Few components of the residency application process are as unnerving as the formal interview. Medical students crisscross the country, travelling to as many as 30 program locations to vie for positions. Along with site visits and social activities, applicants are expected to showcase their expertise and interpersonal skills in face-to-face interviews with program directors, house staff, and current residents.
Applicants feel the pressure most acutely, but interviewers also struggle with how to vet potential residents within a short exchange that typically lasts one hour. A recent AAMC survey of program directors revealed that although many consider the formal interview to be the most important tool to rank applicants, how it is used varies significantly across programs and specialties. The survey also found that while interviewees have numerous resources to help them prepare, hardly any guides exist for interviewers.
To help close this gap, the AAMC published Best Practices for Conducting Residency Program Interviews to guide faculty and program directors through the interview process. Part of the AAMC’s Optimizing Graduate Medical Education initiative, the report, published in September 2016, aims to foster greater consistency.
“Having structure in the interview process improves the quality of the interview.”
Dana Dunleavy, PhD
Association of American Medical Colleges
“A guide like this is helpful in that it provides useful parameters for people who want to enhance their ability to use the interview to select the most appropriate candidate for their program,” said Michael Kavan, PhD, associate dean for student affairs at Creighton University School of Medicine. “The guide not only better prepares interviewers, but it also provides practical information on how to improve the reliability and validity of the types of questions that you are asking the applicant.”
The guide includes an overview of the interview structure and the latest research on other factors such as rating scales, and types of questions that might be effective.
Tony Ogburn, MD, professor and chair of the obstetrics and gynecology residency program at the University of Texas Rio Grande Valley (UTRGV) School of Medicine said the resource is a good tool for people who don’t have a lot of experience with or knowledge about interviewing.
“We know that the people we are interviewing have good board scores and that they are going to graduate from medical school with some basic criteria, so we really want to approach the interview as a way to find out who will be invested in our program’s goals,” Ogburn said.
Noting that programs often have turnover, Kavan said that the guide will help bring new faculty up to speed on interviewing best practices, which “benefits both programs and students by assuring the best fit.”
Mitigating bias
Karen Friedman, MD, vice chair for education at Hofstra Northwell School of Medicine introduced Best Practices for Conducting Residency Program Interviews during a workshop she led for faculty interviewers. She believes that tools such as the AAMC’s guide, along with more standardization of the selection process, may reduce bias.
“I think people make assumptions when a candidate walks into the room and that can inadvertently influence scoring. The only way to mitigate that is for people to start talking about the [selection] process.”
Ogburn agreed that some interviewers may be swayed by whether or not they “like” the applicant as opposed to how well the applicant actually fits into the program’s culture or mission. Interviewers at UTRGV are using the AAMC resource for process improvement. “We are going to go through the dos and don’ts, best practices, how questions should be framed, and what we are trying to accomplish through the interview.”
With so much at stake for all involved—years of education and the goals of each program—Ogburn said it’s imperative that both interviewee and interviewer learn as much as they can from the interaction.
According to Marcy Verduin, MD, associate dean for students at University of Central Florida College of Medicine, the situational and behavioral questions described in the guide give a fuller picture of who the applicant is. “When some of my students who might be a little more introverted or shy are asked an open-ended question, like ‘tell me about yourself,’ it may be hard for them to figure out where to start. Situational or behavioral questions give the applicant a chance to go back to their own experiences—they are less worried about giving the ‘right’ answer.”
Dana Dunleavy, PhD, director of the AAMC’s admissions and selection research and development program, emphasized that the guide is only one tool to enhance the residency selection process. She explained that even if program directors and faculty aren’t using the resource yet, “having the idea out there that doing holistic review and conducting process improvements along the way is important in any selection process.”
“Having structure in the interview process improves the quality of the interview” Dunleavy added. “Programs get better information about applicants, the process is fairer, and both applicants and program directors have more positive reactions to the interview process as a whole.”