May 2005

Med school interviews: not-so-ready for my close-up

It's been exactly three years since I sat and fidgeted in that same room, telling myself to calm down and breathe. Like most med applicants who make it this far, I had jumped through all the hoops, persevered through four years of post-secondary education hoping to maintain a competitive GPA, spending summers studying for standardized tests and gaining 'medically relevant' work experience. I spent loan money on pricey applications, labouring weeks over the essay questions, and soliciting letters from referees whom I've seen only a few times despite having worked months in their labs.

When everything looked good on paper, it boiled down to one final hurdle: the interview.

As an applicant, the interview was a huge deal. Your entire life revolved around those make-or-break 40 minutes, from lovingly ironing your lucky shirt and making sure to eat a good breakfast to the post-interview analysis with other interviewees and coming up with strategies to ace upcoming interviews.

RANDOMIZED CONTROL
That's why I was surprised at how arbitrary and anti-climactic it felt to be on the other side of the table, as an interviewer. By circling certain numbers on the evaluation form, I could effectively eliminate an applicant from entering medicine at my school or, conversely, improve their chances significantly. With that amount of responsibility, I felt uneasy at how unimportant the interview was to me personally and I left thinking that I should have somehow taken it more seriously.

Maybe that's why the medical school admission process seems so random. I remember being extremely frustrated after receiving a rejection letter to my first application, not knowing where I could improve. I was ecstatic when I was later accepted at another school, but puzzled as well because by all counts, my first application was better. My GPA had dropped, my interview was not as good, I didn't gain any significant extracurricular experience and my MCAT score hadn't changed.

This is my second year doing interviews and I'm still trying to figure out how some people get in and some don't. I've informally surveyed friends at various medical schools across the country and they all expressed the same sentiments: the admission process is riddled with inconsistencies, and although each school tries their best to formulize their criteria into neat decimal scores, for all it's worth, they might as well be drawing names from a hat.

SUBJECTIVE OBJECTION
Most variability seems to manifest at the interview level, but perhaps this is to be expected. With a brief 40 minute chat, the interviewee has to convince their committee that they would make a 'good doctor.' Unfortunately, the success rate depends so much on the individual interviewers themselves.

One academic on the committee expressed her frustration with the number of graduate students leaving her lab midway through their program to enter medical school. Would this attitude not immediately put students in post-graduate programs at an immediate disadvantage?

Another committee member, a family doctor, was frustrated with the new generation of so-called 'lazy graduates' and gave special consideration to applicants who worked part-time while in school. Is that a fair distinction to make — particularly when it wasn't an official criteria and wasn't applied uniformly to all applicants?

I've seen interviewers fall asleep during the interviews. Often, there would be interviewers on the team who had not attended training and were not familiar with admission criteria. Interviewers have been known to argue among themselves (where the applicant then wonders if it was a test and they were supposed to do something). Sometimes you might hit it off sharing the same favourite hockey team. Other times, the interview goes too smoothly and you come off too plain or devoid of personality.

Perhaps if we were really intent on selecting the best candidates for medicine, the interview process would be more open and accountable to outside scrutiny instead of being so tangled in respecting privacy that it misses the big picture of serving the public. Maybe we can use the phone numbers of references that we insisted on being provided to actually try and get a better sense of the candidate as a whole. If medical schools talked amongst themselves regarding admissions, we could learn from each other's experiences.

(NB: Names of individuals have been changed.)