The Interview Process

Carey Chisholm, M.D.
Indiana University School of Medicine
Methodist-Clarian EM Residency Director

How competitive am I?

  • Clinical grades, especially IM, Surgery and Pediatrics
  • AOA
  • EM rotation grade
  • USMLE scores (above 50th percentile)
  • Letters of Recommendation (Dean's letter most important) Balance reputation of writer with how well they know you
  • Commitment/exposure to EM Interest groups, professional societies (EMRA, ACEP, SAEM, AAEM), literature (Annals of Emergency Medicine and Academic Emergency Medicine), etc. Do you understand the specialty as practiced in a non-teaching environment? (Beware of selecting your specialty based upon a single rotation exposure in an academic environment.) Remember that 85 percent or more of the physicians in that specialty DO NOT have a similar day to day experience. Get OFF CAMPUS and find out how the specialty is REALLY practiced!!!
  • Pre-clinical grades (first 2 years)
  • Research/writing experiences
  • Extracurricular activities and interests
  • Life experiences prior to medical school

Is there any easy way around the "personal statements"?

One month writing period. Draft it, leave it, then return and repeat this process. Share with others for critique, including your faculty advisor. Avoid small font (use 12 point). Let us know who you are and why you would be a good resident/physician in your chosen specialty. What strengths will you bring to the residency? Why do you think that you are a good career match? One page, maximum. Avoid being bland or overly creative. Type, do not hand write! NO "SPELING" OR "GRAMER" ERRORS! ERAS does not have a spell check, although I believe that you can submit your disk using Word Perfect.

What about my CV?

ERAS has taken away the usual CV venue. However, you need to prepare a CV to present to any faculty who are writing letters of recommendation for you (I recommend that you prepare a packet containing your CV, personal statement, cover letter, USMLE score(s) and latest transcript.) Organize the information so that it is easy to find and flows logically. Provide as much detail as you feel comfortable. DO NOT pad your CV (or related sections of ERAS)!!! Many of us will inquire about specific activities that are listed (e.g. "describe your involvement with the homeless shelter" or "where do you go SCUBA diving"). Note proper terminology for stages of research publications (in preparation, submitted, in revision, in press). NEVER misrepresent data on your CV (ERAS)! You may be expected to present copies of publications at the time of your interview. I personally recommend that you include a section in your CV about personal interests. Yours may click with the program director's. The CV may be attached as an addendum to your personal statement or as one of your letters through ERAS (I prefer the addendum, but you should specifically inquire about this at every program unless ERAS adds a place for a CV.)

Who should write my letters of recommendation?

Balance how well the letter knows you with how well they are known to the EM residency directors' community. A stellar letter from a community family practice preceptor may carry less impact that a solid letter form an EM program director that I know and trust. My concerns about that community practitioner is that they may be comparing you to a different group (or with a different yardstick) than the EM applicant pool. Likewise, they may not understand attributes that make an excellent EM resident. They can provide information about your work ethic and interpersonal skills. Therefore, you need to have at least one letter from an EM program director. Most directors also want to see a letter from every EM program that you did a rotation with (the absence raises questions about how well you did). EM directors will use a SLOR (Standardized Letter of Recommendation) that can be found on the CORD home page.

When should I have my application ready?

All applications submitted to the Dean's office by the first week of October. This will allow the Dean's office some time in getting your information scanned into ERAS (remember that IM is being added this year, so many Dean's offices may be overwhelmed. Get a head start!). Dean's letters come out the first part of November -- some AOA caliber students will begin to receive invitations before then. Most invitations will come between 7 November and 21 November, with another 20 percent going into the second week of December. Try to batch interviews in order to make geographic circuits and take advantage of Saturday layovers if flying. Get your car serviced. Allow extra time for travel due to inclement weather. (That 5 hour drive could become an 8 hour "white knuckle special".) Some locations will provide a place to stay, while others can make recommendations. Staying with residents is a double-edged sword; the person may not be truly representative of the majority of the program's residents. Also, you may not "click" and this may harm your chances. Ideally, arrive in time to see some of the city, and observe in the ED. Review the materials the program has provided to you, and know this information well. Prepare a list of "standard" questions and areas that you wish to investigate at every program, along with specific questions for that program. Write down answers as you go through the day. Your faculty advisor and current EM residents can be helpful in identifying key areas to investigate. Arrive for your interview ON TIME! As soon as possible after you leave that site, write down (or better yet, dictate into a tape recorder while you're driving) your overall impression and other items to investigate. Also be certain to get the names (spelling and title) of the folks that you spent time with (business card from faculty -- some programs provide you with a list). Be sure to interact with some residents (beware of the program that hides them away). I advocate sending a follow-up thank-you note about 1-2 weeks after the interview, although some programs may not wish to receive them (the secretary is a good resource to find out their preferences).

What is the best time to interview?

There's no consensus on this issue. Unlike what is advocated in Iserson's book, many of us feel that the last week of interview season is a bad choice -- the program directors are tired, you are tired, and spontaneity is lost. There is also no bad weather buffer. There is a "learning curve" over 2 to 3 interviews, so perhaps target your "front-runner" programs after you complete several. I particularly enjoy the time in December before the holiday season -- and likewise would avoid the week after New Years.

At how many programs should I interview?

This depends on how good of a student you are, and how much exposure you've had to EM. I would advocate a minimum of 6 and a maximum of 15 to 20. See enough programs to be certain that you are an informed consumer. Time and money are issues, although securing the best fit program is critical, and the extra spent now will be water under the bridge 10 years from now. Don't skimp!

What are the "deadly sins" of interviewing?

  • Don't be a "NO-SHOW"! Most programs have waiting lists, and several people review your file before you arrive. Please do not waste their time, and likewise be courteous to your peers on the waiting list (and perhaps eliminate a competitor from the applicant pool!). Call ahead as soon as you decide you will not be going to an interview. You won't hurt our feelings. A "same-day" cancellation is almost as bad, unless of course there has been a personal emergency or travel problem. However, EM is a small community and if you are a no-show at a program there is a good chance that word of this will spread around -- and could affect your ranking. Do not underestimate how damaging this can be!
  • Don't be late or fall asleep during the process.
  • Don't over or under dress.
  • Don't be artificial. Be yourself!
  • Don't dominate the interview -- let the interviewer set the tone and pace.

How should I handle inappropriate questions?

These may be encountered, and your response should be tailored to the situation. We try to find out as much as we can about you as a person, but for some this may feel like prying. If you are uncomfortable answering a question, say so. One technique is to turn the question back on the person, or say something like "I'm curious why that information would be of interest to you?" Also keep in mind who is asking the question. If a faculty member or resident is asking, it usually is out of ignorance of the "rules" or simply genuine curiosity (an extension of our "history taking" skills). Few of these questions represent true malice, although I would have serious concerns if they are coming from a program director or chair.

What should I do if I REALLY like a program?

I strongly recommend a follow-up visit if feasible. Three or four years of your life are on the line, so make certain that those favorable first impressions hold. Get a better idea about the city. I also recommend a follow-up letter to the 3 or 4 programs that you like the most. Don't tell someone that you are ranking them first unless you really are (again we compare notes). Ask the program how you would know if they are really interested in you as this is very variable and ranges from frequent contacts by the program director to no further contact. The only "illegal" activity would be for a program to promise you a position, or to request that you drop out of the match and they will guarantee you a position.


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