Interview disagreements...impact on admissions/school image

[ynot89125]

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Let me preface by saying that this was at a top 25 ranked medical school. I had an interview in which we disagreed on many subjects. Primarily healthcare but also on residency.

He asked me what the problem with US healthcare was and I started to reply that part of the problem was cost and how it's caused in part by patients asking for unnecessary treatments and tests. Before I was finished the interviewer cut me off and said that that it was not true at all. He said patients do not want any unnecessary treatments because they do not want to pay.

He asked me what I would do to solve cost issues I replied that we should have more family medicine doctors because they are our first line of defense. I suggested that perhaps residency programs should extend the residency training for family medicine to 4 years so that they have a greater breadth and depth of experience and so they don't need to refer to specialists as often. again shut down and cut off and was told family medicine residencies are already 4 years (don't believe this is true)

After the interview I not only thought that this doctor did not know what he was talking about but also thought less of the school because he was affiliated. Obviously during the interview I did not argue much but played it off as my ignorance but I fear that this will be viewed negatively. I fear that his comments will just say something along the lines of "applicant did not know anything" Should I have done anything differently? If this happened to you what would you do? Am I right in thinking less of the school because of this one bad interviewer?

 

[zacharyw]

I assume his view for the first one was unnecessary treatment was caused by defensive medicine and based off of your conversation with the first question, you should've figured out what he thought of the second question (which is probably along the line of tort reform, less treatments prescribed by doctors, evidence-based medicine etc).

It's not lack of skill of FM physicians but the way healthcare system is set up. You take a chest X-ray, it will be read by a radiologist rather than the family doctor, so I can see why he's unimpressed with increased residency as an answer. This would've turned out better if you could've stood your ground with some valid arguments or maybe said something like "that's a good point, I never thought of it that way, hence why I like team based medicine where I get to hear all the different views" and move on to another topic.

 

[Catalystik]

Possibly this was a classic "Stress Interview," the point being to be difficult and argumentative and see how you handled it, in which case no matter what you said, he would have disagreed and cut you off. I can't imagine any physician being unaware that a family medicine residency is three years long. At least you are somewhat informed and actually had an opinion. Be sure to gather more information on "How would you cut healthcare costs" before the next interview, as this is a common question and a good way to shine if you have a few ideas.

 

[ynot89125]

I assume his view for the first one was unnecessary treatment was caused by defensive medicine and based off of your conversation with the first question, you should've figured out what he thought of the second question (which is probably along the line of tort reform, less treatments prescribed by doctors, evidence-based medicine etc).

It's not lack of skill of FM physicians but the way healthcare system is set up. You take a chest X-ray, it will be read by a radiologist rather than the family doctor, so I can see why he's unimpressed with increased residency as an answer. This would've turned out better if you could've stood your ground with some valid arguments or maybe said something like "that's a good point, I never thought of it that way, hence why I like team based medicine where I get to hear all the different views" and move on to another topic.

you should have interviewed in my place. I hope you get an acceptance!

 

[ynot89125]

not really looking for a debate on healthcare but rather if anyone has experienced anything similar and what they did. Did anyone send a note to admissions to complain?

 

[ynot89125]

Possibly this was a classic "Stress Interview," the point being to be difficult and argumentative and see how you handled it, in which case no matter what you said, he would have disagreed and cut you off. I can't imagine any physician being unaware that a family medicine residency is three years long. At least you are somewhat informed and actually had an opinion. Be sure to gather more information on "How would you cut healthcare costs" before the next interview, as this is a common question and a good way to shine if you have a few ideas.

I had other ideas such as increasing preventative care which I shared with the interviewer. He did not seem very impressed regardless. I hope it was a classic "stress interview".... though I don't know why a school would do that especially after promoting how laid-back their interviews were in their presentations.

 

[Catalystik]

1) I had other ideas such as increasing preventative care which I shared with the interviewer. He did not seem very impressed regardless.
2) I hope it was a classic "stress interview".... though I don't know why a school would do that especially after promoting how laid-back their interviews were in their presentations.

1) Good answer.

2) Med schools may set guidelines, but that doesn't guarantee that a maverick with his own views won't buck in the traces.


Are you sure this wasn't a PhD or administrator?

 

[zacharyw]

not really looking for a debate on healthcare but rather if anyone has experienced anything similar and what they did. Did anyone send a note to admissions to complain?

I don't think you should complain since it wasn't blatantly offensive, and they are within their rights to give a tough interview. Use it as learning experience for the other interviews. My first interview was terrible but I slowly became better I think.

 

[ynot89125]

1) Good answer.

2) Med schools may set guidelines, but that doesn't guarantee that a maverick with his own views won't buck in the traces.


Are you sure this wasn't a PhD or administrator?

yes I looked the interviewer up beforehand. Professor of medicine. MD

 

[ThisCouldBeYou]

I agree with the guy who interviewed you. One of the biggest problems with healthcare IS the cost. It's not that people want unnecessary treatments. Why would they do that? The reason for the high costs are many-fold: 1) several doctors are involved in each simple test as mentioned in post by zacheryw. 2) Another reason for the high cost is because doctors can be sued if they don't prescribe a test, so they overdo them instead. 3) And doctors need to get insurance and that's an expense they need to cover.

And then there's the next question/answer. Maybe he was combining the 1 year as an intern with the 3 as a resideny. Besides, there are studies now as to whether that might change. You won't need additional fellowships, which are required if you specialize in a particular area.

So what should you have done? Start off by listening to the guy, not argue. If he makes a counter-point, be open to his ideas. It's not a matter of who's right, especially if you're sharing opinions.

 

[mcloaf]

It's not that people want unnecessary treatments. Why would they do that?

You want to try telling helicopter mom that her kid doesn't need antibiotics?

 

[pietachok]

Maybe he was combining the 1 year as an intern with the 3 as a resideny. Besides, there are studies now as to whether that might change. You won't need additional fellowships, which are required if you specialize in a particular area.

Family medicine residency is 3 years and does not require a separate prelim/intern year.

 

[Catalystik]

It's not that people want unnecessary treatments. Why would they do that?

You want to try telling helicopter mom that her kid doesn't need antibiotics?

. . . . . . An event that occurs many, many times each day in a pediatric office, BTW.

 

[ynot89125]

So what should you have done? Start off by listening to the guy, not argue. If he makes a counter-point, be open to his ideas. It's not a matter of who's right, especially if you're sharing opinions.

I did exactly that for the most part especially after he kept disagreeing with me.

 

[histidine]

I had an interview at a school where my interviewer disagreed with nearly everything I said. We spent 5 minutes on "as a physician, how would you greet a patient?" 5 minutes on "why would you choose this school over our neighbor down the street?" 5 minutes on "how many hours are you going to work as a physician?" It was over an hour of nonstop punishment.

2 weeks later I got accepted.

At another school my interviewer spent the majority of the time telling me about why he likes the school and his job and why I should attend. Waitlisted. I now try to forget everything that happens in the interview room the moment I step back out, as it clearly has very little relation to the end outcome.

 

[ynot89125]

Family medicine residency is 3 years and does not require a separate prelim/intern year.

Except for some special FM residency programs like JPS (john peter smith). I actually talked with a previous JPS resident before the interview and they told me how helpful they thought the extra 4th year was in preparing them.

 

[pietachok]

Except for some special FM residency programs like JPS (john peter smith). I actually talked with a previous JPS resident before the interview and they told me how helpful they thought the extra 4th year was in preparing them.

I was referring to the comment made by ThisCouldBeYou who was apparently defending your interviewer by saying he was just counting intern year in addition to the 3 year FM residency. There are ~20 4 year family medicine residencies, which are participating in an ACGME pilot project to test the 4 year model. This is not the standard, and is essentially experimental. And even in the 4 year programs, FM residents do not do an internship (prelim year, transitional year), rather there is simply an additional family medicine residency year.

In my experience, interviewees are unable to predict the outcome of the type of interview you described. Whether it's because the interviewer was intentionally trying to stress you or observe how well you could defend your stance, the perceived criticism doesn't necessarily translate to poor evaluation by the interviewer.

And all large communities of any type are going to have some rotten apples or mavericks who aren't representative of the group. Go for a second look.

 

[sector9]

It sucks that it negatively impacted your view of the school, but keep in mind that pretty much every school is going to have its fair share of difficult PhDs/MDs/staff/etc. I don't think any school makes it a top priority to hire jerks, so I'd write off this experience as a unfortunate incident and try not to let it hurt your opinion too much

 

[Captain Sisko]

You want to try telling helicopter mom that her kid doesn't need antibiotics?

I got this in an mmi and told mom that if not giving her kid antibiotics caused cancer, I'd eat my hat. Result: accepted!

 

[ThisCouldBeYou]

. . . . . . An event that occurs many, many times each day in a pediatric office, BTW.

Sure, I know there are studies that show how people feel positive about a doctor visit if they come out with a little piece of paper and head to a drug store to get a prescription. Sure all those drug companies advertise on TV and tell their patients to "ask you doctor for …" which is usually some crazy branded-only over-priced pill. Sure there are all sorts of new diseases that are a bit questionable (dry eyes that need special eyes drops, low-T, restless leg syndrome, etc. ) That's mostly (if not all) marketing.

But if you're an ethical doctor, your job is to educate your patients. It's not simply to give a prescription.

 

[ynot89125]

I was referring to the comment made by ThisCouldBeYou who was apparently defending your interviewer by saying he was just counting intern year in addition to the 3 year FM residency. There are ~20 4 year family medicine residencies, which are participating in an ACGME pilot project to test the 4 year model. This is not the standard, and is essentially experimental. And even in the 4 year programs, FM residents do not do an internship (prelim year, transitional year), rather there is simply an additional family medicine residency year.

In my experience, interviewees are unable to predict the outcome of the type of interview you described. Whether it's because the interviewer was intentionally trying to stress you or observe how well you could defend your stance, the perceived criticism doesn't necessarily translate to poor evaluation by the interviewer.

And all large communities of any type are going to have some rotten apples or mavericks who aren't representative of the group. Go for a second look.

I was agreeing with you! What i meant by that is that's how I got my answer for his question. I talked with a former JPS FM resident that said some good things about her 4 year residency especially compared with the traditional 3 year model. That's how I came to say to the interviewer that perhaps extending the FM residency to 3 years could result in more highly trained FM doctors which could decrease referrals and save money.

 

[ynot89125]

Sure, I know there are studies that show how people feel positive about a doctor visit if they come out with a little piece of paper and head to a drug store to get a prescription. Sure all those drug companies advertise on TV and tell their patients to "ask you doctor for …" which is usually some crazy branded-only over-priced pill. Sure there are all sorts of new diseases that are a bit questionable (dry eyes that need special eyes drops, low-T, restless leg syndrome, etc. ) That's mostly (if not all) marketing.

But if you're an ethical doctor, your job is to educate your patients. It's not simply to give a prescription.

The problem is that with the boom of the internet, access of information over the internet is very easy. Patients can look up anecdotal "success" stories anywhere and from that they create their own treatment plan that they then want the doctor to carry out. The expertise of the doctor is being ignored. All doctors will educate their patients but its another thing to say if the patient will listen.

 

[NickNaylor]

I don't think you should complain since it wasn't blatantly offensive, and they are within their rights to give a tough interview. Use it as learning experience for the other interviews. My first interview was terrible but I slowly became better I think.

Yeah, agree with this 100%. Complaining isn't going to do you any good at this point other than making you feel better. Learn from the experience and do better in your future interviews.

Sent from my SGH-M919 using Tapatalk

 

[Narmerguy]

OP, this sort of thing would irritate me as well. I'm not really into playing "games" with some interviewer trying to play a character. If an interviewer is being unreasonable there's not much you can do about it, and I wouldn't waste time complaining to the school or trying to seek some sort of action. For all you know the interviewer still marked you favorably. However, with limited interaction with school faculty/students, souring experiences like this would inevitably affect my selection once acceptance time has rolled around. Thankfully I haven't had to worry about this. Your best bet is to learn to better answer some of the questions from the interview and just put this kind of stuff behind you.

 

[Catalystik]

your job is to educate your patients. It's not simply to give a prescription.

This. Even if it takes more time than writing out a piece of paper.

 

[kyamh]

I'm not saying that having a differing opinion isn't a good thing, especially if you are able to articulate your argument well. What I am saying is that the person you are talking to has a big say about your ultimate acceptance into the school. Is it so bad to gracefully lose an argument for the sake of keeping your interviewer happy? I think 'losing' an argument with an interviewer can show that you are open to new ideas (as other have said), that you have humility, and that you are eager to learn from others. We all do so much other stuff - fancy clothing, fancy EC's, killer grades, insane number of essays - to get into school. Why not also be agreeable?

 

[histidine]

I'm not saying that having a differing opinion isn't a good thing, especially if you are able to articulate your argument well. What I am saying is that the person you are talking to has a big say about your ultimate acceptance into the school. Is it so bad to gracefully lose an argument for the sake of keeping your interviewer happy? I think 'losing' an argument with an interviewer can show that you are open to new ideas (as other have said), that you have humility, and that you are eager to learn from others. We all do so much other stuff - fancy clothing, fancy EC's, killer grades, insane number of essays - to get into school. Why not also be agreeable?

Well that depends on what they are testing. Is the interviewer looking for an agreeable interviewee? Or are they testing you to see if you have the guts to take a stance and hold your ground? You can also agree on certain points and disagree on others. I've had several debates on the ACA that ended in partial disagreement. One resulted in an acceptance. Still waiting back on the others. In my opinion, you don't want to be stubborn, but you don't want to be a pushover. Be reasonably opinionated.

 

[gobigorgohome22]

The only school I have been accepted to so far was the school where I had my worst interview. It was a 45 min interview where I talked for the first 10 mins, then the interviews went off on me about something I said for rest of the time. They basically belittled me for 35 mins🙄😕🙁. Ended up getting accepted a week later🙂

 

[mvenus929]

yes I looked the interviewer up beforehand. Professor of medicine. MD

Just because someone is a Professor of Medicine doesn't mean he/she is not an administrator. One of my attendings did something like 75% administrative work, and only 25% clinical work. One of my interviewers for residency only does a very small portion clinical work as well, but spends most of her time doing administrative work. Our Dean of the Medical School was a professor of Neurology, but I'm pretty sure he didn't actually have clinic hours.

I agree with the guy who interviewed you. One of the biggest problems with healthcare IS the cost. It's not that people want unnecessary treatments. Why would they do that? The reason for the high costs are many-fold: 1) several doctors are involved in each simple test as mentioned in post by zacheryw. 2) Another reason for the high cost is because doctors can be sued if they don't prescribe a test, so they overdo them instead. 3) And doctors need to get insurance and that's an expense they need to cover.

1) I'd argue that reading films is not 'simple'. If it were simple, there wouldn't be an entire field devoted to it. There are subtleties that are not picked up by anyone except the radiologists that could radically change management. Sure, there are going to be obvious films--I say in general that if I can see someone on a film, it's a pretty obvious thing and we don't generally need the radiologist's input. The reason we have more specialists now is because the field of medicine is much broader than it was 30-40 years ago. Yes, Family Medicine docs can take care of the relatively simple things in their realm of experience, but there's a time when they need to refer as well.

2) Actually, generally doctors don't get sued if they don't order unnecessary things, they just either think they're going to get sued (defensive medicine), or they don't want to explain to the patient why those tests aren't needed. I vaguely remember reading some study on the first, and have seen the latter first-hand. On the other hand, I've spent the past two weeks in the ED and have seen countless times where the docs have avoided doing imaging due to clinical guidelines, or have told patients that they aren't going to do blood tests when they aren't necessary. Some patients get rather angry, but if they try to sue, no one is going to take the case. It's about knowing the clinical guidelines, though, and some docs don't care to look them up.

I'd actually argue that a good portion of the increased cost of healthcare is due to overhead expenses. All those billers and coders in the hospital trying to make the money and insurance companies denying claims, causing more man-power to get paid. There are a number of 'low-cost' concierge practices that actually do fairly well just by lowering overhead. But there are lots of ways to fix a broken system.

 

[SunsFun]

I agree with the guy who interviewed you. One of the biggest problems with healthcare IS the cost. It's not that people want unnecessary treatments. Why would they do that? The reason for the high costs are many-fold: 1) several doctors are involved in each simple test as mentioned in post by zacheryw. 2) Another reason for the high cost is because doctors can be sued if they don't prescribe a test, so they overdo them instead. 3) And doctors need to get insurance and that's an expense they need to cover.

Your reasoning for why the costs are so high isn't any better than what OP came up with.

 

[alpinism]

OP, this sort of thing would irritate me as well. I'm not really into playing "games" with some interviewer trying to play a character. If an interviewer is being unreasonable there's not much you can do about it, and I wouldn't waste time complaining to the school or trying to seek some sort of action. For all you know the interviewer still marked you favorably. However, with limited interaction with school faculty/students, souring experiences like this would inevitably affect my selection once acceptance time has rolled around. Thankfully I haven't had to worry about this. Your best bet is to learn to better answer some of the questions from the interview and just put this kind of stuff behind you.

Which is what usually happens.

Many interviewers will be tough on applicants they like on paper and go into the interview with the mindset "its their acceptance to lose."

They're tough on you b/c they want to see if you can handle the stress and can professionally deal with situations where others disagree with your point of view (something that happens a lot in clinical medicine while dealing with patients).

There is nothing wrong with doing a "stress interview" and it is well within the interviewers rights to ask tough questions.

 

[Goro]

The OPs post was very thought provoking for me. Different interviewers definitely will have different styles, and I am inclined to agree with my pal Cat that the guy was trying to ratlle OP.

To: OP, I would only complain to the Admissions Dean if you thought the guy was being unprofessionsal. Bad interviewers do exist and the only way they can be weeded out of the system is to let the deans know.

To all other interviewees, nothing wrong with standing your ground if you know your stuff.

OP, do let us know how this tunes out!

I had an interview at a school where my interviewer disagreed with nearly everything I said. We spent 5 minutes on "as a physician, how would you greet a patient?" 5 minutes on "why would you choose this school over our neighbor down the street?" 5 minutes on "how many hours are you going to work as a physician?" It was over an hour of nonstop punishment.

2 weeks later I got accepted.

At another school my interviewer spent the majority of the time telling me about why he likes the school and his job and why I should attend. Waitlisted. I now try to forget everything that happens in the interview room the moment I step back out, as it clearly has very little relation to the end outcome.

 

[ynot89125]

The OPs post was very thought provoking for me. Different interviewers definitely will have different styles, and I am inclined to agree with my pal Cat that the guy was trying to ratlle OP.

To: OP, I would only complain to the Admissions Dean if you thought the guy was being unprofessionsal. Bad interviewers do exist and the only way they can be weeded out of the system is to let the deans know.

To all other interviewees, nothing wrong with standing your ground if you know your stuff.

OP, do let us know how this tunes out!

I don't plan to complain now I don't even have enough money to flight out there again even if I wanted another interview, maybe after this cycle ends. I will let you know for sure!

 

[ynot89125]

Which is what usually happens.

Many interviewers will be tough on applicants they like on paper and go into the interview with the mindset "its their acceptance to lose."

They're tough on you b/c they want to see if you can handle the stress and can professionally deal with situations where others disagree with your point of view (something that happens a lot in clinical medicine while dealing with patients).

There is nothing wrong with doing a "stress interview" and it is well within the interviewers rights to ask tough questions.

While I agree that may be what the medical school is doing I think it is a flawed plan. If a medical school gives these stress interviews to all applicants they like, I'm sure that some will end up seeing the school in a bad light. This obviously is not the goal of a school. No school will ever contact you after an acceptance to say "hey sorry that was a test" either so its basically up to the applicant to guess if it was really a stress interview or if the interviewer was just a jerk.