How to Answer Difficult Residency Interview Questions

How do you start preparing for residency interviews?

We know residency interviews can be stressful, particularly considering that you are making a commitment to a program and location that you will be spending a minimum of the next three years at (for some, this can be 6 or 7 years). Below is a list of the most common interview questions that are posed by interviewers, and examples of how you can answer them in a way that is safe and effective while giving the best first impression possible.   

1. “What are the areas you think you would most like to improve in?”

This is another form of the “what are your greatest weaknesses as an applicant question”. Pick something real that is relatable, however not a red flag or disqualifying. A good example is ‘Sometimes I take my work home with me and it stays with me for a couple of days when there has been a negative event in the hospital. I have worked on finding healthy ways to de-stress such as exercise and social events with friends that have really helped me in this realm’. Another good example can be ‘Sometimes I can focus too much on the details of note writing and other processes throughout the work day, and I have worked hard on prioritizing tasks to become more efficient’.  A bad example is ‘I keep my colleagues accountable, and sometimes this has led to conflicts at times’ (programs are trying to avoid residents who will make big splashes and cause trouble between colleagues in residency).

2. “What is a conflict that you have had with a patient or colleague, and how did you go about addressing it?”

Here is it imperative to avoid splashy and dramatic stories that will stick negatively in the minds of interviewers. Avoid bringing up stories where someone was reported to the medical board, they were fired, etc, even if you are not the person at fault. The most successful strategies are to pick an incident where there was a lack of communication (i.e. we did not communicate effectively for which new patients we were picking up that morning as residents, and as a result ended up having to quickly rush to see someone that was almost missed which made rounds that morning hectic and could have been avoided. Once explaining the lapse in communication, discuss that you learned how to communicate more effectively via sign-out, touching base in the morning, looking at the patient list together thoroughly, or whichever method you have chosen. This shows you are a quick learner and address mistakes promptly.

3. “Are there any gaps or breaks during your training that you would like to address?”

If there are no gaps, the easy answer is to say no. If there are large gaps, pick a single major reason for why they occurred (avoid over-explaining with multiple reasons), and then quickly move on to why that period has made you stronger as an applicant in terms of finding coping mechanisms, therapy, health ways to deal with stress, or that you gained the opportunity to train in other areas or delve into further research during that time that you can bring with you to your next program. Avoid spending a lot of time explaining the exact situation that led to this, or citing many small reasons, as this begins to sound like justifying or excusing the absence. You want to spend a small portion of your time explaining what occurred succinctly, and a larger portion of your time discussing why you are now a stronger and better prepared applicant because of your experiences and what you have learned.

4. “Can you describe a time where you felt you failed or could have handled a situation differently? What did you learn from it?”

While not specifically a conflict question, here too you can choose a story where there was a miscommunication, and you then took steps to correct the miscommunication and improve that for future interactions to be more effective as a leader and a colleague. Once again, take care to avoid splashy stories that resulted in someone losing their position, being reported, or other incidents that will stand out in a negative way.

5. “What do you feel will be the most difficult part of starting residency?”

DO NOT say the rigor, hours, or anything that indicates you are not willing to work hard. You can state the adjustment of a new city and new group of friends in residency and creating a home base for instance, as this will happen wherever you go if different from your home program (and the adjustment of a new set of friends and colleagues will occur not matter where you match to). It is also reasonable to discuss overcoming obstacles in the real world such as knowing what the best treatment options are for a patient and attempting to prescribe them the correct medications, while dealing with access to care that prevents them from achieving their goals through insurance coverage, social determinants of health, and other outside factors.

6. “What do you think your mentors have said about you in their letters, or would say about you now if I asked them?”

That you are passionate about the research and volunteer projects you have started, dependable, and hardworking. You can also mention that generally you enjoy working with others and being part of their teams, and that you cherished these experiences with them. Avoid being overly lofty and remember to remain humble during this response. Nobody will fault you for a general answer that discusses your research passions or collegiality, but they will certainly remember it negatively if they believe you lack humility.

7. “What do you believe you can contribute to our program as a future resident?”

Highlight any research or volunteer experiences that you would like to continue to pursue during residency. If you have started programs or been in leadership positions during medical school, emphasize that and say that you would love to contribute to leading something like this at their program in the future.

8. “Why would you want to go to our program specifically over others?”

If there are geographic ties, make sure to mention them. However, this should not be the only thing you mention. You should prepare 2-3 things that are program-specific (‘I love that your global health program offers opportunities to serve _____, ‘I saw that you have conducted _____ research in the past few years and this is the kind of work I wish to get involved in’). Do your research in advance in order to see what attendings have published there through Pubmed, and what other opportunities are offered on their website regarding community involvement or global outreach that excite you. This demonstrates that beyond geography, you are genuinely interested in their program for intrinsic reasons and the quality of the training there.

Frequently asked questions

How important is the personal statement for residency?

Since medical schools can receive thousands of applications for very few spots, and many of these applicants all have average or above average GPA and MCAT scores, the personal statement can become and important differentiator.

Should I go through multiple drafts of my essays?

Absolutely. You should have multiple people review your essays for grammar and spelling errors, transition quality, and overall message. The most polished essays that are application-ready have usually been through at least 2 or 3 revisions prior to submission.

What is the most common interview format for residency?

The most common format for residency interviews is one-on-one or panel interviews (two or more interviewers with one applicant). MMI interviews are being employed more in medical school interviews, though it is still possible to encounter this in a few residency programs.

What should I do after my interview?

During interview season, you may have many interviews and it will be difficult to remember everything that occurred during each day and your impressions when comparing programs prior to ranking for the match. For this reason, you should take a few minutes to write down your impressions directly after interview day for each program.

How long should my interview answers be?

Anywhere between 1.5 to 3 minutes is a safe range for answers, although a few seconds more or less than this is completely reasonable depending on the question. The quality of the answer, given concisely and directly, is far more important than the amount of minutes you are speaking. That being said, avoid rambling for overly long periods of time.

Should I send thank you letters or letters of intent?

Thank you letters may not make a difference in ranking at a program, however they are a thoughtful and nice touch. The exception to this is if a program specifically states not to send thank you’s – then you should respect their request. For letters of intent, it is appropriate to choose one program if it is your clear number one choice and send an email to the program director letting them know. Do not choose more than one program to send this letter to – it is first and foremost dishonest to do so, and medicine is a small world and it is not advisable to burn bridges.

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