Being “Backable” for Residency Interviews

After reading stories of match success and failure on social media this spring, I’m already thinking about another set of virtual interviews this fall and contemplating how applicants can shine.

Here are some takeaways from Backable: The Surprising Truth Behind What Makes People Take a Chance on You. While this book and its many examples mostly center on entrepreneurship and how startups can get money from investors, there are some nuggets that cross domains nicely. The interview is in some ways a pitch meeting where you’re selling yourself.

The power of unique perspectives and experience

[Investor Ben] Horowitz responded that great ideas typically stem from an “earned secret”—discovered by going out into the world and “learning something that not a lot of other people know.”

Everyone says the same things in personal statements, is drawn to their chosen fields for the same reasons, and has largely similar clinical experiences. When you have rare real-world experience–frankly in any context or domain–that makes you different.

Share how those insights have changed you and inform your approach to medicine.

Earned insights are rare

What’s the single best piece of advice that would help them succeed?” [Oscar-winning producer Brian] Grazer paused for a moment, then said, “Give me something that isn’t google-able. I want an idea that is based on a surprise insight. Not something I could find through a Google search.”

An idea that stems from hands-on experience is way more backable than the same exact idea if it simply originated sitting behind a desk. But the catch is, without being boastful, you have to make that effort shine through your pitch. It can’t be hidden.

Here’s an open secret: a few months of clinical experience don’t make you an expert in your chosen field just as even less time in other specialties doesn’t make you an expert in those either. Bringing fourth-year swagger to interviews often isn’t a great idea.

That said, real insights–whether about your specialty, health care, or even just being a human being and having a good attitude about showing up to work every day for your patients–are a breath of fresh air. I love when I can tell an applicant has an active mind and thoughtful approach, when I can really see their gears turning.

Why should someone be scared to miss out on you?

As creators, our job isn’t to use FOMO to manipulate backers, but rather to neutralize their fear of taking a bad bet. Though it may sound strange, FOMO can make a risky bet feel safe because it shields us from the risk of being left behind. This feeling of inevitability rarely comes from the argument that we should change the world, but rather from the argument that the world is already changing—with or without us.

If there’s a knock on your record and you’re scared people are going to pass you over, own it. The typical advice is to talk about what you learned after your failure, how you’ve changed, and other such bland platitudes, but the fact is that I expect anyone who has messed up to tell me they’ve grown.

That’s all fine. Go ahead and do that.

But…don’t just approach your candidacy from a position of weakness. What about you is unique or special? Why should a program director be scared to lose you? Why are you backable despite (or because of) that setback?

Connections are powerful

Salman Rushdie once wrote, “Most of what matters in our lives takes place in our absence.” While we’re present for the pitch, we’re most likely absent for the hallway huddles, backroom meetings, and email threads that decide the fate of our ideas. Backers become fierce advocates when they are on the inside of an idea. They crack their own egg and add it to the mix.

Stronger-than-average connections with your interviewer will cause people to go to bat for you in the post-interview huddle. So many interviews are bland Q&A. True connections are rare. If you can get an organic discussion going and the time flies, everybody wins.

Each interaction is an independent variable

We don’t typically win people over in one conversation, but through a series of interactions that builds trust and confidence. Even if the last conversation went poorly, you can use the next one to show them how they influenced your work. This type of follow-up is so powerful that it can often change a backer’s response from no to yes.

You can’t really do this with your interviewer (post-interview correspondence doesn’t carry that kind of power), but you can take each interview as a fresh start.  Don’t let one sour interaction spoil the day.

Interviewing is a skill that requires practice

We’ll spend hours researching, outlining, pulling together slides—but very little time practicing what we’re going to share. The feeling seems to be that if we have the right content and we know it well enough, then there’s no need for practice. But I’ve found that backable people tend to practice their pitch extensively before walking into the room. They practice with friends, family, and colleagues. They’re rehearsing on jogs with running partners, in the break room, and during happy hour. They prepare themselves for high-stakes pitches through lots of low-stakes practice sessions—what I now call exhibition matches.

You need to practice. The common approach is to do practice interviews, often with residents and faculty at your home institution (and potentially online organized on social media). You should do those things.

But I’d take it a step further.

You should talk to strangers. Practice having genuine interactions and conversations with people who don’t know you.  Practice really listening to your patients. Get to know them as the three-dimensional human beings they are.

The easy flow of conversation is a delight to interviewers.

You are a process, not an outcome

The other techniques in this book got me comfortable with content, but I still had to learn to get truly comfortable with myself. I had to learn to let go of my ego—to express, rather than impress.

So much of your identity feels tied to your success in school, the match, and your developing career as a physician. But internal validation is always superior to external validation. You don’t and can’t control outcomes. You–at best–control yourself and your approach.

You will enjoy and likely be more successful in the match process if you are content with yourself, happy to do your best, and try to find a good fit. We call it “practicing” medicine, but living life is also the practice of showing up each day working on being the version of ourselves that we strive to be.

When you receive an interview, your goal is not to impress your interviewers. It should be to express yourself and be open to others so that you can find the best place to live and grow in your practice.

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