Featured topic and speakers
In this episode of Making the Rounds, associate program director of the emergency medicine residency at Geisinger Medical Center, Chadd Kraus, DO, DrPH, CPE, FACEP, offers tips on follow-up etiquette and how to gather information after a residency interview.
- Chadd Kraus, DO, DrPH, CPE, FACEP, associate program director of the emergency medicine residency, Geisinger Medical Center
- Brendan Murphy, senior news writer, American Medical Association
- Todd Unger, chief experience officer, American Medical Association
Listen on the go to the full episode on Apple Podcasts, Spotify or anywhere podcasts are available.
Unger: Welcome to Making the Rounds, a podcast by the American Medical Association. In this episode we continue our Meet Your Match series with associate program director of the emergency medicine residency at Geisinger Medical Center, Dr. Chadd Kraus. He offers tips on follow-up etiquette for after your residency interview. Dr. Kraus also shares insight on how to find additional information on a residency program’s culture and reputation. Here’s AMA senior news writer, Brendan Murphy.
Murphy: Hello and welcome to Meet Your Match, a special series on Making the Rounds. I'm Brendan Murphy, senior news writer at the American Medical Association. I'm delighted to have Dr. Chadd Kraus with me today as our series continues.
In this episode we will cover what to do after your interview, including when to send a follow-up, how interviews should play into your ranking process and a few other post-interview strategies and some of the etiquette. Dr. Kraus, how are you doing today?
Dr. Kraus: I'm well. Thank you for having me.
Murphy: Dr. Kraus is a practicing emergency medicine physician and associate program director of the emergency medicine residency at Geisinger Medical Center in Danville, Pennsylvania. In that role, Dr. Kraus has extensive experience interviewing residency applicants. We're lucky to have his perspective on the match today.
So to start us off, Dr. Kraus, I'd be interested in learning when an interview concludes is there anything you would say that should be your first priority as an applicant?
Dr. Kraus: The first priority after an interview is to take a deep breath and congratulate yourself for getting through another session. It's really important in that post-interview period to jot down your perspectives and your perceptions of the program. What were the things that really stood out to you? Was it a good feel? Did it meet the goals you have for your training program? Is it the type of environment that's going to be supportive and provide you really with the resources you need to succeed as a resident and beyond?
Murphy: So in a traditional job setting one of the things that you're supposed to do pretty quickly after you have an interview is send a thank-you note or a follow-up. Should you do that during residency interviews?
Dr. Kraus: So I don't think there's a hard and fast rule or an easy yes or no answer. Many programs will specifically say please don't send a thank you, or a thank you is not expected. I would say it is always nice to receive a thank-you note. If you decide to do a thank-you note, unless you're specifically told not to, if you decide to do a thank-you note some key points really should be followed.
One is, it should be personalized. So it should be to the person who interviewed you, something perhaps you talked about during that interview. Really shouldn't be generic. It should be again something that resonates with that interviewer, that resonates with you.
And again it's not to impress the person with whom you interviewed, but really to express your appreciation, to describe something that you liked about the program that stood out to you about the program and to let the interviewer know that conversation was really of value to you as an applicant and that you remembered something from it.
What I would avoid is first of all a generic or inaccurate thank you. So it's really bad form and not advisable to mix up interviewers, for example to send a note to Dr. Smith about a conversation you had with Dr. Jones. Those details really do matter.
Just as individuals, we all want to know that the person we talked to is listening. And I think the number one―if you were to take one theme away from the post-interview process―it's sincerity. And that is to really express your gratitude and thanks for that individual interviewing you, to again point out some things about the program that you really liked, maybe some things about the program that you bring and that would make you successful as a resident and as a physician in your career post-residency.
You really again want to make sure that you make that connection. Things like saying for certain, "this program is number one on my rank list," I don't think you need to make those sorts of assertions or those sorts of statements. I think you can express, again, why you're interested in the program, what the things were that stood out in your interview and in your discussion about the program that are unique and meet your needs as a potential resident in that program.
For example, in emergency medicine toxicology is one of our subspecialties. If the program that you interview has a toxicology fellowship or an active toxicology program or service, mentioning that in the discussion that you had again, with Dr. Jones about the toxicology part of the emergency medicine residency program will not necessarily make you stand out but will be again personalized and sincere and show your interest in the program.
Again, telling a program "you're number one on my list," that is probably the exact same thing that a whole bunch of other applicants are also going to tell that program, that you're number one on my list, and again doesn't really meet the threshold of sincerity and gratitude for the opportunity to interview, and something that you found unique about the program to meet your needs.
It's also very important to look at the post-interview timeframe and process. And even thank-you notes in the longer horizon, beyond your residency training. Most specialties are very small worlds, so to speak, and very small communities. And what you say and what you do always will matter for your professional development even beyond your residency.
So thinking about when you write and what you write, how you communicate with programs and individuals in those programs. Not just during the interview process, but after the interview process, it's really all about you as a professional, how you interact with individuals. And again I think when people are insincere or they don't pay attention to those details, those are things that really, again, for your professionalism in residency and beyond, are really important to focus on and keep an eye on those types of details.
Murphy: It's occurring to me that communication is a key competency to being a physician and this note sort of is a way to convey that you are an effective communicator. In that vein can you tell us what an effective thank-you note that you've received in the past looked like and how it may have influenced your impression of an applicant?
Dr. Kraus: So I am not certain I would conclude that a thank-you note ever did or did not change, for example, an applicant's place on the rank list. I would say that it does not, for me as a faculty member, change that perception of an applicant. However, it is, as you mentioned, a very effective method for viewing how someone communicates, which is probably our number one competency as physicians, is to effectively communicate.
So I think if you do write a thank-you note, that there are—and write a thank-you note, meaning either via email or a handwritten note, we can get into the details of that later―really, the notes that stand out are, again, the ones that are sincere, that have a detail and truly are succinct. So receiving a two-page letter, handwritten letter, receiving a long, drawn-out email, really are not as effective as three or four sentences that again say thanks for your time. Here's something that stood out for the program when we talked. I really enjoyed our conversation.
Sometimes you can say I really enjoyed talking about a hobby that I've engaged in or a hobby that you've engaged in or a shared interest that we have. Those are items that really stand out in those types of communications.
Again, I would caution applicants and students or residents applying to fellowship even, to putting a whole lot of weight into if I write a perfect thank-you letter, that's going to change my place on the rank list. I don't think that's reality.
Murphy: One place to take this conversation, then, is there anything applicants can do post-interview to change their standing with the program?
Dr. Kraus: So certainly the entire application interview process has been forever modified and changed and transformed as a result of COVID and how we proceeded with interviews. Certainly, the overwhelming majority of programs now interview via virtual platform. What that has changed is, how do you get a feel for what a program is really like? What is the area around the hospital like? What is the community like?
And I would really recommend when opportunities are available for applicants to interview virtually but then go and visit that community—whether in a formal way from an invitation from a program—or informally if it's easy and feasible and practical to do so. To go to that community to see what the area around the hospital is like, to see what housing in the area is like, to see what recreational opportunities, et cetera are like in that community I think can be really helpful for an applicant in making their final decision.
There is certainly a move towards offering from programs and by programs to applicants the opportunities for what we would call second looks, where applicants can formally come as a group usually and visit a program and see what the hospital looks like, to interact with residents and faculty who are already part of the program.
Most of those opportunities, I will say, do not also impact rank lists for the applicant. So programs do not have, by and large, and in general, the expectation that applicants will come and visit after the interview season is over, and that those visits will somehow impact your place on the rank list. Instead, those opportunities to come and visit in person are really a chance for the applicant to get, again, a better feel for the program, to get a better feel for the community in which they might live if they train in that specific program.
So if those opportunities are made available—and again most programs will be very specific and very clear that those types of visits don't impact your place on the rank list. And in fact, some specialties, including emergency medicine, many programs have publicly said we'll submit our rank list before that post-interview visit is made available to you, so that it for certain doesn't impact, because your rank is already in—that applicants take advantage of those opportunities, again, to make the choice for the program that fits their needs both personally and professionally in the best way.
Murphy: It sounds like there needs to be a measure of confidence in your interview performance and not sort of overthinking it after the interview. Is that fair?
Dr. Kraus: I think it's very fair. I think that the number one piece of advice during the interview—this is a discussion post-interview. But the discussion of post-interview is important to consider the interview itself. And what you can do post-interview is the best thing that you did during the interview, which is to be yourself.
And being yourself gives the best image of you because it's the authentic image of you. It tells a program who you are. And in being yourself, most importantly, you get to know what the program's interaction with you is going to be, which as an applicant and as a resident, as a fellow, is most important. Because what you need from the program is again that environment and that support that's going to make you most successful as not only a resident physician but when you're out in practice as an attending physician. And what best program fits those needs for you as an individual is going to be different for everyone, which is why it's really to be yourself not just during the interview itself, but in that post-interview period, is really important.
Murphy: So you talk about being yourself. And one place that you can express your values, show your personality is social media. Is there an opportunity for engagement with a program via social media after the interview and what does that look like if done right?
Dr. Kraus: So social media is certainly a pervasive part of the entire residency interview process. Certainly, there are―although perhaps not social media―there are applications. There are spaces where applicants gather, informally or formally, to discuss different programs, to discuss their experiences interviewing at programs, to discuss their experiences applying to programs.
And I would caution that those forums for discussing can be problematic for applicants as well as programs. So I would be very cautious that anything that you post to social media, anything that you post in those sorts of forums, expect that they are all publicly available and that programs, that faculty, that residents at those programs are able to see those posts and the perception of you that may come from those posts.
So it's very important. This is not advice to never use social media or that social media is a negative way to communicate. But rather that social media is everywhere, that what you put on social media is available to everyone and really that you should have a measured approach in your use of social media, again, whether it's usual platforms or if it's things like again, interview forums, talking about what different programs offer, don't offer. Those can be detrimental to your overall application, and again, to you as an individual.
So my advice would be to tread cautiously. Not to avoid them altogether but really to think twice about what you're posting, where you're posting and why you're posting.
Murphy: I've heard it said that you shouldn't post anything on social media you wouldn't want your mother to read. You can also add your future program director to that maxim, I suppose.
Dr. Kraus: That is absolutely correct.
Murphy: We often hear that the interview process is a two-way street and that might get lost for applicants. As far as ranking, how should applicants approach each interview after, in the aftermath of it? Are there steps you recommend they take after individual interviews to begin the ranking process?
Dr. Kraus: So thank you for highlighting the very critical and crucial point that interviews are a two-way street. As an applicant, you frequently feel that you are interviewing for a position in a residency or fellowship, which is absolutely true. That said, every program with whom you interview is also being interviewed by you as an applicant. So it truly is a dialogue between the program and the applicant. And I think it's very important for applicants to consider that.
As mentioned very immediately post-interview and that experience is still fresh, you should be jotting down notes, not just about the nuts and bolts of the program, about clinical rotations, about didactic curriculum, et cetera. But you should really use that post-interview time to write down some of, again, your quote-unquote “gut feelings about the program.” What were those interpersonal interactions like? Is that the type of place, at three o’clock in the morning when you've just worked a lot of hours in the past week, that those are the individuals who you're most comfortable working around both personally and professionally?
So those sorts of interpersonal relationships, and again, did you have a feel, did the gut feeling of the program resonate with you? Just as you're trying to impress the program, the program is trying to impress you even if sometimes it might not feel just that way.
Murphy: When a program tells you not to reach out, how important is it to follow that advice as an applicant?
Dr. Kraus: So I think it's very important if a program specifically says please do not reach out. Again, it's etiquette, it's professionalism. If they specifically say that I would not think that it is some sort of trick, that they're trying to see if you'll reach out anyway, even though they said not to. I would really respect what they've asked of you and not reach out if they specifically say don't reach out.
One thing I always tell applicants is, I do not expect you to send a thank-you note. If you feel that you want to send a thank you note, that is totally fine. However, whether you do or do not send a thank-you note is not going to change my impression of you as an applicant.
And many programs will say that. And in that case, saying that again, back to the idea of sincerity, is that's a very sincere feeling is that if you feel that you want to send something, that's great. If you don't, that's OK too. But I think it's really important to respect if a program says please don't send something that you really respect that ask.
Murphy: In marketing, there is a concept called expectancy gap theory. In essence, it means that if you have high expectations and an event or a meeting doesn't meet them, you're bound to look on it far less favorably and vice versa with low expectations. If you have high expectations as an applicant and your interview day experience doesn't match up, should you rank that program? Could it just be an off day for you? Could it be an off day for them? How do you go about that?
Dr. Kraus: So I think again that's the important part of the entire process and particularly why the interview is important in the process. And why an application from an applicant on paper and information you may be able to glean from a website or from others who have familiarity with a program, you might not really get all of the information.
And thankfully, on interview day you are able to hopefully meet with multiple faculty, multiple residents, others involved with the program that really can give you a sense. So that if you have one interview that doesn't go as planned or doesn't meet, again, those expectations, really importantly is to look at the entire picture of that program as a whole.
Was it just that one faculty member that I had a less-than-stellar interview with? Was it that one resident who really stood out as someone I want to train beside?
And so I think it's super important to take the entire interview process in the larger umbrella of the entire application process and look at it really as a whole. You should never as an applicant feel that you're entirely doomed because you had one bad interaction, just like you're not entirely doomed on a board exam if you miss a question or two. You really need to put those behind you, move on and have the next best experience you can, whether it's the next interview or at the next program that you interact with.
So I think it's really important not to feel doomed by a very bad experience, and similarly, not to determine your rank list on one really positive interaction. So really a measured, tempered approach to both an interaction that didn't meet either a high expectation or an interaction that didn't go as well, on the opposite side of the coin.
Murphy: It's possible after your interview you still might not have all the information. We did discuss that second-look opportunity. Is there other avenues you would recommend to go to get all the information to make the most informed choice?
Dr. Kraus: One excellent place to look or resource to concur is alumni from that program or even employers who have hired alumni from those programs. So many programs have a long track record of putting graduates, alumni from their residency and fellowship programs, out into practice. And while some of those experiences may be more dated—someone may have trained in a program 10 years ago. But you still are able to again put more pieces of information into your decision and make a more informed decision.
So certainly, alumni of the program are a great resource. Others who have applied to the program and looked at the program—so very frequently, we'll hear from applicants that “I had someone, a friend of mine who, their friend applied to this program and said I should check it out.” So really every network that you have, personal and professional, it's worthwhile to again get as much information about that program as you can. Because just as not everything about you is expressed on your application, not everything about a program is on a website or in a video or other informational piece that might be easily accessible to you as an applicant.
Murphy: And it's easy to just reach out to an alumni. You would encourage future residents not to be gun-shy?
Dr. Kraus: I think it's absolutely appropriate. It's certainly uncomfortable and perhaps awkward to quote-unquote “cold call” someone who is an alumnus. But certainly, as I mentioned earlier, specialties and communities in medicine are very small. And so there are usually not many degrees of separation between you and an alumni from a program.
You can get a little bit more information about what really it's like to train in that program, what professional opportunities that alumni has had because they trained in that program. And again the important thing to remember in all of this is that no program is perfect. No applicant is perfect. No program is perfect for an applicant.
And the key to all of this in the post-interview period particularly is really to consider where is the program that best fits my needs. And the program really where I fit in the best is really the key question to ask yourself in this post-interview period.
Murphy: We've talked about the ranking process a bit on the applicant end. Is there anything applicants should know about the way programs are going to go about post-interview?
Dr. Kraus: So I think that the way programs go about it post-interview is similar to applicants. So programs think about the entire picture. Who is this applicant? Not just as an applicant on paper, not just as a sum of activities, a sum of medical school experiences, a sum of personal experiences, hobbies, et cetera. But is this applicant a good fit for our program?
So some programs, as an example, maybe more urban or more rural. What is it that might bring this applicant to our program? What might this applicant add to the program in terms of diversity, excellence in all of its forms, et cetera? And so I think that's really how programs perceive applicants as well. And I think it's, to be quite fair, not all that different from how applicants look at programs when they do a ranked list.
Murphy: Is there anything else in this arena of post-interview etiquette or information gathering that you'd like to speak to?
Dr. Kraus: So I would like to share that the entire application process for all involved—whether it's programs, faculty, residents who are currently in training, medical students who are applying to residency programs—it is an incredibly stressful time and high stakes time for all involved. What I would take away from that is to enjoy this process, to meet as many different people in the specialty with which you plan to spend the rest of your career, to really get to know as many programs as is feasibly possible for you and to again enjoy the process. This is the first of many steps in your career as whatever type of physician you aspire to be. So enjoy the process. Don't stress too much about it. All will end up well.
Murphy: I'm sure our applicant listeners will appreciate that wisdom. Dr. Kraus, thank you for joining us on this edition of Meet Your Match on Making the Rounds.
Dr. Kraus: Thank you, Brendan. I appreciate the opportunity.
Murphy: I am AMA senior news writer, Brendan Murphy. Until next time, thanks for listening.
Unger: You can subscribe to Making the Rounds and other great AMA podcasts anywhere you listen to yours or visit ama-assn.org/podcasts. Thanks for listening.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.