Know Your Field

In answering some recent reader emails and doing some mock interviews with fourth-year medical students, I’ve noticed an interview deficiency that’s worth correcting. Residency interviews are generally benign, but you still want to be able to talk cogently about why you’ve chosen the field you have as well about the field itself.

You can start off by knowing that you generally will not be truly knowledgeable about your future in the chosen field after a rotation or two as a medical student. And frankly, if you talk about your future career and your opinions too brazenly, you may come off poorly. If you think back to your interviews for medical school (if you can remember them), then you probably remember how weak your grasp of medicine was. You may have said things that make you cringe now. It wasn’t uncommon for an applicant to tell me that they wanted to pursue “residency” in cardiology or oncology among other simple mistakes. Some didn’t even have a grasp of what residency was! You are probably substantially more informed now than you were then, but the same lessons still apply (especially in the fields that are not core rotations). Your interviews warrant a proper balance of critical thinking and humility.

So, why pick X?

An example: for radiology, it’s common for applicants to say things such as “I like the combination of medicine and technology.” Which is fine, but why? Why would that be meaningful for you? How does that interest in this intersection manifest? It would be just as easy for a urology applicant to say they like the innovative combination of urination and genitalia. Honest radiology applicants could then go to say they prefer patients when they are presented as a stack of two-dimensional images. Surgeons would then counter that they like them in 3D but best when they are anesthetized. None of this sounds that great.

This is all to say, think on it a little harder.

Beyond “why this,” there are some relatively common questions that I think are frequently overlooked opportunities to shine. Asking an applicant about the future of the field, changes to healthcare reimbursement, the push for quality improvement, patient-centered care, medical errors, etc are some of the best ways to see how someone thinks, how they feel, and how they reason through a big issue. You don’t usually memorize answers to these questions, nor should you. But you should think about them, not just for interviews, but also for the career you have chosen and your future within it. Note: You want to be able to answer these questions without potentially offending the interviewer or heavily invoking your political beliefs. You never knew the leanings of the person across the table from you.

For example, in radiology, good topics to think about would be the future of the field, the role of midlevel providers, changes to reimbursement, healthcare utilization, private practice versus academics, quality improvement, how to add “value” both to patient care and the ordering providers, patient-centered care, relationships with referents. You may not have fantastic answers (in many cases no true answer exists), but these questions, if asked, are where you have the opportunity to show critical thinking as it pertains to the field you’ve chosen. Approach these questions with care, humility, and the understanding that the person asking them can see through your BS.

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