10 Residency interview behavioral

questions and answers

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 how you will contribute to their
program.

.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
re ect 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 residency interview services, so you can get familiar with the
three-part structure of answers to these types of questions.
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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.

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 bene t 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.
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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, dif culty
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
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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 bene ts 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.
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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 nish 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 noti es 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 con ict 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
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 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 con ict using an example.

During my clinical rotations for internal medicine, I was assessing

a patient who reported having some dif culty 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 re ection, 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 rst 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
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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 con rm 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 nished. 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 ef cient. Rather than discussing the
neurochemical in uence of SSRIs, I focused on what the patient
was experiencing, namely her symptoms, to explain that weaning
off is safer and less disruptive.
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