A highlight of my intern year was participating in applicant interviews. I won a prize for having the highest interviews to match ratio. Feels like a weird flex, I know, but bear with me.

I had the task of rating applicants and trying to get a sense of their personality, work ethic, and gauging their level of interest in our program.

I interviewed a bunch of applicants and felt like I got good at figuring out who was genuinely interested in our program and who was treating us as rank list filler. Hence my killer interviews to matched applicants ratio. And I want to share with you my secret so that you can make sure your top choices understand you mean business when you say you’re interested.

The secret? The questions you ask.

I don’t want to overcomplicate this, but you should be aware that by asking questions, you are communicating a message to your interviewer. And in the short interaction of a virtual interview, it's important to send the right message.

You can use questions to demonstrate interest and intent. It’s how you say “I am really interested in your program” without just saying it. And as is the case with most things about residency applications, it’s better to show than to tell.

Show what you know. Don’t ask questions you can easily google or that were already answered in presentation materials. These types of questions are commonly asked, and it communicates that you’re just going through the motions. You should spend some time on the programs website and pay attention during their presentations to gather the basic information. You want to be able to dig a bit deeper with your questions. This shows you did your “homework”.

Here's a real life example. I was asked “Do you guys have didactics?” and “How would you rate your didactics?” by quite a few applicants. These are fair questions. I asked similar questions, I’m sure. But I distinctly remember two people who asked me; “Did you feel that the acute care lectures prepared you for rotations?” and “What did you learn during the acute care lecture series?”. The “acute care lecture series” was briefly mentioned during the program overview. I don’t doubt the other applicants were truly curious about our didactics, these two applicants stood out because their questions were specific and a few layers deeper than surface. This came across as a higher level of interest.

Show genuine interest. Ask for information you really want to know. Genuine interest is hard to fake. Genuine questions lead to good conversation and can help you connect with an interviewer as well as learn if a program is a good fit for you. Be aware of who you are interviewing with. Many places provide some basic info about interviewers ahead of time and you can figure out which questions would be appropriate for that specific interviewer.

Show what you value. You communicate to the interviewer what your priorities are with the questions you ask. Be aware of the message you might be sending with questions. This means you might need to strategically ask questions to residents via an email after the interview day or during the “pre-interview happy hour”. It is a totally fair question to ask residents how often they are getting out early from rotations, or how much free time they have during specific rotations. But during the official interview day, these should be balanced with other questions that show you aren’t solely focused on leaving early.

Show how insightful you are. Y’all are smart. Really smart. I know this because you ask super intelligent questions. You can show an interviewer that you intimately understand a specialty and the inherent challenges of the field. These are going to be questions you likely come up with well in advance. That’s right. These are “canned” questions, but they are intelligent. They take some work to prepare, but it is worth the effort.

My younger brother is a bodybuilder. He often uses a quote from Ben Franklin to describe his approach to dieting and I think it applies well to residency interviews. He would say:

Part of that plan should include what you do if the interviewer says, “Alright, what questions do you have for me?” at the top of a 15 minute interview. If you don’t want your sphincter muscle to do the workout of a lifetime, you’d better have some questions prepared.

I want this advice to be broadly applicable so I will provide the framework that I think transfers across specialties. Feel free to adjust as you deem necessary.

So, what’s the anatomy of an intelligent canned question? There are at least three core principles…

Opinion based. Ideally, this would be a question you could ask anyone. Since you’re asking an opinion, everyone is the expert on their own opinion. This also makes the question readily recyclable. You can ask multiple people the same question because there may be different perspectives.

Requires more than a single word response. This may be obvious. An intelligent question often starts a conversation or leads to a discussion. Which is great because people remember good conversations. You can then circle back and reference the high points you discussed in post-interview thank-you notes as well.

Make the interviewer think. This is sometimes hard to conceptualize, but I’ll do my best to explain it. I learned this from podcasters. Chris Van Vliet gave an example during an interview with Danny Miranda. He was talking about how to turn commonly asked questions into better questions that get better responses. He said:

My adaptation for a residency interview would be this:

“What traits do you look for in a resident?”

This is a fine question. But, consider asking it like this instead:

“When you think of the most successful resident you’ve worked with, what are the top 1-2 characteristics that contributed to their success?”

This wording forces them to think of an actual person. They then must pick real traits this person had that they admired. And they essentially tell you how they define success in residency. All this information is helpful and communicates what they value. It’s also a good question, and they will probably tell you so.

I would recommend spending some time coming up with a handful of these types of questions (5-7) that you have at the ready just in case you get put on the spot. These questions can be created from a broad range of topics. Create a few from several categories ranging from the residency program itself and medical specialty, to living in the city and recreation activities.

Even though I’m making a big deal about coming up with good questions, the true purpose is to help you get a good feel for the program and make an informed rank list.

In the age of virtual interviews, this is a huge hurdle. The “gut feeling” people used to tell me to look for wasn’t as obvious during a zoom call. It is still possible, but it puts the onus on you as the applicant to do the leg work to figure out what a program is like.

I would always ask for contact information for other residents I could email questions to. Even if I had no more questions I needed answered. I wanted multiple sources. I didn’t want to rely solely on the tri-hard yes-men that volunteer to participate in applicant interviews (like myself, I guess). If I heard consistent answers, then I felt like my impression was accurate.

These conversations that occur outside the normal channels of the interview can be super enlightening and less artificial feeling. I spent a lot of time talking/emailing with residents and fellows from my top choice programs trying to decide on my rank order list. You often get more candid responses this way. I would still stay as professional as possible and just assume that anyone you talk to could have a say in how you end up being ranked.

Asking intelligent questions is a small part in your overall residency match process, but I think anything you can do to make a good impression is worthwhile. Even in my limited experience on the other side of the interview, I saw how the questions you ask help you stand out from the crowd.