Through the Residency Interview Process: Utilizing Behavioral Interviewing

Sally Weaver, PhD, MD

As we are in the midst of a busy interview season (busier than past years!), I think it’s good to stop and think for a while about the type of applicants we want to eventually become our residents.

Every family medicine residency program is unique, so who we are seeking should not always be the same. For example, my program wants to attract applicants with a strong interest in breadth of training who are going to be comfortable with the amount of inpatient and OB care we provide. Your program may have an emphasis on outpatient clinical management that would not fit well with an applicant who desires more hospital exposure.

Before the interviews, faculty sits down as a group and discusses the top three to five traits or competencies that will bring in future residents who are compatible with our program’s mission and the personnel we already have in our residency program.

We often speak of finding people who will fit in here. Not only are we looking for matriculating students with a strong medical knowledge base, we also want good attitudes, great problem solvers, and learners who are self-motivated and who have high ethical standards. It would be preferential to have new residents who are attracted to the strengths of our program and not ones we will have to keep orienting to how our program works. The issue may not so much be what we think we need in our learners but how to ferret out the desired traits and attitudes during the relatively brief time we have to interview and get to know our applicants.

Many programs have added behavioral interviewing to their interview process to better find these often hard to elucidate learner traits/behaviors/attitudes. Behavioral interviewing attempts to discover how interviewees have acted (or think they would act) in employment/education-related scenarios.

During the residency interviewing process, behavioral interviewing is most often used in a small-group setting with two to four interviewees with a faculty facilitator. Clinical/ethical case scenarios are presented to the group and discussion follows. Scenarios are designed with our residency program in mind asking specific questions that link back to the traits/behaviors/attitudes that our faculty have identified as most important for the program. We let the interviewing participants know that there are no right or wrong answers. Our hope is that the prospective residents can state what needs to be done in a given situation, what action(s) they would take, and what outcomes they expect. This process can elucidate judgment, attention to detail, initiative, self-confidence, insight, integrity, and problem solving skills as well as uncover illogical thinking, overconfidence in clinical skills, control issues (from group dynamics), and problems with interpersonal communication.

Many residencies use a faculty member with training in behavioral science to facilitate these interview sessions. However, this is not a necessity, and faculty without such training can learn to run these scenario interviews quite well. Their goal as facilitator is to provide valuable information on individual interviewees to the resident selection committee.

How much more successful we will be if each program can better identify those medical students who will be the best fit in our program as residents. I do think that behavioral interviewing is an important part of selecting residents that not only fit with our program, but better still, ones that will fit and thrive!