Studying residency interview behavioral questions is a great way to prepare to answer these types of questions confidently. A program committee might ask a candidate to answer various behavioral questions to learn more about how that person handled certain experiences that are conducive to successful outcomes in the program. Sometimes, behavioral questions are referred to as situational questions, because both types of questions involve responses that describe a scenario and end result. The goal of these types of questions is to draw out information about a candidate’s key traits that a program deems important to possess. If you’re interested in improving your ability to answer these types of questions, keep reading, because we’re going to highlight behavioral to know with sample answers, and outline why programs ask these types of questions.
Interviews enable programs to meet their applicants and assess their qualifications for the program. Because interviews can be stressful, it can helpful to create a plan. Alternatively, for US applicants, you can create an plan to help you in advance. Residency behavioral questions refer to questions where candidates are asked to provide an explanation of a past experience involving a challenging or noteworthy situation. Because these questions belong in their own unique category, it’s important to distinguish interview skills that can help you answer them. The goal of these types of questions is to assess your ability to make decisions and problem-solve in challenging or ethically ambiguous situations. Some of the questions might involve experiences the candidate had outside of medicine if the experience highlights good judgement or decision-making skills.
More tips for your interview prep:
These types of questions are predicated on the assumption that past behavior can reliably predict future behavior. In principle, if programs want to evaluate your competency as a candidate, knowing how your thought-processes and knowledge manifest in desired behavior is a good way of evaluating your credibility as a candidate. They want to get to know you professionally, as well as personally, which is why programs often ask during your residency interview. These questions are typically aimed at experiences the student had in medical school, during , in a previous job, during clinical rotations, undergraduate years, volunteer hours, or life experience. As you can see, you do not need to use experiences only related to medicine. The key to keep in mind is whatever experience you choose to use, make sure it demonstrates your good judgment.
For IMG applicants, it’s important to note that the can be slightly different due to the experiences and obstacles unique to this group. An is someone who completed their medical education outside of Canada or the US but who want to practice in either country. IMGs can still use the same strategy to answer residency interview questions, including the ones that address their IMG status specifically. Let’s break down strategies for practicing your responses to these types of questions:
There are a variety of reasons why a program might ask a candidate behavioral questions, but the primary reason is that these questions can help demonstrate the reliability and presence of the candidate’s or . To identify these core competencies, you might refer to the ones you used on your section on your application for residency. Using these as an evaluation guide, programs can assess the probability of success the candidate will have in the program. Examples of core competencies include team work, communication, reliability, critical thinking, and adaptability. Familiarize yourself with these core competencies when you prepare for the interview and keep them in mind when you prepare an answer.
Another strategy for answering a program’s behavioral interview questions is to research their end-of-rotation evaluations. End of rotation evaluations refer to the ways in which a program will evaluate the performance of the resident. Using the information described in a program’s performance metrics, you can identify what traits and qualities are important to discuss in your interview answers. An example of an evaluation question given to supervisors in internal medicine might be “does the resident seek advice from colleagues before offering treatment for patients?”
Another example of resident assessment is patient or peer evaluations. These are anonymous surveys that evaluate , as well as general clinical performance. Programs may also use self-surveys to evaluate their own progress so they can identify potential areas to improve. When you’re practicing your answers, consider the learning objectives involved in the clinical areas within your specialty to help guide your answers.
Another common evaluation method is the mini-clinical evaluation exercise for trainees (mini-CEX). This method is used to assess essential clinical skills of the resident, which can involve a variety of different behaviors. Typically, the test involves observing the resident during a real patient interaction and providing feedback on their performance so they can improve in the future. In your interview practice, include a few questions that involve communication or interpersonal skills that showcase your ability to apply these traits.
Putting these assessments in context of residency interviews, the residency committees want to know if you meet the Core Entrustable Professional Activities (EPAs) for their specific program. These EPAs are activities or tasks that medical students are expected to know how to perform upon entering residency. This system allows supervisors, colleagues, and patients to assess the performance of residents, in terms of both behavior and knowledge. Because programs typically want to see how candidates apply EPAs in a clinical setting, they might ask questions about your experiences during clinical rotations. When you’re practicing your interview answers, it’s helpful to reflect on what you learned during your clinical rotations and consider a few specific experiences so you can prepare to discuss them during the interview.
Wondering how to answer this tricky question?
1. A patient enters your clinic who you suspect might be a drug user. During your assessment, he asks for a prescription to painkillers. What do you do?
I believe the best course of action in a situation in which the patient is clearly exhibiting drug-seeking behavior would be to gently ask the patient why they think they need painkillers, facilitating an open and honest conversation about their relationship with the substance. I would explain to them that a prescription to painkillers isn’t necessary based on my assessment, but that I would be happy to hear why they think the contrary without making any suggestion of addiction or accusation of deceit. If they confess that they wanted to use the drugs for no valid medical reason, I would gently discuss how a drug rehabilitation center could benefit their mental and physical well-being, as well as gradually lower their dependence on the substance. I would show sympathy for the patient by explaining that recovery is possible if we can collaborate, and that I would be happy to answer any questions they had about treatment options.
2. Can you describe a situation in which your initial assessment was proved wrong?
There was one instance when I was working in a clinic where a patient arrived, complaining that in the morning of the previous day, they were experiencing chest pains, faintness, difficulty breathing, and other classic symptoms suggestive of a cardiac event. The patient explained that it didn’t last very long, but that they were concerned about what this meant. My supervisor and I both agreed that we ought to order a blood test to do an enzyme reading. However, when the test results came back, we saw that there were no signs that the patient suffered a cardiac event. While we were waiting for the referral to be approved, I noticed that the patient had been taking medication for anxiety. So, I asked the patient about their mental health and the medication they were taking. They told me that they were taking medication for panic attacks, and that it was possible they forgot to take the medication yesterday and the day before. With this information, we decided that it was pertinent to keep the cardiologist referral just to be safe. In this situation, the solution came down to gathering enough information to rule out other causes. In other words, we had to take a more long-term approach involving regular evaluation of the patient’s symptoms, since the benchmark for the patient’s mental well-being was constantly moving due to the adjustment of dosage for her medication.
3. You’re working in pediatric oncology, and the patient isn’t vaccinated due to their parent's beliefs. Do you risk your immunocompromised patients and accept them into your clinic, or do you choose to deny the unvaccinated patient care?
In an ethical dilemma like this, I believe it would be best to deny the patient care at my clinic, and then refer them to a place that could provide them with the care they needed. I believe that the patient’s right to make their own choices for treatment shouldn’t give them the right to put others at risk, especially in pediatric oncology. I would make an attempt to elucidate the benefits of getting vaccinated, how it works, and address their concerns to the best of my ability. If they’re understanding and willing to get their child vaccinated, I would proceed with the vaccinations immediately so the patient can enter my clinic safely.
4. What would you do if you saw a colleague making a critical error when making a diagnosis?
If I noticed a colleague make a critical error in diagnosis, I would immediately ask my colleague if they had a moment to speak in private to avoid worrying the patient. Then, I would bring my concerns about their diagnosis to their attention so the patient doesn’t suffer any harm from the wrong treatment. I would make sure to establish that the patient’s health and safety is the priority before attempting to negotiate a different diagnosis. Then, I would point out what I think the critical error was, and what evidence exists for an alternative diagnosis, while maintaining respect for my colleague by using a calm and objective tone. Using this strategy, we would engage in a dialogue and refer to the information gleaned from patient interactions to determine the most correct diagnosis and treatment procedure.
5. Can you describe a stressful situation you faced and how you handled it?
Ever since I was young, I was involved in sports. I was on my high school baseball team in senior year and we were playing our last game of the season, which would determine if we would qualify for playoffs. The game was tied, and it was the 9th inning. After seeing two of my teammates strike out, it was my turn to bat. As I was waiting to step up to the plate, my coach pulled me aside and told me that it’s better to go down swinging than to go down without trying.
A couple years later, I was getting ready to submit my assignments for the week for two of my classes in my undergraduate degree program, when I noticed I’d forgotten about an essay I had to write for one of the classes that was worth 10% of my grade. During that time, I thought that it was better to try my best regardless of the late submission, rather than accept that I was going to get a bad grade. I ended up taking 3 extra days to finish the essay. I got a C+ on the assignment, but if I decided to just try and rush the assignment or disregard it altogether, I would’ve likely received a worse grade or a zero. Since then, I prioritize my responsibilities according to their urgency and importance in a calendar that notifies me of an approaching deadline at least a few days before it’s due.
6. How would you handle a situation in which a patient disagreed with your assessment?
Respecting a patient’s choices and autonomy is an essential ethical principle in medicine, but sometimes patients might disagree with a physician’s decisions regarding treatment or diagnosis. In a situation where a patient enters the clinic, certain about what’s causing their symptoms, it’s important to encourage them to talk openly about what’s bothering them and what their concerns are. However, if the results of the diagnosis conflict with the patient’s beliefs, it’s best to explain the diagnosis in full detail and show how we arrived at this conclusion. It’s also necessary to show why the patient’s concerns about what they thought was the issue were inaccurate by focusing on the evidence, while being compassionate regarding the confusion. Having a conversation about the patient’s values and goals can also help facilitate consensus and establish trust with the patient. If they have any additional concerns or questions about procedures, I would gladly discuss those with them.
7. Explain how you handle conflict using an example.
During my clinical rotations for internal medicine, I was assessing a patient who reported having some difficulty breathing with accompanying mental fatigue. When I was discussing the patient’s symptoms and reviewing their history, which involved asthma and a pneumonia, I was asked by the patient if I was a student. I replied positively, saying that I was, and then the patient explained that they didn’t feel comfortable being treated by a someone who wasn’t a doctor yet, and requested a fully licensed doctor instead. Initially, since I’d never encountered a situation like this, I thought the most ethical action would be to try to explain to the patient that I was being supervised and that I was capable of providing an adequate assessment. However, upon further reflection, I knew that it was within the patient’s right to be treated by whom they wish. I told my supervisor, and the patient was provided care by one of my colleagues.
8. Tell me about a time you did the right thing but it didn’t work out.
In my first year of medical school, I was studying for a semester test for biochemistry and one of my classmates asked me to help him prepare because he was having trouble understanding some of the concepts. I agreed to help him study over the next few days, but when it came time to do the test, I received a B-, which I understood as being a result of having spent too much time helping someone else study, rather than making sure I was as prepared as I should’ve been. In hindsight, I believe that supporting my classmate was the right thing to do, but that in the future, I could make a better compromise between helping someone else and ensuring my own success. Since then, I changed my protocol for deciding whether to help someone else with their studies based on the status of my own preparation. If I do decide to help, I establish two study schedules: one for myself, and one with my colleagues, to ensure I’m devoting the right amount of time to ensure my own success.
9. Can you describe your method of integrating feedback using an example?
During one of my clinical rotations, I was discussing anesthesia options with a patient. I established expectations for each option and went through a list of side effects. I provided the initial screening, in which the patient’s medical history warranted no special considerations regarding the anesthetic, so I elected to choose mild sedation for the procedure. Before the patient left, my supervisor explained to me in private that even though the patient’s medical history cleared them for mild sedation, their stress levels for the procedure were high enough to warrant general anesthetic. He explained that it was best to consider the patient’s perspective as well to ensure they’re comfortable before, during, and after the procedure. I decided to ask the patient what they thought about the procedure and the mild sedation option. They indicated that they were ambivalent about the nature of the procedure as possibly being painful, and indicated they would prefer to be completely unconscious to avoid the possibility of remembering it. The following day, I was seeing another patient to conduct an initial screening for the same procedure. In this situation, I began the assessment by describing the options I thought were most appropriate giving their medical history, and then asked what they thought about each option. This way, the patient and I were collaborating and communicating more effectively to come to an agreement on what’s safe and comfortable for them.
10. Can you explain, using an example, your process for delivering complicated information to a patient?
During one of my clinical rotations, I had a patient call the clinic to speak with the doctor about a prescription. They were taking 50 mg of Zoloft and they were wondering how they could wean off of it. I consulted the doctor to confirm before explaining to the patient that they can taper off one week at a time, halving the dose they were taking each week before they were finished. In addition, I also made sure to tell the patient that if they had any questions, they could call the clinic, and that they were scheduled for an appointment to discuss their progress in a week. The patient asked why they couldn’t just quit cold turkey, believing it would be more efficient. Rather than discussing the neurochemical influence of SSRIs, I focused on what the patient was experiencing, namely her symptoms, to explain that weaning off is safer and less disruptive.
1. Why do programs ask behavioral questions?
Behavioral questions work on the premise of past behavior predicts future behavior. These questions are a good way for programs to learn about how you make decisions and assess your analytical skills. Learning about your behavioral patterns also allows them to discern .
2. How do I answer behavioral questions?
Start by describing the situation or real-life example, then describe the actions you took or will take and what the outcomes were or should be. Sometimes, you will get asked to elaborate on if you think those actions were successful. This is a chance to reflect on what you did well, or what you think you could improve on. Always end with lessons or skills you learned from the experience.
3. How many behavioral questions will be asked during the residency interview?
This depends on the committee, but you should practice your responses to these types of questions to prepare for any amount. The best way to practice is to use mock interviews with a friend or , so you can get familiar with the three-part structure of answers to these types of questions.
4. What types of traits do programs look for in answers to behavioral questions?
Programs are looking for answers that can demonstrate competence with the entrustrable professional activities associated with the specialty and program in question. The traits that programs look for also depend on the program and specialty. For example, core traits for residents in family medicine include compassion, interpersonal skills, and strong work ethic.
5. How do programs rate answers to behavioral questions?
Some programs use a rating system to determine how well an applicant responded to their questions. You won’t have access to the rating system, so it’s best to just focus on delivering the best answers you can that target the key traits that predict success in your program.
6. How can I be more confident in my responses?
The best way to prepare for the interview is to practice beforehand. Do your best to remain calm so your answers sound natural and concise.
7. What’s the difference between a behavioral question and a situational question?
The term behavioral question and situational question are typically used interchangeably. Both questions are built on the premise of past behavior and intention predicts future behavior. Remember, consistency and the ability to anticipate information or events is important in a clinical setting.
8. What other types of questions will be asked in an interview?
Programs can ask any variety and combination of questions, so it’s best to prepare to answer ones from all different categories. Aside from behavioral questions, you may be asked situational, conversational, personal, and knowledge-based questions as well.
9. How do I answer questions about strength and weaknesses?
gives the applicant the opportunity to explain why they’re a strong candidate for the program. Since this is a personal question, there is no wrong or right answer. To practice your answers, you can start by brainstorming a list of strengths and weaknesses. Avoid trying to frame certain strengths as weaknesses, as this can seem disingenuous.