Illegal questions are always a hot topic surrounding interviews. As you all know, the NRMP sets very strict communication rules surrounding the Match process, and have very specific requirements of what constitutes “legal” communication. 

From the proverbial horse’s mouth, the NRMP Code of Conduct reads:

“To promote the highest ethical standards during the interview, ranking, and matching processes, program directors participating in a Match shall commit to:

Refraining from asking illegal or coercive questions Program directors shall recognize the negative consequences that can result from questions about age, gender, religion, sexual orientation, and family status, and shall ensure that communication with applicants remains focused on the applicant’s goodness of fit within their programs”.

Furthermore, federal law prohibits most of these questions for any job, not just residency, and it is illegal to make hiring and firing decisions based on this information. 

SDN, reddit, ValueMD, the usual forums people frequent usually have some version of “is this an illegal question” threads with arguments for and against.

My personal and professional thought are that they will happen. Overall - it will happen - these things come up in casual conversation all the time, and usually work their way into conversations that are comfortable during an interview session. Sometimes it is not the interviewer, but the applicant who brings it up, and the conversation flows from there.

Just a quick PubMed search has a 2016 study from Academic Medicine with a sample size of 11,000 applicants - Two-thirds of applicants reported being asked potentially illegal questions. Their data revealed that more women than men reported receiving questions about marital status or family planning in that study.  Similar results were reported in the initial study in 2013 in the same journal - about two-thirds report an illegal questions, and questions about marriage and childhood were a large majority of those questions.

There is no red light, no button, no siren that goes off, and no red phone you pick up to report the incident when these topics slip out, and my recommendation is to just keep rolling and try to redirect to more topical issues.

The rules are there to protect YOU, so you can offer the information, hospitals are just not allowed to ask you. Conspiracy theorists will say that you will give too much away by asking these loaded questions - and that may be true, but I’d say you are reading too much into it.

Often these are not brought up in a malicious way. Some examples of how they can work their way into conversation:

The real Catch-22 in my opinion is that they are important issues to you as an individual - if you have kids childcare is important - if you are a specific religion, perhaps being close to a specific house of worship is important - lots of decisions can hinge on these so called “illegal” topics and could help you pick one program over another, or at least give you some comfort about your overall “fit” with a program. . 

If you feel you have been targeted - discuss first with the PD, then the NRMP / ACGME.

Thanks for listening, hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.matchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in paperback and eBook - less that 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages. Take care.

I recently had the opportunity to chat with Dr. Megan Tresenriter, one of the creators of Swap and Snooze - a free service you can use right now when scheduling interview travel.  They help arrange medical student hosts for interview candidates to not only help you save some money on the interview trail, but also get an authentic experience and see how the students or residents at that hospital live, their surrounding city, and a look at life outside the hospital.

I take full responsibility for a patchy internet connection the day we talked, but we managed to edit together a good bit of our conversation - so without further ado - Dr. Tresnwriter:

Thanks for listening, hope you enjoyed the content and find Swap and Snooze useful on the interview trail. With all of the money you’ll save on hotels, you can pick up a copy of our book, or contact us for personalized coaching services and mock interviews. 

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

Thanks again, remember to send you questions to us through our website at www.matchgurus.com, or twitter @theMatchGurus. Take care.

While I’m sure you all hang on my every word, just in case any of you skip to the next track at the at the end of every show, I want to lead off this episode with a reminder that my partners and I are primarily a boutique coaching and mock-interview service. Too many times we’ve seen very strong applicants either sound average or even absolutely tank their interviews, and conversely weaker candidates outshine their peers and end up high on rank order lists. Interview day means a lot, you only have a handful of hours with a handful of people to impress, and there are things we can teach you that help you put your best foot forward when it matters the most. Our calendar is filling up quickly, but we offer a free 15 minute trial to show you what we can do, and our most popular package is now discounted for the remainder of this 2017 season to just $499 for three 30 minute interviews.  After the first interview, you’ll end up with explicit feedback on your verbal and nonverbal communication style, specific diction to use when answering questions that will help you stand out, and how to work the strongest points of both your personality and CV into the questions you are sure to be asked. We do the same homework I ask you to do and we role-play specific programs in specific cities to best simulate your actual interview day. The remaining two interviews give you a chance to put that feedback into action, and approach questions with a new angle that highlights what program directors want to see.  It is not too late to any of you who are listening to this in the middle of or even towards the end of your interview trail - if you were just blindsided by questions you didn’t prepare for, or had confidence walking into your first few interviews but now want to polish some rough edges before you talk with your dream program - drop us a line as well and we can look at our schedule.

Allright - for today’s topic, to cap off the questions you should be asking programs, I want to simply read an article I wrote for Student Doctor Network entitled The Million Dollar Question.  Link is in the shownotes, and it is based on advice I’ve given countless times, and still think holds true. I want to read it only so that the content isn’t diluted by one of my usual ramblings, and so that you can reflect on why you think it is important, and how it can help you ultimately  decide on the program that is right for you.

The Million Dollar Question

Interview season. The time of year that roads and skies swarm with the best and brightest medical students to all corners of the country taking aim at the next step in their training – residency. Believe it or not, behind the shiny brochures, extravagant dinners and polished powerpoint slides, residency programs are just as nervous about attracting top talent as you are about getting your top choice.

The interview trail is usually a blur of dry cleaning bills, rental cars, and the smell of breath mints masking cheap coffee mixed with nervous sweat. The broken record of the obligatory “strengths and weaknesses” question loops in your head. One of the more terrifying moments in the day comes when an interviewer asks: “What questions do you have for me?” Regardless of who asks it–the intern only four months above you in training or the gatekeeping program director–you know you have to ask something. So why not make it count?

Things like call schedule, orientation timelines, research requirements, away rotations, moonlighting, and meal plans may look important to you on paper, but should not be foundations of choosing one program over another. In fact, the best questions regarding most of these details can not truly be asked until you are in fact already a resident. The proverbial hindsight being of course 20/20. Is a meal plan a perk if the food is terrible? Moonlighting opportunities? Moot point if your paperwork and 45-minute commute are already pushing duty hour restrictions. It is simply not possible to ask an informed question on the specifics of most logistical things before setting foot in the hospital.

The best bang for your buck in this golden opportunity to ask them anything boils down to one “Million-Dollar” question:

Where do the graduates go?

Most programs are proud to tell you, and will have specific data on hand for at least the last 3 to 5 years. Fellowship, small group practice, academic center, private practice, rural areas, urban centers, with program alumni, unemployed, mom’s basement–the nuance in these specifics will speak volumes.

From this data you can easily glean:

• board passing rate
• research requirements
• the reputation of the program over geographic regions
• the reputation of the program in competitive fellowships
• a network of alumni to help with future job placement
• faculty strengths
• procedure exposure
• much, much more

If all graduates of the plastic surgery program you are looking at go into a maxillofacial fellowship at an Ivy League university hospital, and that aligns with your goals, great! You can assume the program has a good reputation, skilled specialty faculty, sound research, strong professional conference participation, and that residents see a heavy maxillofacial caseload. If this is not in tune with your dream of becoming a burn specialist however, you may want to look at programs with a different focus.

You may feel like a specific family medicine program trains the most well-rounded doctors by exposing them to a rural patient population and teaching procedures like colonoscopies and cesarean sections. If on the other hand, you were planning on practicing in an urban area after graduation, those procedures will be lost to specialist. A residency program at a larger training institution might be better suited to your future goals of working as a primary care physician in an urban, specialist-heavy environment.

Variety is paramount here. Private practice, fellowship, rural, urban, hospital setting, outpatient setting, in-state, out of state, etc. A diverse mix of jobs tells us that the graduates leave the program prepared for anything and are competitive in any marketplace.

Free white coats each year? That will run the department a few dollars annually. Free food? Maybe a few thousand dollars over the course of a residency. Daycare? I’ll admit that might be hard to pass up in certain instances. Upon graduation, however, the stakes go up exponentially. Consider the above scenarios: a plastic surgery program can graduate three to four residents annually with average starting salaries in the $300,000 range. A family medicine program can churn out six to eight graduates with starting salaries of about $150,000. Crunch those numbers, and you guessed it: $1,000,000 worth of contracts signed by each graduating class.

Follow all of the usual advice: put your best foot forward, have fun, be yourself, and get ready to talk about the summer research poster you submitted at least 30 times. When the time comes–and it will–remember the “Million Dollar” question, and pay attention to how it either expands or limits the scope of your future practice. Most importantly, envision yourself and your level of future happiness in the scenarios that unfold.

Closing:

Short and sweet today - thanks for listening, as usual I hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in paperback and eBook - less that 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages in more detail. Take care.

Today I’ll continue the series of questions you need to ask programs with three more areas of focus. Remember that each and every program will have some time for you to ask THEM questions. Not asking anything makes you come across as uninterested, asking something you can look up online makes you look like you didn’t do your homework, and asking good questions can show that you know what you are talking about.  

I’ll follow the AAMC document introduced last episode, link in the shownotes, and and cover three new topics. My goal is to explain the logic behind them, and let you know what to expect in an answer.

Employment Issues

• What are the basic resident benefits?
• Is parking a concern for residents at your program?
• Are meals paid for when on call?
• What is your family leave policy?
• Is there reimbursement for educational supplies and books?
• Are moonlighting opportunities available?
• What are the rules for moonlighting?
• How are residents represented at the institution level?

How is the resident member of GMEC selected?

• Is there a union? Is membership mandatory? Are there dues?
• Is there a House Officers Association?

Questions to specifically ask other Residents

• What are the strengths and weaknesses of the program?
• Would you consider the same program if applying again?
• Is there an appropriate balance between service obligations and the educational program?
• Is there enough ancillary support to minimize "scut?"
• What has changed since you came to the program?
• Is the program responsive to suggestions for change?
• How accessible is the faculty?
• Is the relationship with faculty collegial?
• Do the residents get along with one another?
• How do your residents get along with residents in other programs?
• In what activities are you involved outside of the program?
• How does your spouse/significant other like the city/area?

Questions to ask Yourself

Finally, you will likely find yourself facing a decision between one of several programs which are all extremely similar from academic and patient-care standpoints. At this

time, it is very important to consider factors relating to your personal happiness and comfort for the duration of your residency.

• Can I be happy working in this program and with these people?
• Am I confident in the program and the sponsoring institution?
• Are there factors that make this place (city/town/rural area) an attrac

tive place for me to live during my residency? (Factors that you may include are prox

imity to immediate and extended family, happiness of spouse/significant other, housing, cost of living, quality of secondary school system, community opportunities,

and recreational activities.)

Closing:

Unfortunately that’s all the time we have for today’s show. Thanks for listening, hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in paperback and eBook - less than 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages. Take care.

Today I’ll continue the series of questions you need to ask programs with three more areas of focus. Remember that each and every program will have some time for you to ask THEM questions. Not asking anything makes you come across as uninterested, asking something you can look up online makes you look like you didn’t do your homework, and asking good questins can show taht you know what you are talking about.  

I’ll follow the AAMC document introduced last episode, link in the shownotes, and and cover three new topics. My goal is to explain the logic behind them, and let you know what to expect in an answer.

Clinical Duties

• What is the general call schedule?
• What provisions are made for back-up call or sick-call coverage?
• What type of structure for supervision is in place?
• Do your residents express that there is an appropriate balance between independence and supervision?
• How does the resident’s autonomy change as he/she progresses through the program?
• What type of ancillary support is available (phlebotomy, respiratory therapy, social workers, etc.)?
• Does the general volume of clinical responsibility support a balance between service and education?
• Do your residents express they are involved in too much non-educational activity (i.e., “scut work”)?

Resident Performance

• How often are residents evaluated?
• What is the structure of the evaluation (forms, face-to-face, etc.)?
• What other forms of feedback does the resident receive ( in-training exam, etc.)?
• What support structures are in place for residents in academic need?

Program Performance

• What is the status of the program’s accreditation?
• If there were any citations at the last review, what has been done to correct them?
• When is the next Residency Review Committee (RRC) review?
• Are there any plans for changing the program size or structure?
• What is the status of the last Accreditation Council for Graduate Medical Education (ACGME) Institutional Review?
• How solid is the financial status of the sponsoring institution?
• How committed is your institution to resident education and graduate medical education in general? How isthis evidenced?
• What percent of your residents complete your program?
• What percent of your graduates pass the specialty boards on their first attempt?
• Where do your graduates go (e.g., fellowship, academics, private practice)?

Closing:

Unfortunately that’s all the time we have for today’s show. Thanks for listening, hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in paperback and eBook - less than 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages and mock interview services. Take care.

Over the next four episodes, I’ll cover the questions you need to ask programs. Don’t forget - during the interview process, they ask you plenty of questions, but each and every program will have some time for you to ask THEM questions. First of all, always have a question. Not asking anything makes you come across as uninterested.  

Instead of reinventing the wheel, there exists a PDF file online that has been floating around for many years put out but the AAMC that does a great job of breaking down the types of questions that will help you determine if a program is right for you. In the next few episodes, I’ll break those down for you, and let you know what to expect, why they are important questions, and what to look for in answers.

As always, there is a link to the document in the shownotes, or you can just google AAMC “Don’t Forget to Ask.”   

The document starts:

Don't Forget to Ask:

Advice from Residents on

What to Ask During the Residency Interview

The process of applying and interviewing for a residency position is complicated and can be stressful. This process involves both “selling” yourself to a program, as well as collecting the information that you will need in deciding how to rank the various programs you visit. Programs that you consider will all have unique strengths and weaknesses—some of which may not immediately apparent. The following list of questions was created by residents and students from various backgrounds as a guide to assist you in identifying and assessing those strengths and weaknesses. Use this guide in constructing your own more specific questions, and in exploring your own expectations and preferences. Your residency training is an important experience. Identifying the program that is best suited to meet your educational and professional expectations is paramount. Some questions are best answered by other residents in the program, and some questions you will need to ask yourself. Ask the program administrators and residents for specific examples that give a true understanding of the program.

Be honest with yourself about how you want your residency experience to be structured. Good luck! And remember, always be yourself.

Education

• Is there an orientation program for incoming residents?
• Is there a formal didactic curriculum, and what is its structure?
• What are the informal learning opportunities (i.e., bedside rounds, etc.)?
• What programs exist for resident education (e.g. , lectures, journal clubs, grand rounds, board review courses,)?
• Is there a feedback structure that allows for the resident to evaluate the program’s curriculum?
• Is attendance at regional and national conferences encouraged? Is it funded, and, if so, to what degree?
• What are the required rotations for the first year? Subsequent years?
• Are then any required rotations that take place outside of the city?
• Are there opportunities to do “away” rotations?
• Is there a formal mentoring program for new residents, and do faculty serve as mentors?

Research Opportunities

• Are research opportunities provided to residents? Is this a required experience?
• Is there a possibility of "protected" time for research?
• How are fellowships handled?

Teaching Responsibilities

• What teaching responsibilities for medical students are expected of residents?
• If residents have teaching responsibilities, how much time per week is spent with students? Is it "protected"?
• Is there any formal training for residents on how to teach students and other learners effectively, and how to

provide feedback?

Closing:

Unfortunately that’s all the time we have for today’s show. Thanks for listening, hope you enjoyed the content and find it useful.

Please subscribe to catch each new episode as they are uploaded, and if you find the content valuable please take a bit of time to leave a review on iTunes to help get the word out to other med students looking for answers.  Also feel free to give us some feedback on what you think we could improve on.

Remember to send your questions to us through our website at www.thematchgurus.com, or twitter @theMatchGurus - I personally answer every email and twitter DM we get.

To join the Myers Hurt Method Course, visit https://www.drmyershurt.com/themyershurtmethodcourse

 Our book is also available on Amazon in both paperback and eBook format - less than 10 bucks - it is a quick read you can easily knock out on the flight to your next interview. If you find it helpful, please take some time to leave a review for that on Amazon as well - it would means a lot. And of course, any of you looking for in-depth specialty-specific preparation for your interviews drop me a line and we can discuss our coaching packages and mock interview services. Allright, take care.