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    Conducting Effective Structured Residency and Fellowship Selection Interviews: Preparation, Execution, and Follow-Up

    Administering the Structured Interview

    Overview and intended audience

    This section provides valuable guidance for interviewers on key aspects to consider before, during, and after conducting a structured interview. The information presented is specifically tailored to individuals who will actively participate in the interview process, including those responsible for communicating with applicants before their interview and those who will conduct and evaluate the interviews.

    Before the interview — tips for preparing

    This section covers essential best practices for effectively preparing for structured interviews, whether they are conducted virtually or in-person. The following areas are discussed in detail:

    For more information on how to appropriately use geographic preferences, refer to MyERAS Application Updates and Program Signaling: Guide for Programs.

    Familiarize yourself with interview materials

    To ensure a smooth and well-prepared interview, it is crucial to review all relevant documents pertaining to your program’s interview process. Consider the following materials and have them readily available:

    • Interview questions. Review the interview questions that will be asked during the structured interview, if applicable. Examples of interview questions can also be found in Sample Structured Interview Guide.
    • Contact information for technology support. Keep the contact information for your institution’s technology support readily available in case any technical issues arise during the interview.
    • Applicant's contact information. As a backup option, have the contact information of the applicant on hand in case of any disconnections or communication issues.

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    Follow typical interview protocol

    • Ask only permitted questions listed in protocol. Pose the necessary questions for the interview.
    • Avoid prohibited questions. Be mindful of avoiding inappropriate questions that are prohibited by law. These include inquiries about protected groups, such as demographic information, family history, disabilities, military, or criminal history, and more.
    • Take notes when possible. Record relevant information or notable responses during the interview. This helps maintain accurate records and aids in evaluating applicants effectively.
    • Allocate time for applicant questions. If possible, allow time for applicants to ask questions about the residency program or the interview process. Encourage an open and informative discussion to address their questions.

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    Be aware of your unconscious bias

    Everyone holds unconscious biases about other people or groups of people based on attitudes, associations, and stereotypes. Interviewers can help mitigate their individual biases through:  

    • Awareness of personal biases. Recognize and be mindful of any strong reactions, whether positive or negative, toward specific applicants or applicant groups. Being aware of these biases allows for conscious decision-making and fair evaluation.
    • Deliberate thinking and decision-making. Base scores and judgments on thorough consideration rather than relying solely on initial impressions. Engage in thoughtful analysis of the applicant's qualifications, competencies, and responses.
    • Perspective taking. Strive to understand the applicant's perspective and experiences to gain a more comprehensive understanding of their qualifications. Empathy and open-mindedness can help mitigate biases and promote fair evaluation.

    Increasing standardization in interview content and evaluation processes can also help reduce the impact of unconscious bias. Implementing the following enhancements can be beneficial: 

    • Clearly define evaluation criteria. Establish specific criteria for assessing applicants and provide clear guidelines to interviewers for consistent evaluation.
    • Use a scoring rubric. Utilize a standardized scoring system that focuses on relevant competencies and eliminates subjective biases.
    • Ensure diversity in interviewers. Assemble a diverse panel of interviewers with varied backgrounds and perspectives. This diversity can help minimize the impact of individual biases and promote a fairer evaluation process.
    • Train interviewers. Provide comprehensive training to interviewers on proper interview techniques, including awareness of unconscious biases and strategies to mitigate their effects.

    It's also crucial to examine other aspects of the selection process that may contribute to the influence of unconscious biases.

    For more information, please see the AAMC’s virtual seminar “What You Don’t Know: The Science of Unconscious Bias and What to Do about it in the Search and Recruitment Process and an AAMCNews article on unconscious bias in academic medicine.

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    Be aware of common rating errors

    To ensure the validity and fairness of interviews, it's important for interviewers to be aware of and avoid common rating errors. The following are some of the most common types of rating errors to be mindful of when evaluating each applicant's interview responses:

    • Halo/Horns effect. This error occurs when the rating of one aspect of an applicant's performance influences the rating of another unrelated aspect. For example, if an interviewer rates an applicant highly on teamwork, it should not unduly influence their rating on motivation.
    • Central tendency. This error involves rating all applicants in the middle of the rating scale, typically giving average ratings to all applicants. Interviewers should feel comfortable using the entire range of the rating scale and should differentiate among applicants based on their individual performance.
    • Leniency/severity. Leniency occurs when interviewers consistently assign high ratings to all applicants, while severity refers to consistently giving low ratings. It's important to evaluate each applicant's responses objectively and avoid biases that lead to consistently inflated or deflated ratings.
    • Contrast effects. This error arises when interviewers compare an applicant's performance to that of previously interviewed applicants, which can influence their ratings. Interviewers should focus on evaluating each applicant independently, considering their response in relation to the established rating scale rather than comparing them to others.

    To mitigate these rating errors, it is recommended to provide interviewers with regular training and feedback. This training should include guidance on avoiding these errors, maintaining consistency with program standards, and aligning their scoring with other interviewers. By promoting awareness and providing ongoing support, interviewers can enhance the accuracy and fairness of their evaluations.  

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    Additional considerations for hybrid interviews

    If your program is currently using or is considering conducting hybrid interviews, where applicants have the option to choose between virtual or in-person interviews, it is essential to mitigate bias of applicants who choose to interview virtually versus those who choose to come in person. While there are various strategies that may be implemented for this purpose, a few recommendations are presented below:  

    • Those making final admissions decisions should be unaware of the applicant’s interview format; they should only be privy to information on the applicant’s interview performance.
    • Do not consider the environment visible in the background of the applicant’s webcam; not all applicants have access to the same resources to participate in video interviews.
    • Do not let the downfalls of technology (e.g., internet failures) negatively affect the ratings of those interviewing virtually. Always have a backup plan (e.g., conducting the interview via mobile phone) in case there are technological issues.
    • Maintain a highly structured interview for all applicant interviews. It should include minimal small talk and should keep the job-related interview content.

    Interviewers conducting virtual or hybrid interviews may reference Additional Considerations When Preparing for Virtual interviews for a checklist of how to prepare for conducting interviews virtually.

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    Preparing applicants

    Providing all applicants with the same materials to help them get ready for interviewing with your program not only allows applicants to have more equal footing when coming to interview, but also improves their clarity and understanding about what’s expected of them during the interview process. Providing information that answers the following set of questions can provide a better experience for your applicants:

    Who Are they talking to (e.g., names and titles of interviewers)?
    What

    Specific tasks do they need to complete prior to the interview (e.g., logging in to the portal and filling out additional information, downloading and testing the software application used for the interview)?

    Is the format of the interviews (e.g., appropriate response format, amount of time for Q&A)?

    Where Will interviews be held (e.g., specific locations, online meeting room links, dial-in information)?
    When Will the interview(s) be (e.g., date and time, time zone)?
    How

    Should they sign up for interview slots?

    Should they prepare? Any specific kinds of questions or knowledge areas they should be aware of in advance?

    Consider sharing with applicants the AAMC's Residency and Fellowship Applicant Interview Preparation Guide.

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    During the interview — tips for conducting the interview

    This section discusses best practices for conducting interviews, whether virtual or in person, including:

    Use your interview materials

    It is recommended to have your interview materials (refer to Sample Structured Interview Guide) on hand during the interview. You may choose to print materials and hand write notes and ratings or have the materials up on a computer to type notes and make ratings.

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    Use the STAR format to gather information during the interview

    Your primary goal as an interviewer is to elicit comprehensive and insightful responses during the interview process to help you accurately evaluate the applicant. When utilizing situational or behavioral interview questions, the situation, task, action, result (STAR) method serves as a valuable tool for gathering crucial information from residency applicants. Refer below for examples of probing questions using the STAR method:

    Probes for Situational Interview Questions Probes for Behavioral Interview Questions

    Situation or Task

    • What do you consider the most critical issue in this situation?
    • What other issues are of concern?

    Action

    • What would you say?
    • What is the first thing you would do?
    • What factors would affect your course of action?
    • What other actions could you take?

    Results

    • How do you think your action would be received?
    • What would you do if your action was not received well?
    • What do you consider benefits of your action?

    Situation or Task

    • What factors led up to the situation or task?
    • Could you or anyone else have done something to prevent the situation or task?
    • What did you determine as the most critical issue to address in this situation or task?

    Action

    • How did you respond?
    • What was the most important factor you considered in taking action?
    • What is the first thing you did?

    Results

    • What was the outcome?
    • Is there anything you would have said and/or done differently?
    • Were there any benefits from the situation?

    Although using effective probing questions like those shown above can encourage applicants to provide specific and detailed answers, excessive probing can inadvertently reveal the desired answer and potentially lead applicants to provide insincere responses. The following approaches also facilitate the collection of valuable information without leading or biasing responses:

    • Request clarification. Prompt the applicant to provide more details about specific aspects of their initial response. For instance, you can ask, "Could you elaborate on the actions you took in that situation?" or "Please explain in more detail how you handled the task."
    • Explore the context. Encourage the applicant to offer additional context by inquiring about specific challenges or constraints they encountered in the given situation. For example, ask, "What were the specific difficulties you faced during that time?" or "Can you describe the environment in which this task was performed?"
    • Seek outcome details. Ask the applicant to provide further information about the results or achievements stemming from their actions. Inquire about the specific outcomes or quantify the impact of their efforts by asking questions such as, "What were the measurable outcomes resulting from your actions?" or "How did your efforts contribute to the desired outcome?"
    • Discuss personal reflections. Foster applicants' self-reflection by prompting them to consider personal growth or lessons learned from their experiences. Ask questions like, "How did this experience contribute to your personal development?" or "What would you do differently if you encountered a similar situation in the future?"

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    Take notes during interviews

    Taking concise notes during interviews is essential to ensure objective evaluations and make well-informed decisions. However, focus on capturing pertinent information rather than attempting to transcribe responses verbatim. Your notes should justify how applicants are evaluated by documenting key words or phrases that highlight their performance.

    Guidelines for impartial note-taking:

    • Avoid personal opinions and inferences. Concentrate on accurately documenting the applicant's statements and actions, refraining from adding personal interpretations or judgments. Stick to factual information rather than subjective assessments.
    • Exclude irrelevant personal characteristics. Do not include any references to protected characteristics, such as gender, race, religion, or age, that are unrelated to the job requirements or interview criteria. Keep the focus on the applicant's qualifications and performance.
    • Maintain consistency in note-taking practices. Adopt a consistent approach to note-taking and ensure fairness by treating all applicants equally throughout the interview process, regardless of the frequency or timing of your note-taking.

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    Other do’s and don’ts when conducting interviews

    Do's Don'ts
    • Ask professionally and/or specialty relevant questions.
    • Ask questions about the applicant’s interest in and alignment with the program’s mission, goals, and values.
    • Use positive body language such as smiling and nodding occasionally.
    • Refocus the applicant if they get off track by making a brief comment about the applicant’s remarks (such as, “OK”) and then firmly move back to the original question.
    • Spend more time listening than talking.
    • Ask questions related to demographics (e.g., age, race, religion), family (e.g., ancestry, primary or native language, marital status), personal information (e.g., physical and mental disabilities, physical appearance), history (e.g., military discharge, arrests, or criminal convictions).
    • Use negative body language such as raising an eyebrow, frowning, or using a harsh tone of voice.
    • Give feedback to the applicant about their performance during the interview (such as, “Good” or “Great”).
    • Ask judgmental, why, leading, or yes/no questions.

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    After the interview — post-interview tips

    This section discusses best practices, whether virtual or in person, for:

    Evaluate applicants holistically

    The AAMC recommends evaluating applicants holistically. Holistic review involves giving balanced consideration to an applicant’s experiences, attributes, competencies, and academic metrics (EACMs) and, when considered in combination, how the individual might contribute value to the institution’s mission. Refer to the PDF Holistic Principles in Resident Selection: An Introduction for additional information on how to incorporate holistic strategies into all phases of the recruitment and application cycle, including the interview.

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    Other do’s and don’ts when evaluating interviewees

    Do's Don'ts
    • Stay objective — focus on facts, not opinions.
    • Focus on the applicant’s responses to interview questions.
    • Focus on one question or dimension at a time.
    • Focus on comparing applicants’ responses with scale anchors (if your program uses a rating scale).
    • “Fill in” parts of the answer based on your own interpretations of the applicant’s response.
    • Judge an applicant based on anything outside the scoring rubric (e.g., personal appearance, “chemistry”).
    • Compare responses of one applicant with those of other applicants during the interview.

    Post-interview communication

    Applicants and residency programs are subject to violations of the National Resident Matching Program® Match Codes of Conduct during post-interview communications. Specifically, while applicants and residency programs can express interest in each other, they cannot solicit the interests and ranking intentions of the other. This is to ensure that post-interview communications are not coercive for either party.

    In general, research suggests that applicants and residency programs limit post-interview communications to only objective questions about the program.

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    Peer-reviewed articles published in medical journals about post-interview communications

    1. Cornett PA, Williams C, Alweis RL, et al. Problematic communications during 2016 fellowship recruitment in internal medicine. J Community Hosp Intern Med Perspect. 2017;7(5):277-281.
    2. Farber NJ, Neylan CJ, Srivastava A, et al. The urology match process and the limited value of post-interview communication for residency program directors. Urology. 2019;128:23-30.
    3. Grimm LJ, Avery CS, Maxfield CM. Residency post-interview communications: more harm than good? J Grad Med Educ. 2016;8(1):7-9.
    4. Harvey RS, Kovatch KJ, Prince MEP, Malloy KM, Thorne MC. Trends in post-interview communication practices. Laryngoscope. 2019;129(3):607-612.
    5. Jena AB, Arora VM, Hauer KE, Durning S, Borges N, Oriol N, et al. The prevalence and nature of post-interview communications between residency programs and applicants during The Match. Acad Med. 2012;87(10):1434–1442.
    6. Swan EC, Baudendistel TE. Relationship between post-interview correspondence from residency program applicants and subsequent applicant match outcomes. J Grad Med Educ. 2014;6(3):478-483.
    7. Williams CM, Alweis RL, O'Connor AB, et al. Inappropriate communication during internal medicine fellowship recruitment: a mixed-methods analysis. Am J Med. 2019;132(6):770-775.