The premise of the behavioral interview is that past behavior is predictive of future behavior. This type of assessment originated with Tom Janz, PhD, an industrial psychologist, in the 1980s. It made its way into the medical field in 2003 to 2004 via the Accreditation Council for Graduate Medical Education, as shown in this article in The Journal of Education in Perioperative Medcicine. As the report states, it was “well received by faculty and candidates.”
As nationwide staffing company CompHealth explains, employers want doctors who “connect with patients,” and behavioral interview questions add “a human element…that pays big cultural dividends.” The idea is that there’s much more to you as a person than what’s visible on your CV.
The company also says that healthcare facilities are “ultimately searching for the doctor who will represent the facility’s best interests, uphold their reputation, deliver top-notch healthcare to their patients, and quickly become a cohesive member of their team of other healthcare professionals. They also have to ensure they achieve and maintain positive patient satisfaction scores, which ultimately affects their bottom line.”
Getting ‘Under the Hood’ of Applicants
Behavioral questions, once new players on the field, are now very much the norm, says Suzanne M. Miller, MD, and author of “Nailing the Medical School Interview: A Harvard MD’s Comprehensive Preparation Strategy.” She has 15 years of experience as a Harvard pre-med tutor, admissions interviewer, and now as CEO of MDadmit medical admissions consulting.
She says one of the biggest shifts in the application process has been the Multiple-Mini Interview (MMI) from Hamilton, Ontario’s McMaster University, with a major emphasis on behavior. Hypothesis: Increasing the number of encounters for each interviewed applicant would lead to a more reliable assessment of the individual.
As the university explains, applicants move between interview “stations” in a 10-station circuit, with each station hosted by a single rater. Of course, COVID-19 has resulted in cancellations of such in-person encounters, but the format is certainly not retired.
There’s also the CASPer selection tool “used by academic programs to help assess applicants for nonacademic attributes or people skills,” the company says.
“It’s the Multiple-Mini Interview model put into a written test, almost like a personality test,” says Miller.
Think of these techniques as the recruiter or employer “trying to get under the hood” of you as the applicant, she adds.
Prepare Broad-Reaching Answers
“We want to know how people are going to react in challenging situations,” says Miller. “A more traditional interview might ask ‘Where are you from?’ or ‘Tell me about yourself,’ but a behavioral interview question asks ‘Tell me about a time you worked with a team and it didn’t go well,’ or ‘What’s been your biggest mistake?”’
For a medical school applicant or resident trying to predict what might be asked, the task can feel overwhelming. Miller offers a commonsensical and structured method to help ease the angst.
She teaches candidates not to prepare an answer to each individual question, but to take the hundreds of possible questions and divide them into categories, to understand the strategy for answering that type of question.
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“It’s much easier to prepare answers for the top twenty categories of questions likely to be asked than to prepare for the nearly limitless number of possible questions available,” Miller says.
Here’s an example. You’re in a parking lot and see someone hit someone else’s car. What would you do? This question asks about a moment in time, Miller explains.
Maybe you feel like someone probably did something unethical. Maybe they didn’t leave a note. You want to gather more information such as: Does it matter whether there was damage? Did the person realize they hit the car? What’s going on in that person’s life? Did cameras see the entire incident? Does it matter if you, by chance, know the person?
“It’s appropriate to say all of these things out loud, to talk through your thought processes in the interview,” Miller says. “Don’t give the answer up front because this is not so much about the answer but how you get to the answer, how you think laterally. It’s about getting to the core of who you are, and remember: There is no ‘right answer.'”
Avoid the ‘Fumble’
As general surgeon Cory Fawcett, MD told KevinMD, “Even though you may be well-prepared inside-out, behavioral questions often make even the best of candidates’ fumbles. When faced with such questions, it is best to describe the situation in detail followed by your course of action and the outcome.”
In another KevinMD post, Yoo Jung Kim, MD reflected upon the rigors of doing residency interviews with behavioral questions “designed to get me talking about a time I faced a challenge or learned from my mistakes, etc. They’ve prompted me to reveal my struggles and how I overcame them, so they can gauge my ability to work hard during busy clinic days and assess my potential to grow and to become a leader in the field. I answer these questions with examples of how I grew from an experience in the clinic, and then I segue into how I believe this lesson will prepare me for the work that I want to do as a physician.”
There’s humor in the interview process, he says, citing one question that made him, and likely the interviewer, smile. Question: “What sort of car would you be?” My answer: “A Honda Civic, because I am dependable, compact, and Asian.”
From Busboy to Family Physician
A family practice physician for more than six years, Peter Bailey, MD got his medical degree from the University of Illinois College of Medicine. He’s also an expert contributor for Test Prep Insight.
“I feel I can add some value here as a physician who survived med school interviews and as an educator that now helps students prep for med school,” says Bailey.
Now about that “tell me about a time you faced a stressful situation and how you handled it” challenge that shows up in most behavioral interview scenarios: Bailey says he “was asked a variant of the same question by just about every med school I interviewed with.” That gave him lots of time to get his answer right.
“I always told the same story, with great success,” he says. “I worked as a busboy at an upscale restaurant during college and recall one particularly busy Saturday night that two other bussers failed to show up for work. One called in sick last-minute with food poisoning and the other completely no-showed. I later found out that he skipped out for the Coachella Music Festival!”
Bailey says he was getting pulled a million different directions that night—a precursor of things to come in medicine, maybe? He had to clear three times the number of tables than normal while “being barked at by servers.”
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“Despite the madness, I stayed calm and collected and efficiently prioritized tasks, handling the biggest fires first and moving with purpose,” he says. “This story played extremely well with med school interviewers, as it got right to the heart of what they wanted to hear—that I could handle stress, and handle it well. This is important, because as a physician, you are routinely faced with stressful, jam-packed days where you need to remain cool and collected.”
Here’s Bailey’s advice:
- Think of a situation just like his that showcases your ability to stay calm under pressure.
- Learn to tell that story like the back of your hand. Do not under any circumstance wait until interview day to wing it.
- When a variant of this question comes up, you don’t want to have to think twice about it.
- Recall this story and tell it eloquently, but without sounding rehearsed.
- Don’t limit yourself to one story, but have a half-dozen ready to go that can be used in a variety of situations.
- Think of personal experiences that exhibit your best traits, then practice telling these stories and talking about why the tale ties into a sample behavioral interview question.
Formats to Follow with Behavioral Interview Questions
Some interview coaches recommend using the S.T.A.R. format to help prep for behavioral questions:
- S – Situation: Describe a specific situation that addresses the question.
- T – Task: Describe the tasks associated with the situation.
- A – Action: Describe the actions you took to address the situation.
- R – Result: Describe the outcome of your action.
For a really comprehensive summary of potential questions, UW Medicine prepared this for future resident interviewees. It’s a distant cousin of S.T.A.R., it seems, and explains that the answer format for behavioral interviews is:
- Situation: Describe the situation in detail.
- Action: What action did you take?
- Result: What was the result?
Sample behavioral interview questions:
- Tell me about a time you worked effectively under pressure.
- Tell me about a stressful situation you experienced in medical school and how you handled it.
- Tell me about a time you made a mistake and had to tell a resident or attending.
- Tell me how you would you deal with a resident who wasn’t doing his share of the work.
- Tell me about a time that you had a conflict with a team member and how you handled it.
- Tell me about a time when you were disappointed in your performance.
- Tell me about a time you had to build a relationship with someone you didn’t like.
- Tell me about a difficult decision you’ve made in the last year.
- Tell me about a time you when you tried to accomplish something and failed.
- Tell me about a time your performance was criticized.
- Tell me about what irritates you about other people and how you deal with it.
- Tell me about a patient you had trouble dealing with.
- Tell me about a time when you were upset with the behavior of a team member or faculty and how you dealt with it.
After all that “telling” seriousness, let’s close with a little levity from a forum post at StudentDoctor.net: No, these are not necessarily totally behavioral questions, but they’re good for a laugh, which is always useful when prepping for an interview.
- Interviewer: So why do you want to move to (warm city)?
- Nervous me: Well, we can give one of our cats a bath and just put her outside and she’ll air dry really quickly.
- Interviewer: (Speechless)
- Interviewer: If you could be a sandwich, what kind of sandwich would you be and why?
- Applicant: Peanut butter and jelly.
- Interviewer: Why?
- Applicant: Because everyone likes a peanut butter and jelly sandwich.
- Interviewer: So do you always try to conform to what everyone likes? (Ouch!)