A Deep Dive into Residency Interviews
Welcome to This Week’s Episode
Host: Dr. Feeley
Guest: Andrew Gatto, Six to Eight Weeks Producer and Orthopedic Surgery Residency Intern
Welcome back to another episode of Six to Eight Weeks: Perspectives on Sports Medicine! This week, we’re diving into the nerve-wracking yet pivotal experience of residency interviews, focusing on orthopedic surgery. Joining us is our very own Andrew Gatto, one of our interns and the technical wizard behind the podcast. Andrew isn’t just our producer—he’s also fresh off navigating the grueling residency application and interview process. With his insights, along with those of Dr. Lansdown, we’re unpacking everything from preparation strategies to red flags.
The Residency Application Process: A Quick Primer
Residency interviews are the culmination of an intense, multi-step process for medical students, especially in competitive fields like orthopedics. Candidates spend their final year of medical school completing sub-internships, also known as “sub-Is,” either at their home institutions or on “away rotations” at unfamiliar programs. During these rotations, students essentially audition for a spot, working alongside residents and faculty for a month to demonstrate their skills and fit within the program’s culture.
The application process also includes polishing CVs, writing personal statements, and applying to programs. From there, applicants navigate the interview season, culminating in “the match.” The match process uses a Nobel Prize-winning game theory algorithm to pair applicants with residency programs, even accommodating couples applying together.
But how do you ace an interview? How do you prepare for specific programs? And how do you evaluate if a program is the right fit for you? That’s where Andrew’s recent experience and Dr. Lansdown’s insights as a program director come into play.
The Role of the Interview in Residency Applications
Dr. Feeley:
“While the interview is important, it often serves as a confirmation of an applicant’s credentials. Rarely do interviews radically change how I view someone’s achievements on paper—unless there’s a glaring red flag. Most of the time, interviews enhance my impression of candidates. I want to see enthusiasm, honesty, and a genuine interest in orthopedics and patient care.”
Andrew:
“For me, the interview was an opportunity to show my personality and highlight aspects of my application that might not shine on paper. I also saw it as a chance to evaluate programs and residents—to determine if this was a place where I’d feel happy and supported.”
Dr. Lansdown:
“Interviews help us understand personality and assess fit, especially for candidates we haven’t worked with during sub-Is. Sometimes, the conversation reveals the true impact of an applicant’s achievements—things that might not come across fully on paper.”
Key Changes in the Interview Process: The Introduction of Signaling
Dr. Lansdown:
“The application process has evolved significantly. Over time, applicants started applying to more and more programs—sometimes over a hundred—because they felt they had to keep up with their peers. That created a spiral where programs received an overwhelming number of applications and had difficulty determining which applicants were genuinely interested.
“To address this, the signaling process was introduced. Each applicant is given a limited number of signals—30 in orthopedics, for example—to send to programs they’re most interested in. While you can still apply broadly, signaling helps both applicants and programs focus on meaningful matches.”
Preparing for the Interview
Andrew’s Strategy:
- Reflect on Goals and Strengths:
“Months before interviews, I reflected on what I wanted programs to know about me, both professionally and personally. I identified pivotal experiences in medical school that demonstrated my skills and values.” - Practice with the STAR Framework:
“I used the STAR framework (Situation, Task, Action, Result) to answer questions succinctly and effectively. For example, if asked about a challenge I faced, I could structure my response to provide context, my role, what I did, and the outcome.” - Prepare for the Tough Questions:
“Ethical questions were the ones that scared me most, so I spent extra time practicing those. Mock interviews with friends, residents, and family were invaluable in helping me refine my answers.” - Research Programs Thoroughly:
“I scoured program websites, talked to residents, and even checked social media for a sense of the program’s culture. Social media gave me insights that weren’t always apparent on official pages.”
What Program Directors Look For
Dr. Lansdown:
- Enthusiasm and Motivation:
“We look for future leaders in orthopedics. Leadership can manifest in many forms—research, clinical excellence, global health, or education. We want to see what drives a candidate and how they plan to use our program’s resources to reach their goals.” - Honesty and Professionalism:
“Transparency is key. If a candidate exaggerates their role in a project or misrepresents themselves, it raises serious concerns about trustworthiness.” - Self-Directed Learning:
“Orthopedics requires a growth mindset. We want candidates who are eager to learn and adapt, especially as adult learners navigating the complexities of residency.”
Evaluating Programs as an Applicant
Andrew:
“It’s easy to forget that you’re also interviewing the program. For me, one of the biggest indicators was resident happiness. I paid attention to how many residents showed up to post-interview events and how engaged they seemed. At one program, no residents attended a virtual social, which was a red flag. At another, every single resident was present, showing their investment in the program’s future.”
Best and Worst Interview Questions
Andrew’s Favorites:
- “What’s your karaoke song?”
“It’s a fun icebreaker! My answer? ‘Country Girl’ by Luke Bryan and ’99 Problems’ by Jay-Z. It reflected my personality and got a great reaction.” - “What are the medical challenges of serving this community?”
“This question highlighted the program’s values and commitment to community health, which resonated with me.”
Worst Questions:
- “What programs have you applied to or interviewed at?”
“These violation questions are inappropriate. I kept my answers short and tried to redirect the focus back to the program I was interviewing with.”
Red Flags in Interviews
Dr. Lansdown:
- Inconsistencies:
“If a candidate’s answers don’t align with their application, it raises concerns about honesty and trustworthiness.” - Unprofessional Stories:
“Sharing overly personal or inappropriate anecdotes signals poor judgment.” - Lack of Engagement:
“We’re looking for candidates who are genuinely excited about orthopedics and the program.”
Final Advice for Applicants
Andrew:
“Anticipate challenges during interviews and practice ways to stay composed. Not every conversation will go perfectly, but it’s just one part of your application. Focus on being honest and redirecting conversations to your strengths.”
Dr. Lansdown:
“Prepare thoroughly, but also remember you’re evaluating the program. Ask meaningful questions that will help you determine if it’s the right fit for you.”
Dr. Feeley:
“Use the interview to highlight standout experiences that might not translate fully on paper. Show us your passion, your personality, and why you’d be a great addition to the program.”
Closing Thoughts
Residency interviews are as much about showcasing yourself as they are about evaluating programs. Preparation, authenticity, and reflection are the keys to navigating this process successfully.
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