Meet Your Match: Assuaging interview-season angst

In this episode of Making the Rounds, Ami DeWaters, MD, an internist at Penn State, offers residency applicants advice on what to do if you aren’t getting enough interviews and how to stay grounded during interview season.

Speakers

• Ami DeWaters, MD, internist and associate professor of medicine, Penn State
• Brendan Murphy, senior news writer, American Medical Association

Host

• Todd Unger, chief experience officer, American Medical Association

Listen on the go to the full episode on Apple Podcasts, Spotify or anywhere podcasts are available.

Unger: Welcome to Making the Rounds, a podcast by the American Medical Association. In today’s episode, Dr. Ami DeWaters—general internist and associate professor of medicine at Penn State—shares her advice to medical students on ways to handle the stress that comes with residency interviews, how to know if you have enough interviews and more. Here’s AMA senior news writer, Brendan Murphy.

Murphy: Hello and welcome to Making the Rounds, a podcast by the American Medical Association. I’m Brendan Murphy, senior news writer at the AMA. Today we continue our Meet Your Match series with Dr. Ami DeWaters, associate professor of medicine in the division of general internal medicine at Penn State. Dr. DeWaters was also just named interim director for the Penn State College of Medicine’s health system science office. Congratulations on that.

Dr. DeWaters: Thank you.

Murphy: And thank you so much for joining us today.

Dr. DeWaters: Happy to be here.

Murphy: So, Dr. DeWaters has been working with students on the Match for a number of years. And today, we’re going to be getting advice for her on some of the interview season anxiety students might be experiencing, that includes what to do if you aren’t getting enough interviews, how to avoid comparing yourself to your peers and how to try to alleviate the pressure of these high stakes encounters. I think a good place to start off is, Dr. DeWaters, if you could just talk about the capacity in which you work with students during residency selection.

Dr. DeWaters: Yeah. Absolutely. So, I am a general internist. As a general internist, I mainly end up advising students who are applying into the residency of internal medicine. And for the last four years, I was the co-director of our internal medicine residency application committee.

So, me and my colleague, Dr. Nick Duka, would work together to advise the 20 to 30 students who were applying into internal medicine and give them advice on how best to go about the process. I’m not doing that this year, which I have to say, I’m missing quite a bit. But I really enjoyed it for the previous four years when I did it.

Murphy: So, you’re not doing that this year but here you are on a podcast so you’re helping so many more than those couple of dozen students that you would be helping.

Dr. DeWaters: Hopefully, hopefully, it’s helpful.

Murphy: Well, I know we’re glad to have you. At this point, there may be a bit of interview anxiety for some applicants on a number of topics that we’re going to cover. But in that light and speaking generally, what type of concerns do you hear from applicants at this point in the process?

Dr. DeWaters: Usually, by October, you have a lot of concerns about the number of interviews. People want to know how many interviews they should have, when they should expect to hear and when they need to be concerned. And there’s also a fair amount of concern about how do you go about the interview process, especially with what’s happened over the last couple of years with doing interviews over Zoom. One of the big questions I will get is, how do I actually figure out what the culture of a place is like. There can be a fair amount of anxiety surrounding that.

Murphy: Well, thank you for bringing that up. I should point out that we have an episode in the Meet Your Match series that’s dedicated entirely to assessing program culture and remote interviews. So, if you look back through our channel, to our listeners, you can find that and a few other topics.

Looking at that number of interviews, at what point should they be concerned about their interview invite numbers? Is there a number that they should be shooting for, as applicants?

Dr. DeWaters: Yeah. That’s a great set of questions. So there really is no magic number. And you need to keep in mind that every specialty is very different, which is why I think it’s very important that you have a mentor from your specialty who understands what the application process is like, in the current year.

Because, keep in mind, that things have also changed drastically over the years with specialties. So I think it’s really important that you develop that mentor relationship in your field, so that they can help guide you on the number of interviews. There is no magic number.

What I will say for internal medicine is, I tell the individuals I’m mentoring, “Please, let me know if you have not received an interview invite by the end of November. I’d like to get together with you. We need to relook at the list you put together of where you applied. And we need to think about whether or not we need to broaden that list.”

So for internal medicine, I really consider it end of November, when we need to start thinking about, boy, do we need to change our strategy here if you haven’t gotten an invite for an interview yet.

Murphy: That’s great insight. And I know this is specialty dependent but I should point out that in 2021, the number of median invites for matched applicants was 14. But, again, that is very specialty dependent. Does when you get the interview invite matter?

Dr. DeWaters: You know, not really. I ended up getting my interview invite to the place I ended up ranking very high on my list, that I ended up matching into—I think I didn’t get that interview invite until late December. And I didn’t actually interview, I don’t think, until January.

Now you can’t quote me on that because I’m old and my memory is not good. But I think, that’s true. So, I tend to tell my mentees, “Be excited if you get an interview. Don’t worry if it’s set up for later in the year. Just be excited about the interview.”

Murphy: So we got into this a little earlier but what are some of the reasons these interview figures might be lower and are they addressable?

Dr. DeWaters: Yeah. So sometimes the number of interviews you get might be lower because it’s possible that you just applied to programs, that the programs are looking at your application and they’re not entirely sure you’re a good fit for their program.

Let me give you an example. If let’s say, a program has a really strong emphasis on scholarship and you happen to not be that interested in research, you decided to build a list that has very scholarship-focused institutions on your list. Well, those institutions might look at your application and they might think, boy, we’re not sure they’re the right fit. We really prioritize scholarship. Scholarship does not seem to be a big part of their professional identity.

So, in that case, you might need to go back and look at your list and say, “Does the list of institutions really match what I’m looking for, out of a residency program?” So, I think that mismatch between what your application highlights, in terms of your strengths and what the institution prioritizes, can sometimes lead to a low number of interviews.

Murphy: And what do you do if your number is low?

Dr. DeWaters: I think, if your number is low, the number one thing you can do is reach out to a mentor and ask their advice on reviewing your list. Somebody who’s knowledgeable in the area. And I think, that can sometimes be hard for students because they might feel that most faculty members are knowledgeable. But the reality is that’s probably not true.

The type of mentors who would have knowledge about these things are your APDs, your PDs, your clerkship directors, your student affairs dean in your medical school, who are used to going through this process every year. And you can meet with them and say, will you take a look at my list, make sure you think I’ve applied to the right programs for me.

Murphy: And is it worth it to apply to additional programs?

Dr. DeWaters: I think so. I have encouraged many of my applicants to apply to additional programs. And it has worked out for several of them. Several of them have ended up not only loving those programs but ranking them quite highly and matching there. So, I think, applying to additional programs can be a successful strategy, at least, I’ve seen it be the case in internal medicine.

Murphy: How should you go about picking the additional programs? I assume that students made some sort of list and maybe there was a cutoff. How have you gone through students with it in the past?

Dr. DeWaters: Sometimes, what we’ll do is we’ll sit down and we’ll review their personal statement. I try to start with a place that values alignment. You want your values to align with the values of the institution you end up with.

So, if being in a rural area and participating in rural health is really important to you, then we should be broadening our scope to look at any possible program in a rural area. So, first step is always to make sure that you’re staying true to what you value and you’re picking programs that match that.

I think the next step is making sure that you are including programs that you may not have thought of before, which is where can really help to use a network. Because it’s really hard to figure out what a program is like or what an institution is like. But hey, your mentor may have this friend who works at this program you had never heard of and it’s a really great program. And it sounds like it would exactly meet your needs. So I think, utilizing your network can help you pick out more programs to apply to, as well.

Murphy: Can it also maybe help you get interviews if you reach out to people while you’re—after you’ve applied, while you’re waiting? Is that a measure you would recommend? Have you seen it work?

Dr. DeWaters: I have seen people ask their mentors to reach out for them. And I’ve seen people—frequently a question is should I send an email to a program director at a specific program and ask for an interview. In my personal experience—I can only speak anecdotally, but in my personal experience, I have not seen emails to program directors from the applicant themselves be all that successful in getting an interview. I don’t think it hurts your prospects. So, I think you can try it. In terms of the mentors reaching out, I think that can be more successful because there’s a trusted relationship there that helps vouch for you and your skills.

Murphy: So there is a part of the process that student applicants maybe can have an effect on and that is interview distribution. There has been, especially in the virtual era—I don’t know that these are especially founded but there have been some expressed concerns about the prospect of interview hoarding. Can you talk to what that might look like and how students can be judicious, and sort of, help their colleagues by taking only the interviews they need?

Dr. DeWaters: Yeah. Absolutely. I mean, the first thing I would say, is that the interview process is exhausting. Especially, if you’re introverted like me. If you’re an introvert, you’re going to feel really tired by the end of interview season. It’s a full day of really being on the entire day, answering a lot of questions and asking a lot of questions. And so, you want to think about that and be mindful of that when you’re planning your interview schedule. Because you’re not going to have the energy for 30 interviews.

So, I think, again, a way to be helpful to your colleagues, and preserve your own wellness, would be to really look at the programs that you feel like match your values best, from what you can gather, from your external review before you’ve interviewed. And do not be afraid to decline an interview, if you feel like, “You know what, I did apply, I’m looking at this, it doesn’t seem like it’s going to be a good fit.” It’s OK to decline an interview.

Murphy: That’s very helpful, that it can also help your peers but also help your own performance, which I don’t think, many people consider when they’re looking at these invitations.

So when it comes to the actual interviews, all students want to maximize their performance. It’s likely a little more important if you have fewer interviews. What can you do to maximize your performance?

Dr. DeWaters: Prep. Prep. Prep. I think preparation is key. A lot of schools will do a great job of scheduling interview prep sessions. So your medical school may already be planning this. In the off chance that they’re not planning this, a trusted friend, family members, a colleague, somebody you know, should really prep you by asking you interview questions and making sure you’re ready with some clear, succinct answers.

Murphy: So preparation is a way to probably assuage some anxiety, which is what we’re here to do today. But also, there is just pressure associated with these interviews. They’re high stakes.

Dr. DeWaters: Yeah.

Murphy: How can students maybe not internalize that pressure? How can they deal with it in the most healthy way?

Dr. DeWaters: I think that we put a lot of pressure on these interviews because of a couple of reasons. I think, everyone has this internal fear that they’re not going to match. And you need to recognize that statistically, it’s highly likely you will match.

But I also think that we sometimes feel like there’s only one path or one way to get to our career that we dream of. And if there’s anything I’ve learned, it’s that there’s actually a million different ways to get to the career you want. And so many people are able to build the careers they want taking a very unique route.

So, I think, realizing that not as much relies on this as you may think, that in the long run, you can still build the career you want, regardless of the outcome. And I really think that’s true.

Murphy: So, I think, another common trap, and this is certainly not unique to medical students and residency applicants, is that you compare yourself to your peers. Is there a way to avoid that?

Dr. DeWaters: Ooh. I don’t know. Shut down social media? That’s probably not going to be a very popular suggestion. So, I think, it’s really tough not to compare yourself to your peers. I think, one of the things you do need to recognize, though, is that specialties are completely different and that people—even though you may be comparing yourself to people applying to the same specialty, their list may look totally different than your list. And you probably don’t have a great idea of what everybody else’s list looks like. So be mindful of the fact that before you compare, understand you probably don’t have all the information and comparisons probably are not all that helpful.

Murphy: I have heard of medical schools that don’t let people talk about the Match during certain hours of the day and have Match-free zones, and things like that. So, if you can just get out of, sort of, this mono focus, I imagine that is helpful.

Dr. DeWaters: Absolutely. Oh, I had not heard of that before. That’s a great idea. Yeah. Absolutely. I mean, one of my big pieces of advice is don’t lose the stuff you love. Make sure you make time every single day for the stuff you love. So, if you’re a runner, go running. And that should be your time to break out of the Match brain.

Murphy: How did that apply to you when you were an applicant?

Dr. DeWaters: For me, I was very, very into the arts. And so, when I was an applicant, I tried to go to museums, I tried to go to the orchestra, I tried to go to ballets and just help stay engaged in the things I really love, and break away a little bit from just thinking about Match all the time. Recently I’ve started floral design arranging, which has been very good for getting away from work.

Murphy: These are certainly outlets that you will be able to have through your entire career, as you’ve shown us.

Dr. DeWaters: Yeah.

Murphy: So, I guess, the encouraging anecdotes you could maybe provide and I know that you have some because we’ve spoken for a story, which is on the AMA website, about instances in which applicants have applied to number of programs, gotten very few interviews and matched. Have you seen that work? And is it encouraging for applicants this year?

Dr. DeWaters: I absolutely have seen that work. So, I have mentored applicants who have only gotten one interview and came in very late, and they’re going into the Match with that one interview and that one rank, and they match. And they’ve gone to that program and absolutely loved it. And so, I’ve seen that work.

And I know it’ll be different for some of the specialties. Maybe, internal medicine can’t be generally applied in that regard. But there have been some pretty amazing success stories I’ve seen, even though people did not have what would be considered a robust interview season.

Murphy: So we do always hear, it only takes one program. And you’ve seen that it actually is applicable and true.

Dr. DeWaters: Absolutely.

Murphy: We have covered a lot of ground. And I think our medical student listeners will be grateful. But is there anything else on this topic, you would like to add?

Dr. DeWaters: I guess, I would say try to do everything you can to enjoy the process. And remember that they’re not just evaluating you; you’re also evaluating them. And I think students sometimes forget that. And they enter into this mindset of, “It’s all about me impressing them. It’s all about what I’ve done.”

And I’d really like to empower students out there to think a lot about what they want from programs, and what they’re looking for in a training program and to really try to pursue that, meaningfully. So that would be my last piece of advice.

Murphy: Well, that’s great advice. And we are so grateful for your time. Thank you so much for being with us, Dr. DeWaters.

Dr. DeWaters: Absolutely. Thanks for having me.

Murphy: I’d like to thank all our listeners for joining us on Meet Your Match. I’m AMA senior news writer, Brendan Murphy. We’ll see you next time.

Unger: You can subscribe to Making the Rounds and other great AMA podcasts anywhere you listen to yours or visit ama-assn.org/podcasts. Thank you for listening.

Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.