Interesting Case Residency Interview Question: How to Answer

Why the “Interesting Case” Residency Interview Question Is Asked

You will likely be wondering, “what do residency program directors look for?” In terms of the interesting case question, it can be helpful to know why a program director might ask this question:

1. The first and most important reason is that they want to evaluate your medical knowledge and patient assessment skills.
2. They are checking to see if you can communicate your answer and, in a way, make a compelling case for that patient scenario being “interesting.”
3. They want to use your answer to jump to another related question.

Students often think that program directors ask this question because they want to evaluate your perceived commitment to your chosen specialty. While it’s true that they do value this quality, that isn’t exactly the aim of this question. You don’t have to present a clever diagnosis or a bizarre patient case; most medical students don’t have an extensive enough inventory of cases to draw on besides clerkships and medical school electives – interesting doesn’t have to mean challenging or complex.

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What Makes a Patient Case Interesting?

Many medical school graduates are nervous about this question because they don’t remember all of their patient cases in enough detail. While this is a residency interview question you must know, you don’t have to have a photographic memory to have a strong answer.

In fact, going into too much detail can distract from the purpose of the question, which is to show the program director that you can communicate effectively. Still, you will need to refer back to what you wrote in the ERAS experience section to develop a good answer.

What makes a patient case interesting? That’s entirely up to you, but here are a few common reasons:

• The case was personally meaningful or inspiring
• It influenced your desire to pursue a particular specialty
• It taught you a lesson about what it takes to be a medical professional
• It had an unusualness to it that made it memorable

How to Structure Your Answer to This Question

1. Pick a case from a clerkship in your chosen specialty

While you don’t need to talk about an experience that inspired your decision to want to pursue a certain specialty, you should ideally be prepared to talk about an experience in that specialty. You need to show that you know how to choose a medical speciality with confidence and forethought. For example, if you’re applying to internal medicine residency programs, you should be able to talk openly about what you like about the average day of an internal medicine specialist, rather than encounters with special or extraordinary cases.

2. Describe what stood out to you

Carefully reflect on what stood out to you about the experience. You may not remember the diagnosis, but you should remember personal details about the patient; perhaps they made you laugh, think, or become frustrated. Don’t get caught up in trying to trace down every small detail – look at the bigger picture of why the case was memorable. Your perspective is reflective of you as a person and as a candidate. You can’t present a case that you read or heard about – it says nothing about your personality or your subjective experience. If you’re still having trouble thinking of a good answer, consider a residency application consultant.

3. Show enthusiasm

Your description should be full of strong adjectives that show enthusiasm for a medical career and your chosen specialty. Note that a lot of the residency personal statement mistakes to avoid also apply to the interview: don’t simply list each step of the patient interaction in excruciating detail. Enthusiasm is more than just what you say, it’s about your body language; showing brightness in your expression will improve the quality of your answer, and it will show the program director that you have a positive, professional attitude.

Sample Answer #1 to the Interesting Case Residency Interview Question

I remember one of my patients in a family medicine rotation at a clinic, who was an eight-year-old boy with bilateral vision blurriness. His vitals were within normal range, he didn’t have a prescription for glasses, and his medical history indicated nothing substantial. It was, admittedly, hard not to crack a smile at the boy, who was incredibly curious and interested in picking up every instrument in the room. His father got upset with him and asked him to sit down on the patient bed; he listened, but at the end of the assessment, I let him take my blood pressure with the sphygmomanometer and my temperature with the ear thermometer. He enjoyed that. I shook my head with amusement when he left the room.

His actual complaints were peculiar and took some investigation to figure out what was going on. He had trouble distinguishing shapes held from a short distance but denied any sort of traumatic cause. We ordered a consultation with an ophthalmologist, who discovered optic nerve swelling; we ordered an MRI to assess potential structural causes, which revealed the presence of bilateral optic neuritis. We performed a series of other measures, including lumbar puncture and cerebrospinal studies.

The patient had returned to the clinic a few times to discuss treatment and procedures. Sometimes he was with his mother, sometimes with his father, or both. Without fail, he always asked if he could take my blood pressure and temperature – of course, I agreed, how could I say no? He was one of the few children who not only wasn’t afraid of any of the procedures he underwent but actually looked forward to them.

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Sample Answer #2 to the Interesting Case Residency Interview Question

In a dermatology clerkship, I had a patient who was experiencing hair loss on her parietal scalp; it was really patchy, and I thought initially when she came in that it was a case of trichotillomania, which I had a distant awareness of from a few case studies I’d reviewed in a class. The patient was what she described as “being in a bad way,” which is I guess an antiquated way of saying she was anxious or depressed. She was just 15 years old; she had trouble speaking without stumbling on her words, and it looked like she was on the brink of tears for the entire consultation. I took her medical history, which revealed nothing relevant to the hair loss.

It was difficult to discern potential causes from questioning the patient, because she was having trouble speaking. I gave her a moment to take a deep breath, sat with her, and then once she seemed to have calmed down a little bit, I began the examination. I knew that all she was interested in was an answer, so I didn’t want to make her wait longer than necessary. She told me that no lifestyle factors preceded the hair loss, including stressful life events or dietary changes; she also had no other family members who reported hair loss, besides her father. She said she hadn’t tried any treatments, but that she had been trying to add extensions or wear a hat to avoid being made fun of. Her situation made me sad – she’d been avoiding school and was terribly afraid of having her fair fall out in public.

We confirmed a diagnosis of alopecia areata. We began treatment right away using intralesional corticosteroid injections. It wasn’t a particularly idiosyncratic patient case, but I do remember the anxiety of the patient very clearly; most of her relief came from simply knowing what the cause was. To be honest, the main reason I remember her specifically is because I sympathized with her; she pops up in my thoughts occasionally as a victim of bullying myself. I did also learn that there’s a lot more to treatment than just a correct diagnosis. The markers of anxiety are often subtle; I felt like it was a good chance to practice allowing the patient to dictate the assessment in a way that was comfortable and agreeable.

Sample Answer #3 to the Interesting Case Residency Interview Question

During a psychiatry clerkship, I was working in an inpatient facility, where I was exposed to a lot of patients with a variety of mental health issues. I could probably go on and on about cases that were interesting, or at the very least memorable, but to give just a single answer I’ll go with a patient who was in his mid-thirties who had treatment-resistant chronic depression. He had a remarkable memory, and he was incredibly sharp to a degree that I didn’t think was possible, especially for someone who was struggling so severely with a chronic condition; it was inspiring. He described himself as having been generally in a low mood since before high school, which he attributed to transitional periods in his life; he told me that his first episode occurred when he moved to a new city and primary school. His parents both started new jobs, so they weren’t around as much. He didn’t make many friends, despite joining sports teams and clubs.

He'd been on SSRI medication in recent years but reported feeling numb and apathetic. We started mindfulness-based cognitive therapy (MBCT) as an adaptation to his treatment-resistant status. What was interesting about this patient was his willingness to “try and see the positive,” despite multiple unsuccessful attempts to resolve his condition. I also admired his perspicuous memory; when I asked him how it was so sharp, he told me that his theory was that 10 or so years of being a taxi driver had something to do with it. On a clinical level, it was interesting to see a patient who was treatment-resistant; he had a long clinical history of different treatment methods failing, so our goal with MBCT was also to modify the way we discussed his illness. Instead of focusing on the depression itself, we addressed the symptoms.

Sample Answer #4 to the Interesting Case Residency Interview Question

In emergency medicine, it often feels like most patients we see are exceptional or memorable in some way, which is probably because most of the time, the situation is urgent and requires us to work quickly. I got quite the jolt when on my first day at the hospital, we had a patient who had been brought in by ambulance and was suspected of overdose or alcohol poisoning. The patient was unconscious when he arrived, but we were told that he’d been vomiting profusely in the ambulance; his temperature was very low and his clothes were wet with perspiration. We checked his vitals – his heart rate was very low, his breathing was slow and irregular, and his oxygen level was also dangerously low. We pumped his stomach and set him up with an IV. We were lucky to be early enough to treat him via gastric suction.

What made this patient case memorable for me was the adrenaline rush – it was my first day of the clerkship at the hospital, and without warning, we had a patient whose life was in serious danger. The physicians I was working with were incredibly quick to identify the problem and the solution. The patient had no other substances in his blood, which was also another stroke of luck: since they’d arrived at the hospital so quickly, we knew that gastric suction would flush out any other substances that might have required further treatment. I learned that I enjoyed the urgency of the situation and thrived in it. I also thought the precision with which physicians, nurses, and technicians interacted was seamless, like a well-oiled machine. And this was really the first instance of when I could appreciate the work as someone who was part of the team instead of on the sidelines.

Sample Answer #5 to the Interesting Case Residency Interview Question

I have a rather simple and yet ordinary patient case that I found interesting – she had arrived at the clinic where I was doing my internal medicine clerkship. It was a small community clinic with eight doctors and a nurse practitioner. A young woman who was in her teens complained of headaches and back pain; she told us that she was a rugby athlete with a history of concussions, so the routine was familiar for her. We performed a physical assessment and found that there was some pain emanating from a disc in her thoracic spine, so we ordered an MRI, which confirmed the diagnosis.

We discussed the results in another clinical session; some of the pain had subsided, and her headaches weren’t as severe when she returned to the clinic for a second time, so we prescribed her an anti-inflammatory medication and told her she needed to take a break from sports and strenuous activity, especially lifting. She wasn’t convinced that her injury was severe enough to warrant rest and was adamant that her team needed her. She was rather irritated by the suggestion, so we sat down with her and went over the results of the MRI once again; we explained that she was perfectly capable of making her own decisions but that the consequences of refusing to rest could increase the likelihood of permanent nerve damage and chronic pain. She was competing at the high school level with a dream of making the state team, so we cautioned her accordingly without trying to tell her what to do. Ultimately, she left the clinic upset but convinced that taking some time off wouldn’t be so bad.

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