In evaluating candidate interview performance as part of the physician residency selection process, programs put heavy emphasis on fit with program culture.
As highlighted in a National Resident Matching Program survey of more than 1,000 residency program directors who participated in 2023–2024 Match cycle, “fit” is a central consideration in the interview process. In evaluating fit, interviewers assess whether medical residency applicants align with the program’s mission, values and culture.
Fit isn’t just a one-way street—it matters for both residency programs and applicants. As the interviewee, it’s vital to use your experience to gauge whether the environment and culture align with your goals and priorities.
So, how do you assess that? Here are four keys identified by an AMA physician expert on the residency-selection process.
Don’t force fit
The desire to match—for any applicant—is very real. A former pediatrics residency program director, John Andrews, MD, said being somebody you are not just to show you fit at a program isn’t serving your interest or the program’s.
“You want to be at a program where you fit in, and in the interest of having a successful interview, you don't want to misrepresent the way you might fit in just to impress someone,” said Dr. Andrews, the AMA’s vice president for graduate medical education innovations. “You want to be honest. If your interviewer says that everybody in the program drinks coffee and you don't drink coffee, you don't say you drink coffee just to fit in.”
So what makes for a good fit?
“Fit is more of a feeling than something clearly defined,” Dr. Andrews said. “It includes the social environment in and around the program. Do you have shared interests with members of the residency community that will lead to a feeling of kinship? It also relates to the professional environment. Will you find shared interests with your peers that contribute to a sense of community? Are there faculty who understand and will support your professional ambitions? Are there outlets to explore the types of practice you are interested in, whether those are community-based, academic, urban, rural, suburban, or some combination of those?”
Highlight genuine connections
Even if you’ve done your pre-interview research, what you read online only paints a partial picture. Use the interview to learn more about the residency program. If something excites or concerns you, make note of it.
“For the large majority of interviews, you don't know enough about the culture to know whether you'd be a fit,” Dr. Andrews said. “You may learn things in the interview about a place that you never expected that make you really excited about it because you know you’d be a good fit. When those moments occur, it’s worth highlighting them.”
That means aspects of your past experiences or future ambitions as they come up throughout each conversation. The information you glean on interview day and how it aligns with your personal aims will ultimately help you construct a comprehensive Match rank-order list.
For applicants doing pre-interview research or constructing their rank-order lists, no online resource contains as much information as FREIDA™. The AMA Residency and Fellowship Database® includes information on more than 13,000 Accreditation Council for Graduate Medical Education-accredited residency programs and offers a streamlined user experience.
Don’t mail it in for a mismatch
You may pick up on hints throughout an interview that simply don’t align with your vision for your residency experience. Continue to put your best foot forward despite that.
“If in an interview, you pick up on aspects of a program that really don’t appeal to you and you realize that it sounds like a program you really don’t want to be a part of, that’s an important signal to you,” Dr. Andrews said. “You don’t necessarily have to raise it in the interview, but you have learned something from the interviews.”
“Certainly stay professional and respectful throughout the conversation while being direct and honest about who you are,” he said.
In his role with the AMA, Dr. Andrews has helped lead the Reimagining Residency initiative to transform residency training to best address the workplace needs of our current and future health care system.
Most residency applicants fit in
If you’ve done the research and are confident in your desired career path, you likely applied to a group of residency programs that are a good fit on paper. That generally translates into a good fit on interview day.
The most effective way for an applicant to approach a residency interview is by being the most professional and personable version of yourself, Dr. Andrews said.
“The best thing you can do is offer thoughtful responses to questions in an authentic way,” he said. “If you relate your experiences honestly, you allow the people assessing you to understand whether you're a good fit.
“The bottom line is if you match to an internship, you're probably going to complete that internship and stay for at least a couple more years of training. Your goal isn’t just to get an offer, but to find a program and environment where you’ll truly succeed and be happy.”
