illegal interview questions

[treonaut]

Recently I recieved a request for information from a program that I am interviewing at requesting what medical conditions I had, isnt this an illegal question for them to ask? What are some other ones?

---

Members don't see this ad.

 

[Winged Scapula]

Recently I recieved a request for information from a program that I am interviewing at requesting what medical conditions I had, isnt this an illegal question for them to ask? What are some other ones?

They are not illegal, especially this one. Jobs in which you must have certain physical skills and lack certain handicaps include medicine. If you have a medical condition which prevents you from doing your job and getting licensed, it is well within the program's right to ask you about that as you would not be eligible for residency.

 

[Samoa]

They actually are illegal, according to the accepted interpretation of Title VII of the Civil Rights Act of 1964, and subsequent legislation expanding its scope to include age and disability.

Here's a link to an employer hiring manual from about 10 years ago. It's under the section "initial concerns."

The rest of it's worth reading as well, especially if you're currently in a position to hire and fire people.

 

[treonaut]

f

 

[Winged Scapula]

They actually are illegal, according to the accepted interpretation of Title VII of the Civil Rights Act of 1964, and subsequent legislation expanding its scope to include age and disability.

Here's a link to an employer hiring manual from about 10 years ago. It's under the section "initial concerns."

The rest of it's worth reading as well, especially if you're currently in a position to hire and fire people.

I'm not sure the employer hiring manual is relevant here since in many states residents are considered students. But admittedly, it is a gray area.

I'm fairly sure we've talked about the issue of disability before and that it is not illegal to ask about ability to perform the duties of a physician or anything else which might prevent you from becoming a licensed physician in the state. State licensing boards and hospitals are allowed to ask you if you have any medical or psychological conditions which are either being currently treated or have been treated in the past, so I'm not sure that employers in this sense are prohibited from asking the same because it is a relevant question.

Perhaps aProgDirector can weigh in here as to why it would be acceptable for licensing and hospitals to ask but not residency programs.

 

[Winged Scapula]

Are Goattees a big no-no for interviews?

I have heard some conflicting reports

Depends on the field and how conservative it is. Most would probably recommend shaving and having short hair to be safe.

 

[gutonc]

Are Goattees a big no-no for interviews?

I have heard some conflicting reports

They are a big no-no for life!
(Insert ironic smiley here)

 

[dragonfly99]

I believe it depends how the question was asked.
They can definitely ask you if you have any medical conditions that would affect your ability to function as a resident.

There are many questions you may or may not be asked that would definitely be illegal in a normal job interview, and probably should be prohibited in a residency one (i.e. marital status, plans for marriage or children, your ethnic background, etc.). Whether the Civil Rights Act applies to residency or not is probably a gray area, as programs could try to say residents are not employees and it's not a job. Courts have found in the past that residents ARE in fact employees, but the AAMC doesn't accept that interpretation (see AAMC web site for court case). I think it's totally reasonable for a program to want to know if someone is willing and able (physically and mentally) to do his/her job, but I don't think they should be asking inappropriate questions. I think a question about whether I have a boyfriend or fiancee is inappropriate, but I have been asked that, as well as asked in writing my marital status and presence or absence of kids (and their number!) both verbally and on secondary applications.

 

[Samoa]

I'm not sure the employer hiring manual is relevant here since in many states residents are considered students. But admittedly, it is a gray area.

According to the text of the law, it specifically applies to educational programs as well as employment.

 

[Law2Doc]

According to the text of the law, it specifically applies to educational programs as well as employment.

Most of the med schools I applied to had questions relating to one's ability to physically perform the tasks deemed necessary for completion of medical school and licensure. So it's hard to imagine that all these places are in violation of the law. And certainly when I obtained licensure in another profession similar questions were asked.

It doesn't make sense for places to not be legally allowed to ask whether a person can perform the role of resident without accommodations. What's the point of ranking someone who cannot do the job? While they can't legally discriminate against someone who can do the job despite his disability, it doesn't make sense that they can't inquire as to that limitation. And hence many places do.

 

[Samoa]

You're allowed to ask questions about abilities which you can establish are necessary to the job for which you're recruiting. Which is why they list all the specific things you need to be able to do, and ask if you can do them, instead of asking "do you have a disability which might affect your performance as a physician?"

It's a subtle difference, but very real, and important, in that you're not assigning someone to a class of people, and then making assumptions about that class of people. You are asking a specific question about someone's ability to perform the specific tasks of the job.

As another example, you could ask someone "this job requires frequent schedule changes on short notice. Will you be able to change your schedule on such limited notice?" Instead of asking whether they are married, or have children, or plan to have children during the period of employment.

 

[NotAProgDirector]

Samoa has summed it up nicely.

I can ask "Will you be able to perform the essential functions of this job with reasonable accomodation". As he/she points out above, it's usually more fruitful to specifically lay out what those functions are -- i.e. overnight call / 30 hour shifts, weekend work, frequent schedule changes, ability to move about / between hospitals, etc.

Note that I can't ask you what medical conditions you may or may not have, simply ask about what effect any such conditions might or might not have.

In an interesting legal twist, note that the question is "can you do this job with reasonable accomodations?". I can't ask you in advance what those accomodations are, nor whether we agree they'd be reasonable. I can imagine someone matching into a program and then disclosing that they have fibromyalgia, and require a 15 minute break every hour. Or they can't type because they have some medical condition. Or, perhaps they're allergic to electromagnetic waves and hence can't use a computer at all.

 

[michaelrack]

I have applied for jobs at several state psychiatric hospitals as well as community mental health centers. Each of these had 2 applications- one for the job and one for staff privileges. Only the application for staff privileges had questions about med problems. Of course, if you don't get approved for staff privileges, you don't get the job. This allows the employer to avoid asking any "illegal" questions on the job application.

One hospital at which I was recently given staff privileges required me to undergo a physical exam.

 

[Law2Doc]

Only the application for staff privileges had questions about med problems. Of course, if you don't get approved for staff privileges, you don't get the job. This allows the employer to avoid asking any "illegal" questions on the job application.

If the questions were illegal, this end run wouldn't actually hold up in court -- judges hate folks who try to get cute like this and a substance over form argument would surely prevail. However, assuming the questions were worded as Samoa suggests, I think the consensus is that these questions aren't per se illegal -- the job has the right to know that you can do the job, just not your actual condition. A physical would be hard to defend.

 

[DarthNeurology]

I can ask "Will you be able to perform the essential functions of this job with reasonable accomodation". As he/she points out above, it's usually more fruitful to specifically lay out what those functions are -- i.e. overnight call / 30 hour shifts, weekend work, frequent schedule changes, ability to move about / between hospitals, etc.


In an interesting legal twist, note that the question is "can you do this job with reasonable accomodations?". I can't ask you in advance what those accomodations are, nor whether we agree they'd be reasonable. I can imagine someone matching into a program and then disclosing that they have fibromyalgia, and require a 15 minute break every hour. Or they can't type because they have some medical condition. Or, perhaps they're allergic to electromagnetic waves and hence can't use a computer at all.

I AM allergic to electromagnetic waves, but I wear an aluminum hat on the wards and at clinic when I use computers which helps with any interference the waves might produce inside my head, and my white coat is lined with tin foil so most people don't even know about my problem except for my shiny hat, and I usually just joke that my kid made it for me.

But seriously, I don't think a residency PD can ask what medical conditions you have, only if you can do your job as a resident, which in general should be answered as someone who makes it through third and fourth year is likely an able bodied adult who can do a lot of work.

What if a residency had breast cancer, and it was removed margin and lymph node free, . . . as far as she know she is cancer free, would she have to report her past history of breast cancer?? She does run a risk of a recurrence, but at some point people have the right to pursue happiness in a career of their choice.

Or, what about an applicant with multiple sclerosis that has only mildly or perhaps not at all affected their work in medical school? They may end up working fewer years as a physician so would the PD do society good by not ranking her?

It seems that at most medical conditions would decrease the number of quality years work a physician could work, and rarely, very rarely, would a resident have to quit residency due to a medical condition.

However, if PD and medical schools for that matter really cared about productive years physicians worked then why have I seen so many "older" applicants/residents? I saw a resident with grey hair who was overweight in IM, (I think in her fifties) would she contribute 60+ years to medicine like some who start in their 20's and 30's?

Doubtful, but if older applicants are made exceptions for (you have to spend money to train TWO older applicants in their 50's to equal the work a person in their 20's would give to medicine, and there is twice as much time spend in residency) . . . however, residency directors and med schools gush over how much their life experience is worth. Personally, I think someone who had suffered breast cancer as a med student or resident in their 20's or 30's has more life experience applicable to medicine then the hundreds of 50 year old who make it into medicine each year. I.e. have more empathy for patients.

 

[Law2Doc]

I AM allergic to electromagnetic waves, but I wear an aluminum hat on the wards and at clinic when I use computers which helps with any interference the waves might produce inside my head, and my white coat is lined with tin foil so most people don't even know about my problem except for my shiny hat, and I usually just joke that my kid made it for me.

But seriously, I don't think a residency PD can ask what medical conditions you have, only if you can do your job as a resident, which in general should be answered as someone who makes it through third and fourth year is likely an able bodied adult who can do a lot of work.

What if a residency had breast cancer, and it was removed margin and lymph node free, . . . as far as she know she is cancer free, would she have to report her past history of breast cancer?? She does run a risk of a recurrence, but at some point people have the right to pursue happiness in a career of their choice.

Or, what about an applicant with multiple sclerosis that has only mildly or perhaps not at all affected their work in medical school? They may end up working fewer years as a physician so would the PD do society good by not ranking her?

It seems that at most medical conditions would decrease the number of quality years work a physician could work, and rarely, very rarely, would a resident have to quit residency due to a medical condition.

However, if PD and medical schools for that matter really cared about productive years physicians worked then why have I seen so many "older" applicants/residents? I saw a resident with grey hair who was overweight in IM, (I think in her fifties) would she contribute 60+ years to medicine like some who start in their 20's and 30's?

Doubtful, but if older applicants are made exceptions for (you have to spend money to train TWO older applicants in their 50's to equal the work a person in their 20's would give to medicine, and there is twice as much time spend in residency) . . . however, residency directors and med schools gush over how much their life experience is worth. Personally, I think someone who had suffered breast cancer as a med student or resident in their 20's or 30's has more life experience applicable to medicine then the hundreds of 50 year old who make it into medicine each year. I.e. have more empathy for patients.

Age is not considered a disability -- in fact there are places that prefer the older crowd and you can find many articles to that effect -- folks who have proven themselves in other arenas, have more realistic expectations in terms of hours and salary, etc. The issues with disability are not whether someone will have a long career -- in fact young people also can become disabled and have their career cut short, and are more likely to change careers than someone on a second one -- there is never any guarantee that someone will work a long time. I suspect purely based on the numbers involved that more young people don't complete residencies than old (because there are many more young people) so from the residency point of view it cuts opposite of what you are suggesting (perhaps longterm positions would cut the other way. However, a 4 year residency doesn't really have to worry about that -- they are only hiring for 4 years, so unless the applicant is in his/her late 70s the longevity issue shouldn't matter to the residency program. The concern of PDs isn't whether you will have a long and productive career -- this is mistating the issue. The issue with disabilities is about completing the residency -- it is the med school itself that has already made the determination as to whether you are too old to get a seat in the profession (that ship has sailed -- med school seats are carefully controlled to ensure the inflow into the profession, so the longevity issue gets addressed there, if at all). The issue with disabilities is different -- that is something that will impact the residency program itself potentially, so programs ask whether you are likely able to complete the tasks involved. If you are an outstanding resident for the 4 year program the PDs are happy and couldn't care less that you stopped working a year post-residency. It's not their role in the process.

You aren't necessarily accurate in saying that making it through med school means you could make it through residency. There are schools that have made accommodations that many residencies would not make -- allowing blind individuals to graduate, for example. So saying "I made it through med school" definitely wouldn't be the definitive response.

 

[soulofmpatel]

Lets talk about another illegal question-asking an applicant how s/he plans to rank a program. I have personally decided that a strict "don't ask/don't tell" policy is essential to the student-optimal match. Program directors should rank students in the order consistent with how desireable they are as candidates, making no assumptions about how likely the candidate is to rank them highly. Students have a right to interview at backup programs just as programs have a right interview back up students. The stakes for the students dwarf the stakes for the program director a hundred fold, and I consider the rights and desires of the program to be negligible in comparison to those of the students. Thus, I am willing to outright lie to any program director that dares ask me this question.

"This program has impressed me beyond my wildest dreams. Oh and I love this city! My two cousins and several old college friends live here...and there is so much art and culture. I've already looked into buying houses. You are for sure my #1 choice!"

 

[Ludicolo]

to Samoa.

There are many guidelines concerning what you cannot explicitly ask during a job interview. The Americans w/ Disabilities Act, the Civil Rights Act of 1964, the Equal Employment Opportunity Commission, etc. These include questions on race, age, marital/pregnancy/child status, political/religious/sexual orientation, etc.

We as interviewers cannot ask about the existence or nature of an applicant’s medical conditions, nor can we ask about prognosis, severity, or cause – with the important exception of how the condition pertains to necessary job qualifications. We are instructed to be careful in this regard, limiting questions to necessary, not desirable, physical requirements for the job. So as Samoa pointed out, we can describe the job requirements (call frequency, expected # of procedures to become competent, etc), but not “do you have a condition that would prevent you from performing XY and Z?”

However, if an applicant introduces a physical disability him/herself, say in their personal statement or in the course of conversation, then as an interviewer I can discuss it within reasonable limits. I can ask what they consider "reasonable accomodations". In PM&R we see a lot of this. Some programs admittedly handle it better than others.

You aren't necessarily accurate in saying that making it through med school means you could make it through residency. There are schools that have made accommodations that many residencies would not make -- allowing blind individuals to graduate, for example. So saying "I made it through med school" definitely wouldn't be the definitive response.

I agree with this statement. Unfortunately, this is sometimes the case, whether a graduate has a disability or not…

 

[michaelrack]

If the questions were illegal, this end run wouldn't actually hold up in court -- judges hate folks who try to get cute like this and a substance over form argument would surely prevail. However, assuming the questions were worded as Samoa suggests, I think the consensus is that these questions aren't per se illegal -- the job has the right to know that you can do the job, just not your actual condition. A physical would be hard to defend.

The physical was for hospital staff privileges; I bill the patients I see there myself. I made an appt with my FP and got him to fill out this form:

I (certifying physician) hereby certify that (applicant) who is known to me, is in good physical/mental/emotional health, to the extent that he is capable of rendering his professional duties and responsibilities without limitation. I have noted any present physical/mental/emotional problems known to me that the applicant has been or is being treated for within the last 2 years, if such exists, to my knowledge or have stated "none" below in the space following:
____________________________________________
______________________________________
__________________________________________
_________________________________________


__________ ____________
signature of certifying physician date





The way I interpret the language on the form, the certifying physician has to list any physical/psych condition the applicant has, even if they don't affect his ability to practice medicine.

 

[Law2Doc]

The physical was for hospital staff privileges; I bill the patients I see there myself. I made an appt with my FP and got him to fill out this form:

I (certifying physician) hereby certify that (applicant) who is known to me, is in good physical/mental/emotional health, to the extent that he is capable of rendering his professional duties and responsibilities without limitation. I have noted any present physical/mental/emotional problems known to me that the applicant has been or is being treated for within the last 2 years, if such exists, to my knowledge or have stated "none" below in the space following:
____________________________________________
______________________________________
__________________________________________
_________________________________________


__________ ____________
signature of certifying physician date





The way I interpret the language on the form, the certifying physician has to list any physical/psych condition the applicant has, even if they don't affect his ability to practice medicine.

Someone could run to court and say that this effectively allows the employer to ask illegal questions which he then will use in his determination for the employment, not the privileges. A skilled law firm could get this requirement thrown out pretty handily (for the right price ).

 

[DarthNeurology]

The issue with disabilities is about completing the residency --

It is wrong to state that PDs could care less if you don't practice after your residency. PDs do care to one degree or another about producing competent physicians for society, . . . it is easy to get an M.D. foreign or otherwise to fill a vacated spot by someone who had a "medical illness." Obviously, some PDs try a little too hard to avoid this IMHO by trying to pry too much into an applicant's personal life. I would estimate that most residents with a medical condition will be able to practice medicine as well as any other resident.

Which returns to the original debate of freedom to pursue happiness versus good to the society, or perhaps good for the PD. Regardless of how anyone views age, it is against the law to discriminate based on age. So, obviously this helps people out who are in their 40's or 50's applying for medicine. It is an undisputable fact that if the mean age of residents raised from late 20's to say 50's then YES these physicians would on average be expected to work at least 20 years less than their younger counterparts. However, medical schools and PDs make allowances for older applicants to pursue their inner dreams of becoming physicians as they have a right to pursue happiness.

Obviously, however, from a purely financial standpoint it makes no to society to admit large numbers of very much older applicants, especially with a physician shortage. But, we are a society where individuals are supposed to be judged on their own merits, and age should not be a factor.

However, I feel that the resident with a medical condition also could be grouped in the same class a an older applicant. They may have to curtail their training (most likely not at all), but want to pursue their definition of "happiness."

Personally, I think it is a little hypocritical to allow older applicants even ground to residencies and medical schools, but to treat residents with medical conditions as defective. On average, I think that residents with a medical condition (most of which are chronic and won't limit life much) can give back more to society than an older applicant.

For example, say a 50 year is applying for a neurosurgical residency, he/she gets it and practices for 15 years and retires at 65 versus someone who starts their residency when he/she is 26 and practices for 39 years until he/she is 65 and then retires.

Not that I am against such admission of older applicants. Some older applicants are good, others I found to be snobbish, rude and domineering over younger students whom they may have resented. Just that residency applicants with a medical condition should be given the same even playing ground as these older applicants have enjoyed for years. It is odd that there is such a stigma of people with medical conditions in the medical profession. Actually, not that odd, as doctors for years harbored racist attitudes that were reinforced on how medicine perceived minorities. If more physician/patients are allowed to practice than maybe better care of patients would result.

 

[pulvinar]

I have another question. Is it illegal to ask about religious affiliations? I cover my head with a scarf so it is obvious that I am a Muslim. But could they go into depths about my religion?

 

[DonStracci]

At an interview yesterday, a program director questioned me about a medical issue that is addressed in my personal statement/cv. I am fine with this, as it affected my journey through med school. HOWEVER, they asked me about what medications I was taking/am taking for it... which I thought was inappropriate. I dodged the question and gave a vague answer that indicated I was not going to answer that. I was very, very surprised by the medication question.

 

[dragonfly99]

several of you on here are saying it would be illegal to ask certain questions, such as marital status or kids, or plans for future marriage or family any time in the future.

I am telling you I was asked these questions multiple times during fellowship interviews and they were even on the secondary application in some cases (specific lines where you had to fill in married/single, and presence or absence of kids). So I guess that it hasn't been found improper for residency or fellowship programs to do this - otherwise the courts or the ACGME would have stopped them. I figure that residency and fellowship programs get around the law(s) by saying that residency and fellowship are not jobs and resident physicians are not employees....that is AAMC and ACGME's stance, I believe.

 

[soulofmpatel]

I have another question. Is it illegal to ask about religious affiliations? I cover my head with a scarf so it is obvious that I am a Muslim. But could they go into depths about my religion?

They could, but it is unlikely that they would unless you wrote about it in your personal statement. I heard a story of one Jewish woman who applied to medical school and was asked, "why haven't you accepted Jesus Christ as your Savior?" by her interviewer.

 

[Samoa]

several of you on here are saying it would be illegal to ask certain questions, such as marital status or kids, or plans for future marriage or family any time in the future.

I am telling you I was asked these questions multiple times during fellowship interviews and they were even on the secondary application in some cases (specific lines where you had to fill in married/single, and presence or absence of kids). So I guess that it hasn't been found improper for residency or fellowship programs to do this - otherwise the courts or the ACGME would have stopped them. I figure that residency and fellowship programs get around the law(s) by saying that residency and fellowship are not jobs and resident physicians are not employees....that is AAMC and ACGME's stance, I believe.

No, it's just that no one wants to destroy their career by complaining.

It applies to students as well. My school actually did give us a list of illegal interview questions. But knowing they're illegal doesn't help you at all, when they're asked anyway.

 

[dragonfly99]

I heard there is actually going to be a resolution proposed at the next AMA meeting to try to deal with/get rid of some of these illegal questions. I mean, there is a smoking gun the way some of these programs do things (i.e. asking the questions on the secondary application).

 

[HumbleMD]

I was just at an interview where the program chair literally went around the room of 25 applicants and asked every applicant whether they were couples matching (fair question), and then everyone whether they were single or married, and what their spouses did. He took notes on the face sheet of applicants, circling some applicants and jotting down notes.

I can deal with "where are you applying," "let us know if you're interested," but these non-discrimination violations piss me right off. It's a particularly hot-button topic as a gay man where I may or may not have protected status depending on the state and program (but marital status is explicitly protected federally). I think I want to report it to the NRMP, but it doesn't appear that it can be done anonymously (you can request anonymity, but I know for a fact this PC is on the RRC). This program isn't my top choice, but I don't want to land on their DNR list either. Anyone know anyone who has ever done this sucesfully?

 

[NotAProgDirector]

Why don't you plan to report it after the match? If you match there, then you deal with it internally. If not, then you can report it externally.

However, the NRMP may not care. Asking about your sexuality or marital status is illegal, but it's not for the NRMP to enforce that. I think you'd report something like this to the gov't directly -- either the AG's office, or the EEOC, or perhaps the dept of labor. Honestly, I'm not certain, but I don't think it's the NRMP's responsibility to address things like this. It's more the ACGME/RRC, but even then this is a legal issue that attaches to all employers.

 

[wannabeOBGYN]

I had an interviewer point blank ask me if I'm married, engaged, in a relationship, or single. I don't care about answering, but it was kind of awkward as I thought "this isn't allowed..." to myself.

 

[Law2Doc]

I had an interviewer point blank ask me if I'm married, engaged, in a relationship, or single. I don't care about answering, but it was kind of awkward as I thought "this isn't allowed..." to myself.

True It's not allowed. But at the places that stay within the law, they are still going to probe into what kind of support system (financial and emotional) you have at home to help you while enduring the stresses of residency, and likely get at the same answer. And that's totally legit. I'm not sure why the format of getting at that information matters so much to people. If you are married your PD and coresidents are going to find out. They will find out your lifestyle. It's going to be a small close-knit working relationship for a number of years. Better to know what you are getting from day one for both sides, I would think.

From a PDs perspective, I would think the single person with no external baggage/family is the guy who doesn't complain about 2 months of night float back to back, or about working every major holiday, or about never seeing his wife/kids, etc. So I'm not sure the discrimination goes the direction some people on here are suggesting.

 

[HumbleMD]

From a PDs perspective, I would think the single person with no external baggage/family is the guy who doesn't complain about 2 months of night float back to back, or about working every major holiday, or about never seeing his wife/kids, etc. So I'm not sure the discrimination goes the direction some people on here are suggesting.

That's what I'm hoping for, but I'm afraid I'll seem like a rolling stone and a question mark as to where I'll land.