Interview Tips for Pathology Residents

This is Lab Medicine Rounds, a curated podcast for physicians, laboratory professionals and students. I'm your host, Justin Kreuter, a transfusion medicine pathologist and assistant professor of laboratory medicine and pathology at Mayo Clinic. Today we're rounding with Dr. Reade Quinton, an associate professor of laboratory medicine and pathology and anatomic pathologist in the Department of Laboratory Medicine pathology at Mayo Clinic to talking about advice on applying and interviewing for

residency. Thanks for joining us today, Dr. Quinton. I am happy to be here again. Dr. Kreuter. Thanks for having me. Absolutely. Let's kind of kick off with what are a few things that most interviewers are

probably trying to assess during those interviews we have for residency? Yeah, so there's a lot that goes on in that, and I think of course every interviewer is going to be slightly different, but in general I can give you some basics. I think one of the things that the applicants need to remember is that if you're already in the interview process, if you have been invited to an interview, there's a ton of things we've already sort of gotten through and established.

So number one, we've already seen your scores and how many publications you have, where have you presented all these little details of the application. So when I am sitting down during the interview process, I'm not really worried about that at that point. It's like you've already made it past that level, so I'm not necessarily going to sit there and ask about the granular details of your USLE scores or anything like that. So the first thing that I like to ask or get a sense of is

just the idea of are they aware of what they're getting into? It's kind of easy sometimes to establish in their personal statement, do they really know what they're getting into if they go into pathology as a residency program. But sometimes it's a little unclear and sometimes people have had more or less exposure in their med school too.

So kind of just chatting with them to see does this person really understand what the next four years will entail, that perhaps maybe they really like one thing in pathology, but do they also know they have to do these other things? So I really like to see do they know what they're signing up for? The other thing I really like to assess is just in general communication and personality and are they going to fit well in the

program? Knowing who I have as faculty, knowing who I have as a pool of current residents, does this person seem like somebody who would slot in nicely, get along with everybody and kind of work in that team and you can gauge your team. My team here is going to be very different from other programs teams. And so just getting a sense of who is this person and do they seem like they would work well with our group is very important to me. I feel like we can train everything else.

We can teach you the pathology, but it's more difficult if you're not comfortable in the environment. We want to make sure that the trainees are in the best environment for them so that they're successful. And then finally, sort of the third thing I love to ask about and a lot of us do is it is a little bit like that idea of do you know what you're getting into?

But really it's what are your goals moving forward? Now, some of our applicants don't know yet, and they are, as we like to say, in pathology, they're undifferentiated. They don't know exactly what they may want to specialize in yet, and that's perfectly fine and valid. And knowing that upfront kind of changes the discussion somewhat too.

Other people though have very distinct needs and goals as far as maybe they're very heavily interested in research, maybe they're heavily interested in educational opportunities. Maybe they already know I'm absolutely going to go into transfusion medicine, so I want to target this type of program. And so knowing that upfront can help us guide that person as far as would

this program a good fit for you? So if somebody says, I absolutely want to do pediatric pathology, they might be a great applicant, but in my program here, we don't have a dedicated children's hospital that they would rotate through. So we might have a discussion of, well, here's all the amazing resources and things that we could provide here. However, let's talk about that a little bit more because there may be other opportunities

that are better for you. And that being said, I don't believe you should ever target a residency based on exactly what you want to do for fellowship. So for instance, we don't have a forensic fellowship here, but we have an amazing experience for people who want to go into forensic pathology.

So I don't think the applicants need to necessarily target a residency training program at that level, but having those discussions about do they know what they want to do in the longterm can really help us focus on, okay, great. If that's important to you, let's talk about the opportunities here and how we might be able to guide you through that process.

I think that's really wonderful to highlight for listeners who might be interviewing this year in future years, this idea that the interview is also looking out for them in the sense of might we be the right program for you? Or maybe even highlight for them, maybe some weaknesses that our program has, which might highlight for questions that they have for other interviews that they go through.

So it really is kind of a collaborative experience rather than, I think sometimes when you're interviewing, you kind of feel like you're trying to swim upstream and it's just you versus the world. Exactly. I think it's just as important to us that we get not only great residents, but we want them to be happy and successful. So it's like I love to have that complete discussion of what is

your best opportunities here versus other places? And again, it does not hurt my feelings if somebody in the end after they've seen all the data, they go, well, this actually is a little bit better for me, and it's a small community. We're all going to be in touch anyway, so we'll see you in the future and congratulate you wherever you end up.

On that note too, I think that for maybe junior faculty that are listening to this podcast, I think you're giving insights as far as reminding us maybe what are some of the aspects to focus on when we're in these interviews,

what kinds of questions are we looking for? Right? You're kind of highlighting the importance of talking about that communication style, thinking about what somebody's interests are. How does our program support those goals? I'm curious, what advice might you have for these interviewees as far as the interview process, as far as how can they best convey their communication style, their personality, these aspects in the interview?

Yeah, I mean, number one, be yourself. Don't try to be somebody you're not. Just relax and embrace the interests you have and the things you like to do, and don't be shy about talking about them. I find a lot of my interviews spend more time just chatting with somebody about where they grew up, what kind of environment do they like to hang out in, and just to get a feel for, oh, well, would they like our area?

Would they like to live here? So just relax, be yourself, but also be really cautious about aggressively overselling yourself. I have some applicants sometimes who want to jump into the interview and immediately start to tell me everything about where they were in their class ranking, every publication that they've done, every research project they're involved in. And that's all great, but keep in mind, again,

we already have that information. So what I like is if there is a particular thing I'm interested in, I'll ask you about it and because I want to hear more about it. So oftentimes we'll have somebody who says, oh, I did this summer research project and then that has progressed in the year since then and I might really be interested. Okay, great. Tell me more about that. What did you get out of that? And have that discussion.

But I've had some who almost turn it on its head where I feel like I'm being interviewed and they're just kind of bludgeoning me with a little too much information all at once. It's like, just have a conversation, enjoy it, and we'll get to the important things. I think what I'm taking away from it is if somebody's coming in and they're having that kind of like, I'm swimming upstream, it's me versus the world.

Maybe if they're hitting you with all this information that that's going to consume that period of time that you have for the interview, and you might, I guess I think end that not really having much information to go on for that individual. Correct. Already. Like I said, we've already got this huge packet of information about that individual, and so just hearing it again might reinforce it, but doesn't really help me learn anything new about that person.

And so the interview is really to sort of get to know somebody at a level that we can't achieve just by reading. So in terms of advice for people interviewing this, it may sound cliche, but be yourself and you're really looking to have a back and forth conversation and letting the interviewer kind of take the lead on the direction. Yes, absolutely. One aspect I think at least I usually have a conversation

about with medical students is kind of that part of the interview, what questions do they have for the program? And my sense is sometimes applicants don't necessarily have a great sense on what they want to ask early on, and so maybe they have one or two that they just ask.

Do you have any kind of advice for those interviewing as far as how to approach thinking about questions that are going to be, I don't know, the way I think about it is meaningful for making their rank list after they're done with interviews.

Exactly. Yeah. I mean, it's such an intimidating process because they are told you've got to have some questions because if you don't have any questions, there's this appearance of like, oh, I either didn't do my homework about the program, or I'm not very interested in the program, which you definitely don't want to come across as, but at the same time, it's exhausting to come up with all these different questions.

And then of course, the longer you go through that interview season, you get more and more tired as you go. But yeah, I know it's cliche to say, but yeah, definitely have a bank of questions prepared. But I think an important point to make about that is it does not have to be necessarily about the residency program, although those questions are great, but just anything that conveys an interest in the program, the area,

remember this is where you're going to be for four years. So I've had some people that ask me great questions about childcare, about opportunities for travel in the area and what's around that area. And then of course, we get lots of questions about the program itself. But one thing I think people don't think of is that in an interview, we are specifically not allowed to ask questions. We can't ask people about whether they're married, whether they have children or anything like that.

That is a very specific block that we have not working against us per se, but just that we're not allowed to ask about. So when somebody asks me a specific question about what's childcare in the city, that opens up a whole different avenue of things that we can discuss that I can't ask, oh, do you have children? Because we've got great schools here.

So things like that give us a lot of flexibility. The other thing that I love to tell people is don't be afraid to ask the same question to multiple people. So you can have a really important question that you think, I'm going to ask a resident that, but I'm also going to ask these other faculty that I wouldn't repeat the same question to every single person you're interviewing with. But we're not taking notes.

So it's not like we're going to sit down in a room afterwards and say, well, what did they ask you? But I think it can be very eyeopening because you can talk to different people and get different responses, and sometimes that can really help your decision-making process because the perception of the chief resident and how they answer a question may be different from how the faculty answers a question, and that would be very valuable to you in that interview process.

The other thing is, I always say when you're talking about questions, be cautious about asking faculty to granular questions about their own cv. Sometimes it's very important because maybe you're very interested in their research or their type of career because that's what you want to go into. And so if you're asking, saying, okay, hey, I read online that you've done this and this, sometimes that can open up fabulous areas of discussion to say, oh,

you're interested in that. Great, let's talk about that. The only reason I caution people on that is I have seen the approach where people are doing their homework and they want you to know, I have done the homework and I've studied your program, but they start asking a lot of things about your publications or your research where they really don't have any necessarily interest or understanding of that. Exactly. And they just will basically say like, oh,

I saw you did a project on blank. Can you tell me about it? And it can come across strangely because again, I'm not the one being interviewed, so I would caution people, again, if you have a particular interest in something fabulous and let's talk about it as much as you want. But I wouldn't just ask general questions like that about somebody's cv. I'm glad you brought that up.

If I can kind of dig in just a little bit then and ask a follow up about, are there a couple other maybe ways that somebody can kind of convey that they've done their homework without asking the kind of detailed publication record? Because like you say, that's what is trying to get communicated across, but like we're saying, that can really eat up a lot of time and that may not actually serve anybody's interests.

So I think, again, if you're one of the applicants who's coming in with a very specific interest, I want to do pathology because I want to do GI path, then I think it's much easier to ask these very specific questions because you have a genuine interest. Maybe it might be even an area of research you're already working in, and so you're trying to target like, oh, do you do this in your lab? Because I'm really interested in that. That's fabulous.

But if not that level of granularity, then I would say asking more questions about the program, but being specific. So if I know for instance that you've done your research and you've looked at our program and our curriculum and you're aware that we have a separate, let's say, informatics rotation and to be able to point out like, oh, I see that there's an informatics rotation that's usually offered first or second year. Can you tell me more about how that works?

That tells me the same thing. You've looked online, you've seen what we do, and you have a specific question about the curriculum or the program in general. So those types of questions are a little bit more open to the program as opposed to the specific interviewer, which can definitely open up discussions without putting the interviewer sort of on their back foot.

Right on. If I can then turn, and I realize maybe it's a little bit of a problematic area to talk about as a program director, what if any kind of follow up, and I use the word here and I realize this is fraught, what do you expect from those that you have interviewed? Right? Because I know that there are rules about contact that happens, and I think certainly there's a lot of conversations that happen amongst interviewees about thank you letters or follow up emails.

What are your thoughts about what you might see from somebody who

is interested in the program after they've interviewed? Yeah, absolutely. I think it's pretty common for someone after they have done the interview to send out just a general thank you email for the opportunity to do the interview, and you can be as detailed or not on that. It could just be a really, thank you so much for hosting me, look forward to talking to you in the future, or something like that.

Or it can be more detailed if you had something that you really wanted to highlight as a great experience during that interview day. But there's not an expectation that we necessarily get that feedback, but at least sending the one sort of follow-up email is usually kind of nice just to know that they had a good time. And sometimes I've actually reached out to some just because I wanted to make

sure they got home safely or what have you. I had one, I think it was last year or the year before, who was basically sick during the interview process and made it through, but was just struggling the whole time because it was all virtual anyway. And so

I followed up with them just to make sure you, okay. So that being said, we encourage, and I think most program directors encourage all the applicants that if you have any questions as you go through the rest of this process to reach out anytime to us. So especially if you're early in the interview process, you are going to discover questions later that you wish you would've asked.

And that is an open door policy for us where it's like at any point you can email, call back and say, Hey, now that I've done this, I have this question about your program. What do you offer for this specifically? We always embrace those. That being said, we also make it very clear that it's kind of a one-way street for communication. If the interviewee opens up a dialogue with us, we are happy to have as much of a conversation as they want so that they can

understand as much of the program as they can. But we are very limited on how we reach back out to the applicants other than right after the interviews, I'll usually send out an email that just says, thank you for joining us last week, or what have you. But then I tell all of them during the interview season that we are not in the practice of reaching back out to you multiple times to see if you need anything else. We really try to avoid any kind of pressure on that applicant later

as they're going through their rank list. We want them to make that decision. And again, we're here to answer any questions, but I'm not going to hound them on any of that. I think that's important for the audience to hear both for trainees from this or for people that are me interviewing to know that they can reach back out. I think there's been a number of people that have come into my office after doing their interviews and they're kind of like, okay,

how should I make this rank list that? It's kind like, well, how did these places do in your estimation? And maybe there are questions that they didn't realize in the beginning that they'd want to go back and ask some of those earlier, excuse me, some of those earlier programs about, so kind of letting them know that they can always reach back out.

And then also the idea that there are certain rules around how does contact go from the program just because the match process is trying to maintain that sanctity of the decisions. Yes, and I think going back to one of the things you touched on a second ago, it's really important for the applicants to understand that this is designed for them. It is weighted towards them first, not us. And I cannot emphasize enough the idea of just make your rank list in the order you want it.

Don't play any mind games with yourself trying to figure out, well, I don't know if they want me or not. Just rank them in the order that you want and it'll all work out. But I think people try to overcomplicate the psychology behind it. Sometimes.

We've been routing with Dr. Reade Quinton talking about advice for interviewing for residency. Thanks for taking the time to talk about this with us. Thank you, Dr. Kreuter. It's always a pleasure to be here. I appreciate the opportunity. To all our listeners, we thank you for joining us today. We invite you to share your thoughts and suggestions via email to MCL

[email protected]. If you've enjoyed this podcast, please subscribe and until our next rounds together, we encourage you to continue to connect lab medicine and the clinical practice through educational conversations.