Internal Medicine residency interview questions
Internal medicine interviewers listen for curiosity about the whole patient and the patience to work a problem through. They also want a sense of where you are heading: primary care, hospital medicine or a fellowship, and why.
- Clinical reasoning out loud
- Care for complex, chronic patients
- A direction after residency
What internal medicine programs ask
Questions about the specialty itself, beside the ones every program asks.
Tell me about a patient with several chronic conditions whose care you were part of. What made it hard?
- What they're listening for
- Whether you think about the whole patient: medications, social situation and goals, not one organ at a time.
- How to answer
- Pick one patient, name the competing problems, say what you did to coordinate them (a medication review, a call to a family member, a social work referral), and what you learned about managing complexity.
- Where it goes wrong
- Turning it into a case presentation with no sense of your own part in it.
Are you leaning toward primary care, hospital medicine or a fellowship?
- What they're listening for
- Whether you have thought about your career, and whether the program can support it.
- How to answer
- Give your current leaning and the experience behind it, what you would want from residency to test it, and that you are open to where training takes you.
- Where it goes wrong
- Naming a competitive fellowship with nothing behind it, or saying you have no idea at all.
Tell me about a time the diagnosis wasn't clear. How did you work through it?
- What they're listening for
- Your reasoning under uncertainty, and when you ask for help.
- How to answer
- Walk through your differential, the test or history that changed it, who you discussed it with, and what you would do the same way next time.
- Where it goes wrong
- A story where you were right from the start and nothing was uncertain.
A patient with heart failure has been readmitted three times this year. What would you want to understand before discharge this time?
- What they're listening for
- Whether you see what happens after discharge: medications, diet, follow-up and the patient's own situation.
- How to answer
- Ask about adherence and cost, understanding of the plan, home support and follow-up, and say who on the team you would involve.
- Where it goes wrong
- Only adjusting medications, with nothing about the patient's life.
Have you been part of a goals-of-care conversation? What did you take from it?
- What they're listening for
- Comfort with the conversations internists have most often and find hardest.
- How to answer
- Describe your part honestly, what the attending or you did well, how the family responded, and what you would do yourself next time.
- Where it goes wrong
- Talking about the conversation as a task to get through rather than a part of care.
Interns on our wards teach students and lean on seniors every day. How do you see yourself in that team?
- What they're listening for
- Whether you can both learn and teach, which ward teams depend on.
- How to answer
- An example of teaching a student or a peer, an example of asking for help in time, and how the two fit together.
- Where it goes wrong
- Only talking about what you will get from the team.
The questions every program asks
Expect these too. Each is explained in full on the main questions page.
- Tell me about yourself.
- Why internal medicine?
- Why are you interested in this program?
- What is your greatest weakness?
- Tell me about a time you had a conflict with a colleague or team member.
- Tell me about a mistake you made in patient care, and what happened.
- That's everything from me. What questions do you have for us?
Questions to ask internal medicine programs
Ask what their website doesn't answer. These show you have thought about training there.
- How are interns supported on nights and during their first ward months?
- What do residents who want primary care, hospital medicine or a fellowship each get from the program?
- How does the program handle feedback on clinical reasoning, not only on notes?
- What has changed in the program in the last two years because residents asked for it?
Reading an answer isn't saying it
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