The Good, Bad, and Ugly – A Guide to Optimizing Interview Season

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Interview season is incredibly unique to our chosen profession. After 3(ish) long, hard years of training, from your white coat ceremony before this whole journey started, to your nose being stuck in your “First-Aid for Step 1” book, to endless anatomy tag exams, to your first day on the wards, to your first 30-hour call day – you finally made it. Regardless of your step scores, the number of honors you had, the letters of recommendation you received, you’ve come this far. So first of all, a sincere congratulations on a wonderful achievement!  You’ve earned it!

I idolized the interview season in my mind, thinking it would be really fun to travel the country and see what different programs have to offer. And though that is the case, there was so much on the interview trail that I wish I knew. This post serves to address common misconceptions, money-saving tips, pre-interview etiquette, and much more for interview season, regardless if you’re a 4th year about to have a string of interviews, a 3rd year starting to think about away rotations, or even if you’re still in your preclinical years wondering what it will be like for you. Nevertheless, this will be the brutally honest, comprehensive guide to making the interview season the best it can be!

 

The Good

Travel

    • If you like to travel, the interview season will quench your wanderlust! This depends on where you apply, but based on the preliminary ERAS 2019-2020 numbers, people are applying to more programs than ever before! It is extremely fun and intriguing to see what all of the different programs have to offer, and even more exciting to picture yourself living at each of the places you interview at. I would encourage you to take as much time as possible to see the city you’re visiting. This won’t be possible everywhere you go, but whenever you have time, go to a local coffee shop or eatery in a popular location to see whatever you can in the limited amount of time you have.

Pro tip #1 – Get plugged into an air miles rewards program with whatever airline you think you’ll be using most. If you’re in the pacific northwest, get Alaska or American. If you’re in the South, get Delta. If you’re in the Midwest, American is probably a safe bet. Either way, if you buy flights on one airline throughout interview season, the rewards miles will rack up fast!

Pro tip #2 – whenever possible, do NOT check a bag. Most places you will go will be for a very short stay, so try to fit everything you need into a personal item and a carry-on bag! (American, Delta, Alaska, and Southwest will all let you take a carry-on for free…others will charge you around $35 for a carry-on.)

Networking

    • The interview trail is a fantastic time to get to know fellow students who are applying to your specialty. Often, you will run into them in a random city multiple times – you might even run into people from your home program! People don’t generally talk about the number of interviews they got or where they received them, so it’s hard to know who you will encounter and when. However, it’s always fun to see familiar faces. I would encourage you to connect via social media whenever you think it’s appropriate – who knows, you may end up being co-residents shortly!

Pro tip #3 – This kind of goes without saying, but this is not a time to flirt with other interviewees or with residents! I’ve seen it happen, and it is not pretty. Take this time to focus on your future career.

Pro tip #4 – Get out of your comfort zone! If you’re sitting at an interview dinner and you feel like conversation has stalled, feel free to switch it up and go talk to different residents.

Meeting Leaders in the Field

    • I was constantly amazed by each of the Program Directors (and associate/assistant program directors, other faculty members, and residents) that I had the pleasure of meeting on the interview trail. Each program that I interviewed at was unique in its own way. Being treated as a fellow colleague in the field for the first time really set this experience apart; knowing that I’m now being sought after as a resident, that I have marketable value, and that there are many paths to take to get where I want to go in the field brought me great joy, and I’m sure it will do the same for you!

Pro tip #5 – Generally, as you will hear on the trail, you don’t need to send thank-you emails or letters. However, if a particular person or conversation stood out to you, feel free to do so.

Pro tip #6 – Do your research beforehand. Look into the PDs, APDs and chief residents so you know a little bit about the people interviewing you. It makes finding common ground easier and makes you look/feel prepared! Checking out their website is a good place to start, but the amount of information displayed on said website can vary. Try checking local news outlets for recent news on the program, Google Scholar for recent publication trends, and/or recent abstracts from prominent organizational meetings.

 

 

The Bad

Cost

    • I am an excel spreadsheet nerd, so naturally, I created a huge workbook to keep track of these costs in detail, starting with Step 2 and away rotations. Let me tell you, this process is not cheap. There’s a huge conversation that needs to be had there about how the exorbitant costs of medical school ostracize minority groups and people of lower socioeconomic status in medical school, but that is a conversation for a different time and place. My purpose here is to try to highlight the costs in detail so that you can prepare as much as possible. Bear with me as I discuss this in excruciating detail (and if cost is not an issue for you, I am so happy for you! Feel free to skip to the next section!) Anything that I’ve marked with an asterisk denotes that there might be federal or school funding available for this particular cost: for example, an away rotation can be covered by federal funding if you can demonstrate that it is required for your specialty (i.e. emergency medicine). Also, Step 2 testing costs are often worked into the school’s budget. Take home message: inquire with your home financial aid program early and often!
      • Step 2 (end of 3rd year, beginning of 4th year)
        • Step 2 CK – $630*
        • Step 2 CS – $1,290*
        • Study materials for both: UWorld ($499) + textbooks (~$80) – $579
      • Away rotations
        • VSAS (portal to apply for away rotations) – $40 base fee for 3 applications, $15 per after that
        • Registration/tuition – anywhere from $0 to $300+ for the month*
        • Housing
          • Hard to say. This can have a huge range. My advice: rotate somewhere where you have family or friends that can put you up for a month. Ideally, this location would be close to your workplace, or in a prime location for public transport so you can avoid renting a car.
        • Car Rental
          • $950 (that’s at $34 per day…there will be some places where it’s cheaper, and somewhere it’s more expensive, but if you need a car for a month that’s what you’re looking at)
        • Gas costs
          • Variable. Easy to calculate based on the location you will be staying, the number of shifts you will work, and the price of gas in the area.
        • Parking
          • Depends on your program, but I’d plan on about $35-50 for the month
      • Residency Application
        • ERAS (portal to apply for residency) à $725 for 40 programs*
          • Exact formula – Up to 10 programs $99, 11-20 is $15 each, 21-30 is $19 each, and 31+ is $26 each
        • Sending USMLE transcripts to programs (required part of ERAS application) à $85*
        • Registering for the match via NRMP – $85*
      • TSA Pre-check (highly recommended if you will be flying rather than driving) – $85
      • Interviews
        • This will be highly variable, so I won’t list dollar amounts here. There is some amount of federal funds available, but you need to keep track of costs in detail and save receipts, so contact your financial aid office. Some categories to think about:
          • Airfare
          • Lodging
          • Car rental
          • Ridesharing
          • Food/drink during travel

Pro tip #7: Research and use public transit whenever you can, ESPECIALLY to/from the airport! Airports are often situated away from the high-density areas because, obviously, they’re large. Checking out a city’s public transit system can often get you much closer to where you’re staying for a fraction of the cost – plus you can see some sites along the way. In addition, Pro tip #7.5: After your interview day is over, chances are that many applicants are headed to the airport: if you can’t use public transportation, consider sharing an Uber or Lyft with other applicants to the airport – this can help decrease the cost immensely.

Pro tip #8: Pack snacks in your carry-on luggage! Airport pricing for food and drink is hyperinflated, so if you plan accordingly, you can mitigate some of that cost.

Pro tip #9: Residency programs will occasionally include a contact person within the program that has information on residents willing to house applicants for their interview. Utilize this whenever you can, as I have only had positive experiences from it – residents are happy to have you, can give you insider information on the program, and it’s a free place to stay!

Pro tip #10: Check out Swap and Snooze, a website that verifies your 4th year med student identity and then allows you to see other med students around the country that are willing to host applicants for free. We help each other out as a community! There are other resources like this out there too, but this was probably the most helpful and safe option I found.

Pro tip #11: Don’t buy last minute tickets if you can avoid it! It’s generally accepted that 3-4 weeks prior to your interview date is the ideal (read: cheapest) time to buy your ticket. If you’re unsure about scheduling back-to-back interviews, buy a one-way ticket to your interview and worry about the return trip later.

Pro tip #11.5: If you’re planning on getting a credit card to pay for interviews, get one with good mileage rewards. Southwest’s credit card sometimes has promotions so that you can get a companion pass for free, Delta’s card gives you 35,000 bonus miles, American’s card gives you 60,000 bonus miles…those perks add up!

“So, do you have any other questions?” & Interview Burnout

    • It is natural to begin feeling a little burnt out as you near the end of the interview process. The bottom line is that red-eye flights, sleeping in different beds, time zone changes all take a toll, and even the interview days begin to look the same after a while. You’ll find yourself thinking, ‘If I see one more ED, or if ONE MORE PERSON asks “Do you have any other questions?” I just might scream!’ You are valid for thinking these things. It is a long couple of months! Try wellness techniques to prevent interview burnout. This means different things for everyone (I won’t make you sit through a 2-hour wellness module, don’t worry). Take joy in the fact that this is a once-in-a-lifetime experience and try to make the most of each visit. Check out local eateries, ask for recommendations from the residents and faculty, and try to practice whatever makes you “well” in each city. Many people enjoy hiking, reading books, drinking coffee, running, doing yoga, writing…take those hobbies and practice them in each city at a local spot to get a new twist on it. Aim to get the feel of what it would be like to be a resident in that particular location – this may be the last chance you get before matching there (Woah). Additionally, remember that your interviewers, coordinators, and program directors are spending an immense amount of time and resources to be good hosts for you. Return the favor by being good applicants, meaning, be prepared, do your research, and remain engaged during the interview day. It’s okay to say, “You have all done a great job answering my questions in the presentation and at the dinner last night! I don’t think I have any more questions at this time, but if I do, would it be alright to send you an email?” This accomplishes conveying your interest in the program and establishing a means of NRMP-approved post-interview contact.

Pro tip #12: As much as possible, try to regionally cluster your interviews. Buying one-way tickets to multiple cities in a row is far cheaper than round trip tickets and making multiple trips back home.

Pro tip #12.5: Utilize mock interviews to be the most prepared you can be!

Scheduling Logistics

    • Interview season gave me SO much respect for program coordinators, clerks, secretaries…anyone that has to deal with maintaining a complex calendar. Interview offers come in and you, quite literally, have to instantly schedule it. For the first few interviews, this is no problem since your schedule is wide open. But after you have already scheduled a few of them, you start to realize that there are not that many available days to interview in the months of October-January! If you are on rotation at school during this time, it is even harder to balance a clinic/inpatient schedule while trying to take days off for interviews. Only a few programs interview the week of Thanksgiving, no one interviews the week of Christmas, and New Year’s is its own thing – your days are limited, believe it or not. Then after you think you have it all figured out, you get an offer from one of your top programs and have to rearrange everything, trying to regionally cluster them, and asking yourself, ‘Is 22 minutes enough time to get to the airport, go through TSA, and board? Yes, I think it is.’ Rest assured that though complicated, the process will work itself out. Keep whatever calendar works best for you (I am old school and actually write things on paper) and be honest with yourself about how many interviews you think you want to go on, because if you end up with 20+ offers, you are going to be 1) out of money and 2) out of time. Set a goal, stick to it, and do not be afraid to cancel interview offers at programs you’re not interested in, provided that you give at MINIMUM two weeks’ notice to the program.

 

The Ugly

Red Flag Interview Questions

    • There is a group of questions that are considered inappropriate for the interview setting that occasionally, whether purposeful or inadvertent, get asked on the interview trail. These include, but are not limited to, asking a woman if she is planning on having kids in residency, asking a parent if they have missed numerous shifts to take care of their kids, asking how many interview offers you got, asking where you will rank their program, and many others I’m probably forgetting. My advice is to practice a response to these questions that 1) dodges the question, 2) shows poise, and 3) you were uncomfortable with it. A typical response I have heard is, ‘Oh, my advisor told me I wouldn’t be asked questions like that…I guess I would have to put some more thought into it.’ The caveat to this is that sometimes these questions come up naturally in conversation and can be completely innocent. The bottom line is that you should trust your gut – if it feels benign and you feel comfortable answering, then great! But you will know if it feels malignant/shady…trust your gut and keep the red flags in mind when rank lists come around.

Unspoken Rules/Etiquette

    • Gosh, I could write a whole novel on the unspoken rules of medical school, let alone the interview trail/interview season. The closer the ERAS submission date approaches, the more people seem to clam-up…even your closest friends! I will list just a few of the unspoken rules and etiquette that I have seen and heard about along the trail and briefly attempt to address them:
      • Never ask someone how many interviews they have been on
        • This can make people uncomfortable if they have been on a lot or very few. Stay clear.
      • Never drink more than one beer at a pre-interview dinner
      • Only accept interview offers at places you’re actually interested in
        • Ideally, you only applied to programs you want to interview at, but the truth of the matter is you should accept offers broadly and then parse through and cancel after that. But if you can’t see yourself going to a certain program or living in a certain city, then open that spot up for someone else by canceling the interview.
      • Don’t bring up controversial program topics in the interview
        • If you have heard of problems with a certain program, this is the time to ask! You only get one shot at the interview, and if you are agreeing to spend the next 3-5+ years of your life in one place, you want to be sure you are well-informed. Ask the juicy questions of the residents and even in your interview if you feel comfortable.
      • Don’t cancel an interview too close to your interview date
        • Ideally, you should give a program 4 weeks notice, but at a minimum, you should give 2 weeks notice, and under no circumstances can you no-show (outside of the normal medical/family emergency stuff…but even then, you need to be adept at contacting the program to let them know).

Scheduling (again)

    • I previously heard rumors that scheduling interview invites were stressful and needed to be done immediately…and I was not disappointed. Offers can come in at any time of day starting the day after ERAS is submitted, without warning. Some programs give out more offers than they have slots available, so you can miss out on an interview day just from being ‘too slow’ to respond (though this trend has decreased recently). Additionally, later in the season, when your availability is limited, an offer can come in and if you don’t schedule immediately, you might only be left with days you’re unavailable. Recently, many programs have adopted 10/15 as a “common release date” for interview offers…yet, not all programs will release on that day, which makes that day horrible for your mental health. I had a friend get 6 offers on that day, while I got one.

I don’t write all this to scare you, but rather, to prepare you. Whatever rotation you are on in October, try to make sure it’s one where the faculty and residents understand that you will need to be checking your phone to schedule interviews. Rest assured, you can always go back and reschedule your interview if there are available dates to do so, which is also very helpful.

Pro tip #13: You can set your phone to a custom vibrate or ringtone for your email. That way, at least you know when it is your email and not a text from a friend.

Pro tip #14: If you know you’re going to be 100% booked a certain day, give a trusted friend or loved one access to your email and schedule for that day in case any interview offers come in. For example, I was actually on an interview on 10/15, the common release day. Giving my wife access to my email and giving her potential days that would be ideal for an interview to be scheduled on gave me the headspace needed to focus on my interview without feeling the need to check my phone.

On Loneliness

    • This one is not that hard to figure out – you are traveling a bunch, without friends or family, into unknown areas and new cities, for weeks on end, spending a bunch of money you don’t have. It’s lonely. And the sooner we can all acknowledge that the sooner we can take steps to combat it. Helpful tools:
      1. Video chat with friends/loved ones after an interview to tell them about how the interview went. They can read your reaction, and it will help you process how well you liked a program.
      2. Journal or take a video of yourself after interview days to ensure you remember the program and its highlights.
      3. If you have friends applying to the same specialty, check to see if you have any interviews together. It is so comforting when you see a familiar face on the trail – then you can share rides and experience the city together!
      4. If you are driving to an interview, invite someone with you! They can keep you company and there’s a lot of quality time to be spent on the road.

 

 

Reflection

Because of all of the rumors and unknown surrounding the interview season before it started, I was incredibly nervous. I felt unprepared for what was about to happen, applied to more programs than necessary, and spent way too much money. But I also met incredible people, made new friends, and learned a lot about what I want in a residency program! Admittedly, my rank list looks much different post-interview season than it did before I started. I am so grateful that I had the opportunity to interview where I did. I do not think I have all the answers…I still have a few more interviews to go on! But hopefully, through this article, you can optimize the interview trail to make it the best possible experience for yourself.

 

Final Thoughts

Interview season is a ton of fun and this will likely be the only time in your life you will be able to do something like this. By knowing what you are up against, planning ahead, and using our pro tips, interview season will be an awesome, fulfilling experience for you!

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