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Emergency Room Physician Interview

20 Questions and Answers by Ryan Brown

Question 1 of 20

How do you feel about law enforcement entering your sphere if your patient is involved in a crime—as either a victim or perpetrator?

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Emergency Room Physician Interview Questions

  1. 1.

    How do you feel about law enforcement entering your sphere if your patient is involved in a crime—as either a victim or perpetrator?

      Law enforcement has an important job, and your duties often intersect with the repercussions of crime upon its victims. Your attitude should be that they are part of the team when appropriate, unless it interferes with your care.

      Ryan's Answer

      "They have a job to do, just like I have a job to do. That said, I will cooperate in any way I can which doesn't interfere with the care and well-being of my patient. If there's a conflict between us, since the ER is my realm, they have to defer to my judgement. The only exception would be when safety cannot be assured without their securing the scene."

  2. 2.

    Have you had any lawsuits or settlements?

      You have a few layers of medicolegal protection here--the group and the hospital itself. Nevertheless, you'll be named even though you won't be the final scapegoat in litigation--the ones with the deepest pockets will, such as the hospital. But it is true that all physicians are at medicolegal risk, whether actual suits ever pan out or not. You won't be rejected because you have lawsuits, unless there are so many that you're the problem. Your interviewer knows suits are filed for purposes of discovery (to determine whether or not there is merit to a case) and that the frivolous ones go away or prescribe. A settlement, however, is looked upon just as poorly as a suit you lose, because it's made when an unfavorable verdict is likely.

      So, what do you do if there is a suit or settlement? Tell your side, because that's half of the story--the important half. Don't blame your previous institution or group, because that looks evasive. If you can explain why a suit occurred due to a complication and not due to your negligence, use it, because this is accepted as part of being in the profession.

      Ryan's Answer

      "I have two lawsuits, neither of them for any real malpractice. One of them was over a diagnosis I couldn't make because of a preliminary result that was negative; when the final results indicated infection, I contacted the patient in a timely manner yet was blamed for allowing his illness to last an extra day. The other was due to a tracheal stricture after a patient I had intubated required prolonged intubation. After discovery, I expect both of these to be dropped."

  3. 3.

    If the Executive Committee summoned you to address a practice issue of yours that had clinical importance, such as a medical dose error, what would you do?

      You should give this answer a high priority, because medical errors kill a lot of people, and hospital departments are very sensitive about it. Yet, mistakes happen and your answer, while acknowledging this, should include your recognition of programs, policies, and attitudes that have evolved to minimize them.

      Ryan's Answer

      "Medical errors are a serious concern, especially in the ER where things can move quickly and even skip the usual reassuring checks in place to prevent them. However, the policies and programs that have been implemented to prevent medical errors still apply, if not just more quickly. In other words, I want to follow these procedural safeguards whenever possible, especially with a keen eye on those emergency events in which procedures must be done or medication given quickly. If time constraints inherent in the emergency result in overlooking specific safeguards, I want to take the extra time, after, to document everything so that any shortcuts that were necessary can become part of the record, helpful after the fact if needed."

  4. 4.

    What would you do if a verbally abusive patient were to begin shouting ethnic slurs that your other patients found disturbing?

      This is similar to the interview question: What would you do if a patient were combative and verbally abusive, even including spitting and forcefully removing things like IVs and catheters? However, instead of physical danger, the risk here is to the feelings of others and/or the outrage that such behavior evokes, which is never good for any enclosed space. These are things that can escalate quickly into physical behaviors that are dangerous.

      Ryan's Answer

      "The ER is a very dynamic, eventful environment, and there is really no room to make things worse. Whether the verbal abuse is part of the pathology or simply because someone is racist or intolerant, removing him or her from earshot of others will be the best thing in maintaining smooth continuity of the work being done. There are some private areas that are normally used for other things, like gynecology or fatalities, that can be used for situations like this. My responsibility is to take advantage of this as soon as possible to prevent any escalation."

  5. 5.

    What do you feel you can personally bring to our group?

      You don't just want to say that you're well-trained or that you have the experience. Be bolder than that and flaunt your talents. ER work requires book knowledge, prioritization, and 'good hands,' in an emergency. Tell them about these as part of your tool chest. Our answer example may be a bit cheesy, admittedly, but how else do you answer such a question? The cheesier the question, the more you should rely on generalizations about excellence.

      Ryan's Answer

      "The ER is a place in which the rug can be pulled out from under you without warning or mercy, and patients' lives depend on how you respond. This is a position where I feel my response should include prioritization and triage talents and then the knowledge and technical skills to deliver what's needed, even when it requires intense resuscitative measures."

  6. 6.

    How would respond to a substance abuse patient having a seizure or other life-threatening event because of withdrawal? Should you deny him and teach him a lesson or give him what he needs?

      This is a stupid question, but it is just an example. Nevertheless, there are many stupid questions you could be asked, and this is just one of them. There's no right answer, but only the right attitude. You can never go wrong putting your patient first, as an answer to any question--stupid or otherwise.

      Ryan's Answer

      "My job is not to teach anyone a lesson. My job is to render objective care for my patient's well-being. If that means finding a remedy that doesn't encourage his addiction, that's what I'll do. If it means giving him something--even the abused substance--to mitigate his life-threatening withdrawal, that becomes part of my legitimate treatment. My mission is to render care while, above all, causing no harm."

  7. 7.

    Here we have a policy of our staff not moonlighting as a medical expert for medical malpractice law firms, since you’re paid an annual salary. Do you have a problem with that?

      You should never have a problem with any policy of the place to which you're applying. Many hospital-based physicians will have to accept such policies, so before your interview you should decide whether you are happy with just the one salary. For most, this will not be an issue, but the problem can become fuzzy when you are subpoenaed to be a fact witness. Make sure you assure them you are clear on the policy.

      Ryan's Answer

      "I wouldn't seek a position here if I had a problem with your policy on this. I know I'll probably have to testify as a fact witness in malpractice cases from time to time, but I won't seek remuneration for my opinion, since that would make me a for-hire expert witness which, according to your policy, isn't allowed. I'm fine with that."

  8. 8.

    Please introduce yourself and tell me something about why you’re applying here?

      You should answer this concisely but politely. This question asks why you want this employment and why you're leaving your current (or previous) employment. Come off as sincere and informative.

      Ryan's Answer

      "I'm [NAME] and I want to be a part of your group and the hospital your group serves. I am married with one child. After finishing my residency, I did a lot of research on where I wanted to go next, and that brings me here."

  9. 9.

    What can you think of that might improve the ER we provide and the services we offer?

      This isn't their wanting to ask you for ideas, but to offer you the opportunity to prove your initiative in wanting to improve things proactively. Continuing medical education is a pre-requisite for continued board certification, so this is your chance to brag about how you aggressively keep up with the literature and how you intend to use such advances.

      Ryan's Answer

      "You should expect anyone on your staff to remain current with the latest literature in his or her specialty and recognize the value of evidence-based medicine. I believe an aggressive policy of having routine lectures assigned to the physicians so that they can make others familiar with recent developments as well as determine whether instituting such developments would benefit our department and result in better care."

  10. 10.

    Do you have any medical conditions that might affect your dependability?

      A hospital-based physician can disrupt the normal goings-on of a hospital if absences are not anticipated or filled as they occur. Underscoring the importance of duty, this is really just a question about your reliability. However, such a question is probably illegal. Yet, you cannot hide behind that, saying you refuse to answer because it's illegal--that's just picking a fight during your interview--the most important first impression of you as a prospective employee or partner.

      Our answer example is a cop-out answer, but it's the only way to answer it, especially if you have inflammatory bowel disease, migraine headaches, fibromyalgia, or any other conditions that could result in frequent sick days. The alternative is to admit to any conditions and hope for the best--and if your truancy has not been significant, they'll probably not hold it against you.

      Ryan's Answer

      "I take my responsibilities seriously, and it would have to be a dire situation to keep me from my work without reasonable notice--for example, a sudden severe illness or accident. I have not had any concerns in the past over my reliability."

  11. 11.

    What would you do if a patient were combative and verbally abusive, even including spitting and forcefully removing things like IVs and catheters?

      Many who arrive in the ER are not themselves, ranging from cranky to psychotic. Such behavior, unfortunately, can present danger to you, your associates, and themselves. The frequency of this occurring does not mitigate its seriousness and presents as one of the most challenging types of patient care. Equanimity, self-restraint, and objectivity are the qualities your interviewer needs to hear in your answer.

      Ryan's Answer

      "Safety first. My first concern is safety--for my patient and everyone within contact range of him or her. This may require restraints for the patient in combative situations as well as personal protective equipment for the personnel. If restraints are used, I will accept nothing other than the established ER protocols in place. In respect to my own behavior, I recognize that such maladaptive behavior--even abusive behavior--is part of the pathology, so my intent is to stay on task, regardless of how ugly the situation becomes. Obnoxious, threatening, self-injurious, and abusive behavior can never be taken personally in this environment."

  12. 12.

    Are there any things in your past that would show up in a background check done on you?

      Background checks have become a staple of employment in many realms. If you have an indiscretion in your past, own it but give a detailed explanation about how you have remedied any likelihood of recurrence, via rehab, therapy, or other means. Let the interviewer know that this problem is no longer a concern but also state, as a gesture of good faith, that you are comfortable with a period of probation or supervision.

      The right answer is 'No,' but you may have had a problem in your past for which you would have to answer, 'Yes.' If so, your job is to turn things around and make them comfortable with you. For the sake of example, below is a sample answer of someone with a substance abuse history:

      Ryan's Answer

      "I had a problem with alcohol as a teenager and I recognized I had a problem, so I self-referred myself for help. Rehab required a prevention program, and I can furnish a completion certificate if you want. I consider this part of ancient history for me, and I have had no problems since."

  13. 13.

    If you are treating someone repeatedly for crises that occur because he or she won’t modify a certain lifestyle, how can you help this patient?

      This question serves no purpose but to hear how you think. It's just part of the 'getting to know you.' It also poses you in an impossible situation because of the non-compliance that is guaranteed to waste whatever efforts you're making for a patient.

      Ryan's Answer

      "Whether it's substance abuse or smoking, sexual promiscuity, dietary choices worsening a metabolic syndrome, and other things, there are many reasons why people don't get better or experience the same damaging effects on their bodies. Depending on the cause, there is probably a support group or educational platform I would make a part of their therapy, along with the education I can give about how things end badly when prevention is not part of the picture. I also know that there are persons for whom none of these efforts will do any good. If that's because of mental illness, psychiatric referral is indicated; if not, then there just may be no helping them. As an ER doctor, I have to come to terms with the fact that there are some people who can't be helped."

  14. 14.

    There are things you will see every day in the ER most people only see once in a lifetime, if at all. What measures do you use to remain objective or even avoid the depression that naturally comes from such consistent exposure to tragedy?

      If you want to avoid having your 'heartstrings' yanked, the ER is a bad place for you. The fact that you chose this speciality means you've come to terms with the nature of the beast. Nevertheless, constant exposure poses a real risk to your mental health, as the recent pandemic has proven. You need to state that you're aware of this risk and that you will use steps to avert your own pathology, such as the depression that can occur.

      Ryan's Answer

      "I know that bad things happen to good people, and the ER is the place that sees it. Certainly, in the heat of the moment I commit to staying on task, no matter how psychologically disturbing it may be when I process it later. It's not lost on me that these things can sneak up on me and risk my own mental health. The fact that I recognize this danger means I've taken the first step to prevent it and also means I'll have no problem taking the next step and seek professional help if I find myself consumed with inappropriate feelings."

  15. 15.

    Would you be willing to use our proprietary electronic health records?

      This is a question about your willingness to go along with team policy, so yes.

      Ryan's Answer

      "I want to be complaint with all procedural protocols. Things like this are best managed by those who manage them best. My role is not to re-establish your way of doing business."

  16. 16.

    Pregnancy termination is a controversial subject, even when extended to 'emergency contraception.' Would have any issues providing such treatment, especially in a case of rape or incest?

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  17. 17.

    What invasive procedures are you uncomfortable with?

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  18. 18.

    If you were to see a peer having difficulty with an emergency procedure (e.g., blood gas retrieval, chest tube placement, intubation, etc.), how would you respond?

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  19. 19.

    An Emergency Medicine physician traditionally does not see patients after they leave the ER. Do you plan to interact with the patients who have required admission after their ER incidents?

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  20. 20.

    What is it about [ENTITY REPRESENTED BY INTERVIEWER] that made you select us?

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