What Are Great Tips For Surgical Residency Interviews?

Stephen W. Leslie MD FACS; Associate Professor of Urology, Creighton University.

Once you are invited for an interview, you have passed the first and most important screening test.  It means your scores and written credentials are acceptable and you are one of the chosen few to be given a precious interview.  Now you have to master the interview.  This is the make or break event in the residency selection process so it is worth getting prepared for. First, some general recommendations.

Only accept interviews to programs you might actually consider going to and for which you have a reasonable possibility of gaining acceptance. Experience has shown that you have the best chance of acceptance to programs that are relatively close to home or at least in the same part of the country.

The Association of American Medical Colleges has a really nice section on their website. On the basis of your STEP scores, they predict how many programs you should reasonably apply to.

General Interviewing Tips

Understand that you are being interviewed to assess your personality, work ethic, character, and how well you will get along with both faculty and your fellow residents.  Final decisions on top candidates often depend more on your personality during the interview than on your STEP scores, letters of recommendation, or anything else.

• Make sure you are on time and dress appropriately. 
• Be absolutely honest.  Nothing is easier for an interviewer to spot than a falsehood and that will definitely hurt your chances.
• Ask a few personal questions of each faculty interviewer such as what brought you here, what would you like to see changed or improved, do you have a research project in mind we might be able to work on together, etc. It shows personal interest and some enthusiasm for the program. Try to make some kind of emotional contact with at least one faculty member who can go to bat for you during ranking deliberations.
• Show some enthusiasm for the program and city. Find something nice to say about your trip, the program and the interviews.  If really interested in the program, make sure you send real, handwritten “thank you” notes and not just a quick email.
• Don’t be negative about anyone or anything.  It just doesn’t go well with a successful interview. 
• Always be polite and respectful of everyone you meet.

Be prepared for some tough questions such as the following:

Sample Surgery Residency Selection Questions You May Be Asked:

These are some of the questions I personally ask medical students applying for our highly selective and competitive surgical residency. They are much tougher than the average questions you will probably be asked but you should be prepared just in case. Do not rehearse your answers too much or they will sound fake and insincere.

• What are you looking for in an ideal surgical training program?
• How well to you think Our Institution fulfills this ideal?
• What made you decide to apply to Our Institution when there are so many other choices?
• What do you see as the advantages of Our Institution compared to a larger/smaller training program?
• What convinced you that Surgery was your future?
• What will you do if you didn’t get into a surgical residency program?  Any other field of medicine attract you?
• Where else have you looked and what do you see as the strengths/weaknesses of these other programs?
• Describe your interest level in research.
• You have done or been involved in some research or done lectures on a surgical topic.  Tell me about the conclusions of this study and your role in it or about the lecture you gave.
• Are you considering a Surgical speciality, subspecialty or Fellowship as your ultimate goal?
• Where do you think you might ultimately want to practice? 
• Academic or Private Practice?
• How will you improve your exam scores since In-service exams and Boards are becoming increasingly difficult? (Try to give some concrete examples rather than just a generic “study harder”.  Possible acceptable answers might be to “devote at least 1 hour a day to study or reading plus review StatPearls questions daily for at least another 30 minutes, etc.)
• How are your knots and basic surgical skills?  You should be able to reliably tie a one-handed and a two-handed knot with your eyes closed to be considered “good” or at least “adequate” at knot-tying.  If you are not at this level yet, it’s best to just say so but indicate that you will be competent by day 1 of your residency!  In my residency program, you do not get to do a surgical case unless you can do your knots.  Practice your knots until you can meet the above standard!
• You will not be asked any medical questions on the interview.  It’s considered “bad form”, but you should still be ready day one to do a simple surgery such as a hernia, wound repair or appendix. Practice as much as you can and read about these simple procedures so you know the anatomy and the technique.
• What do you see as your personal weaknesses and how are you addressing them?
• What has been the greatest adversity you’ve ever faced?  How did you handle/overcome it?
• Tell me about your most interesting Surgical case so far.
• What do you feel you could personally add to our program? 
• What qualities, attributes or experiences distinguishes you from all our other excellent applicants for this position? In other words, why should we pick you? (If you are asked this question, you really need to hit it out of the park!  “A personal commitment to exceed expectations” is one good answer, but only say it if you mean it. Try to come up with something more original, if possible)
• Any questions for me?

Questions to Ask Your Faculty Interviewers

It’s perfectly OK to ask your faculty interviewers a question or two.  It shows interest and enthusiasm for the program, but don’t overdo it.

• What are the greatest strengths of your program? (weaknesses may be volunteered by the interviewer when you inquire about the program’s strengths, but ask specifically about weaknesses if it’s not volunteered.)
• How were these strengths developed?
• What is being done to address any weaknesses?
• What is the typical OR experience for residents? Clinic experience?
• Research experience – Is it required? How are research projects selected?
• Where does the research funding come from? 
• What major changes do you see in the program in the foreseeable future?
• What changes, if any, have occurred recently?
• Any people retiring (e.g. department chair) or likely to leave (e.g. junior faculty) in the near future?
• Where do most of your graduates end up? Community private practice, fellowships, academia, etc. 
• What practice opportunities are available in the local area?
• In surgical programs, ask about Laparoscopic and Robotic experience as well as trauma and transplant surgeries as well as adequate open surgical training? For example, in a Urology program, ask about how many TURPs and major Robotic procedures are typically done during training.
• Is the training in Pediatric surgery adequate?
• How many affiliated hospitals are associated with the program?  Are any out of town?  Is a VA hospital part of the training program? (VA hospital training is very important because residents operate more independently than in most university academic medical centers.) 
• Is there a formal resident education syllabus?
• Are faculty reimbursed for teaching time or is it resented as it takes time away from more remunerative activities?
• How do the residents from this program fare in terms of case numbers, in-service exams and Urology Board passage rate?  Any graduates not pass their Boards on the first try? 
• What is the clinic experience like? Is there enough of it?
• Do residents typically or frequently present at regional or national meetings?
• Can they provide you with a list of recent graduates?
• What is the current accreditation status of the program and has it ever been placed on probation, watch or contingency status by the ACGME or appropriate Board?
• Is the program a separate Department or is it a Division of the Department of Surgery or Medicine? (A separate Department is usually better as it means they have control of their own finances. For example, a bad Surgery Department Chairman can cripple a previously good Urology program.)
• Is the program likely to change in any appreciable way during your tenure?
• How much time does the faculty spend in resident teaching?  What percentage of the time does the residency program director devote to teaching?  Is most of the urology teaching done by faculty or more senior residents? 
• Have any residents who started the Urology program failed to complete their training?  If so, how many and for what reasons?  (If at all possible, be sure to contact these people for their perspective.)
• Are there faculty sub-specialists in all appropriate areas? Are they Fellowship trained in that subspecialty?  Are there any substantial areas where there are no subspecialist faculty?
• Do any faculty have national prominence, leadership positions in national professional organizations or give national post-graduate conferences, courses or lectures?
• If you could change one thing about the program, what would it be?
• Be concerned if there is any particular faculty member or resident who you are not able to meet or at least talk to.  This person might turn out to be your next chief resident or primary faculty member!
• What are the primary attributes of your ideal resident candidate?
• What made you decide to come to this institution as faculty and are you planning to stay during my proposed residency time?
• What do your think are the strengths and weaknesses of other Surgery residency programs in the area? What do you think about Program X (any program you may be seriously considering. This is a great way to find out about other programs.)
• Are there any current Surgery faculty who were residents here first? (If so, usually a good sign.)

Questions for Current Residents

• Why did you decide to come to this program? 
• Would you come here again if you were doing it over or would you choose another program?
• What other programs were you considering when you were applying?
• Is there anyone in particular I should talk to about the program who isn’t on my interview list?
• Strengths of this program?
• Weaknesses of this program?
• Faculty contact and teaching time? 
• Quality of the faculty and teaching?
• Floor responsibilities?
• Typical daily census?
• How's the ancillary staff?
• How are you treated by Faculty?
• Is there a dedicated OR surgical team for your speciality?
• OR experience - i.e. how much of the case do the residents actually get to do?
• Are cases distributed equally in all years or are all the most significant cases done by Seniors/Chiefs? Who decides which cases get which resident?
• How many major cases such as Robotic Prostatectomies, TURPs, Whipple’s, etc. have they personally done or do they expect to do by the time they are finished?  Enough Robotic, trauma, Pediatric and Laparoscopic cases?
• Time on General Surgery-how are they treated, how hard/interesting is it, are the rotations tailored to what the residents want, how is the quality of the training?

Chief Year: What are the Clinical and Administrative Responsibilities

• Research requirements and opportunities?
• Program's general emphasis and assistance on research?
• Clinic time, organization, and demographics?
• Number of hospitals, distribution of residents, travel time between hospitals?  Are any out of town?
• Academic vs. private practice emphasis?
• What did most recent graduates do?
• Computer system issues?
• Hours, call schedule, back up vs.1st call?
• Effect of 80-hour work week?
• Vacation?
• Social life: do the residents go out together much, are they mostly married/single? Do they meet together socially?
• Housing - where do the residents live?
• What's the scoop on the other programs in town?
• What other questions do you think I should ask?
• Overall, how would you rate this program and what would you change about it if you could?