First Aid for the IMG From a successful international medical graduate
comes this reassuring guide to preparing for the USMLE
and residency. Focuses on the U.S. directed curriculum,
healthcare delivery system, and ethical issues--and the
differences IMGS should expect.
interview day can be the most important part of your application
Meeting people in person can make or break your
application. As they say, there is no second chance to make
a first impression. There really is no way to make up for a
poor first impression. The interview, and any communications
that you have prior to the interview, can significantly impact
You may begin to receive offers to interview as early as October.
Some programs will offer appointments to interview even before
the dean's letter is available. Others do not begin evaluating
any of their applicants until the dean's letter is ready.
with the rest of your application, professionalism is the name
of the game
Whenever contacting a residency program, whether
by phone, fax, or email, remember to be courteous and professional.
You never know who you may come in contact with. Also, remember
to be courteous to the various office staff and administrative
people you meet. They meet all the applicants and will remember
the applicant who was rude. Often they may be part of the ranking
meetings as well.
the advent of ERAS and the widespread use of the Internet,
interview invitations will come via email
During the application process, always keep up to
date with reading email. This is the preferred method of communication
for many programs because it is less costly and less time consuming
than postal mail or phone calls. If you plan to be on an away
rotation, this becomes especially true. Typically, the program
will present to you a variety of dates for which they interview
applicants, and you may choose between days. Try to contact
the program as quickly as possible to arrange your interview
because the spots can fill up quickly. Make sure you have second
and third choices available for interview dates.
can be critical for the applicant
Schedule your most important interviews in the middle
of your interview trail.The first few interviews you attend
will probably be your most difficult. It takes time to get acclimated
to the interview and tour day. Use your first interviews as
warm-ups to your more important interviews. Also, try not to
schedule your most important interviews too late into the process.
As you near the end of the interview trail, you will likely
tire of the entire process, and you want to be at your very
best for your most key program interviews.
Scheduling your interviews in clusters can save you time and
money. Generally, programs are quite flexible in scheduling
interviews. Often you can cluster your interviews in particular
geographic areas. This can save you travel time and money. If
you have scheduled several interviews in one area, and are still
waiting to hear from a particular program in that region, you
may call ahead and try to arrange an interview. Calling ahead
to a program and telling them that you will be nearby during
a given time period can often secure you an interview.
If for any reason you must reschedule your interview,
try to do so as early as possible. Even if the day before or
the morning of the interview you have an emergency, always phone
ahead. No one will fault you for having an emergency, but they
will remember you as the person who showed up late without calling
first, or as the person who did not show up at all.
Scheduling early or late does not necessarily help or hurt your
application. Many opinions exist on this issue. If you interview
early, you may have a better chance of being reviewed when interviewers
and committee members have fewer competitive applicants to compare
you against. Interviewing later, you may make a more lasting
impression on committee members, who may remember you more clearly
when it comes time to create rank lists for candidates. It probably
does not make a huge difference if you interview early or late.
Plenty of stories exist where candidates matched at their first
interview location, or their very last interview location.
are many ways to save on travel and accommodations during your
Planning early can save you money on plane tickets
and lodging. You can often ask the residency office for suggestions
on inexpensive places to stay. They may even be able to put
you in contact with a resident or medical student in the area
who you can stay with. Consider emailing the student affairs
office if that program is affiliated with a medical school.
They may be able to arrange a place to stay. For airline tickets,
there are many Internet travel sites that offer good pricing.
Sites like travelocity.com and expedia.com offer comprehensive
airline, hotel, and car rental packages. Another good site is
cheaptickets.com (be aware that cheaptickets.com is notoriously
inflexible in changing your flight schedule, and they require
a several additional days to mail paper tickets because they
currently do not offer electronic ticketing). If you are very
flexible with your flight time, you may consider buying your
tickets through a business to consumer bidding site such as
priceline.com. These sites can sometimes offer excellent pricing,
but do not allow the buyer the flexibility of choosing exact
flight times. If you have frequent flyer miles, you may want
to use them on some of your last minute or mid-week trips, as
these can be the most expensive to schedule. Flights including
a Saturday night stay often yield the lowest prices. There are
many bargains available to student travelers, and you should
research these carefully.
for your interview can be as important as the interview itself
Many programs do not have paper brochures for
information since the Internet has made it more economical to
post information on a website. Browse the program website and
learn about the major aspects of the program. It is bad form
to ask questions during an interview which make it obvious that
you have not reviewed information from the program website.
Avoid asking questions that you can find answers to on paper
brochures or websites. If you are traveling to an interview,
you can print out a few of the key pages from the Internet and
read them the night before or on the plane trip to the program.
Be aware of various hospitals residents may rotate through,
outside clinics, and community outreach programs. You will need
to convince your interviewers that you really know something
about their program and can give reasons why you are interested
in attending their program.
comfortably and professionally on your interview day
Again, remember to be professional. Men should
wear a jacket and tie while women should wear business appropriate
attire. Choose more conservative colors. Don't make people remember
you because of your choice of a tie. Make sure all your clothes
are ironed and clean. Shoes should be well polished. Remember
to wear comfortable shoes, as you will likely be doing a great
deal of walking during your day. Lay your clothes out the night
before to avoid having to make last minute decisions in the
interviews typically take most of your day
Your interview and tour day may start early enough
for you to attend morning report or grand rounds. From there
you may be invited to attend rounds with a ward team or have
breakfast with residents or program directors. Typically, some
interviews are conducted in the morning and some in the early
afternoon. You can expect to have at least two faculty interviews
and possibly a resident interview. This varies by specialty.
Generally, you will have lunch with residents present, and sometimes
with faculty as well. Take this opportunity to ask residents
questions about their program.
interviews are generally nothing like medical school interviews
It is refreshing that residency interviews are
usually very pleasant. You will find that you spend very little
of your time trying to sell yourself to programs or answering,
"why should we take you?" types of questions. The entire match
process is like the major league baseball draft, and you will
be treated like a potential draft pick when it comes to your
interviews. In many interviews, you may find that the interviewers
have not asked you many questions at all. In fact, they often
ask if YOU have questions for them! Be prepared to think up
questions to ask your interviewers. Ask thoughtful questions
about their program.
You may ask questions about the program's stability, future
plans/changes, community outreach, research opportunities, plans
of graduates, etc. These are all fair questions to ask. Avoid
asking questions about benefits or compensation as these may
make you appear greedy. These are questions you can ask more
freely during your tour or lunch with residents. In general,
you should also not ask questions which you can easily find
answers to in paper brochures or on the program website. These
questions may give the impression that you have not prepared
for your interview adequately.
This being said, your interviewers may ask you a whole range
of questions. Very few interviewers are malignant. Interviewers
are interested in finding out about you as well as telling you
about their program. Some questions asked of recent applicants
What can you bring to the program?
Why do you want to be a part of this program?
What attracted you to this program?
Why did you choose to go into internal medicine?
Where do you see yourself in 10 years?
What makes you different?
What are your strengths/weaknesses?
Who was your most difficult patient?
What are your goals for residency?
What do you hope to get out of the experience?
Are you really willing to leave the west coast for the east
How would you describe yourself?
What was your toughest challenge in life?
One final tip for interview day: firm handshakes are a must-
no "dead fish" handshakes!
the residents during your interview day your most pressing questions
You need to be candid and open with the residents
you meet. As long as your questions are intelligent, you should
not fear that they will reflect negatively upon you. Do not
be afraid to ask questions. If you are going to commit yourself
to years of training at an institution, you have the right to
know the inside story. Some questions you may consider include:
Are the residents happy?
Are they treated fairly?
What are the major problems with the program?
What is lacking at this program?
Is the administration responsive to resident concerns?
Do residents feel that they are taken care of?
What is their impression of the teaching quality at the program?
Has the program lost residents in recent years? Why?
It is also not a bad idea to get a few names, email addresses,
and phone numbers for contacts in the event that you think of
additional questions when you leave the interview. Interview
days can be very tiring, and you may forget to ask questions
you would like to know the answers to later on.
Don't shoot your mouth off!! Although all the residents will tell you that "you
can say anything you want. I'm not on the residency committ."
Watch your questions carefully, and for God's sake don't make
an @ss out of yourself! Residents WILL be giving their program
coordinators the skinny on all the applicants. You don't want
to be the one who says, " I'm looking for a really cushy
program." Just be careful!
programs invite applicants back for a "second look"
At the end of your interview day, or perhaps in
a letter after your visit, you may be invited back to a residency
program to take a more in depth look. These visits are perfect
for applicants who desire to attend a program, and have more
questions they want to ask of the residents or faculty. The
interview day is packed with a scheduled routine. Sometimes
there is not enough time to see everything an applicant is interested
in seeing. Also, keep in mind that interview days are somewhat
"scripted" in that applicants see only what they were meant
to see. You may want to return on a day where you can observe
morning report, ward rounds, and walk around the hospital on
your own to get a better sense of what the program is really
like. In addition, it is a great opportunity for you to ask
questions you may have neglected to ask on your interview day.
Occasionally, the second look can dramatically change your opinion
of a program, and these visits can be helpful when occurring
close to rank list submission.
your interview and tour day, consider sending "thank you" letters
Within the first week after your interview, you
may want to send a simple letter to thank your interviewers
and tour guides for their time. These letters are not required,
but certainly cannot hurt you. Keep them short and to the point.
Feel free to express your interest or desire to attend the program,
but do not become overbearing.