For international medical graduates (IMG), interviewing at residency programs is often fraught with challenges. Besides the normal nervousness and everyday imposter syndrome, there are often differences in communication styles.
An education session at the first annual AMA Distinguish Yourself IMG Summit explored three pillars—or three C’s—of residency-interview preparation and communication to help IMGs relax and come across as their true selves.
“Back in 2009, when I applied for residency, I was doing everything right,” said Roopa Naik, MD, who chairs the AMA IMG Section Governing Council.
Dr. Naik had taken Steps 1, 2 and 3 of the United States Medical Licensing Examination (USMLE) and passed them all in her first attempts. Dr. Naik got good grades too, and she had plenty of clinical experience.
“I got many interviews,” she noted, and she did match. But the residency program in a correctional medicine setting was, ultimately, one that Dr. Naik decided against pursuing.
“So when I thought about it, other than the fact that I was sad, what it made me think was that I was not very good at interview skills. That was my weakest point,” Dr. Naik said, noting that she believed that shortcoming impeded her ability to match with a more desirable residency training position.
So over the next several months, she sought out every speaking opportunity she could find—presenting posters at state and national meetings, attending grand rounds, doing morning reports.
“Every little speaking opportunity I got, I took it, and that was very transformative for me. It really boosted my confidence,” and eventually she matched in internal medicine with a hospital in Rochester, New York.
"As IMGs, I feel that we often wait for people to give us permission to speak. We don't have to wait. We have the talent. We have worked very hard,” Dr. Naik said, noting that IMGs are united by their shared experience.
“Stand for yourself, because you're not just standing for yourself alone. There will be people who are going to be able to get help because you stood for yourself,” added Dr. Naik, who is an assistant professor of medicine at the Geisinger Commonwealth School of Medicine and a core faculty member for the Northeast campus of Geisinger’s internal medicine residency program.
Geisinger is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Pillar 1: Clarity
“Knowing your message—being very clear about your message—is very important because that is how people understand what you’re trying to say your vision is,” Dr. Naik said, adding that interviewees should take note of what often starts an interview: the icebreaker question.
“You need to have what is called an elevator pitch,” she said. “It's a short, direct, clear, memorable talk about yourself. It should include who you are. It should include what it is that you value. And it should include what you're looking for.”
Ideally, an elevator pitch can be delivered in under 60 seconds—the time it takes to ride an elevator, she said.
“You want this to flow naturally, not as if you are blurting out something,” she said. “It needs to be natural.”
But clarity also means being able to explain how you have dealt with real-world clinical challenges, so it’s important to be able to cite specific examples.
“What was the task you went to do when that situation arose? What did you do about it? And what was the outcome of it?” Dr. Naik said. “This is a framework that actually keeps your answer very focused, and it gives the interviewer exactly what they are looking for. So, the idea of being clear in your speech is to make sure you are not going on this monologue. You don't want to be talking on and on. Your message has to be clear. It has to be short, but to the point.”
The way to organize your thoughts, she said, is to think in bullet points.
“You have to have two to three key takeaways of what your vision is, what you are really doing in that interview,” she said. “What is your key takeaway from this interview? What do you want them to remember? You want to make a message or deliver a message that is hard to forget.”
Navigate the process of practicing medicine in the U.S. with the AMA IMG Toolkit (members only).
Pillar 2: Confidence
“Confidence is not about being loud and flashy. It’s being very comfortable with yourself. It's being very consistent with your presence and your message,” Dr. Naik said, adding that interviews with residency programs typically run a generous 30 minutes.
That’s plenty of time to explain who you are, she said, although you might need to calibrate your delivery.
Many IMGs, she said, “come from cultures where being loud, being talkative and speaking out in public is not something that we appreciate. We consider being reserved a sign of humility, a sign of respect,” she said. “But here in the U.S., it might be interpreted as somebody who lacks confidence, who lacks intention. Something to keep in mind—you are in a different country now.”
There is one thing that every IMG should appreciate, Dr. Naik said.
“You are not just an IMG. You are here for a reason. You have your own unique story. You have cultural diversity,” Dr. Naik said. “You are resilient. That's why you're here. Sometimes it takes more than one Match—like it did for me—to get through.”
Being an IMG is, in fact, not a drawback, she noted.
"What this country needs is diversity, both in patient care and in medical culture,” she said. “Use that to your advantage.”
The AMA Road to Residency Guide will help you successfully plan your path to residency, from researching programs and excelling at interviews to navigating Match Day and more.
Pillar 3: Connection
“People don't remember data. People don't remember facts,” Dr. Naik said, emphasizing that personal experience is huge. “What they do remember is a good story. What is it that you have to say? How did you even end up in this interview?”
Sharing your personal experience may be stressful, but once you get to this stage in the profession, it’s essential. Because everyone has to do it eventually.
“Whatever your journey has been, that resonates with people—that’s the emotional connection you are looking for,” she said.
But you also have to know who you’re talking to.
“Please, before you go to the interview—the day prior, the day off—look at the program that you are going to,” she said. “Always have a message that is tailored to that program.”
Lastly, it’s important to appreciate that you're not the only one being questioned.
“I’m being questioned as an interviewer about my program. This is a time for you to ask questions that matter to you,” she said. “Whenever you are in an interview, you have to understand that you deserve to be there.”
Learn more about the AMA IMG Section, which gives voice to and advocates on issues that impact IMG physicians. Next week, the AMA will mark IMG Physicians Recognition Week to honor and celebrate IMG doctors, who are a vital component of the physician workforce and the AMA.
