Thursday, October 3, 2013

Rules of the Road: Ch 7 Summary: "The Residency Application Process - Visits and Interviews"

Originally Published: AAEM's Rules of the Road for Medical Students, First Ed. Chief Editors: A. Antoine Kazzi, MD FAAEM MAAEM; Joel M. Schofer, MD RDMS FAAEM
Chapter Summary by: Kari Gorder, Medical Student Council, Regional Representatives - Northeast

Choosing a residency program is one of the most significant decisions a medical student will make. While the match experience can induce a considerable amount of anxiety, it is also an exciting and memorable time. With the right amount of research and preparation, applicants can navigate the process with skill and success—and hopefully the least amount of stress possible! This chapter briefly outlines the steps of interviewing for an EM residency.

Mock Interview
Practice makes (almost) perfect, so it’s a good idea to hone your interviewing skills before you set out on the application trail. Ideally, this should be with your EM advisor or another physician who knows you well and is also familiar with the interview process. Your mock interviewer should be prepared to ask challenging questions, to provide constructive criticism and also to help you work through some first interview jitters. Treat this like a real interview — research the program, develop answers to probable questions, and dress professionally!

Scheduling Interviews
Like most specialties, EM uses the Electronic Residency Application Service (ERAS), which opens mid-September. While programs know that some components of your application will come in later, it is in your best interest to have your application as complete as possible when ERAS opens. Ask for letters of recommendation early on and aim to have at least one EM rotation complete prior to submitting your application.

As you begin receiving invitations for interviews, you will face the task of scheduling your visits. Most applicants will interview at their home institution first. Even if you don’t plan on staying in the area for residency, it is both polite and good practice to interview at your medical school’s affiliated residency. Despite some talk of scheduling strategy, there is no proven correlation between interview date and position on the rank list,[1] so plan your subsequent interviews as they best work for your schedule.

You do not need to accept every interview offer, and there is no maximum or minimum number of programs at which you must interview. While a commonly cited figure is 10-15 programs,[2] you should make this decision with your EM mentor, taking into account your application’s strengths and weaknesses. If you are fortunate enough to receive more offers than you intend on accepting, you should give the program the courtesy of early notification. Two weeks’ notice is generally acceptable. Do not cancel at the last minute—or worse, fail to show up for a scheduled interview! The world of EM is small, and it may hurt your chances at another program.

Before the Interview
Once you have scheduled your interview with a program, you should arrange the logistics. You are responsible for arranging travel, lodging and transportation, so make sure you give yourself extra travel time and plan for contingencies. Before the interview, familiarize yourself with the details of the residency so that you are able to ask informed, thoughtful questions about the program. You may also want to take the time to research the publications and areas of interest of key faculty who may be interviewing you.

Interview Day
When interview day comes, keep in mind that you are being evaluated—but you are also evaluating the residency. Be nice to everyone you meet, but also be genuine; this is your opportunity to see if this program is a good fit for you. The dress code for interviewing is professional business attire.  Many applicants choose to bring a professional binder in which they can take notes, hold papers, and carry copies of their CV and personal statement. Throughout the day, you will likely spend time with current residents; remember that they likely have a say in the rank list as well, so continue to be professional and polite. Finally, take down names of those individuals to whom you would like to send thank-you notes after the interview.

It goes without saying that the interviews themselves are very important in determining your position on a program’s rank list. The interview may be structured or more conversational, and questions can touch on a wide range of ethical, clinical, social or personal topics. While the program director has likely read your file, other interviewers may not be as familiar with your application. If there is something you would like your interviewer to know about you, you should guide the discussion to those aspects of your application. Be prepared to answer questions about anything and everything you put into ERAS—nothing is off limits. However, certain legalities apply: you cannot be asked about your marital status, criminal records, or family plans, and you cannot be asked questions about potentially discriminatory categories, such as age, religion, sexual preference or political affiliation. Finally, come prepared with questions to ask your interviewer about the program. Not only do you want to seem interested, but this is your opportunity to learn more about a residency and gauge how well you would fit into the program.

Common pitfalls in the interview process include: inadequate preparation (e.g. not knowing the basics about a program, arriving late); giving inconsistent or evasive answers during the interview; demonstrating poor interpersonal skills (e.g. poor eye contact, texting during lectures); and demonstrating “red flags,” such as appearing bored, criticizing other programs, disparaging your home institution, or acting over-confident.

After the Interview
It is common to send a thank you note or email to the residency director and/or faculty who interviewed you. Also remember that, in general, faculty and residents are very open to answering questions, so feel free to email them after the interview as you create your rank list.

The interview is an extremely important part of the application process. A positive and memorable interview can be the key deciding factor in determining your position on a residency’s rank list, and can supersede grades, board scores and even letters of recommendation in importance![3] By doing your research, staying organized and being prepared, you can approach interview season with the least amount of stress possible and the greatest likelihood for success!

[1] Martin-Lee L, Park H, Overton DT, et al. Does interview date affect match list position in the emergency medicine national residency matching program match? Acad Emerg Med. 2000; 7(9): 1022-6.
[2] National Resident Matching Program. Charting Outcomes in the Match: Characteristics of Applicants Who Matched to Their Preferred Specialties, 4th edition. 2011, pp. 57-69. Available online at:
[3] National Resident Matching Program. Results of the 2012 NRMP Program Director Survey, August 2011; pp. 34- 41. Available online at:

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