Personal questions:
Q1: What are your strengths and weakness? How do you handle your weakness?
My biggest strength is good communication and interpersonal skills. I can work very well with people at different level.
I am a good student. I have got good fund of clinical knowledge. I am thorough in taking medical history and performing physical examination. Besides, I am always ready to learn new things. I am a quick learner.
I am a professional. It means that I am responsible and dependable person who is well organized with his work. I will follow hospital work ethic.
(Professional, team player and quick learner)
Q2: What will you do 10 years after completion of residency?
Since I love teaching, I see myself working as an attending physician in academic institute.
Q3: What made you join medicine?
Doctors are highly regarded by society. As a doctor, I can have opportunity to have positive impact on lives of many people. Besides, doctors have excellent job security. So I will say that this is the job that will enable me to nurture not only myself and my family but also the community.
Q4: Why did you leave your country? Why did you come to America?
I wanted to have training in the field of Public health prior to residency. In India, there is no formal public health training. More important thing is that residency program over here has much more resources available in terms of education and patient management. Residency program over here will enable me to deliver high quality health care in the community.
I accept that my country needs me the most. After I have served for few years in this country , I will head back to my country to work as a physician and utilize my advanced training and experience
Q5: Describe yourself in 3 words.
Professional, quick learner and team player
Q6: As an IMG what differences you see between health care systems in the United States and India?
In my country, health care is universal. Majority of health care is provided by government through civil hospitals. Small proportion of health care is provided by private practice but it limited in city and major towns. Health care delivered by government is free. Private health care is expensive. That is why health insurance is not much popular.
In U.S.A., 84% of people have insurance either owned individually or provided by employers and government. Health insurance is expensive. Cost of medical bill is very high.
(In USA there is a lot of emphasis on preventive health care. In my country, our health care system is saturated by acute conditions like infectious diseases. WE emphasize curative aspect medicine more than prevention.)
Q7: What is your medical career plan?
My short term goal is to join internal medicine residency program. After finishing my residency , I would like to work as a attending physician at academic institute.
At present I am not decided about fellowship. Once I finish my first year of residency I will be in better position to make decision.
Q8: What do you do in your spare time?
(I use my spare time for volunteer work. I am working as a peer health educator for XXXXX.) I like to listen to music and watch movies. Sometimes, I go for a walk. I also prefer to spend my free time with friends.
Q9: What are your interests?
Hobbies include as per cv.
Q10: How do you handle adversity?
Usually because of my friendly nature, I do not frequently face adverse circumstances. However, we are human beings and conflicts are likely to arise. The most useful tool to resolve adversity is open and honest talk with the person. (We can involve third party who can think over the situation independently and contribute to conflict resolution.) If I have made a mistake, I will be ready to accept it. I will make sure that it will not be repeated. I will expect same kind of response from opposite party if he is in fault.
Q11: What is your opinion about socialized health care?
Socialized medicine is a term used to describe health care system controlled and financed by government. The major source of fund will be tax. The advantage of this system is that all people will have access to health care services. This can help eliminate health care disparities among different segments of population.
Q12: Tell me about yourself.
I was born and brought up in XXXXX. During my high school, I decided to go to medical school and prepared myself accordingly.I competed for the Medical Entrance conducted for all over the state and succeded to secure a seat in Medical school of my choice. My medical curriculum included one year of rotating internship after 4.5 years of basic and clinical science. After intern ship, I worked as a junior resident in medical and intensive care units in a reputed corporate hospital XXXXX FOR XXX TIME. Then I came to USA for MPH program. As a MPH student, I realized the importance of preventive care and health promotion programs. During my summer vacation, I worked as a research assistant in the department of XXXXXX. ( EXPLAIN ABOUT THE RESEARCH )
My contribution will lead to three research papers, manuscripts in preparation. This research experience was very rewarding, and I learnt to be patient while doing research without getting frustrated when the expected results don’t come and it increased my research interest in medical field. Finally, I would describe myself as team player, quick learner and professional person.
Q13: If you could change one thing about your personality, what would it be?
I always try to finish entire task at once. Sometimes, I do not care about time. I will work late to finish it up even though I know that I can complete the task next day.
Q14: If you had unlimited money and two free hours, what would you do?
First of all, I will pay off my educational loan that I have taken for MPH program. I will spare some amount for future. Rest of the money will be used for charity for example I will give money to students who want to study abroad, patients who can not bear medical cost , I will donate money to free clinics and health care program
Q15: If your house was burning, what three objects would you save?
Mobile so that I can ask for help
Wallet- my id, credit card
First Aid lit
Q16: How would your friends and coworkers describe you?
My friends describe me as a well organized person who is easy to get along with and will be ready to help friends whenever need arises.
Q17: What physician characteristics do you admire most? Least?
Physician must have good bedside manners. I admire their patience.
Grades in board exams.
Q18: What do you like to read?
I like to read newspapers. I can know what is going on in the community. Besides, I like to read articles so can keep me up-to-date with medical knowledge. I do online CMEs to keep myself updated.
Q19: When are you least efficient and effective?
I feel great degree of energy and enthusiasm when I have some work to do. Usually I maintain same degree of efficiency and effectiveness. However, I am a human being. I may feel tired after working long hours. This can negatively affect my work efficiency. I may take little bit more time to accomplish my task but quality of my work will remain same.
Q20: What makes you procrastinate?
I have got good time management skills. The chances of being late are few. However, in real life we work as a team as for example residency program. So, It depends on other people’s work efficiency also. Besides, If I have been working for long hours, I may feel tired and may need more time to finish task .
Q21: Have you ever been fired?
No
Q22: Have you ever dropped a class?
No
Q23: If you couldn’t be a physician, what would you be?
I like to work with patients. If I could not be physician here, I will go for PhD in Public health. People in the community have some bad life style choices in general. As a public health professional, I can plan interventions or programs so that people make healthy life style choices
Q24: With what types of people do you have trouble working?
I have trouble working with people who are not open and honest with their coworkers. I do not like lazy people. Most of the time, we have to work as a team. When we are working as a team, certain level of commitment is required from each and every member to accomplish the goal. If one member of team is lazy than whole team has to face negative consequences.
Q25: Why should we take you in preference to other candidates?
It is a difficult question . I understand there are many applicants who have same qualifications as me. So, you are in better position to decide. However, I can assure that I am going to work hard, I am going to learn, I will teach my junior residents and medical students. I will not disappoint you regarding your decision to select me.
Q26: How do you see the delivery of health care evolving in the twenty-first century?
I believe that there will be changes not only in the way medicine is practiced but also in the way it is paid. There will be much more emphasis on prevention rather than treatment. Health insurance will be portable. It means people will have same insurance wherever they live or work. Besides, medical liability system will be fairer. Nowadays, to avoid lawsuits physicians practice defensive medicine which increases the cost of health care. The concept of Health saving account is becoming more popular. People themselves will save money for future which decrease burden over the government. I think many good changes are going to occur.
Q27: What is the solution to the health care crisis?
The major problems are rising cost of health care and increasing number of people who are uninsured. In order to decrease cost, we need to practice prevention so we have to spend less on diagnosis and treatment. We need to make medical liability policy fair so we do not practice defensively and waste money on unnecessary tests. Health savings accounts are very good option. Another, solution can be Universal health care or socialized medicine. All people will have access to health care.
Q28: What would you do if you saw another resident or physician snorting cocaine at a nightclub?
I will tell him that he must not be under the influence of drug while dealing with patients in hospital. If this happens I will inform program director. If this is not the case than it is the choice that he made for his life. However as a well-wisher, I will talk to him and ask him if he needs help.
Q29: What do you think of hospitals that refuse admission to patients without insurance?
As per Emergency Medical Treatment and Active Labor Act, hospital must provided screening services to identify any emergency medical condition exists. If yes than hospital is obligated to provide appropriate health care irrespective to insurance status. Same concept applies to females who are in active labor. However, when patient is medically stable this obligation ends. We are in trouble if we are not following this act.
Q30: Teach me something non-medical in five minutes.
Health belief model to change smoking
Q31: What are your hobbies?
Listening to music, playing guitar, watching cricket and tennis, playing chess, watching movies, cooking,drawing,and browsing.
Q32: What do you think about house staff unionization?
House staff unionization has both positive and negative sides. Positive things are that it will increase strength of house staff in the organization. They can better represent their ideas to their superior. They can discuss different issues together and try to find out solutions. But sometimes there can be misuse of strength. They may make inappropriate demands like increase in pay. If they decide to go on strike together than entire system may be messed up. I will say unionization should be there but there should not be misuse of power to fulfill inappropriate demands. I will not support any such inappropriate demand.
Q33: How will you deal with possibility of being sued?
I believe that If I follow the practice guidelines and hospital work ethic appropriately chances of being sued are almost nil. The most common reason for malpractice sue is communication gap between patient and doctor. If I made a mistake I will discuss the issue with patient to present my side and explain his questions. This can definitely avoid lawsuit.
Q34: What was the last book you read that wasn’t a medical book?
Q35: How prepared are you to treat the patient and disease population here?
I have good clinical knowledge and experience which will serve as a good base to develop career. Besides, I am going to have three years of training as a resident. My MPH training will enable me to consider psychosocioenvironmental factors while treating symptoms. All these attributes will enable me to provide high quality health care here.
Q36: What if you do not get matched?
I am confident about match result. But I have to prepare myself for any adverse outcome. I will try to find out some externship or research assistantship position. I will work hard to get good letter of recommendation. That is the future plan.
Q37: What leadership roles have you held?
When I was in school, I used to be class representative every year. During my final year of medical college, I served as a student coordinator for first year medical students. We will assist them in hall placement, arrange monthly meetings, identify any problems and help student deal with those problems.
Q38: What was your favorite course in medical school?
I like all subjects but my favorite one is medicine. If we have to rank different courses as per their importance, medicine will be the first one. Even in board exams 70 percent q belongs to medicine. Besides, medicine offers wide range of disease conditions to learn. If I am thorough with medicine I will have knowledge about physiological, pathological and pharmacological aspects of each and every organ system. This intellectual aspect of medicine fascinates me most.
Q39: What motivates you?
I always want to excel and to be successful in my job both for my personal satisfaction and my superiors. This desire to do well motivates me to put my 100% effort for the job.
Q40: If you could do medical school all over again than what would you change?
I think my medical curriculum was very strong and there is nothing that I would like to change. However, I can change the way in which I completed it. First I will try to complete few of my clerkships over here. Second I will finish my board exams during medical school only so that I can save few years of my life.
Q41: Describe best attending you have ever met?
Dr. BBS is my best attending ever. He is currently head of the unit in internal medicine. He was a master clinical teacher. He used to discuss each and every case in detail. He involved not only residents but also students in the discussion. He had very good bed side manners also. As a person, he was very nice, easily accessible and ready to help students and residents. In one line he was completely professional human being.
Q42: What is the greatest sacrifice you have made to reach where you are?
I have invested a lot of time and effort to reach where I am. Six years of medical school, 1 year of job and 2 years of MPH is a very long time. I am satisfied what I have achieved till now.
Q43: How well do you take criticism?
It depends on what kind of criticism In case of constructive criticism, admitting the mistake will be the first step. Next, I will ask what needs to be done to improve my work. Lastly, thanks for pointing it out. In that way only, I can make progress in professional and personal life.
How ever, if it is destructive criticism, I will try to ignore it.
Q44: If you could be any cell in the human body, what would you choose to be? And why?
I would like to be neuron. They transmit signal to and from the site of stimulus. In that way, they enable us to respond to our environment. Similar to neuron, I will take knowledge from other people. I will also transmit it to colleagues. I will be sensitive to patient need and respond accordingly.
Q45: Have you always done the best work of which you are capable?
I always try to excel and to be successful in my job. I put 100% effort for my job and that is why usually get best result.
Q46: How well do you function under pressure?
I maintain my poise when I am under pressure. In my first semester of MPH, I registered for 9 credits. In addition, I had to give my step 3 exam in December. I had one and half month to prepare myself for midterm and final exams of MPH and step 3 as well. Besides, I have to work on project also. I was under pressure. In December, I gave 5 exams in a row- step3 and MPH. I got GPA of 4 in MPH and 89 in step 3. The reasons for success were: perfect planning, good time management to follow the plan, I never looked at amount of work I have to do I just continued to finish it as per plan.
Q47: What have you learned about yourself from previous jobs?
I have found out certain attribute about me from my previous experience. Hard working, quick learner, detail oriented, team player, perfect planner.
Q48: Tell me about your medical education.
I had my basic science in first two years of medical school. In the third and fourth year of medical school, I had my clinical clerkships. During my clerkship, I used to take history, perform physical examination and formulate differential diagnosis and treatment plan. I used to present cases to attending also. As a part of medical curriculum, I underwent one year of internship. I involved myself in all aspects of patient care from admission to discharge and follow up. My cumulative GPA at the end of curriculum is 3.95 on a 4 point system.
Q49: Have you ever taught medical students?
I like teaching medical students. During my internship, I used to teach medical students regularly (once a week). Besides, I used to be mentor for one medical student every year. I will guide what kind of books we need to read, what topics must be emphasized. I will personally discuss topic that are found difficult by student.
Q50: How would you describe your decision-making style?
I never make any decision in hurry. I think over the situation carefully. I will try to find out what choices are available to me. I will try to identify what are the positive and negative aspects of each option available to me. In that way, I can make good decision.
Q51: What do you do to cope with stress?
I think I have to options. I can minimize sources of stress or I can improve my ability to cope with the stress. In order to better deal with stress, I remove myself from stressful situation. I avoid extreme reactions. I try to think positively. I try to relax myself. I listen to music or go for walk or take nap for one or two hours. Once I feel relaxed, I can think over the situation once again. In order to deal with stress at its point of origin, I usually set realistic goal in order of their importance. I plan my work well so my work do not get piled up subsequently there will be less stress..
Q52: What kind of patient do you find it most difficult to relate to? What tactics would you use to establish optimal rapport with such a patient?
I think silent patient will be most difficult for me. If patient is silent, I will not have enough information to deal with the problem. Second it will take much more time for me to gather information so other patients may have to wait for long time which can create problems.
I will try to find out a reason for silence. I will ask open ended question: you seem quiet today is there any reason for this? If there is no response, I will explain how important it is for me to gather information. If I am able to identify the reason, I can address it.
Common causes for silence are hearing problem, cultural issues, sad or depressed mood, language barrier, fear of serious condition, shy nature..
Q53: What is your concept of the doctor/patient relationship?
There must be professional relationship between patient and doctor. If the relationship is no longer professional, it brings up two issues. First, physician may make inappropriate assessments and decisions. Besides, patient relies on clinician for knowledge and guidance. So if patient feels that there is misuse of trust, patient may feel exploited. This can cause significant emotional harm. Whenever physician thinks that he is not able to maintain professional relationship with patient than it is better to refer patient to another physician.
Q54: List several qualities that you feel are the most important in being a good medical school student.
A good medical student is a student who is a good observer, ready to learn new things, who has got good communication skills and able to develop mature appropriate relationship with patients and last but not least able to apply knowledge of basic and clinical science to manage patient..
Q55: What is your concept of the biopsychosocial model of medicine?
According to this model, we need to treat person as whole and not only the symptoms. In order to achieve, this goal we need to consider whole range of biological, psychological and social factors and environmental factors.
Q56: Describe your personality.
I will say I am well organized person. I am detail oriented and work hard to achieve my goal. I like to plan my work ahead. I am easy to get along with and like to work with people. I am strong but always sensitive to needs of other people.
Q57: How do you think your role as a physician fits in with your role as a member of the community?
As a member of community, I have some obligations for other people. It will be my duty to help out any community member. If I can not be beneficial than I will not do any harm. As a concerned physician, I will advocate for certain health issues like smoke free communities, obesity and HIV education. Besides, I can provide few hours per week to free clinic so that I can serve people of lower socioeconomic class.
Q58: What do you think is the most pressing issue in medicine today?
There is an increasing number of populations who has no health insurance coverage. Since funding for Medicaid and Medicare is decreasing, many state governments like TN, Florida have decreased number of people covered and number of health care services provided. These uninsured people are more likely to end in emergency room. Besides they do not have access to preventive services so they are at risk of developing chronic health problems increasing burden over Medicare.
Q59: What steps have you taken to acquaint yourself with what a physician does?
In India, I had my Internship for a year. Besides I have worked for more than a year as a primary care doctor. More importantly in the United States, I have been working in Commonwealth Free Clinic. I have done two observershisps in major academic settings. I had both inpatient and out patient exposure. In clinics we do a lot of education and prevention whereas in wards there is much more emphasis on diagnosis, treatment and rehabilitation.
Q60: How would you go about improving access to health care in this country?
The most important step to improve access to health care is to improve insurance coverage. There are different ways for this like tax credits- those who purchase insurance will receive certain tax benefits, We can make it compulsory for employers to provide insurance to employees, We can make health insurance mandatory for individuals as auto insurance. We can expand programs like Medicare and Medicaid to cover more number of people. Or we can introduce Universal Health care system or socialized medicine to cover all people.
Q61: Do physicians have the right to deny care to patients on Medicaid?
According to Emergency Medical Treatment and active labor act physicians can not deny care to any person. Otherwise, they can deny care patients on Medicaid. State government has difficulty paying Medicaid cost on time. This can create financial difficulties for clinics. The only way to deal with this situation is to reduce the number of Medicaid patients. However, this is also unethical and clinics can be sued. The better way to deal with problem is to provide tax credits to clinics depending on the cost of seeing Medicaid patients.
Q62: List three issues that confront medicine today. Of the three, which is the most important and why?
Access to health care, obesity and smoking
Q63: I see that you have had considerable volunteer experiences. What have you learned from those experiences?
My volunteer experiences have enabled me to further hone my communication, team building and leader ship qualities. I think I feel more comfortable to work with people of different cultures. My clinical exposures have taught how different health care professionals work together to deliver high quality health care, what are the major health related issues and how to deal with them.
Q64: How do you relax?
Usually I listen to music and watch movies. I go for walk. I talk to friends . Even a nap of 1-2 hours can relax me.
Q65: You are granted any three wishes by a genie. What would your wishes be?
1. Give me a job as physician- I can earn bread and butter for my family plus I have opportunity to help other people
2. Wonder drug that can cure all disease
3. Long healthy life. I want to enjoy as much as human being.
Q66: What do you do when your schedule is interrupted? Give an example of how you handle it.
I always keep one thing in my mind that when we are driving the car, speed will depend not only upon ourselves but also on other people on the route. First I will accept it. I will not get frustrated. I keep myself calm so I can think clearly how to complete the work without much delay. For example, I will try to work faster and whatever work is remaining can be finished next day. I will start working little bit earlier to compensate for the time lost. Besides, I will try to follow the schedule of that day.
Questions related to CV
Q67: Do you have a standard ECFMG certificate?
Q68: Do you have any medical research experience?
Q69: What are your USMLE scores?
Q70: Explain 1 year gap in your CV.
I decided to achieve Master of Public health degree with Health education as my major before entering into residency program. By the time I prepare GRE and TOEFL and board exams, I started working as a primary care doctor. As a primary care doctor, I had both inpatient and outpatient exposure. I worked for almost more than a year till I got visa. I am currently enrolled in my final semester of MPH. I will have my MPH internship in January. I will graduate in May 2008. By the time, to expose myself to US health care system, I completed two observer ship in major academic setting during summer vacation. I am also working at Commonwealth Free clinic.
Q71: Have you completed all ECFMG requirements to start residency?
Q72: How did you get such a good scores? Did you take any course?
I didnot take any course for steps. I used to read books and try to correlate it with clinical findings among my patients. So that I can have specific clinical picture for every syndrome. I used to discuss different topics with friends and practice a lot of questions.
Q73: How do you rank in your class?
We can say in my medical school there is no ranking system. We are given percentage for each exam. My average percentage was around 65 .I was among the top 30 percent students in the university. My overall GPA is 3.95 on a 4 point scale.
Q74: What were major deficiencies in your medical training?
Overall my medical curriculum was strong. However i think that we put less emphasis on prevention and health education. The reason is that we have large number of patients to take care of so it is not possible to spend an hour with each patient in clinic.
That is why I am enrolled in MPH with health education as a major.
Q75: Tell me about the error you made in patient care.
During my internal medicine rotation, I was taking care of an old patient who had symptoms of anemia. I ordered few basic tests like iron, vitaminB12, occult test.. Everything came normal. I told my attending that there is no chance that this patient can not have any nutrition deficiency. My attending asked me did you check serum homocysteine, methyl malonic acid I said no sir. He told me that we have to order three panel of test to rule out B 12 deficiency. Serum B12 is a reference range and it can be normal even when there is a clinical deficiency.
Q76: What subject or rotation was most difficult? Why?
I think my first ever clerkship in medicine was the most difficult. One reason was that it was the first time that I was working with patients. Since I had no previous experience, there was a fear factor also. However, I started to spend more and more time in wards. I would read the book and try to correlate it with clinical findings. Whenever I had query, I immediately consulted my resident so that mistakes can be avoided. Within1 week, I adjusted myself to new atmosphere.
Questions related to specialty:
Q77: What made you choose this specialty? What would be the toughest and least enjoyable part of this specialty?
I chose internal medicine for different reasons. First, I can have broad and varied practice. I will have opportunity to treat disorders ranging from heart disease, diabetes to minor infections. I can work in different settings like private practice, wards, ICU, nursing homes, hospice care. I will have largest segment of population to work with. Besides, it has a very good intellectual component. Most of the time, we have to fit the symptoms in a particular scenario. We order a set of test and prescribe medicines. In addition, we have to consider drug interactions also. We also have opportunity to have long term relationships with patients.
Q78: Do you have any research interests?
I want to stay more towards clinical side of medicine. I think we need to focus much more on prevention and education. If we encourage people for healthy life styles like no smoking, and substance use, if we increase compliance to treatment than we can make a lot of difference. This does not mean that there should not be any research. Research is must for advancement in any specialty.
Q79: Do you have any plans for fellowships?
Right now I am focusing on my internal medicine residency only. Once I finish my first year I will in better position to decide about fellowship.
If community program with no fellowship, I will say I do not want to do.
Q80: Are you interested in academic medicine or clinical medicine?
I want to work in an academic setting but even there I want to stay on clinical side.
Q81: How can this specialty fit your long term goals?
My long term goal of the career is to be a health advocate for community in general. I want to contribute to elimination of health care disparities among different segments of population. I want to reduce morbidity and mortality associated with chronic health care conditions like diabetes, obesity, cardiac disease. Most important tool to achieve this goal will be informing and enabling people for healthy life style like exercise, diet, smoking, alcohol. As an Internist and public health professional I will be in better position to achieve this goal.
Q82: What have you done to inform yourself about career in this specialty?
I always knew I wanted to pursue medicine. In order to better inform about this specialty, I have started working at Free Clinic. My observer ships at Vanderbilt and medical college of Wisconsin have gave me better idea about health care system in general. I am aware of the common health care problems and what resources are available to deal with them. I have talked to number of Internists also.
Q83: What challenges do you foresee that will potentially affect this specialty in the next ten years?
The major health problem is obesity. One third of US population is obese and one third is overweight. There is a lot of morbidity and mortality associated with obesity. It will increase burden on the health care system. Besides this problem is much more prevalent in low socio economic class and many of them are uninsured and have no access to primary care. The result is more patients in ER. More burden on Medicare and Medicaid.
Questions related to program:
Q84: Why do you want to join our residency program?
First step in selecting a residency program is to prepare a list of programs and what are their application criteria. I was able to meet your criteria. Besides, I have gone through your program website. I have found very good balance between clinical and academic aspect of your residency program.
Before going to interview identify following:
Mission statement
Clinical training sites
Size of the program
IMG friendliness
Very good patient volume/variation
Electives
Good academic aspect
Q85: How did you come to know about our program?
Frieda online is the best source for residency programs.
Q86: What can you offer to our program? Tell me three things about you that will make you especially valuable for our program.
I am going to put my 100 % effort to complete my clinical and academic work load
I will be ready to learn.
I will be ready to tech my juniors and medical students.
Q87: What is your perception about strength and weakness of this program?
Focus on following points.
Mission statement
Clinical training sites
Size of the program
IMG friendliness
Very good patient volume/variation
Electives
Good academic aspect
Q88: What are you looking for in a program?
Comprehensive clinical training
Good amount of teaching
Very good level of understanding between professional at different level
Encourage participation in community activities
Q89: What factors would lead you to rank a program very highly?
Focus on following points.
Mission statement
Clinical training sites
Size of the program
IMG friendliness
Very good patient volume/variation
Electives
Good academic aspect