By Sana Khan, MD
My residency interview preparation consisted of introspection, reviewing commonly asked questions, and looking over my submitted application. I picked my answers apart and ensured I was pleased with my responses to the ever-so-important “Tell me about yourself” and “Why surgery?”. I thought about which hobbies I wanted to speak about, and then wondered if I was embarking on tangents about the gym. I decided against disclosing my exact workout routine, unless specifically asked. I tried to avoid sounding underprepared or too rehearsed. I even thought about which surgical instrument I would be, just in case I was asked. I chose what I knew best as a medical student: the retractor. Like a retractor, I did my best to help in the OR, assisted with visualization and tried not to get in the way. During my preparation, however, I was woefully aware of the possibility of encountering questions that I perhaps could not prepare for.
Whether you scour online forums or scroll through “med-twitter”, you will find numerous anecdotes shared by applicants who were asked illegal, or potentially illegal, interview questions during their residency interviews. I was introduced to this phenomenon by a report by Hern et al. from 2016 about the prevalence of potentially illegal interview questions among all specialties and their impact. Illegal interview questions include questions about marital status, family planning, age, religion, and sexual preferences. Potentially illegal questions are those that allude to an applicant’s membership in these protected classes. If an applicant is not hired, illegal and potentially illegal questions can be used as evidence of discrimination. Unique to the Residency Match, interviewers can also commit match violations by asking applicants where else they interviewed and how high they plan to rank their program.
Unsurprisingly, women were more likely to encounter questions about marital status and family planning than men. Surgical specialties, including neurosurgery, orthopedic surgery, obstetrics and gynecology, and general surgery, were found to be the most likely to ask about applicants’ memberships in the mentioned protected classes. Applicants reported feeling uncomfortable when programs asked potentially illegal questions and subsequently lowered the programs on their rank list.
After four years of medical education, large student loans and power dynamics leave residency applicants in a vulnerable position, where speaking up and reporting is not the norm. During my interviews, I remember feeling helpless when receiving inappropriate comments about my appearance or on how well I spoke English (which I have been able to pick up in my 20 years of living in Canada). My focus was on showing that I was not offended so I did not make the interviewer uncomfortable. Similar to the theme in Hern et al.’s paper, these programs went to the bottom of my rank list.
A guide to answering potentially illegal questions should not be necessary in a field where professionalism is emphasized so heavily. Ideally, the effort made by applicants preparing for illegal interview questions would be shifted to programs ensuring these questions are not asked during residency interviews. The reality is that programs that choose to ask illegal questions will continue to do so until a culture of accountability is achieved. Applicants can report programs that breach match policies and ask illegal questions to the NRMP at firstname.lastname@example.org.
Sana Khan, MD, is an incoming general surgery intern at Wayne State University School of Medicine, recently completing her medical education at Saba University School of Medicine. She grew up in Toronto, Canada and attended University of Toronto where she majored in Biology and minored in Sociology and Social Geography.
Our blog is a forum for our members to speak, and, as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.