Difficult Interview Questions: Learning To Hit A Curveball Out Of The Park

By Michelle Finkel, MD with CrispyDoc

You put your heart and soul into your compelling, charismatic personal statement; you showcased your accomplishments and drive to succeed in your activities section; and you demonstrated the endorsement of respected faculty allies in your letters of recommendation. Now your hard work has paid off and helped you get a foot in the door: You’ve been invited to interview at your dream medical school or residency program.

Like the ghost stories we told around a campfire as children, interview horror stories have a certain inexplicable staying power. I can still recall a friend’s recounting of an acquaintance’s experience in an Ivy League faculty member’s office: The acquaintance was asked to open the window, only to find (after sweating bullets for several minutes) that it was nailed shut. This trick was allegedly this professor’s cruel attempt to assess how the interviewee coped with adversity. Some weeks later, I recounted the tale to a mentor, who told me that the same story had made the rounds 20 years earlier. The power of this terrible tale faded once I recognized it for the myth it was. This ability to demystify the medical school or residency interview is crucial to framing it as an opportunity for showcasing your strengths.

An equally important key to preparing for the interview is realizing that a) interviewing is a skill and b) practice improves performance. Every year too many medical school and residency candidates expend tremendous energy assembling fantastic applications, only to undermine their chances by approaching the interview with twisted laws of entropy and enthalpy: They prepare for it with maximum randomness and minimum energy.
Once you’ve done adequate groundwork, the interview represents your opportunity to distinguish yourself and impress your interviewers as the type of candidate they’d love to have at their institution.

That’s not to say every interview will be full of hugs and puppy kisses. Like the myth of the interviewer whose window was nailed shut, there may be uncomfortable moments and even illegal questions. With a bit of preparation, you can learn to hit these curveball questions out of the park.

Let’s explore a few examples that have come up in the not-so-distant past.

Rehearse Your Elevator Pitch
While most interviewers take the time to read your application materials in advance, don’t be offended by the faculty member who did not prepare, is blankly flipping through your application right there in front of you, and who asks open-ended questions, such as “Tell me about yourself” to be brought up to speed. View it this way: These faculty members are offering you the opportunity to define how you’d like to be remembered.

Your goal should be twofold: 1) to persuade them how much you’d add to their institution and 2) to make their job easier by giving them the bullet points they’ll need to persuade their peers about your candidacy’s worthiness. When your interviewer sits around a table advocating on your behalf, steer her to use terms that will be germane to your candidacy. Are you the, “global health advocate who volunteered with Mother Teresa and ran his school’s homeless food program?” Or perhaps you are the “first generation college graduate who held premier leadership positions in medical school?” Help your interviewer help you.

Explain Inconsistencies in Your Application
You took a year off after college and moved to Barcelona to pursue an exciting romantic relationship, only to find yourself dumped two months later. You moped the rest of the year and had neither research nor volunteer experiences to show for your time off. Your interviewer asks what you did during the gap year.

A prepared candidate can see this interview question as an opportunity to turn a skeptic into an ally. Responding with a calm demeanor – without making excuses or delving into the intricacies of your personal life – will make you look professional. This is a great time to explain that, although you graduated college with a minimum of life experiences, your year off helped you consider alternative professional paths and strengthened your resolve to enter medicine. Consequently, you will pursue your medical career with greater maturity and commitment and a broader perspective than those who went straight through.

Skillfully Manage Illegal Questions

There are clear boundaries set by the law as to what should not be asked of a candidate during the interview. Despite explicit guidelines, rarely, interviewers will ask questions they should not. Although the practice is extremely unfair, resist the temptation during the interview to identify the question as illegal; the interviewer, for better or worse, has significant influence over whether you will be offered a position.

It seems that female applicants are more often forced to navigate loaded questions, such as, “Do you have a boyfriend?” An advisee told me that one of her surgical residency interviews started with the chairman’s saying, “I know I’m not supposed to ask you this, but do you plan to have children during residency?” Strategies for coping with these questions range from deflection to addressing what you perceive to be the interviewer’s underlying concern.

An example of deflection: “At this point in my career, my professional pursuits are my highest priority.”

An example of addressing the underlying concern: “I think what you’re asking is whether my personal life is likely to interfere with my medical training. Let me assure you that I am 100% committed to not just completing, but also excelling, in my medical education.”

Legal but awkward, some interviewers may allude to the fact that geographic relocation has historically served as a barrier in attracting applicants from a desirable location. Hence, the West Coast surfer who applies to Midwest residencies has to prove her willingness to relocate. Prepare in advance for the biased interviewer who asks, “Californian applicants tend to rank our institution below West Coast schools. Why should we offer one of our limited spots to you?”

A sample reply might be, “I am committed to pursuing the best opportunity for professional training. I can assure you that my medical education is my top priority, and I don’t intend to let other interests undermine my pursuit of a superior education.”

Additionally, it might be wise to do your homework in advance and cite a couple of faculty research interests that overlap with your own, if applicable. Your response will be more credible if you demonstrate that you’ve looked at the research coming out of institution X, and your interests align.

Check Yourself Before You Wreck Yourself
Before you travel to your interview, practice summarizing the capsule message of who you are and what you bring to the table as an applicant. If you are not naturally comfortable speaking about your accomplishments or guiding an open-ended conversation, now is the chance to get expert feedback on your interview skills.

When you go through mock interviews, accept critiques about shortcomings, so that you can fix them. Do your answers come across as inconsistent? Might the candid personality your friends cherish come across as abrasive to an interviewer? Do your answers about weak spots in your application appear defensive? Do you seem less dynamic as an interviewee than your family knows you to be? These are uncomfortable issues to face, however, given the opportunity to improve your interview skills before the stakes are high, there is a clear benefit to soliciting expert feedback in advance.

In the end, difficult interview questions are less intimidating if you both prepare well and have an attitude that they are an opportunity to clarify and further your candidacy. No one likes to be put on the spot, but having a definite plan of how you’ll handle the aggressive (or even toxic) interviewer will calm your nerves when he asks you to open that impenetrable window.

About the Author

Dr. Finkel, formerly an Assistant Residency Director and faculty member at Harvard Medical School, founded Insider Medical Admissions to level the admissions playing field by offering advising services for residency, medical school, fellowship, post-baccalaureate, and dental schools applicants. Check out Dr. Finkel’s under-one-minute, stop motion Guru on the Go© videos on her Youtube site and join her on Facebook and Twitter.
CrispyDoc is a graduate of Stanford, UCSF, and the UCLA-Olive View Emergency Medicine residency. He completed his MPH and International Emergency Medicine Fellowship at Harvard.