The Med School Interview

Oh why, hello again.

I’ve been reflecting on my time in medical school and what a tremendously weird road it was to get here. And your specific path may just as weird as mine! Or it may be easy breezy pumpkin squeezy. And if that’s the case, I somewhat envy you; but at the same time I’m proud of how I got here. But overall, reflecting is something I’ve found myself increasingly doing lately… I’m going to blame turning 30 on that.

Anywho, in less than a year I will be undergoing residency interviews, so I figured it was about time I wrote this post. What are some important aspects to review for a medical school interview?

I may or may not also have some inside information… but like with every post, please take this with a grain of salt. Everyone’s experience is different. Things that can change how your performance goes. Some major things that can help you:

  1. Confidence. Oh my how this is a big one. You should be confident, but not arrogant. They know you are going to be nervous. Can you work through this?
  2. Prior interview experience. You are more likely to be comfortable on an interview if you’ve had one before.
  3. Prior experience at that campus. If you happen to have gone to school there for a previous degree I can promise you will automatically feel more comfortable at your interview.

Don’t worry if you don’t have #2 or #3; those are things that may help you but aren’t required. But you definitely need to have #1. And only you can work on that!

Oh.

And this is going to be very list heavy. Sorry not sorry.

Researching before you go!

First off, are you interested in MD or DO? Because that will change how you answer some questions…unfortunately.

I have interviewed at both, but in total of my 3 years of trying to get into medical school I only received 3 interviews. One each year. My first year was at an MD school, and my second two years were at KCU where I eventually ended up. My significant other had a good range of interviews between MD and DO, so I will add in some of his experience as well.

  1. You need to research what is important to the school. Look at their values. Now, repeating them verbatim won’t help you, but understanding what they are looking for is important.
  2. If you are interested in DO, you should already know we do a lot more with our hands. Our hands are one of our major tools! So research what DO actually is please! Don’t be the student that walks in and tries to wing it because your CV got you an interview but really you are just interviewing at a DO school for your backup. Don’t be that kid.
  3. Also on the DO route… learn the 4 tenants of osteopathic medicine. That will win you bonus points. And try to be able to describe how you would use them in the specialty or field of medicine you are currently interested in. You will likely change what field you want to go into by the time you graduate, so don’t worry about being sold on that specialty when you interview. But if you are interested in it, work that into your conversation. If you aren’t sure, no big deal! You can still explain how the 4 tenants can help you as a physician.
  4. What type of environment is the school in? City? Suburban? Rural? These will all play a big part in your interview day. Ultimately, if you can’t see yourself being in that area, then you won’t thrive there. If you are a city person at heart and go to ATSU (Kirksville is the birthplace of DO, but there’s nothing there) which is very rural, will you be able to thrive as a student and a person? All things you need to consider.
  5. Talk to students who have been there. Ask them how student life is? Is it student friendly or is it very much top down administration? Are there great resources that your school can help you with? Curriculum is big, but what exactly do you want to know about the curriculum? Make sure you are getting a good understanding of what you want to know, so you can really develop good questions on interview day. (P.s., interviewer’s hate curriculum questions. It’s the scapegoat for all students to ask about when they don’t have anything else to ask).
  6. Are you interested in research? Does this school have that opportunity for you?
  7. What is available in the community?
  8. What types of clubs are on campus? Are you interested in any? Can you see yourself being a part of that? Same goes for SGA, student ambassadors, tutors, etc. If this is something you are interested in doing, know what that school has to offer. A lot of this can be found on their website.
  9. Go to the campus. Try to go to one of the days they have tours. This is where you can get more time with the guides to ask more specific questions. Ask about GPA requirements, MCAT scores, maybe sneak off and talk to a few of those students like I mentioned earlier. Being on campus and actually feeling the vibe will tell you if you fit in there or not. Trust your gut. If you walk onto that campus and immediately it doesn’t feel good or it feels strange, not for you. Versus if you walk on the campus and feel welcome, good choice for you!
  10. Know if the school is big on keeping students in the area or not. Some schools make you sign clauses that you will practice for x amount of years in the area. If this isn’t something you are willing to do or compromise on if you get in there, then don’t waste your money applying.
  11. Are there big-little programs to help you orient your first year? Or groups of students who are willing to help? Do they offer tutoring for first year students? What resources are given to you first year? All of these things won’t make or break a school, but are helpful in knowing if they are available or not.

Questions to prep for

Yo, this will be difficult. But the main thinking goes along this:

  1. Can you answer it coherently? Is it a well rounded answer that you aren’t stuttering through and that answers the question? This is honestly one of the biggest things in interviewing. Answer the question, and do so in complete sentences and coherently.
  2. Confidence when answering. Don’t fidget. Good eye contact. If you need a minute to think of a scenario then tell them you need a second to rack your brain before answering.
  3. If you are passionate about something in your life, make sure you use that in your examples of answering questions. They like well-rounded candidates. Obviously they want to see you have a passion for medicine, but your entire life shouldn’t be revolved around that. Do you have hobbies? Do you play sports? Are you an avid traveler? Or crafter? Whatever it is, make sure you work it into your examples somehow.
  4. Know the basic interview questions. Strengths/weaknesses. Have several scenarios where you’ve had to overcome an obstacle or issue or working with someone that was difficult and how did you work through it. They can seriously ask that question in 10 million different ways. Why MD vs DO? Why do you make a good candidate? What would professors at your undergrad or previous institution say about you as a student? If you could invite any 3 people in the world to dinner or on vacation, who would it be and why? If you were stuck on an island, what x amount of things would you bring? You know, those types of questions. There are 8 million websites that have examples of this and can probably give these better than I can.
  5. Know why you want to go to that school. Seriously. You should be thinking about this. If you are interviewing there, why did you spend all this time and money if you aren’t sure why you want to be there? Think about it and make sure you can answer that question.
  6. If you answer too curtly or you drone on during answering your questions it won’t look good. Treat it like you are having a conversation in a coffee shop with a business colleague. Good length, long enough to answer appropriately and hold attention. If you answer too short, they will run out of questions with you. Too long and they won’t get to ask you what they need to get through. And obviously be professional. No swearing people!
  7. Ethics questions. Ah, so many students are nervous about this. There is no right answer to an ethics question regardless of what someone might tell you. They simply want to know if you’ve given the answer some thought, why you would choose that answer, and can you give a coherent and confident answer. They aren’t expecting you to understand medicine… because you aren’t in medical school yet. That is their job to teach you. Use your common sense and be able explain why you chose that answer. But no, there isn’t a right answer to those questions.
  8. It’s really hard to prep for any odd ball questions honestly.

Dress

This is a very controversial topic. Some schools are hella sticklers for what you wear. Some are more relaxed. Rules are as follows:

  1. Dress professionally.
  2. Cover yourself.
  3. Shower; groom yourself well.
  4. Wear comfortable shoes.

For men, this means a suit and tie. For women, this can be a pantsuit, a skirt suit, or a work dress with or without a jacket.

Bold colors and wild patterns are honestly bit no-no’s. But just know a lot of people will be in black. It’s a power color, and it works in every situation. HOWEVER YOU WILL NOT STAND OUT IN BLACK. Go with a gray or navy suit. Girls if you wear a dress, it’s okay to have a tiny pop of color, or you can do a navy, dark green, tan, gray, or white dress. For shirts, a lot of people like I said will be in black suits and white tops. Women most commonly wear black suits and a pale pink top. I’ve seen girls wear light red and green tops. I’ve worn jewel tones before and it was just fine. Just make sure it isn’t too in your face, but enough to set you apart.

Day of:

So, most of the interviews will be split into two blocks on the same day in order to maximize the amount of people being interviewed.

  1. You interview in the morning, and then go through all the information midday
  2. You go through all the information midday and interview in the afternoon

For most of my interviews, I fell into the second category. So the information includes the following in an interview:

  1. Curriculum set up/type. They won’t give you too much information. You will get that at orientation.
  2. Vaccinations
  3. Other expectations if you accept and deadlines to get it in.
  4. Tour of the place.
  5. Usually they feed you. Which can be hella difficult. KCU offered me barbecue BOTH TIMES. Try not to get that all over your nice clothes. But it was very delicious, I’ll give them that.
  6. Then the interview.

Some tidbits:

  1. Don’t be the obnoxious person talking over everyone. You won’t make friends, and if the people leading the tours are students they will give that information back to the committee.
  2. Don’t be on your cell phone. I’ve seen too many kids do this. THIS IS NOT PROFESSIONAL. You can text/call whomever after the day is over. Put it down. Or better, turn it the fuck off.
  3. If the tour is student lead, now is your time to ask the good stuff. What don’t you like about the school? What are some of the biggest issues you’ve run into as a student? You can always ask them the positive side of those questions to, but I personally want to know the nitty gritty. Is there a department to look out for? How do they handle mental health? What are some fun things that you’ve gotten to experience since being there? etc.
  4. Do take notes. Take notes of the people talking. Take notes of the people’s names who interviewed you. If you interview at KCU, you can actually look up the faculty by first/last name or department. Most of them have photos (not all). That way you can get their names to write them a thank you note!
  5. Do pay attention. I know it is long, and exhausting. Try to be as attentive as possible.
  6. And for christ’s sake. Be friendly. Mingle. Chit chat. Show you are a communicative person. Everyone is nervous, but they look to see if you are by yourself or mingling or entirely hogging the spotlight.

Let’s see, what else is important… Oh, ask your interviewers questions!

Ask those questions back when you are being interviewed! It is okay to have a list of previously made questions. This is why you brought that bad of paper/portfolio. Well, along with other things. But this is where it will also be of use to you.

Again, don’t ask those damn curriculum or grading questions. It’s a cop-out, and they hate it. Interviewers can tell you don’t actually know anything about the school or you didn’t put any thought into your interview. 

Ask what you want to know about the school. So think about this while you are writing your questions. Some examples:

  • Why did the professors choose to teach there?
  • Why did the professors choose teaching in general?
  • What are they passionate about? And how did they become passionate about that topic?
  • How do the students feel relative to x, y, z?
  • Are the students/professors/staff happy with their choice of school?
  • Is there something they absolutely love about their school/campus?
  • Is there something they dislike about the school/campus?
  • If there is one thing you could change about this school or campus, what is it?
  • What is a hidden gem in the area/community that you love to go to?
  • Since I’m in town, what are some great places to explore before I leave to really get to experience the area?

Post-interview:

Don’t bombard them with an answer after you interview. If they tell you how long it will take to hear back, expect it to take that long. It will just be a pleasant surprise if they give you an answer before then! I think KCU typically takes 6 weeks to decide. They do several interviews and then make a decision on that chunk of interviews for everyone. Know that any thing around holidays or breaks will take longer or be closer to that 6 weeks.

But if they don’t tell you during the information session, it is okay to ask how long you can expect to hear back. If they don’t get back to you in the time they told you they would, then reach out.

Thank you notes

Honestly, doesn’t really matter if you do these. I usually do just as a nice gesture, but you do not have to. Again, make sure you are writing down who you spoke to and interacted with on the day of the interview.

  • You can write a general thank you to the admissions team
  • You can write a thank you for all of your interviewers, or you can send them one specifically.

It is fine to be generic or have a template, but it won’t be as touching. If you choose to thank the admissions team, it can be more general. But for your interviewers, make sure to add in what you spoke about (i.e. what topics you discussed outside of their set interview questions).

I’m pretty sure most schools don’t factor in if you sent a thank you letter into their decision. It is just a nice touch and helps keep things professional.

If you do write them, write them immediately and send them off within a few days to a week of your interview. It is bad etiquette to send it in later than that. Plus, you are likely to forget details of your interview as time passes.

What about non-interview scenarios? Like MMI’s or skit scenarios?

Well, I’ve had a few and so has my significant other like this. What are the types of interviews you can walk into:

  1. A panel. It is you and several people all starting at you. It could be 3+ people. Very intimidating. Expect at least one to try to be a bitch or hardass.
  2. One-on-one interviews. You will usually have many if you do one-on-one. That way, each interviewer can ask the same questions to everyone and a range of people get to meet them. However, I’ve had one interview where only one person interviewed me for 45 minutes. It depends.
  3. MMI or multiple mini interviews. This can consist of a mini scenario on the door and then you go in with your answer and answer questions. This is the only non-traditional type of interview I did. Sometimes this will include a small group project.
  4. Acted scenarios. These just suck. They usually include actors.

The whole point of these is to see how you act under pressure and under a possible chaotic scenario. Can you keep your cool? Can you calm the situation and answer in a well-thought out manner?

For my MMI, I had several mini scenarios (ethics, non-ethical, questions for me) that I had x amount of time to read and think of an answer, and then x amount of time to present that and answer additional questions with the interviewer.

For the scenarios, thankfully I didn’t have this. But my significant other did. He said most of the time the scenarios were absolutely outrageous, could include politically charged or controversial topics just to see how you would react, and if you could calm the scenario down and answer appropriately. I think this is ridiculous and not a good judge of character. And personally, I wouldn’t want to go to a school like that. But I digress.

Also know that you will likely have to do a group activity. How do you work well with others? Medicine is a team sport after-all!

The other big thing is schools are now asking you to do a writing prompt on interview day. This is to see if your interview paper materials are similar to how you wrote on the day of your interview. They want to know if someone else did your personal statement, answered your secondary questions or if you did it.

One last major thing…

I know. This post is long.

SET YOUR SOCIAL MEDIA ACCOUNTS TO PRIVATE DURING INTERVIEW SEASON.

I’m not joking. There are people at the university or interviewers who will look you up online and see what you’ve posted. And since the type of information they gather from an online search is very subjective (based on the interviewer), a drinking photo, a smoking photo, doing weed, partaking in questionable activities, etc can all come back and bite you in the ass.

Set it to private. Keep it private. Once you have been accepted (or denied) and interview season is over you can set it back to public. Once you are in they don’t care. But it could be JUST the extra thing they needed to kick you out and give you a denial or waitlist. Don’t do that to yourself. Give yourself every chance.

And uh, I think that’s it. It’s a long one, and hopefully a helpful one. I recommend you look at many different sources for this to prep, but always take each person’s experience with a grain of salt. Just because it was easy for one person doesn’t mean it will be for you or that it was actually that easy (they could be lying). Good luck with interviewing!

Pediatrics Rotation

Hello!

I wanted to give you an inside look on my pediatrics rotation. I am actually really passionate about kids and they just light up my day. I have to say, I usually feel physically tired at the end of the day, but I don’t feel mentally or emotionally drained when I work with kids. It’s really hard to! They are always a joy to be around (for me anyways).

Pediatrics is another core rotation. This means that I will have another shelf or COMAT exam at the end of my rotation. Most students work with a pediatrician in clinic for their core rotation. That way, you get to see a lot of well child examinations and really get a good look at growth through the ages.

I actually had my core rotation with the pediatric hospitalist group! Thankfully, I got to do well child exams and examine newborns during my ob/gyn rotation in family medicine/ob. I also got to do circumcisions during that rotation as well. For this rotation, there was a much different feel as we were inpatient.

Much sicker children.

Much higher acuity.

Note taking is also very different from your typical outpatient notes. It is still a SOAP note (in theory anyways), but your most detailed note is the H&P when they first get admitted. More on that later.

Schedule/Daily Work Hours

This rotation was a little farther away from my last one, so I did have to get up earlier and drive farther. Not my favorite thing to do since I dislike mornings, but you do what you need to!

Around 7:15/7:20am: I get to the hospital and go up to my floor.

7:20-8am: I am reviewing notes on what happened last night and rounding on my patients. The floor can hold 19 rooms (2 kids per room), but they don’t typically like to double up in the rooms unless they have to. As a medical student, if I don’t have any patients that I’m following I MUST round on two of the patients on the floor. And I need to have seen my patients before huddle and before the provider comes to the floor. Some days I was able to push myself and see more than 2 patients.

8 am: Huddle. Huddle involves everyone in each child’s care to be present so everyone knows what is going on and what the plan is. On my floor, the nurses present their patients and any updates overnight to the physician. Pharmacy, social work, nutritionists, and child life (enrichment and counseling) are all present during this.

Depending on when Huddle ends we will start rounding.

8:20/9am -10:30/11am is rounding. This time is very very variable. And if we get a lot of admits in the morning or consults, rounding will be slid in-between. Generally we take this time to check in on each patient and update the parents on what we are going to do. Not all the patients on the floor belong under the hospitalist. Some patients are under trauma (burn and MVC patients), some are under Hem/Onc (cancer patients). Everyone else is under the hospitalist group. We may also have someone in the PICU (down a few floors from us) to see as well.

After rounding the physician usually works on any discharges that they have. I use this time to work on my notes or look up information on the diseases some of our patients have. Some days we have a lot of discharges, others we have maybe one.

After rounding to 3/4pm. This is where we take consults, the provider calls for other consults to help with patient care, and check up on labs/imaging or order anything new. Most of these patients have a lot going on, and usually take up more time than you would expect. Some days we have barely any consults, some days we have a lot.

When the provider or myself isn’t taking a consult, they usually take that time to teach! The busier the day = less teaching. And after each time I take a consult or round on a patient, I need to write a note.

For example, today we had a kid come as a step-down from the PICU to our unit. So I was sent to the PICU to examine the patient and get a history to get things started while the provider did something else. I was also sent down to the ER as the ER wanted us to admit a child. So I again started that history and physical for the physician. At the same time, we had two transfers come in as direct admits; I took one and my provider took the other. And finally we had another ER admit. While that was going on, my provider was also trying to get a specialty consult appointment set up so we could discharge a patient, and consult another child’s geneticist who was being admitted.

They usually send me home around 3pm, unless we were busy and I would stay a little later. The latest I have stayed is around 5 pm. The unit I’m on has a rule about students not really being there past 3 and not to work on weekends. After discussing my hybrid situation with my attending, most of them are okay with me coming in on weekends to spend some extra time learning.

Notes

So note taking is a bit different for inpatient. It is still a SOAP note, but depending on the type of note will depend on how much information you put in it.

H&P: This is the note you write when admitting someone. So if you get a consult to admit from the ED, see the kid after a transfer to the floor from another hospital, or see the kid from a direct admit from their pediatrician, you do this type of note.

It involves a full HPI, ROS (multiple systems), and PE (multiple systems). The more complete = the better. You need to verify PMHx, SHx, meds, allergies, Family Hx, all that jazz. Some physicians also want a good social history; which for kids involves who they live with, if they go to school/daycare, any pets, any activities they do. If they are still infants or young toddlers, you need a birth history from mom.

Assessment for the H&P isn’t always what you end up diagnosing them with. For a lot of kids that fall under “failure to thrive” I usually put poor weight gain. Because one person’s definition of FTT is different from another. And a lot of times physicians use FTT instead of poor weight gain. So my initial assessment/dx is a working dx or a symptom unless something specific was found on workup.

Plan is much more in-depth and usually involves going by system. So a plan for an admit may look like this:

  • Resp: on RA, oxygen, albuterol q.2 hours, etc.
  • CVS: Hemodynamically stable. Will monitor vitals q.8 hours.
  • GI: (usually includes diet). PO diet as tolerated. Consult dietician and SLP for evaluation.
  • Renal/Endo: I never put anything here unless its a specific case for it.
  • ID: If we did a respiratory panel, stool panel, etc we would put findings here. This is also where we may put antibiotic plan here.
  • Neuro: If there I something specific like EEG or MRI or near consult we put that here. Otherwise usually Tylenol/motrin for pain will be put here as well.
  • Social: where we typically put that we’ve updated the parents on plan.

Any labs or imaging can be put under their associated section OR I usually pt it above with a statement to make it nice and neat. It just depends on how you do it.

Progress notes: So this is what you put on a patient that you’ve rounded on. Since insurance only covers one “bill” a day, only the day shift rounds on patients in the mornings. The night doctor doesn’t do any notes that would fall under progress. Some physicians like to add the day # at the top.

HPI for this is usually any updates since last written evaluation. So this can be that management was switched in the afternoon or evening, and how they did overnight. Did they spike a fever? Did they vomit? Diarrhea? How did they sleep? (very important in gauging kids). Did they eat? Can they tolerate PO? Were they playing yesterday? All of that is important.

ROS you don’t typically do for a progress note since the HPI is an update on how they are doing.

PE can be limited to a few systems. If it is a newborn/infant, you need to do a full exam every.single.time. Otherwise, I usually do constitutional, skin, eyes (if old enough), heart, lungs, belly, and neuro. You can add/subtract from there. Or you can do a full exam each time. It’s up to you.

A&P: similar set up as before. You either define/find a better diagnosis or continue to use the previous working diagnosis. Or maybe you use the working diagnosis and add on more based on findings and how the kid is doing. Plan is set up the same way. Any changes to treatment, any added medications, consults, labs/imaging need to be added. If you have an idea of what you are looking for before you discharge them, make sure that is noted in your plan. Otherwise the next attending on may not remember from sign-out what you’ve told them.

Discharge note: This is a brief HPI, PE, pertinent lab/imaging findings, and A&P. Plan should include follow up with their pediatrician and any other specialists, any follow up labs/tests you need them to get, and what symptoms they should look for that would prompt re-evaluation. Any medications you are discharging them with and how to use them along with any patient education needs to be in the plan and patient papers. Most of the subjective can be wrapped up nice and neat in a summarized “present” during their whole time there. Some providers like to have a full few paragraphs on the course of what happened while there. Others do less involved. PE should be pretty damn near normal or as normal as they can get for their condition before sending them home. Like, you shouldn’t be sending home a kid who is in respiratory distress and it shows that on your exam.

Cool things to see on the floor:

  • Trauma (although I didn’t manage any of those and neither did the hospitalist).
  • Burns (also trauma)
  • hem/onc patients (we didn’t manage this, but interesting to look up and study)
  • pyelonephritis
  • asthma exacerbation
  • bronchiolitis/croup/pneumonias. One pneumonia was chlamydia related!
  • appendicitis
  • LOTS of pyloric stenosis at this floor. Like holy crap.
  • omphalitis and cellulitis
  • scalded skin syndrome vs toxic shock syndrome vs weird allergic reaction
  • osteomyelitis
  • diarrheal diseases
  • so much failure to thrive/poor weight gain. Some of them are due to dehydration, some due to poor feeding schedules/too much given by parents/not enough given/not feeding at night. Some are the kids had a virus and everything got out of whack. Some of them are actually from some pretty serious diseases.
  • Febrile seizures was also pretty common to see.
  • Hirshprung’s disease.
  • rule out Kawasaki’s
  • Seizures (several had associated genetic diseases)
  • Duodenal hematoma (that was actually really interesting to look into management)
  • BRUE
  • Seizure management and workup
  • Abuse cases 🙁
  • Kids with genetic metabolic diseases and the fall out/recurrent issues that occur with those.

I most definitely spent time reading during clinic while my providers were doing phone calls or charting. That allowed me to cement a case with what I saw and with the information about it.

What are some major things I learned?

Well besides how inpatient medicine works and learning about kid diseases, I learned more about interacting with patients than I thought I would.

  1. I need to know my cases well, because parents will still ask me questions. I need to do my best to answer with correct information; and if I don’t know, I need to be able to defer it for when my attending arrives.
  2. Just because you are worried about a disease course for a specific disease/problem, doesn’t mean you need to tell the parents all of that. Lesson learned. That mom didn’t like me very much.
  3. You need to do a full exam. Every. Single. Time. As a student, it is time for you to practice. Not good at listening to murmurs? Listen to all the hearts. Not good at finding pulses? Practice. Plus, since your differentials aren’t fantastic yet, it helps you possible catch something you weren’t sure could be helpful!
  4. I have learned that even though you can complaint or discuss something in person, you cannot write certain things in your notes. Even if it is causing you issue with management of a patient. Word truthfully, but without accusing or painting a non-neutral picture in the chart.
  5. I really really like kids. And I really really like babies. Which is NOT helping me push off having children.

Hope this was helpful, and good luck on peds!