Resident Candidate Interviews: Best Practices

Improving resident selection is of utmost importance. Reviewing the plastic surgery and medical education literature provided information on the types of candidates that we have, those that are most likely to be successful, and what candidates are looking for in a program. It also revealed that >30% of programs have had attrition and >60% placed a resident on probation in the last 10 years, despite a majority of surveyed program directors reporting satisfaction with their current process.1 A review of literature on human resources revealed 2 valuable lessons: screen for the necessary skill set and interview for cultural fit.2 Screening for skill set involves critically reviewing the application for objective data indicative of the skills needed to perform or learn the necessary tasks. For surgery residents, this translates to the ability to pass in-service examinations and boards, perform research, work well as a member of a team, educate subordinates, and exhibit good manual dexterity.3 Screening applications can be delegated to those uninvolved in the interview process to avoid biasing interviewers with the details of an application. The interview is for assessing an applicant’s suitability and fit into existing culture, defined as the values, habits, and beliefs of a society, people, or organization (ie, “the intangibles”). To interview for cultural fit, it is critical to honestly assess the traits valued in your most successful residents and what your program’s culture truly is. Not all programs put the same emphasis on research, interest in global health and international travel, or the ability to blend with the resident cohort. After establishing screening criteria and defining the program’s culture, the interview techniques can be addressed. There is a time and place for individual, panel, and group interviews. A panel interview of 2 to 3 interviewers to-1 interviewee is a high-yield format allowing applicants to meet more faculty and/or resident interviewers and for multiple interviewers to assess the same answers and responses from a candidate and compare reactions, impressions, and assessments. Within the interview, an unstructured, semi-structured, or structured approach may be taken. Semi-structured and structured interviews allow for direct comparison of applicants by an interviewer and provide applicants with a sense of uniformity, organization, and fairness about the process. Behavioral interviewing style questions, where applicants are asked questions about situations or traits and further required to give examples of how they dealt with a problem or achieved a goal or to define their role in a project or on a team, are the recommended means of obtaining information and assessing cultural fit. Once selection is complete, it is imperative to reflect and evaluate. External feedback should and can easily be obtained through surveys to be completed anonymously and placed in sealed envelopes at the completion of the interview day. Internal feedback with analysis of the process and its individual components (screening criteria and ease, flow of interview day, evaluation of the applicants, developing the rank list, and success of matching) should be scrutinized at the completion of each interview season, instead of repeating the same potential mistakes, resting on laurels, or settling for mediocrity.