Nothing engenders as much stress as The Interview. You're jetlagged, exhausted, running around in a strange city, and you have to charm a string of strangers while you jostle your way through a crowd of competitors.
Yet nothing is as important as the interview in pushing your candidacy to the top of the rank list or to the bottom of the pile.
I. Getting the offer
As soon as you get an interview offer, every one of your actions should send the message that you are a polished, professional candidate who would be a hardworking resident with no attitude, and who would give back to the field in the future.
And that starts with your acceptance and yes, even your rejection of an interview offer.
When you accept your interview offer, you will be interacting with the program administration, whether it be the coordinator or the administrative assistant. These people are vital to the smooth running of the residency program, and therefore are generally well-liked and held in high esteem by the faculty and residents. Do not be rude to them, and do not lie to them. This sounds like a no-brainer, but it is shocking how many candidates are actually rude to residency administrators. The fact is that we all talk: Residents talk to the PD, the PD talks to administrators, and the administrators talk to the residents, in one big circle. Assume that anything you say to one will be repeated ad nauseum--especially if it exposes you as a card.
"Lying?" you think. "Why would I lie in accepting or rejecting an interview offer?" Again, the ordinary person would be shocked at what applicants think they can get away with. You say your flight was delayed and the traffic was horrendous, and that's why you are late, or why you simply couldn't make your interview. Was your flight *really* delayed? Was the traffic *really* that bad? You may lie, but Google never does. And yes, administrators have been known to check out your veracity on weather.com. We residents hear these stories, and all we can do is hit ourselves upside the head.
If you don't want to interview, turn down the offer with plenty of advance warning. If you accept, and you later are dying to get out of the commitment, contact the administrator and simply say, "I'm sorry, but I won't be able to make the interview." Period. And DO affirmatively contact them. A no-show is remembered, and just provides us more tidbits to gossip about you behind your back at the AAD.
II. The Interview Day
Residencies structure their interview days differently, but all have basically the same fundamental format. There is a preinterview social gathering the night before the interview. On The Big Day itself, candidates may be staggered into groups or shepherded through in a rotating herd for their interviews. You'll also get the obligatory tour, which I always thought was pointless, so make sure you're wearing comfortable Allen Edmonds or reasonable heels and appropriate outerwear.
A. The preinterview social gathering
Whether it be a cocktail hour merging into a fancy dinner, a stand-alone fancy dinner, or a pizza free-for-all, residencies usually host a social gathering before The Big Day. Sometimes faculty will attend, and sometimes they won't. At times there will be a more formal presentation about the program, covering the basics like the residency's strengths, and details about its three-year layout. Whatever the format, the preinterview social gathering is truly a sincere attempt to welcome applicants, acknowledging that they've slogged their way across country and at least deserve a nice stiff drink on the house.
While the preinterview event is sincerely meant to be a relaxed affair, you are interacting with the residents and possibly faculty, and therefore you need to be on your best behavior. This first Jungian impression you leave on them will be in many respects indelible, and will factor into whether they think they want to work with you. No matter how unfair you think it is, many an applicant has been judged on their ability to have a friendly, relaxed conversation without looking constipated. The impression you make will carry over into conversations between residents that evening, into the next day, and no matter how objective everyone tries to be, into the rank list.
So calibrate how you come across. Tend to be loud? Try to modulate your voice. Shy? You may want to try harder to make friendly small talk, no matter how much you want to faint. Don't dominate the conversation. Don't gossip about other programs, don't gossip about other applicants. Be positive. The only things you should complain about are the weather and the airlines.
(Why the preceding paragraph? Because these little transgressions are all things that applicants have done which left negative impressions on others.)
You should wear business casual to the preinterview social event. Realize that the residents and faculty will be coming from work, where they have been wearing business casual all day. You want to look like them. So by golly, don't wear a suit.
It is not the end of the world if you cannot attend the preinterview event, but realize that you do not want to miss an opportunity to have the residents get to know you. If you are a social Quasimodo, that might not be a bad thing, but generally you want to try to go. Travel plans get in your way? You don't need to go so far as to contact the chief resident in advance, but you may want to mention in passing during The Big Day how sorry you were that you couldn't attend because of your crazy travel schedule, and make an extra attempt to show the residents how friendly and nice you'd be as their colleague.
B. The Interview
Every residency program organizes The Big Day differently, but almost all will provide a simple breakfast and lunch, have a tour, and drag you through a series of interviews. Do not be shocked that you will meet nearly every important attending through a chain of interviews, each staffed by either one or two of them. A handful of places may also have a panel interview where you stare down a tableful of faculty. Additionally, programs will have you formally interview with residents, and if they do, they will nearly always include the chiefs, as well as possibly residents who volunteer to martyr themselves. The number of interviews may be push double digits, and therefore you will not have too much time at each -- sometimes as little as 10 minutes.
Because of the limited time, you need to be ready to make a good impression at each interview station in 5 minutes, and convince your judges that you are The One. How to do this? Practice, practice, practice. Be able to describe any high points of your life, including your research, in 1 minute as there is no time to drone on endlessly. Understand that interviewers can meet more than 20 new people in a day, and their eyes are glazing over as the minutes tick by. Come across pithy and focused to spare them more pain.
Also because most interviewers are bored to death, smiling and (appropriate) joking goes a long way in making a positive lasting impression. If interviewers joke with you, relax and parry back. People want to see an element of your personality, as they will be working as your supervisors and colleagues. Alternatively, they will also remember how unmemorable you were, as no one wants to work with a dud.
Rehearse your answer to the classic question, "Why dermatology?"; be prepared to weave that seamlessly into remarks about other issues. And when you do answer that question, provide a unique specific reason why you are interested in the field which does not involve bashing other practices like primary care. Certainly, we all fled from the torture of late-night calls begging for OxyContin refills that drive PCPs nuts, but when you scoff at the noncompliant patients in primary care, or when you say, "I just couldn't work up dizziness anymore," you come off as sounding arrogant and, worse yet, naive: Dermatology has its own scourge of noncompliant patients, and acne can get very boring.
Also be able to communicate some of your life goals in a pithy one or two liner, and link that to how you will be giving back as a dermatologist. And this brings me to a major point: Despite what everyone thinks, you do not have to hammer home how you want to be an academic dermatologist. Over and over, interviewers have stated how they just want some honesty when they ask applicants where they see themselves in 10 years, because everyone knows that most people will go private (and specifically, many people want to go Mohs). Truly, it is *ok* if you are frank and state that you enjoy academics, but that your interest lies outside the ivory tower. But in order to answer this question well--meaning, in order to not come off looking like a money-grubbing swill, or a deluded naif--you need to truly understand what options exist in dermatology. Surprisingly, a career in dermatology can assume many permutations, from straight academics, to part-time academics, to running clinical trials in private practice, to working in public health, the military, or the Indian Health Service. Where you see yourself in ten years reflects the experience and background you bring to dermatology now, which obviously may very well change while you go through residency. Admitting that you may change your mind is alright too.
Have a question prepared for the end of each interview. We all realize that you have likely run out of questions by the time you reach our program, but you nevertheless leave a positive psychic impression when you are able to look interested and ask a question at the end of your interview. Why? Because interviewers are human, and humans like to talk about themselves and their opinions. So even a simple question is better than no question, because saying, "I don't have any questions," risks making you look bored and disengaged (which you probably are, but why broadcast that?). Good questions include "What do you think are the strengths of this program?", and - if you're feeling edgy - "What do you think the program could improve?" (Although that may come off as confrontational, if you're not socially smooth enough.)
Read an interview prep book, even though those are aimed at the business world. In the age of easy digital video, tape yourself answering questions posed by your friend, as you cannot underestimate how powerful performance anxiety can be in ruining your interview. Cut out the "umms," "ahhs," "likes," and "you knows," as those are annoying and make you seem insecure and immature.
Fundamental point: Honesty is key. Do not hedge or fudge because people will compare notes and flush you out. At the same time, you don't have to compulsively show all your warts, which some people tend to do when they are under the gun. Market your strengths.
C. Everything else about the interview day
While you are on campus, be unfailingly polite with the staff. If you are the typical med student with blinders on that block everything else non-medical out of your life, you may not have heard of the widely-broadcast devastation one recent job hunter wrought in his life. Besides lying about interviews he didn't receive, this person also treated the administrative staff like dirt at the various firms he was applying to. (See
http://dealbreaker.com/2009/10/jeffrey-chiang-will-be-receivi.php for all the gory details.) Of course, unlike this person, we know you wouldn't dare lie about or even exaggerate your achievements on ERAS (as derm is such a small world, you WILL get found out), but what about treating the staff dismissively or worse yet, downright rudely? You're tired and jetlagged, hungry and sick of making nice--it's easy to end up snapping at someone. Remember, however, the admin staff serve in many ways as gatekeepers to your goal, and they talk to faculty, residents, and the PD who will be making a final decision on your chance at their program. So be cloyingly sweet.
During your time on campus, monitor your interaction with residents, even in the most insignificant encounters, because rest assured that even if the residents don't have a formal vote in ranking applicants, they certainly have influence. Don't discount your chitchat with residents who are not interviewing you. Even those who are just crowded around the lunch spread, and who seem solely focused on nabbing the roast beef sandwich with horseradish dressing, are attuned to how you carry yourself. If you rub them the wrong way, they *will* ensure that decisionmakers know. They're just as invested in who comes to the program as the faculty, because they will be working with you, and they want to recruit the best of the bunch, because who doesn't want to be proud of their residency program?
General no-no's: Try to control your nervousness, because it just makes everyone around you uncomfortable. That means modulate your voice as well as the speed at which you talk. Don't babble nonstop if you sense that residents whom you're talking to are tuning you out. Don't speak badly about other applicants (yes, this has happened--probably because the poor soul thought that s/he would somehow get a leg up on others). Come across as relaxed and friendly, like someone you'd love to spend the afternoon with. Arrogance is unseemly.
Whether emailed or hard-copies, thank-you notes are generally pointless, in my opinion, because decisions are made very soon after interviews, sometimes even on the same afternoon. Send them if you are a Miss Manners acolyte but they are dispensable. If you choose to send them, know that I've overheard some attendings criticize emailed notes as being impolite, based on their philosophy that if you're going to do a thank-you note, send a proper one. Then again, emailed thank-you's to the PD get to the recipient instantaneously, possibly soon enough to arrive within the decision-making window.
