By Sarah Wesley

You’ve made it….you have passed your med school classes, aced your USMLEs and sub-internships, received amazing recommendations, bought expensive plane tickets, and now you are sitting in front of the program director and are being asked a question that is very simple in nature but that is also really simple to mess up. Here are two common IMG-specific questions and some short tips on approaches to your thinking when answering these and others.

1) Why are you coming to the United States and not staying in your country of training?

In explaining your rationale, describe only your logical not your emotionally-guided reasons. For example, you may want to share that you are interested in radiology and are drawn to certain aspects of training not available in your home country. Avoid mentioning that you are following a partner to the US, unless it seems appropriate but never as your primary reason. Avoid judgments of your home country system as well.

In my case, I was asked about the medical system in the U.K. and Ireland and why I would want to leave a place where I still had on-going research and also a universal healthcare system that paid residents overtime and didn’t require that we deal with insurance companies. I had to be careful not to insult either system – the one responsible for my academic training or the system I was hoping to become a part of. In this case, I thought it best to keep my reasons based on logical needs: 1) the training at the institution where I was interviewing was world-class, and I wanted to have best training possible, 2) the training was shorter in the US, 3) my family had moved from Europe to the east coast of the US, and I wanted to be in the same country with my parents as they aged. Keep it simple, keep it logical.

2) What do you know about the American healthcare system and what would you change about it?

Be careful with this one, as you never know the political opinions of the person interviewing you. Avoid judgments about Obamacare, high costs of healthcare, etc etc etc. Speak of your POSITIVE experience in US hospitals but stay away from generalized opinions about the American healthcare system such as “all American hospitals seem like this or that.”

When I was asked in an interview what I would do to change the American healthcare system, I steered away from politics and brought it back to education, focusing on how I would train medical students to be better clinicians and thus tailor treatment to clinical findings not solely lab or imaging results; this all as a way of decreasing healthcare costs. This sort of answer is good because you are talking about something you know about: medical school education, not something you know very little about until you have spent years training in such a system. Also, very few people will disagree with a suggestion that supports an academic way to cut costs.

Best of luck and remember to smile!