Practice Perfect 682
Residency Interviews 2019: A Director’s Perspective

Get ready students, here we go! Coming your way to a lovely hotel in Frisco, Texas. Yes, 4th year podiatry students, you too will be a participant in the yearly ordeal that is the residency interviews.

Even the name is intimidating: CRIP. The Centralized Regional Interview Program. Sounds like you’re part of a Los Angeles gang. Or the sound your white coat makes as you tear it up in frustration for answering that one wrong question. C-R-R-R-R-I-P!!! We can make a game show out of this except what you win isn’t a new car or that blender you’ve always wanted. You get…A NEW RESIDENCY!! Yes, it’s only the lynch pin to the rest of your professional podiatry career. Absolutely no pressure, right? …RIGHT? Gulp.

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As a student, I participated in the 2003 CRIP, and at that time there were actually three interview locations (East, Central, and West). On my way to the Central interviews in Chicago I had put myself under so much stress that I began suffering from hives. I vividly remember feeling a very itchy sensation while sitting in my airplane seat on the way. I first noticed it on my legs and then any spot on my forearms that touched the armrest. “Wow, why am I so itchy?” I thought. I pulled up my sleeve to see angry, red, itchy welts – hives. I suffered through the rest of the flight in wiggly discomfort, reading my study guide to distract myself from the itchiness.

When I finally got to my hotel room, I pulled off my clothes to see most of my body was covered in hives. In fact, every part of my body that contacted the seat had red, itchy welts. Yes, even my buttocks! I was breathing fine and didn’t have angioedema, so I didn’t think it was an emergency. In fact, I’d been suffering on and off with these hives for the later part of my 4th year of school. I initially thought it was due to a shrimp allergy but thank everything holy in the world (I love shrimp!!!), I found out later they were stress-induced urticaria. To be honest, even if I’d had an emergency, I was dumb enough that I wouldn’t have gone to the hospital. That would have ruined my residency interviews! Questionable priorities, right? Anyway, I laid down on the bed stark naked – anything touching my skin at that point was agonizing – and fell asleep. Thankfully, the next day the hives were gone, and interviews went well overall. I did, obviously, match with a program, and the rest for me was history.

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I tell you this story, 4th year students, not to make a complete fool of myself – I can do that just fine without any help, thank you very much – but to help you realize that behind the mask of residency program directors and faculty those people who will interview you went through the process themselves and actually understand what you’re going through. That doesn’t mean, though, that we’re going to take it easy on you. Oh, no!

Let’s take a glance behind the scenes. In my experience most students go into the interviews without a thought to the general environment of the interviews, and it might be helpful to understand the “physics” that guide those interviews.

Take, for example, the length of time for an interview. CASPR, the organization that runs the interviews, mandates a minimum of 20 minutes for one interview, and most programs do about 30 minutes. That means an interview has to be structured to allow the residency interviewers to gather what they need from an interviewee in that short period. A number of programs get around this limitation by having call back interviews and social events. That means, my intrepid young colleagues, that the socials are NOT places for you to let your hair down and have fun. They are NOT the places for you to get drunk and say dumb things that ruin your chance to get that program you want so much. My advice is to appear relaxed and be friendly – the program doing the social does want to see that you can interact in a social environment – but don’t let your guard down and do something stupid.

The short interview also creates an environment where the interviewers have to ask questions that have multiple purposes. If I ask you to talk me through a case of a diabetic foot infection, I can use that case to test your basic knowledge, organization, and thought process, while also correlating the quality and speed of your answers with your class rank. If you’re the valedictorian of your class, I’ll expect a different speed and quality of answers than someone ranked in the middle of the class. I can also gauge your reaction to the stress of the situation and how you respond to distractions during the questions. In some cases, the actual answer might not matter at all; the interviewers might want to see an interviewee’s reaction. Because there is likely to be subtext during the interview, the feeling you did well on or failed an interview may be inaccurate, so don’t stress out if you think you didn’t do well. You don’t want to sabotage your subsequent interviews.

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Similarly, social questions are deceptively simple appearing. Students spend so much time studying the science that they often fail to consider simple questions like “if you were an animal what would you be?” or “what’s the most recent book you read?” What makes these complicated is the virtually infinite number of questions that can be asked (so no one can be totally prepared), their requirement for us to talk about ourselves (something many people don’t want to do in an interview), and the fact that what is said in the answer may not be as important as how it is answered. These questions are also wide open for interpretation, which makes them doubly dangerous. For example, if I asked the question “if you worked in a restaurant what job would you do?” and you answered “I’d work in the kitchen,” that could mean you want to work behind the scenes (you’re not a leader) or it could mean you like to cook.

The key to answering this type of question is the fundamental instruction for all interviews: think out loud. State the reasoning behind all your answers whenever possible so the interviewers can fully understand your answers and not make mistaken interpretations. This also goes for academic questions. Think out loud. You might answer correctly without even realizing it. The only time this doesn’t apply is for rapid fire questions where the interviewers want short, simple answers within a couple of seconds.

Desert Foot 2019

Residency interviews are full of stress, and for some of you the stress will be a motivating factor. For the rest of you, hang in there, and do the best you can while looking like the stress is a motivator for you. For more advice from past issues see Practice Perfect numbers 582 - Interview Time, 533 - Succeed at the CRIP 2017, 483 - Residency Interviews and Resident Selection 2016, 433 - The CRIP 2015, and 374 - Upcoming Interviews: What I Want in a Resident. Good luck on your interviews, and I’ll see you at the CRRRRRIP!

Best wishes.

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor

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