Residency Program Interviewer Etiquette

A residency interview should be performed in a professional and respectful manner and adhere to proper interview etiquette. Unfortunately, reports of unethical behavior during resident interviews have surfaced. In 2017, Hendrickson et al. ^[1] published the results of a survey conducted by the University of Washington following the initial two years of the MedPhys match to assess the "application, interview, and post interview experience, match results, and overall satisfaction with the process ^[1]." All candidates and program directors that participated in the match were contacted via email, and approximately 30% and 57%, respectively, voluntarily responded. Based on the responses, candidates reported that at least once during their interview process they were asked about their marital or relationship status (40% in 2015 and 49% in 2016), whether they had or planned to have children (23% in 2015 and 28% in 2016), where else they were interviewing (69% in 2015 and 79% in 2016), and how highly they intended to rank a given program or which program they intended to rank first (13% in 2015 and 20% in 2016) ^[1]. Not only are these questions uncomfortable for candidates, but they are also inappropriate.

Interview questions should be focused specifically on determining whether a candidate's qualifications and personal characteristics align with a given position, and if the candidate will work well with the existing team. The U.S. Equal Employment Opportunity Commission (EEOC) prohibits employers from requesting information pertaining to an applicant's race, color, religion, gender/gender identity, childbearing status, sexual orientation, national origin, age, or disability ^[2]. Further, according to the National Matching Services (NMS) Inc. agreement, neither the program or applicant "may solicit the intention for ranking from the other party" or solicit "information regarding the positioning of any applicant or program on a Rank Order list ^[3]." Although NMS rules do not prohibit interviewers from asking an applicant about other programs to which they have applied or intend to apply, candidates have indicated they felt uncomfortable answering this question ^[1]. In 2017, the National Resident Matching Program (NRMP) did prohibit medical residency programs from asking this question ^{[1, 4]}.

To ensure appropriate interview etiquette is followed, programs should:

• Avoid any questions that could be construed as discriminatory;
• Educate all faculty and staff participating in the interview process on appropriate conduct and questions that may be asked, explicitly instructing participants not to initiate topics prohibited by the EEOC; and
• Eliminate post interview communication to minimize the risk of divulging or soliciting rank intent information.

Additionally, programs should avoid:

• Making offers or requiring commitments from applicants;
• Asking applicants about their ranking intention;
• Informing the candidate about how they intend to rank them;
• Asking the applicant where else they are interviewing; and
• Offering incentives such as a future clinical or faculty position.

A sample code of conduct agreement that could be adopted by programs is available in Figure 10 of Hendrickson et al. ^[1]. Similar rules should be followed when interviewing students for graduate school.

Oftentimes inappropriate questions are asked unintentionally, possibly because the interviewer is unaware the question is illegal or the interviewer is attempting to initiate conversation with the applicants in a more social setting (e.g., over lunch or dinner) ^{[1, 5]}. If faced with such questions, the candidate may choose to ^{[7, 8]}:

• Politely answer the question;
• Politely answer the question by addressing its intent versus substance;
• Redirect the question to highlight their attributes, and what they can contribute to the position;
• Answer the question they wished they were asked; or
• Refuse to answer the question.

Practicing appropriate interview etiquette reflects respect and professionalism of both the individual conducting the interview and the program they are representing. As we enter the next MedPhys match cycle, let us strive to practice and model this behavior within each of our respective institutions, and ensure that an already stressful activity is a little less intimidating for our candidates.

References:

1. Hendrickson, K.R.G., T.Juang, A. Rodrigues, and J.W. Burmeister, “Ethical violations and discriminatory behavior in the MedPhys Match,” J Appl Clin Med Phys 2017; 18(5): 336 – 350.
2. https://www.eeoc.gov/laws/practices/index.cfm, last accessed December 12, 2018.
3. https://natmatch.com/medphys/rules.html, last accessed December 12, 2018.
4. http://www.nrmp.org/communication-code-of-conduct/, last accessed December 12, 2018.
5. Antolak, J.A. and T.D. Solberg, “The dark side of the MedPhys Match,” J Appl Clin Med Phys 2017; 18(5): 4 – 5.
6. https://www.thebalancecareers.com/how-to-answer-inappropriate-interview-questions-2061334, last accessed December 12, 2018.