Why usual residency interview preparation fails IMGs? An unconventional interview preparation for IMGs .

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In my senior year of internal medicine residency, one of my friends asked me to get her an interview at the program. I knew she was hard working, smart and a great team member. So I sent an email to my program director who invited her for the interview (do contacts help?). Before her interview, she called me a few times and we prepared for the interview. We talked about all the common interview questions and how she was going to answer them. On her interview day, she was well prepared. After her interview, she mentioned that everything went great. But when it came to ranking her, she was not ranked high. The reason I later came to know was the attendings and other residents she met during the pre-interview dinner thought she was "too shy" or "she may not be able to work in a close-knit team like ours"

With this article, I will show you what is the conventional way of preparing for the interview that most IMGs (including my friend here), why this does not work for IMGs and an unconventional way of preparing for the interview suited for IMGs.


Step 1: memorize your personal statement and CV.
Step 2: google most common residency interview questions, memorize the answers.
Step 3: Have your best friend or family member ask you those questions and you answer it like you would in an interview. Or speak in front of the bathroom mirror.
Step 4: Buy a suit. Book your flights.
Step 5: Show up on time at the pre-interview dinner and the interview.

As you can tell, this does not sound very good. Especially for something as important as residency interviews. We work so hard to get these interviews, we want to go an extra step and make sure we nail them. Pretty much every IMG I know (including myself) spends a reasonable amount of time preparing for the interviews. Generally, their preparation is enough to get them a shot at being ranked high by the program; if their scores are high, they have good letters of recommendation and they do not need a visa. But that is not the majority of IMGs. No matter how hard we try, chances are most IMGs have some red flags on their application. So we need a little more than just a cookie cutter interview preparation.


You see, my friend had decent scores, contacts in the programs, good interview but was not ranked high by the program because she did not appear socially fluent during the interview and the resident dinner.

That is the problem with our conventional interview preparation; it does not help with social fluency, which is what most people perceive when they meet you for the first time. Not how well you answer the questions like "tell me about yourself".


This is a supplement to your convention interview preparation mentioned above. But this is far more effective than the previous. You still read your personal statement and CV a few times before your interview. You still buy a nice suit (and get it tailored), you still show up at the interview on time. But you take it one step further. You work on your social fluency. Social skills like any other skill can be learned.

I know what you are thinking: I have so much to do, how am I going to learn a new skill in such a short time?

That's where the unconventional interview preparation comes into play. Nothing worth having comes easy or fast. But if you take some simple steps starting now, you will appear much more socially fluent and less awkward.You will not face the problems that my friend mentioned above faced.

Before we dive into these simple steps let's look at five reasons why IMGs need social fluency for interviews:

1. English is not our first language, so it is harder for us to express our views in English
2. We are in a different country with different mannerisms and culture.
3. We are not very savvy with sporting/political/musical/TV events of this country. So if someone starts talking about these things, we wouldn't have much to say.
4. We are always busy with USMLE, observerships, research, jobs to be able to go out and be social
5. We hang out mostly with people from our home country after moving to the US.

We know why my friend mentioned above was not ranked high for the match. In spite of good scores, contacts and apparently doing well at the interview, her lack of social skills came off as poor communication, shyness and not being a team member to the staff in the residency program.

The good news is, within a few weeks you can improve your English fluency, body language, vocal tone and communication in general. This will help you appear more confident, fun and attractive to the attendings and other residents during your interview. I know this because I was very socially awkward when I first came to the US and even today if I don't use these steps regularly, I go back to being that shy unconfident guy.

# Step 1: Talk to people. (Groundbreaking, I know!)

When I say talk to people, I don't mean your mom. Or your best friend from medical school. I mean people you barely know or don't know. Because, when you go for interviews, you are going to spend a whole day with people you've never met.

Here is what I do. You can be creative and find ways suitable for you.

1. Talk to people during your day-to-day errands. At the grocery store, on the subway commuting for your rotation, waiter/waitress at the restaurant etc., make a habit of talking to 5 people a day. Just say hi, how is your day? Give them a compliment about their shoes or something. Don’t feel bad if they are not friendly, most people are not social anymore (cell phone culture). Try this for 3 days. On the 4th day, you will feel more open to communication and it will come naturally to you.

2. Friends - not the ones you talk to every week. Someone off your facebook friend list who you’ve never talked with. Talk to them in English.
3. Speakeasy, bars, festivals- talk to everyone there.

4. On your way to the interview, flights, hotel where you are staying, elevators. Make it a point to chat up people. You don’t have to say much, just say hi, how are you today? I like your dress, what do you think of this hotel etc. You get the point.

# Step 2: Understand small talk.

A lot of IMG candidates I see have no concept of small talk. Back in the day, I hated small talk. I wanted to get straight to the point of conversation. But that is not how interviews go.

You meet the residents during the dinner or the attending in their office; they are not going to launch off into typical interview questions. They will start some small talk. Some of my interviews were only small talk. We all know how to small talk. Remember the last time you had a small get together with your closest friends or family members. The small talk lasted for hours. You weren't discussing you resume that time. Have the same mindset when you first meet the residents and attendings. You are just getting to know each other. They are asking some questions about you and you can ask questions about them. You are not trying to prove yourself or show off how much you learned during your observership. Keep it light and playful.

# Step 3: Stop judging yourself when talking to people

If you do above steps right, this will happen automatically. Us IMGs are always focused on how our accent is, is our English okay, are we impressing the other person etc. This makes IMGs sound stifled and not very confident during interviews. You English is fine and you are confident. Accept it.


In addition to the common interview preparation that we all do, these three steps will help you tremendously to enjoy the interview process and be successful.

My first interview did not go that well because I was not in the practice of talking to random people. I knew the most common questions, I had also memorized my personal statement and cv. I was able to answer questions in a factual manner but I was not able to have a conversation with the other interview candidates, residents in the program and the attendings who interviewed me. I knew I had to do something, I still had ten more interviews to change that. I followed the steps above ( and I still do). My interview performance got much better. I was able to talk about myself in a very effective way so that people remembered me. In fact, I was offered an out of match position after one of my interviews because the program director enjoyed a conversation we had about my perspective of medicine in the US as an IMG.

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