How Residency Interviews Really Work
A perspective from someone who’s interviewed, mentored, and made the hard decisions
My Own Interview Season
When I think back to my own residency interview season, I remember feeling nervous, not only because of how many applicants there were, but because I didn’t really know what to expect. I only interviewed at one program, and it was the one I was least familiar with. Still, somehow, I was able to make a strong impact on everyone in program and, ironically, it ended up being the place I loved the most and the place that shaped me into the clinician and person I am today.
A lot of the anxiety I see now is the same. There is fear around wanting to show who you really are. For many applicants, this is the first real job. Applicants are trying to figure out how to prepare, what programs are actually looking for, and whether they should even be doing a residency in the first place. I remember searching far and wide for any sort of advice I could find for PT residency interviews.
The Two Questions Everyone Should Be Asking
The two biggest questions applicants lose sleep over are whether they should even do a residency and, if so, how to know which one is right for them.
There are three things I think you need to consider before applying. First, can you afford it. Residency is both a time investment and a financial investment. It was worth it for me, but if you are carrying six figures of loans, that deserves serious reflection. Second, are you burnt out. Residency is mentally similar to the hardest year of PT school, just with a paycheck. If you are already exhausted or disconnected, residency can become a recipe for disaster. Third, do you really know what you want to do. PT school makes you a generalist. It teaches you how not to hurt people, not how to treat everything well. Many people apply to ortho or sports residencies without actually being sure that is the path they want long term.
What We Care About More Than Perfection
A lot of applicants obsess over being perfect students, but the way you learn in school and the way you learn in residency are completely different. There is still didactic content, but this is a practical job. Knowing theory is one thing. Applying it in front of mentors with real patients is another. What I care about far more than perfection is openness to feedback. We have faculty from multiple residency programs, all with different styles. If you are not open to having your beliefs challenged, residency will be a rough year.
It is hard to walk the line between humble and confident, but that is what we look for. Overconfidence is a red flag. Being overly self deprecating is also a red flag. The strongest applicants are willing to advocate for what they believe, let that belief be challenged, and accept when they are wrong. We also look closely at whether you understand what this job actually is, whether residency aligns with your career goals, and how you respond to feedback, especially in clinical scenarios. We do not recruit for culture fit. We recruit for culture add, people who bring new interests, skills, and perspectives.
Don’t Try to Fit a Square Peg in a Round Hole
We have turned down incredible applicants simply because we could not give them what they wanted. A lot of people apply to us for our White Sox spring training opportunity, which is unique and exciting, but we do not see a ton of baseball or upper extremity volume in our clinic. When someone comes in with a very specific expectation that we cannot meet, that mismatch usually ends in frustration. Sometimes not matching is actually protection.
The most common mistake I see is not knowing what you are signing up for, and it is incredibly easy to fix. Talk to the director. Talk to the coordinator. Talk to the current and past residents. That initiative is a massive green flag.
Another mistake is not reading the room during your interviews. Our interviews have three distinct rooms. The first is leadership and directors, where professionalism matters and we are looking for whether you can communicate like a future leader in the profession. The second is the faculty room, where your coachability, personality, and likability matter because these are the people mentoring you day to day. The third is the clinical scenario room. You will probably get something wrong, and that is okay. I got both of mine wrong during my interview. What we are evaluating is how you respond to feedback. We intentionally find something to coach because coachability is everything.
You’re Not the Only One Being Evaluated
You are not just interviewing for us. We are interviewing for you. Residency is not mandatory. You are not trapped. Use interview weekends to look for whether the faculty seem to enjoy working together, whether they are personable with you, and whether they care about you as a person. Those answers matter more than most applicants realize in the midst of interviews. Residency is already a planned stressful time in you career but is a great way to jumpstart your career if you surround yourself with the right people/ program.
Interview season is one of the most joyful and hardest parts of my job because there are so many exceptional candidates every year. Despite declining interest in orthopedics, the talent I see is unbelievable. At the end of the day, I ask myself two questions. Can we see ourselves enjoying a year with you, and do your goals, learning style, and values align with ours. When those line up, that is when a candidate truly stands out.