What are three adjectives that best describe you?
* What is a symbol that typifies you as a student?

These are all very different questions but each fits nicely into the single category of Personal Values or Characteristics. The interviewer could go on to ask 10 more similar questions and you could easily answer each just with the information you collected and placed in this category.

Again, there is much more detail that goes into the process of category formation but here a few ideas to help get the process started:

* Abilities
* Accomplishments
* Personal Values
* Hobbies

Feel free to adapt, combine or rearrange these categories to best fit your needs. Category creation is largely determined by the way you think, as well as how you want to organize and access your personal information. The categories you choose will likely be different from the choices of the applicant next to you.

In The End

The new school year offers many great opportunities: the chance to learn, meet new friends and come one step closer to realizing your dream of becoming a physician. The interview plays a large role in that process and preparation is the key to success. Use the above steps to help get started, and make this interview season your last!

Please watch for the next article which will contain information on the mechanics of interview preparation.

E-mail your medical school interview questions to jdfleenor@gmail.com.

To discuss this article, please visit its discussion thread on the SDN Forums.

Another admissions cycle is in the history books. For those of you who got accepted, congratulations! I hope medicine is everything you thought it would be and more. For those of you who didn’t, I’m sorry this wasn’t your year. This article is for you.

As any great athlete knows, performance level during the season is largely determined by the choices made during the off-season. Here are some options to consider as you make your summer plans.

What Worked and What Didn’t

In a perfect world you would be able to find out what a given admissions committee thought about your application, both good and bad. Fortunately, many schools offer such a service. This feedback is worth its weight in gold. If any of the schools you interviewed offer post-interview feedback, make sure to get it.

Even one school’s feedback can provide great insight into their evaluation of your strengths and weaknesses, but trends across multiple schools hold even more power. For example, if several schools comment on a low course grade or a particular letter of recommendation, this is likely a critical focal point for your efforts. This sort of information is especially useful if you have multiple weaknesses in your application, because it allows you to improve the most limiting area.

Critical Evaluation

It is paramount to spend some time looking over all aspects of your application. This is where the rubber meets the road. It can be hard to honestly evaluate the shortcomings of an application. Nevertheless, the best chance for success next time around lies in addressing these very issues. Consider sitting down with an advisor or other qualified person and ask questions like these:

• What are the strengths I bring to the table?
• How am I a unique applicant?
• What are the weaknesses of my application?
• Which can I reasonably fix in the short term? Long term?

For example, if you determine you lack medically relevant experience, then the best course of action is to focus your summer activities in this area. Try to set up internships or ask if you can shadow your family physician.

If there is a particularly damaging course grade, consider re-taking the class during the summer semester.

If you discover you struggle communicating during interviews, practice mock interviews in front of a video camera. Replay the tapes and work on expressing yourself more clearly.

Multi-Task

One skill almost every physician possesses is the ability to multi-task. At the risk of preaching to the choir on this topic, wise planning of your summer activities can be a great way to kill many birds with one stone. For example, when I’m evaluating an applicant I’m usually very pleased when I see he or she has traveled abroad. It’s almost impossible to go to another country and not be changed for the better. With this in mind, if you lack medical experience, consider doing clinic work in a foreign country. There are many short and long term medical trips to destinations across the globe. These outings are often set up through churches or charitable organizations; most are usually very happy to have extra help. This sort of activity can broaden your life experiences, add to your medical repertoire and, possibly, provide a great letter of recommendation.

Sit Under the Apple Tree

Most medical schools have a summer break between the first and second years. Historically, it has been a challenge to decide on an activity covering that time. (This may be analogous to the choices facing you this summer.) In the process of informing me and my classmates of the various options available to us, our Dean of Student Affairs kindly said it was fine to “sit under the apple tree” and do nothing. I’m glad she gave that option because I think it’s very viable. It holds and important, yet underappreciated, place on the list of things to do. Here’s a story to help illustrate the concept.

There once was a competition between two teams. The goal of each team was to be the first to saw through an enormous, thick tree. Each team had two men and one long saw with a handle on each end. The men were opposite one another and pulled and pushed the saw back and forth in the cutting process. The competition began early in the morning and was expected to last most of the day.

Close to mid-day, the first team decided to take a break. They rested for a bit, ate some food and sharpened their saw blade.

The second team saw the first team taking a break and viewed this as their chance to win the competition. They kept sawing with even more intensity in hopes of distancing themselves from the first team. Unfortunately, the more the second team would saw the duller their blade became. As the day wore on they had to work harder and harder just to keep the same cutting pace.

In contrast, when the first team returned from their break they found themselves sawing with ease. The sharp teeth of the blade allowed them to put forth less effort for each cut. The food and the rest fueled their bodies for the remainder of the long day.

In the end, the first team won by a substantial margin. The reason they won was because they stopped to rest and sharpen their saw blade.

Is this the summer for you to sharpen your saw blade for the long road ahead? Only you can answer this important question.

Summary

The summer break offers many things to the applicant: respite from the storm, time to strengthen weak areas and a chance to take inventory and refocus. What you choose to do in this off-season can make a world of difference when the next application cycle roles around. I hope this information helps you make the best choices possible for your particular situation. Good luck in your summer plans.

Please email your medical school interview questions to
Dr. Fleenor at jdfleenor – at- gmail.com

To make a goal of comfort or happiness has never appealed to me; a system of ethics built on this basis would be sufficient only for a herd of cattle.

-Albert Einstein (1879 – 1955)

I was recently asked by an applicant how to approach ethical questions asked during an interview. His concerns about answering this type of question echoed those of many other applicants. In light of this common woe, I’d like to share a simple three-step approach for handling interview questions regarding ethics. You’ll be happy to know reasonable answers are probably easier to frame than you think. Further, interviewers are often as nervous about asking ethical questions as you are about answering them!

Abortion, euthanasia, stem cell research, and pharmaceutical “perks” are super-charged topics currently facing physicians and our health care system. It is a truly scary proposition to be asked about your stance on such issues, especially in the glare of an interview. When your goal is to make a good impression (and not rock the boat), it can be hard to share your views on these sensitive topics. What’s an applicant to do?

I suggest the use of three concepts to help guide your responses:

1. Realize a correct response is one which falls within a fairly broad range; in other words, there is not necessarily a right or wrong answer.
2. Be consistent in your remarks.
3. Always answer with a patient-focused approach.

Normal or Extreme?

It may come as a shock, but as long as your belief about a particular ethical issue is within a fairly wide spectrum of “reasonable” it doesn’t really matter what it is. We are entitled to have our own opinions regarding controversial issues. The majority of the nation may view an issue one way – you may hold the opposing opinion. That’s okay. The key to this concept is as follows:

“It doesn’t matter what you believe as much as why you believe it.”

Most often applicants feel a strong urge to try and tell interviewers what they think they want to hear. Ethical questions usually concern sensitive, emotionally charged subjects. In the pressured setting of an interview, nobody wants to create tension. So it’s easier to simply mouth the popular view, or to try and discern views of the interviewer and espouse those. This, however, can be a very dangerous practice. (Please see the following section for further details).

Simply spend time [before a given interview is to take place] figuring out what your views are on current ethical dilemmas. Think about why you hold these views. After all, your beliefs are just an extension of who you are as an applicant and future physician. Incorporate them into the overall package you are presenting to the admissions committee. This will allow you to be who you are and will help facilitate a genuineness that is so important to success in the application process.

A quick note. The idea of reasonable or normal can be a little slippery but I like to think of it in terms of a bell shaped curve: you can probably hold a view that is within two standard deviations from the “mean” of public opinion on a topic and be within the norm. However, a view in the third standard deviation from the mean would likely be thought extreme. This approach isn’t absolute but provides some guidance.

Consistency

In hopes of determining whether an applicant is really saying what they believe, an interviewer will often ask two seemingly different moral questions and see if the applicant answers the same way, or changes his/her stance. What’s worse, these questions can come back to back, making it all the more deceptive. Therefore, it is imperative not to tell the interviewer what you think he wants to hear. Now that you know that you are entitled to have reasonable opinions, simply answer questions sincerely and consistently.

It’s Always About the Patient.

A patient-focused answer is the cornerstone to any ethical question response. Remember, as a physician (soon to be), your purpose is to take care of patients. The very nature of the job is to help someone else. Regardless of your personal stance on stem cell research or abortion, your views should have the patient’s best interest in mind. Having this understanding will prove valuable during an interview and in daily practice. As I struggled through ethical dilemmas in my own practice, a mentoring physician once told me, “Do what’s right for the patient and you’ll never go wrong.”

In the End

The drive of ethical questioning is to determine whether you have thought about common dilemmas facing physicians. The questions are not designed to trip you up. The committee must determine if you have a reasonable approach for dealing with these challenging issues. You can have your own opinions on controversial matters. However, they must be reasonable, a true extension of who you are as a person and focused on the best interests of the patient.

Please view the approach I’ve presented here as a place to start. Preparation for ethical questions is best accomplished by discussing the issues with your friends and professors. Share your ideas with others as a reality check. Compare your views to those who feel differently. Become educated on as many different sides of an issue as possible. This will allow time and opportunity to strengthen your arguments and become comfortable talking about sensitive issues.

Good Luck!

Please email your medical school interview questions to
Dr. Fleenor at jdfleenor@gmail.com