This booklet was prepared to assist you as you make your way through the residency interviewing process. We hope that you find it helpful. It includes a sample of a CV and some examples of personal statements. Please read it as you prepare for applying for residency and scheduling your early interviews. You may wish to take it with you to re-read on a flight or as you are waiting for your interview. Adapt the check list to your needs. Make a copy for each program, and fill one out after each interview, while facts and feelings are fresh in your mind. Allow yourself to enjoy the adventure of this process. It is quite different from the interview process for medical school. Don't let it overwhelm you. Please call if you need help. Good luck! Have fun!

Dr. Parrish and Marie Hartman

Choosing a Specialty

As you go through medical school, experiencing the different medical disciplines, some simply don't feel right. Or, and making decisions harder, more than one could provide the professional satisfaction you seek. Careers evolve, and people and practice in the various disciplines also change and evolve. People change career directions as they grow and develop professionally. The fit of a specialty may be influenced by several factors:

• Ability and style: Your inherent abilities and acquired skills, your personal style, and your overall medical school record as an applicant to a given specialty are important factors to consider.


• Personal factors and values: There should be congruence between your personality, values and approach to life and that of individuals in the medical discipline and program which you select. Think about what you are comfortable with. Do you like a lot of variety? Quick decision-making? Working with a specific age group? Diagnostic puzzles which may take some time before they are answered, if at all? Doing things with immediate or short range measurable outcomes?


• Future Colleagues: Consider the people you worked with in each specialty. Were you comfortable with them? Would you like people like them to be your colleagues throughout your professional life? What is your "gut" feeling about whether you would be comfortable in this discipline? If you like the "image," but have to "put on" that persona with your clothing each day, consider how that would feel after several years.


• Lifestyle: Consider what you want and realistically evaluate what/how much you have the energy to handle successfully. You should research the schedule, earning potential, flexibility of time, length of training, etc.


• The job market: How are the changes in need for physicians in different disciplines and subspecialties changing? What are the needs in different parts of the country.?


• Future plans: What do you see yourself doing ten years or more down the line? Where will you be? Is the specialty you are looking at changing as a result of other changes in the health care delivery system, changes in technology, or other areas?


• Family: In making career decisions, consider your spouse/partner, children, parents or anyone to whom you are committed. Such considerations should affect your decision in terms of location, finances, and flexibility of time, among others

Applying to Programs and Preparing for Interviews

By the time you start interviewing, you will have gotten the taste of several medical specialties, experienced their ups and downs, spoken to people who are active in those fields, and finally selected the one in which you will likely spend your professional life. With this commitment made, it is time to get practical. In order to present yourself, your accomplishments, and your abilities to a selected group of programs, in one of which you will pursue your graduate medical education, you will obtain and fill out applications. You will prepare/update and print your curriculum vitae and your Personal Statement. And you will select your potential interview wardrobe. You will also need to begin to do your homework.

You must do your homework to be an excellent interviewee. This begins as you begin sending for brochures and applications. Take advantage of these early sources of information. They provide an inexpensive way to start comparing programs. Use - http://www.ama-assn.org. Select Ethics, Education, Science. Select Education. Select FREIDA ON LINE.

Knowing what is available and what you like and dislike is the key to choosing programs to apply to which will have the potential to provide you with a satisfying residency experience. As you receive each program's information, read it carefully, take notes and highlight features important to you. Use a checklist (Appendix A) to create a uniform set of criteria for all of the programs that you will be considering. Additional information may be obtained by calling the House Staff Office or residency program coordinator. Evaluate the check lists after reviewing the information and assign a grade or preliminary rank to each program. This exercise will help you to remember the details of each program and help you to formulate a complete picture of what is available. The average student considers (but may not necessarily interview at) twenty five to thirty programs. This adds up to a large amount of information to keep organized. So take detailed notes. Periodically review your growing list of programs to compare the pros and cons of each, and revise your list as needed. The scale you are using to evaluate your programs will change as you gain more knowledge, so go over and revise old checklists. As you do this, you may find you wish to eliminate some programs.

As you are deciding which programs to apply to, you must simultaneously begin assembling your application credentials, including your curriculum vitae and your personal statement. The curriculum vitae, an impersonal, but concise, outline of your academic and work history. It is an excellent reference tool that will give interviewers a basic understanding of your education and past work experience at a glance. Your personal statement is an opportunity to present information about yourself coherently, concisely (no longer than one page in a clearly visible font) and precisely. The Electronic Residency Applications System (ERAS) for participating programs includes a section for your personal statement which permits a bit more that a single typed page. ERAS does not have a section for CV's. Students should be prepared to submit one. Some students add it to the bottom of the Personal Statement for transmittal or use an available letter of recommendation slot. All students should prepare a CV. In your personal statement avoid being outspoken, and avoid being too narrow in the expectations you have for your residency program as you present them in this document. Avoid being too stylistic. The personal statement has the potential to turn off program directors. Each program director has individual and unpredictable taste. What one finds an intriguing presentation may be totally distasteful to another. Your personal statement should give some background information about yourself and your medical school experience, but the core of your personal statement should define your reasons for having selected that particular specialty and outline why and how you are a good match for that medical discipline. Provide some information about your future career plans and hopes and your educational objectives.

If you are not applying through ERAS, both your personal statement and C.V. should be printed on quality paper. Have them (and any other materials you have prepared) proof-read by someone else. Typographical errors and correction fluid are not professional looking.

The Dean's letter, the third item in your credential packet, is prepared by one of the associate deans in the Office of Student Affairs. Following a format outlined by the AAMC, this letter provides background information on your education and employment, if any, prior to medical school and a summary of your basic science performance. The heart of the Dean's letter is comprised of the evaluations of your clinical work as they were submitted by the core clerkship directors. The letter describes your extracurricular activities and interests, any awards or commendations you have received, and concludes with a summary section. The Dean's letter, may contain one or two senior year evaluations, if they are submitted in time. If you wish to provide them, you may, if the programs permit it, send copies of your fourth year evaluations to program directors to add to your application materials.

Faculty letters of support are an important part of your application materials. Most programs ask for two or three letters of recommendation. Some will specify that one be from the Chair of the discipline's department. The other letters should be from individuals who can truthfully provide a clear and positive picture of your clinical work. If you have completed a rotation in an institution to which you are applying, a letter from someone there who can evaluate your clinical performance there can be very helpful. Be sure to allow your letter writers ample time (one to two months) to prepare and send your letters. Personal statements and C.V.s are excellent resources for faculty to have on hand as they write on your behalf. Provide your faculty referees a set of mailing labels for your programs.

Before filling out your applications, make copies to use as rough drafts (or to create templates for your computer). Fill out the copies by hand then type or print on the originals. After completing each application, file a copy for yourself. The suggested time for mailing your applications is between early-September and the beginning of October. Programs participating in ERAS may begin to offer interviews prior to release of the Dean's letters. The earlier you get your application submitted for an ERAS participating specialty, the better. Some non-ERAS programs will ask that a separate copy of your application be sent with your Dean's Letter. Be certain to have any such applications in the Office of Student Affairs by mid-October at the latest, so that they may be sent with the Dean's letters. Dean's letters are being placed into mailing envelopes at this time, and are mailed November 1 of each year.

ERAS 2002 (Electronic Residency Application System) (ERAS) will be used by most residency programs. The list of ERAS participating programs will be available in the AWS software and on the WWW in late-June at www.aamc.org/eras.

Timing of Interviews

There is a great deal of mythology and conflicting information regarding interview timing. Early in the interview cycle, interviewers evaluate applicants in comparison with projected qualifications based on previous experience. This may have a variable and unpredictable effect on how early applicants are "judged." Another example of student folk lore is that applicants should interview as early as possible, since interviewers may become bored with recruiting and conducting interviews as the winter months progress. This may or may not have validity. For some programs you will have little choice of time - you will be given a date, and will be expected to adjust your schedule to meet it. One word of advice is applicable to all: if at all possible, get a few "experience interviews" under your belt before you present yourself to those programs you most desire. As a general rule, the earlier your application is received by a program, the more flexibility you will have in scheduling interviews. A late application may arrive after there are no more interview "slots."

Interviewing and Senior Rotations

Course directors do not view the senior year as a year of job hunting. They expect you to be present and working on senior rotations. Most will work with you to have a couple of days off during a block, but please do not approach this privilege as an entitlement. And, under no circumstances, be so unwise or inconsiderate as to simply not appear at your rotation because you have an interview.

Travel for Interviewing

Some skill is required to get through the trials and tribulations of interviewing successfully. The AAMC offers special travel fares to students interviewing for residency positions. Shop around with a travel agent, you may be able to get fares at even less cost than the AAMC discount. Cluster interviews geographically to reduce the travel expense. Allow a whole day for each program. Allow yourself plenty time between interviews to record detailed notes, to reflect on each day's events and to digest the information that you have received. Combining interviews with vacation is a pleasurable and practical way to arrange appointments away from home. Take care that your need for a vacation does not interfere with being on-stage for your interviews. If you are interviewing on vacation, you may wish to limit your interviews to the first few days and defer relaxation until the end. Invest in good carry-on luggage, so that lost luggage will not land you in the nightmare of facing an interview in whatever you traveled in. You must be on time for your interviews.

Attire

Carry a brief case, pens (working and not chewed up), a pad of paper, extra C.V.s, and your checklist. Be Professional. For both men and women, interview clothing should be a tailored, professional looking suit and shirt or blouse, or classic (not faddish) blazer with pants or skirt. Avoid overwhelming colognes and perfumes. You must be neatly groomed. Do not chew gum. Guidelines for men: stick with solid, dark-colored socks and tie, a dark leather belt and shoes. Limit jewelry; strongly consider avoiding wearing earrings. Guidelines for women: minimum conservative jewelry and conservative cosmetics. Avoid very high heels and outlandish nails. Avoid having your skirt length one which draws attention.

The Appointment

A few weeks before your scheduled interview, call the residency secretary/coordinator to confirm your interview. Ask for any updated information, such as a new edition of their brochure. Inquire about the schedule of events on the interview day and the names and titles of the people with whom you will be interviewing. Be sure to obtain and write down the correct pronunciation of their names. Ask whether or not you will have free time during the day to walk around and to talk with residents. If not, block some time to do this. Be sure to account for travel time. Also, be sure to get exact directions to the institution and to the department. You do not want to get lost in a maze of hospital hallways on the way to your interview. Go over your checklist the day before your interview. Make a list of questions to ask each individual.

"Psyching up" and Interviewing

Mental preparation is the key to a successful interview. Your attitude should be confident and forthright, but not cocky or arrogant In the back of your mind, you should believe that you are the best qualified person for this position, but recognize that you must present yourself before the appropriate decision-makers who will then be able to see that you are indeed the person for the job.

There are a number of clues to your manner and interpersonal skills of which you may be completely unconscious, but for which interviewers look. Maintain eye contact. Interviewers will be concerned about anyone who cannot or will not do so. Your voice is an indication of solidity and confidence; hold a strong and unwavering tone. Don't make your answers too long (easy to do when responding to the question "how did you come to choose X as your specialty?), but don't answer in only one or two words. Body language can communicate confidence, arrogance, disinterest, nervousness, or whatever else you are feeling. Be conscious of the signals you are sending. Once the interview has begun, resist any temptation to look at your watch. The interviewer may perceive this as an indication that you are bored or disinterested.

A certain amount of anxiety is normal. Your attitude should reflect recognition of the importance of this day, but not project stark terror. Although most programs will do the traditional one-on-one interview, some will conduct other types. An increasing number of programs are using panels to interview applicants. You may find yourself seated alone with three or more individuals firing questions (panel interview). You may find yourself one of three or four applicants meeting together with one or more interviewers (group interview). In each case, the format will provide the interviewers with information about how you carry yourself and how you communicate as a part of a group. The "never-says-anything" applicant and the "dominates-the-group" applicant will not fare well in a group interview. The interview should end on a strong note. Don't run out of the room. Initial interviews will generally last around thirty minutes. Be sure to thank your interviewer and give a firm handshake and a smile (with eye contact).

The purpose of the interview is to provide the opportunity for the interviewer and interviewee to meet and gain knowledge and understanding that cannot be gleaned from academic credentials or program brochures. As a result of the competitiveness of some specialties, however, some programs use the exchange between interviewer and applicant to address more definitive factors. An applicant might be asked a double-edged question, which will be followed by one sort of question if answered "yes," or a different question if answered "no." These interviews may feel somewhat intimidating. Some programs in "competitive" specialties will ask questions about patient management problems and/or ethical dilemmas. If you have engaged in research, do your homework about your project. Expect to be asked about your hypothesis, choice and rational for methodology, data analysis, etc. Some interviewers might even ask somewhat outlandish questions just to observe your reaction. Although the latter is uncommon, you should be aware that you might be faced with a situation that requires considerable diplomacy and certainly more than just a straight answer. Some interviewers will ask those questions which you know they should not be asking at all - such as those about an applicant's plans for family, etc. A word of caution - the interviewee is in a tough spot in regard to the amount of information they wish to reveal about sensitive issues. This extends even to the point of interview illegality with such topics as pregnancy, family planning, sexual preference, race and religion. Flatly refusing to answer an "unacceptable" question or answering forthrightly may both lead to problems. However you choose to answer, avoid showing hostility or anger about the dilemma.

There is an abundance of questions that you might be asked in an interview. Although you cannot prepare answers to all possible questions; you should prepare answers to a number of standard questions. Rehearse mentally or with a friend or faculty member. Prepare and think through a broader list of questions, and have a sound understanding of other topics which you might be asked to discuss. The key to answering questions well is preparation. Go over all of the information provided by the program (brochures, etc.) so that when you are asked a question pertaining to that specific program, it will not be the first time that this knowledge has crossed your mind. Read through your checklist, refreshing your knowledge of the program and helping you determine what information you will need to seek out on the day of your visit. Organize your thoughts. The more clearly you present your ideas, the more easily the interviewer can comprehend and recall the content and quality of your answers.

You should have a thorough knowledge of your own academic history and be prepared to answer any questions. If you have any inconsistency in your record, your interviewer will probably ask you about it. This is an opportunity to allow the interviewer to see how normal you are and that you are capable of coping with problems. Avoid being defensive. Take responsibility for your own performance.

Some questions to think about are listed below:

• What will you do if you don't match?


• Why have you chosen this specialty? (Take care not to go on with this one until the interviewer begins to lose touch with what you are saying.)


• Why have you chosen this program to look at?


• Was there a particular event or person which influenced you to pursue this specialty?


• Describe your personal interests, outside activities.


• What is the last book you read for enjoyment?


• What do you do for fun?

Be able to talk about:

• What about you makes you a good match for this program/specialty.


• Any discrepancy in your record, i.e. a class that you failed, time that you took off, a rotation in which you did poorly. (Take responsibility for your own performance.)


• Current medical events in the specialty.


• The changing health care environment and this particular medical discipline.


• Current politics. (Be careful!)

When answering questions, be concise and enthusiastic. Watch the interviewer's body language for feedback. Listen carefully to the whole question that is asked. Often, in an interview situation, we are so anxious to please that we presume the direction of a question and answer without listening to the end. If you completely miss the question, do not take a shot in the dark, ask the interviewer to repeat it.

Avoid dominating the interview. You may ask your questions, but avoid seeming to interview the interviewer. You may encounter an interviewer who seems to expect you to lead the interview. If this happens, start off by giving information about why you feel that this specialty and, in particular, this program is appeals you, and in turn, why you are well qualified for it. Ask questions about specifics of the program. Try to read the interviewer's reactions in order to give you some direction.

Questions to ask

Here is where good homework pays off. After researching the program by reading the information packet, comparing it with the other programs available, and finding out about what is going on in the institution, you now have the opportunity to meet with a representative, usually someone integral to the program, the ultimate source of information.

Questions for the Program Director - Your focus here should be upon educational questions. Let the interviewer lead, but get the information you need.

• Are there any changes or new developments for the program anticipated in the near future?


• If appropriate for the specialty, what subspecialty/fellowship training programs are available?


• What are the other residency programs at the institution? How does your specialty fit into this?


• How many full-time teaching staff? How much of the day are they in the hospital? How stable is the group of teaching faculty over time?


• What medical schools are the residents from? Where do they go after completing the program? What are the statistics on passing their specialty boards? Do they subspecialize?


• Who are the attendings? Where did they train? (Do your homework. This may be in the informational material you have.)


• What percentage of residents do not make it to the end of the program? Is the program pyramidal?


• Will you have any research responsibilities or opportunities should you wish them?


• What is the extent of your responsibility for teaching medical students? Do residents receive preparation for these responsibilities?

Questions for Housestaff Coordinator - Use your checklist to figure out what information you are lacking. This individual is often a non-physician staff member who has a close working relationship with the program director.

Questions for Housestaff - Here you can be somewhat more relaxed and direct. Ask for somewhat specific information and "read" the responses. Don't criticize the program or dwell on lifestyle issues. The housestaff could view you as a potential detriment to the team. The bottom line - are they happy with the program and why? If not, how would they like to see it change so that they would find it better met their hopes/needs.

The Follow-up

One to two weeks after your interview, send a thank you letter to the program director. You may wish to reiterate your interest in the program. If your interview was early in the season, it is advisable to recontact the program either by phone or by another letter to express your continued interest later in the interview season.

Review your notes. You will most likely remember the aspects of the program that dazzled you and the points that you thoroughly disliked; but it is a good idea to go over all of the information that you noted to keep an accurate and ongoing perspective. Remember that you will have to rank all of the programs in which you are interested, and the nuances and small details will shade your final decision.

If you feel that you still need to know more about the program or about the institution, schedule a follow-up visit with the housestaff. Ask to tour with them, round with them, and even take call with them. If you are seriously interested in a particular program, this can be your opportunity to see it run from the inside.

Appendix A: (Please modify / adapt a form like this to your unique needs.)

Residency Program Evaluation Check List

Program Address

Program Director

House staff Coordinator

Secretary Phone

Community and Personal Factor to Consider	1	2	3	4	5
Type of institution (academic, private, academic affiliation, etc.)
Type of community in which located (urban, rural, suburban, etc.)
Cost of living/ housing in the community
Safety, crime rate in the community
Religious/ cultural needs and opportunities
Proximity to family
Availability of work for partner/ spouse
Quality of Schools, public and private
Availability and quality of day care
Insurance costs for cars, housing
Job details and benefits:
Salary
Health Insurance
Dental Insurance
Life and Disability Insurance
On-call facilities
Vacation
Family/ maternity/ paternity leave
Parking
Student loan forgiveness

Service/ Educational factors	1	2	3	4	5
Economic status of the hospital/ academic medical center
Number of residents on the various services
Supervision of resident inpatient work
Frequency of on-calls
Number of patients managed per resident
Means for patient coverage
Number of patients covered when on-call
Amount of ambulatory training
Supervision of ambulatory care
Means for inpatient coverage for residents in ambulatory setting
Number of medical students on the various services
Resident responsibilities for medical students
Length and location of the various rotations
Amount and timing of electives
Affiliations with medical school(s)
Affiliations with other hospitals
Number of inpatient beds
Percentage of filled beds
Average length of stay of inpatients
Annual admissions
Annual outpatient visits
Number of procedures, as relevant to specialty
Number of residents, as relevant to work load
Patient mix and ethnic/cultural balance
Physician support services (IV team, etc.)
Laboratory services
Radiology services
Social services