From Trainee to Radiologist: How I Learned to Win the Interview & Other Lessons on Landing the Job

If you are nearing the end of your radiology training, you are no stranger to the interview process.  From medical school through internship, radiology residency, and fellowship, you’ve likely participated in at least 50 (if not more!) interviews.  This experience might have garnered greater confidence in the interviewing process, but are you really prepared for what comes next?  

When interviewing for the first big J-O-B, there are several key similarities, as well as important differences compared with interviewing for training programs.  

And I know – I’ve recently been through it!

First Things First: “So…tell me about yourself.” 

Despite the number of diverse programs and training paths available, nearly all the interviews you’ve encountered in your medical career have likely led with this open-ended question.  And as I quickly learned, so do most radiology job interviews.  But why?

The answer likely lies in the very nature of interviewing.  The concept of the modern interview is generally credited back to Thomas Edison in the 1920s. When faced with hundreds of applicants for a single position, he had to find a way to separate a qualified individual from the pack of applicants (sound familiar?). 

To do so, he developed a test with knowledge-based and opinion-seeking questions that helped him suss out the characteristics he was seeking to fill in his open position.  This test was ultimately leaked and published in the news, and with that, the modern interview began to evolve.

Interviewing as we know it today, particularly in medicine, generally has a twofold aim– proving you have the necessary knowledge/skills for the job, and assessing your personality and potential fit into the existing workplace culture.  

Our knowledge/skill can be proven by or attested to with our training record, test scores, and letters of recommendation, but in many cases, there may be little distinction between equally qualified candidates on paper. 

As such, it is often the latter of the two aims that becomes the focus of the interview (the personality and workplace-fit factor). 

Beginning the interview with the ubiquitous “so…tell me about yourself” kicks off the search for a personality match.  

Yes, Having a Prepared Answer is Really that Important

While the interviewer may see this as an open-ended, softball question posed without one single right answer, the interviewee should see this as a critical moment in which a well-prepared, concise speech can be delivered that is tailored to both the position and particular organization.

“Unfortunately, there seems to be far more opportunity out there than ability…We should remember that good fortune often happens when opportunity meets with preparation.”

 – Thomas Edison

Think back to your own interviewing experiences. Though you probably assumed the question was coming, how many times did you fumble through your answer?  Did the words coming out of your mouth sound nothing like what was in your head? Did you wonder if you had said too little or too much?  Did your answer help keep the conversation flowing or did it grind to a halt?

I suspect that like myself, many of you floundered in your first interviews for residency. Though I consider myself adept at public speaking and am pretty quick on my feet, it was frustrating to hear myself give a generic answer to these questions—lacking passion and personality. Leaving these interviews, I sought to become better prepared so that I might seize the opportunity to highlight my personal accomplishments.

How I Prepared my Answer

Every day I rehearsed my answer out loud in my car during my commute.

I started my preparation by writing out answers to the “tell me about yourself” and “why radiology” questions every interviewer seemed so keen on.  From there, I edited the answer down to one that was concise yet complete, highlighted my personal accomplishments, and gave me the opportunity to control the direction of the interview.  

Once written, I began practicing.  Every day I rehearsed my answer out loud in my car during my commute.  Over and over again, though not always verbatim, I followed the same general outline of points to touch on until I was able to deliver a prepared answer that I was proud of yet still seemed genuine.

Late in my fellowship interview season, one program director remarked “I can tell you’ve given that answer before”.  Worried that I had seemed disingenuous or too rehearsed I apologized.  He was quick to reply that he actually appreciated my prepared answer and felt that it proved I had put effort into preparing for the interview.  

He told me that from his perspective as an interviewer, having candidates who were prepared to answer the expected questions helped him to more naturally keep the conversation moving and ultimately helped him achieve a better understanding of the candidates.

Take a Page from The Elevator Pitch Playbook

Whether you are a radiologist, an engineer, an accountant, or anything in between–the concept of having a prepared speech that defines yourself and your goals is vital to making a great first impression. 

These so-called ‘elevator pitches’ are designed to create an opening for a conversation, which piques the interest of the interviewer so that he or she will want to ask additional questions.  In just a few short sentences.  Brief, as in the length of an elevator ride. 

Your prepared answer to the “tell me about yourself” interview questions may certainly require more than just a few short sentences, but they can be successfully modeled against the ‘elevator pitches’ that are ubiquitous to the professional world.  

While the content of your speech may evolve over time, these pitches are critical to interview success in both training and when job seeking (so it’s a good idea to take it out and dust it off every now and then).

Crafting the perfect radiology elevator pitch requires attention not only to content, clarity, and persuasiveness, but also the need for a direct approach (rather than speaking in generalities), as well as proficient delivery.

Also important is a short, strong closing. To conclude your speech, end your pitch by posing a targeted request that’s memorable to the receiving audience.

The spirit of the ‘elevator pitch’ and the strong close can be further applied to the skill of interviewing.  

Anticipating that most interviews in medicine will begin with the same expected question allows you to not only prepare compelling answers, but also allows you to close in a way that helps you to control the direction of the interview.

Focus, Focus

In the same way that an ‘elevator pitch’ should close with a ‘targeted request’, it is important that your answers to the expected open-ended interview questions end with a focused topic.  

This focus could be a reference to a recently completed research project, a leadership position, or any other accolade that is a point of professional pride or something from your CV that you think will be of particular interest to the interviewer.  

Ending in this way may encourage the interviewer to ask follow up questions on the topic you have directed them to, providing you with an additional opportunity to speak more specifically on the accomplishment or experience of your choice rather than to a different unexpected question.   

The J-O-B Interview (Your One Shot to Get it Right)

While the residency and fellowship interview process provides the opportunity for applicants to “try, try, again” with respect to honing answers to common interview questions, the job interview process is much less forgiving.  You may formally interview with only a single individual or only have a single opportunity to answer these important questions, so preparation is critical to success.

Similar to the residency and fellowship process, it is important to not only have an ‘elevator speech’ prepared, but to also have answers ready for other common questions.  

Such questions you might anticipate include: What are you looking for in a job? Where do you see yourself in 5-10 years? or Why are you interested in joining our practice?

Finding yourself at a loss for words when faced with answering these questions may not only derail the rhythm of the interview, but may also make you appear disinterested and unprepared. 

To give you a little tip and to quote comedian Mitch Hedburg, the best answer to the question, where do you see yourself in 5 years? is probably not, “Celebrating the 5 year anniversary of you asking me this question.” 

Preparation Involves Research and Introspection 

Being ready to answer these questions and being prepared for other potential questions means not only reflecting on your own aspirations and achievements but arriving at the interview as well-versed in the group and job position as you can be.  

This type of information can easily be gained through websites, job description, word of mouth, or even by reviewing the services offered at the affiliated hospitals. Doing your own bit of investigation into the nature of the group and the position may also help you to more naturally come up with relevant and meaningful questions – the type that will truly help you determine if the job is the right fit for you. 

Early Career Radiology: Graduating from THE Match to Finding a Match

While opening your envelope (or email) on Match Day may make the NRMP process seem like a lottery, it is actually an algorithmic process that uses the rank lists supplied by the applicant against those supplied by training programs to find the most cohesive ‘matches’. Luckily for trainees, this process is designed to favor the applicant.  Aside from lacking a Nobel Prize winning algorithm, the process of ‘matching’ oneself to a job is different from The Match of training in other important ways. 

Compared to the transparent and regimented elements of The Match, the process of finding an actual job is much murkier and generally is not designed to favor the applicant. 

When seeking a residency or fellowship position, it is completely transparent for an applicant to see where there are open positions, available for everyone to apply to under the ERAS application.  While certain applicants may be more likely to receive an interview offer based upon geographic considerations, it is at least possible for all applicants to be aware of every residency position in the country and to know what their options are.  Furthermore, this process also follows a prescribed timeline that affords applicants to take several months to interview at a number of places, gives time to allow for reflection and comparison of institutions, and provides applicants the exact date on which they will find out their match results.

Compared to the transparent and regimented elements of The Match, the process of finding an actual job is much murkier and generally is not designed to favor the applicant. Open positions are often interviewed for and filled based solely on word of mouth.  Unlike the public postings of open residency positions, a job seeker may never know a job was even available before it’s filled.  Word of mouth and having a network of mentors invested in your future is much more pivotal to finding a job and may be the difference between having the opportunity to apply and interview for a particular position versus never even knowing it was available in the first place. 

Similarly, the job interviewing timeline is much less forgiving than that of The Match. Prospective employers interviewing several candidates may take weeks to months to make a decision while others may offer you a position nearly immediately and expect an answer within days.  This type of variable timeline may make it difficult for applicants to have the time to interview at more than one job before having to make a decision on a potential offer or may make applicants feel they should accept the ‘sure thing’ in lieu of waiting for an answer from the job that they actually want. 

While the overall job finding process is not generally designed to favor the applicant, there are certainly times in which the process is much less time consuming and nerve wracking than The Match.  For applicants that are fortunate enough to interview for a desirable job in the geographic area of their choice, they may find themselves with an offer they are inclined to accept within days of their very first interview.  In some cases, this may even mean accepting a job before graduating residency.  In these instances, the process of getting a job can be a more relaxed process in which the applicant feels that he or she has more control and is being pursued by the potential employer.

Interest Versus Expertise – Taking an Honest Inventory of Your Skills

The interviews we go through in training tend to revolve around aspirations and interests, rather than committed directions and proven skills.  In a residency interview, applicants might say (even earnestly), “I am definitely interested in breast radiology,” or “academics is definitely the field I want to pursue.”  Despite these sweeping declarations, it is perfectly acceptable for the resident to later find themselves pursuing body imaging in a private practice.  When it comes to specialization and career paths, trainees are not beholden to the statements they make in their residency interviews.  It is understood that these aspirations will evolve over time based upon experience and the realities of the job market.

The same is not true for jobs. When considering your first job, you may find yourself at a true crossroad in which you have to commit (at least for a few years) to a particular direction – academics, private, or hybrid practice.  Depending on life or job market circumstances, you may even find yourself pursuing a direction that you would not have considered when you were first starting residency. 

Unlike residency interviews in which you can express a fleeting interest in something and never have to actually pursue it, job interviews require you to take a more honest inventory of your skills and commit only to that which you are able to appropriately perform. 

More than picking a general direction, you need to be sure that you can fulfill the specific responsibilities of the job for which you are interviewing. When a potential employer says, this job requires you to read mammograms, will you be okay with that?, you have to really weigh whether or not you could meet this request. Unlike residency interviews in which you can express a fleeting interest in something and never have to actually pursue it, job interviews require you to take a more honest inventory of your skills and commit only to that which you are able to appropriately perform.  

For a first-time job interviewee desperately seeking a job, it can be tempting to overstate your skills or abilities in an attempt to please the interviewer. To avoid this, applicants should have an honest conversation with themselves before any interview takes place and have a mental list of the skills they are confident they can bring to the job.  Some common considerations include whether or not you can/want to perform breast imaging or do light procedures, or are willing to work swing/night shifts.

Job Heterogeneity

When applying to residency and fellowship, you may have felt that each training program was incredibly unique.  You may have even developed lists of characteristics that differed between each program to help you determine your own rank list.  But reflecting back on this process, how different were these programs actually? Training is largely regimented by ACGME requirements, meaning each experience ends up being very similar to the next.  The differences we perceived between programs on the interview trail were likely related to the people and the culture of an institution, not necessarily the actual training or the expectations of the trainee.

Like training programs, the people and culture of a job play a large role in determining whether you will ‘fit’ in.  Unlike training programs, however, post-training positions can be markedly heterogeneous with respect to the actual job requirements.  This heterogeneity is one of the greatest features of radiology in that particular jobs may be suited to the interests and needs of individual applicants.  

Though most of us are aware of the major division of types of jobs available in radiology (namely private versus academic), first time job applicants should also be aware of more specific differences between jobs.  

These differences might relate to the type of work that is expected in the job position (how much of your time is spent reading your subspecialty versus general), the way in which you are paid (RVU-based or shift-based), or expectations that fall outside of the reading room (participation in group or hospital committees or trainee education).  

The types of questions job applicants should be asking in their interviews – particularly first time job seekers – should help them understand not only what the job entails but how they get paid, how labor is divided, and how the practice handles stress and change.  Generally speaking, these types of questions were never considered when interviewing for residency and may not be on the mind of job applicants.  

If you are unsure where to begin, it may be helpful to speak to former co-residents who are in their first few years of practice to assess what they wish they would have known before they took their first job and what types of questions they would advise you ask in your own interviews.

When the Job is Not THE Job 

Throughout medical training there is an unrealistic expectation set up in our minds: once we graduate we will find THE job.  The one job that meets all our expectations, the job that we have been working our entire adult lives toward.  Yet many first jobs do not fit this ideal.  Moreover, many people have several different jobs throughout their career.  Why then do we set trainees up for the expectation that they must look for one perfect job? 

Whether based upon the realities of a tight job market (thank you, COVID) or personal obligations, it is likely that the first time job seeker will find themselves faced with job prospects that do not necessarily check each and every box on their list.  

Job seekers, especially first-timers, should enter the job search with the expectation that their needs and preferences may change with experience and during different stages of life. 

This does not mean that the job you are presented with is not the right job for right now.  Taking a private practice job in the same city as your spouse while you wait for your dream academic position to open up is not the end of the world and does not mean that you have failed.  

Realizing after a year or two that you would rather put your nose to the grindstone in private practice than spend time making lectures in an academic practice doesn’t mean you have failed.  Job seekers, especially first-timers, should enter the job search with the expectation that their needs and preferences may change with experience and during different stages of life. 

Though you may not be faced with a dream job, you may be given the opportunity to gain valuable experience and make connections in your field while waiting for your dream job to become available. 

When it comes to interviewing, first-time job seekers should also be prepared to keep an open mind.  Though you may not offered your dream job, you may be offered a job with opportunity to gain valuable experience and make connections in your field while waiting for your dream job to become available.  Do not write off a position just because it isn’t perfect.  Be prepared to answer to the realities of the job market, particularly if you are limited geographically.  Keeping an open mind in the job interview will also help you to appear more of a team player and flexible with respect to changing expectations in a practice. 

Crossing the Finish Line 

Graduating from fellowship to your first job is an exciting time of change and progress.  The culmination of efforts put into becoming a radiologist can put a lot of pressure on the job search.  Drawing on lessons learned from interviewing in medical school, residency, and fellowship, first-time job seekers can prepare themselves for the unique challenges of their first job interview.  

Tempering your expectations with the realities of the job market and your own skill set will help ensure that you approach these interviews with a realistic understanding of what type of job you would accept and will also help you to ask the questions necessary to understanding the practice. 

There’s only one thing left to say.  Good Luck!