The Art of Interviewing: Knowing your intern candidate

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The Art of Interviewing: Knowing your intern candidate (and other ERAS tricks)

  • Sheilah Bernard, MD
  • Associate Program Director, Medicine Residency
  • Chair, Internship Recruitment and Clinical Competence Committee
  • 10/28/14


  • Understand the role of the interview
  • Reflect on how to determine if you would like to work with that candidate (or just socialize) e.g can this candidate care for my loved one?
  • Familiarize yourself with interview Do’s and Don’ts
  • Review for the experienced and stimulate the novice

The process….

  • Candidates apply to many schools 12-50
  • Many ERAS (Electronic Residency Application Service) applications are received
  • All are screened
    • MSPE (Medical Student Performance Evaluation) or Dean’s letter –where do they rank in the class?
    • DOM letter: where do they rank amongst IM applicants from that school?
    • IM Clerkship/IM SubIntern grades
    • USMLE scores: are they coachable?
    • Extracurriculars: what could they contribute to program?
  • Only 10% are selected to interview; 10% of these match

Know who “we” are (Mission, Vision, Values)

  • Come to Infosession, email to follow if you can’t
  • Socially responsible, academic municipal hospital in Boston serving diverse patient population (98% insured state-wide) with a VA experience
    • Triad of education, research and patient care
    • Exceptional Care Without Exception, or The Right Care, no more, no less
  • Block schedule (ambulatory distinct from inpt)
  • Entirely electronic (Epic experience appreciated!)
  • Opt into tracks as PGY2
  • Successful matches into subspecialties

The “pre-interview”

  • Frequent complaint is “the interviewer did not read my application”
    • Program will try to match interviewee with both a faculty/junior faculty sharing similar birthplace, college, med school, fields of interest (in and out of medicine)
    • Last minute changes occur, we try for Friday distribution prior to interview week (M/W)
    • Look for an underlying theme linking personal statement, work experience, research, or extracurriculars; ask open-ended questions to explain

The interviewer should…

  • Maintain professional atmosphere in a quiet room, avoid interruptions; turn beeper over
  • Limit discussion to issues related to candidacy for residency position
  • Ask only for information necessary to make a sound decision
  • Use proper terminology: we interview residency “candidates” for further training, in business we interview “applicants” for variable skill sets

Identify Red Flags

  • Misdemeanors
  • Typographical errors
  • Gaps in education (buried in transcript or Dean’s MSPE)
  • “Nice, punctual” are not flattering adjectives
    • “Will develop”, “Made strides”, “gaining confidence”
  • Special considerations
  • Information provided on application is subject to questions

Identifying Key Words

  • Every school is different, interpret in quartiles or quintiles or sextuples
  • MSPE: Outstanding > Superior > Excellent > Very good > Good > Capable
  • DOM: “We will be recruiting him/her to stay at our institution”
  • Integrity of LOR: From researchers, mentors or family acquaintances; “in my 30 (vs 2) years’ experience”

Guiding Principles for Interview

  • Be time sensitive
    • 2 interviews plus tour: 30 minutes limit/interview
  • Introductions
    • The applicant may have Google’d you (do they know you more than you know them?)
  • Be aware that online Residency Interview Tips on YouTube are popular this time of year
  • Always observe
    • Composure, fluidity of thoughts/language
    • Motivation, “fit” at BMC, Talk the talk or walk the walk?

The interviewer should…

  • Approach the interview as s/he would a patient encounter
  • Ask open-ended questions
  • Avoid interrupting the candidate
  • Use silence or pauses to encourage the candidate to speak candidly
  • Ask the same questions of all candidates regardless of gender or ethnicity

The interviewer should…

  • Focus the interview on the candidate’s expressed capabilities and attitudes in relationship to the residency or fellowship appointment
  • Avoid stereotyping candidates; use gender neutral terms
  • Try to get feel for candidate’s humility, intellectual integrity and willingness to work
  • Use nondiscriminatory language to identify special needs (are there any reasons you would not be able to perform expected duties?)

Areas to avoid

  • Although questions about social, personal or family issues may put a candidate at ease, one should not ask about age, marital status, pregnancy, family planning, number of children and childcare issues, religion, physical disabilities or race
  • Ask questions that the Selection Committee would need to know

Recommended questions

  • “Are there any current or foreseeable family obligations or health considerations that might make it difficult to work as a resident at BMC?” Open ended, can be asked of all candidates
  • “Are there any questions I can answer about community life outside the medical center?” Allows candidates to ask about childcare, etc.

Types of interviews

  • Structured
    • Standard panel of questions each candidate must answer
    • Allows us to train and standardize interaction
    • Less spontaneous and more formal
    • May put off candidates

Types of interviews

  • Structured
  • Semi-structured or unstructured
    • Allows the interviewer to individualize the contact
    • Allows more critical evaluation of weaker candidate; allows more inviting format for stronger candidates
    • Interviewer evaluates interviewee while interviewee is evaluating interviewer
    • Allows the flexibility to scrutinize or recruit the candidate

Types of Interviews

  • Individual (standard)
  • Panel
    • A panel of interviewers evaluates a single candidate
  • Group
    • Interactions with program coordinators
    • Watching interactions during Meet & Greet
    • Feedback from tours
    • Board games for down time
      • IPSC, leadership, assertiveness/passiveness

Establish rapport

  • What would you do if not medicine?
  • What do you think makes a good resident?
  • What do you do to relax (in application)?
  • What motivates you?
  • What are you looking for in a training program?
  • What is important to you?

Ask about past performance

  • Tell me about your research project. Why did you choose that hypothesis?
  • What areas do you think you can improve on? How have you worked on them in the past?
  • Tell me about an interesting or inspirational patient (personal statement) and why.
  • Tell me about a challenging patient. What did you learn from it?

Ask about past performance

  • At the end of a “good day”, what makes it good?
  • How would you like to be remembered by your medical school?
  • What was your most challenging goal and how did you achieve it?
  • What was your most difficult decision in medical school and what influenced that decision?

Assess interpersonal skills/stress management

  • What kind of person has been difficult to work with, and how did you deal with it?
  • What do you think constitutes teamwork?
  • Describe an unpleasant or stressful situation in medical school and how you dealt with it.
  • What gets you going, what keeps you going?
  • What will be your biggest challenge as resident?
  • What barriers would keep you from coming to our program?

Assess character and personality

  • What single quality distinguishes you from other candidates? What should I know about you to help us decide if you were a good candidate for our program?
  • How have you changed over the past 4 years?
  • What in your life are you most proud of?
  • What do you like to read?
  • Describe your weaknesses
  • What are your goals during residency?

Clarify understanding

  • What are your 10 year goals? Your 3-5 year goals?
  • How would you describe the ideal physician?
  • Who is your role model? Whom do you emulate inside or outside of medicine?
  • What 4th year electives are you taking and why?
  • What will you like most/least during residency?
  • How would you change your medical school curriculum? What are its strengths?

Clarify understanding

  • What are your reservations about IM residency or our program specifically?
  • Tell me what interested you about our program today.
  • Can I clarify anything you heard or saw today?

Challenging questions

  • Ask candidates to tell you how they do something at which they are adept (e.g. cooking a dish, golf swing, jigsaw puzzle). See how well they convey information
  • (Ask riddles/brain teasers)
  • (Present challenging clinical cases)

Review notes and finalize impressions

  • Standard interview rating form
    • Objective grades/scores
    • Letters of references (MSPE, DOM, others)
    • Extracurriculars and level achieved
      • Volunteerism
      • School activism/civic duties
      • Research
    • Interview x 2
    • Exit interview

Review notes and finalize impressions

  • Quickly jot down feelings and impressions
  • Document concerns (Red Flags)
  • Document the context and who initiated if sensitive topics discussed
  • Document items for discussion by Selection Committee
    • VIP candidates, current residents’ friends/opinions
    • Need to be in Boston, Visa issues if not already documented

Post-Interview Communications

  • APDIM Statement distributed to all candidates discouraging post-interview communications
  • Communication for second-looks or clarification of issues is appropriate
  • Received communication: respond to the interviewee that you enjoyed talking to them and you wish them professional success; bcc program office.

Why review interview process?

  • Helps add your voice to our candidates’ application
  • Struggling residents had evidence of difficulties recognized in the application process
  • We will endorse a candidate’s application if we feel we can support him/her
  • Your interviewees are seeing all these questions on the internet, YouTube so be prepared! (How have you prepared for this interview?)

Present concepts

  • The Behavioral Interview
    • Behavioral interviews are based on the premise that a person's past performance at “work” is the best predictor of future performance
    • Interviewer asks how candidate acts and reacts in certain circumstances; how one handles a situation rather than just gathering information
      • Give specific "real life" examples of how candidates behaved in situations relating to the questions
      • Give an example of a goal you achieved and tell me how you achieved it

Future directions

  • Multiple Mini-Interviews
    • Started at McMaster University with 6-10 timed stations through which applicants rotate
    • Each station has a scenario, task or question
    • Medical schools seek to admit individuals who will make not only excellent students, but ultimately become outstanding physicians. The best physicians are those who are not simply repositories of information; they are ethical, caring professionals and excellent communicators.
    • The MMI was created as a potentially more effective means of assessing qualities that lie outside the realm of grades and test scores


  • Standard interview questions may not reveal an individual’s communication skills, problem-solving abilities, level of professionalism or other skills important for the practice of medicine.
  • The MMI approach uses a series of stations to assess specific skills and qualities and assigns the same interviewer to rate all applicants at a station in order to address some of the weaknesses of the standard interview format
  • Used at the medical school level, technique is filtering into residency programs

MMI stations

  • Ethical dilemmas or questions about policy or social issues.
    • The instructions describe a situation and then ask the candidate to discuss the ethical or other issues involved.
    • The interviewer may follow up with questions designed to probe the applicant’s response
    • Obamacare supports care for all over care for the individual. Discuss.

MMI stations

  • Standard interview questions.
    • An MMI may include one or more stations with traditional interview questions such as “Why did you apply to this school?” or “Describe an obstacle that you have overcome.”
  • A task requiring teamwork.
    • Since the ability to work as part of a team is essential to medicine, some stations involve two applicants working together to complete a task.

MMI stations

  • Essay writing.
    • Some schools include an essay component as part of the interview process so a station may involve responding to a prompt in writing.
    • This station may be longer than the others to allow for the applicant to formulate and write the response
  • A rest station.
    • An interview takes a lot of energy, since the applicant is “on” the whole time and being presented with challenging tasks at every station.
    • Many MMIs include a rest station. The applicant can clear their mind and get ready for the next station.

MMI stations

  • Interactions with an actor.
    • At these stations, the applicant is provided with a scenario involving an individual who is played by an actor.
    • The applicant may need to give the individual bad news, confront the person about a problem e.g. catching a friend cheating, or gather information
    • An observer present in the room will rate the applicant based on his or her interaction with the actor

Does applicant personality influence multiple mini-interview performance and medical school acceptance offers? (UC Davis)

  • Looked at 5 traits in 444 applicants in 2010-11 (agreeableness, conscientiousness, extraversion, neuroticism, openness) undergoing MMI
  • Extraversion was associated with MMI performance, whereas both extraversion and agreeableness were associated with acceptance offers.
  • Adoption of the MMI may affect diversity in medical student personalities, with potential implications for students' professional growth, specialty distribution, and patient care.
  • Acad Med. 2012 Sep;87(9):1250-9


  • Understand the role of the interview
  • Reflect on how to determine if you would like to work with that applicant (or just socialize) e.g can this applicant care for my loved one?
  • Familiarize yourself with interview Do’s and Don’ts
  • Review for the experienced and stimulate the novice

Motivational Interviewing

  • “...a collaborative, person-centered form of guiding to elicit and strengthen motivation for change.”
  • MI is a particular kind of conversation about change (counseling, therapy, consultation, method of communication)
  • The style of MI is calm and focuses on drawing out motivation to change from the interviewee rather than trying to force the interviewee to make positive changes
  • Used in addiction patient encounters
  • Used in mentoring/coaching to change behaviors

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