Monday, 5 November 2012

Recognizing Interview Fatigue and Importance of Correcting it

This is a busy interview season for a lot of residency applicants. Travelling for even a single interview can throw the daily schedule of a medical student M4 or residency applicant in a tizzy. It is important to recognize fatigue during the interview circuit and take active steps to correct it. If unchecked, it can adversely affect your interview performance, undermining your chances of matching into the program of your choice. I have identified some areas which contribute to significant fatigue for a residency applicant.

1. Stress of travelling:
Not all folks are battle hardened seasoned travelers and flying or travelling for an interview is stressful. Long wait times, security, TSA, boarding can all contribute to exhaustion and some folks just decide to forgo flying and drive to their destination. No matter what mode of travel you take, it is going to be taxing.

a. Physical exertion: there is considerable physical effort involved in flying which then adds to the stress of travelling. Lugging your suit and interview clothes around with your travel bag is certainly a chore. pack smartly and reduce the amount of luggage you carry. Another tip to mitigate physical stress is to plan out your flights such that there is enough lead time and lag time allowing you to rest, if needed for the travel and interview. Select flights by taking into account the travel time to the airport, ride, shuttle etc.

b. Mental hassle: is my flight on time? storm in northeast – flights delayed? What if I am on standby? These are just few of the stress inducing thoughts that we think of when we are travelling. To minimize the mental stress and the exhaustion that ensues from travelling, check with the airlines and confirm that your seat is booked and your flight is indeed leaving when it should. Last minute cancellations and delays are common this time of the year due to increased passenger volume and inclement weather.

c. Make it a habit and learn to relax! Meditation and music are good ways to slow down the time and help de-stress.  Dont forget that you can also use the amenities in hotels and relax prior to your interview. Many hotels have a gym room or a pool which you can effectively use to unwind after long day of travel. Another advantage of physical exercise is that it will help you sleep better. If you prefer not to go to the plebeian gymnasium, then make sure you do some stretching or yoga in your room. One time while travelling, I was passing through Denver airport and had a 4 hour layover. Some folks including myself were sitting in the corridor with their computers or phones, and this young woman whipped out her exercise mat and started doing stretching exercises and yoga in the terminal! Now while you don’t need exercise at a busy airport, do it in your hotel at least.

2. Disturbed food intake: if you are travelling, we often tend to ignore what we eat and when we eat. Travelling all day with the with one cup of juice (with/without peanuts) that airlines provide (southwest airlines is my favorite and is actually good about consistently providing tidbit snacks)  is a bad idea. Eat on time and make sure you eat well. It is tempting to grab a burger or fries or pizza etc at the airport but eat something light and nutritious like a salad or fruit  instead (almost all fast food places have a “relatively” healthy option). Eating greasy fatty food is not the best nourishment for a pre-interview candidate.

3. Reduced fluid intake: How often do we forget to drink water while traveling and then make it up with a jumbo soda or worse not drink anything at all? This is not ideal scenario. Make sure that you drink plenty of fluids - water. Avoid caffeinated drinks as they can affect your sleep health and stay away for energy drinks (especially if you are not in habit of using these).


Table 1: Factors causing stress and steps to correct them












4. Irregular sleep
: try your best to sleep on time. You tend to accrue a ‘sleep deficit’ every night you do not sleep your fixed amount. Do not accrue this deficit in days leading up to the interview, you will look tired and will perform sub optimally for the interview.

5. Anxiety of doing well on interview: This can cause you to feel tired because you are constantly feeling anxious about how you will do on the interview. While some anxiety is good and can improve performance, when prolonged, it can make you tire out easily. Focusing attention on the task at hand and practicing breathing techniques will help you overcome the anxiety.

6. Hyper attentiveness and increased multitasking: this is a common theme in interview circuit, especially as the interview seasons drags on. You are doing so many things at one time, thinking about your medical school or job, things you need to get done, thinking about the next trip, thinking about how you performed on your previous trip, flights, schedules etc the list is seemingly endless. All this information processing and cogitation is stressful and can contribute to interview related stress. Learn to prioritize. Make a list and triage which task is more important than other. Deal with the more important tasks first and other jobs later. This high efficiency approach will improve your productivity, reduce stress and streamline your schedule.

7. Enjoy the journey, worry less about the destination: residency interviews are tough and grueling interruptions in your daily life. They are inevitable part of a medical students life who wishes pursue graduate medical education. Since it is something that has to be, why no enjoy it? Enjoy the trip, talk to new people, see new things, try new experiences which will make it a positive experience for you.

Conclusion: residency interviews are stressful. There are important modifiable and un-modifiable factors which contribute to the stress. Inability to manage stress of residency interview affects your interview performance and undermines your chances of matching into a program of your choice. Recognition of these factors and taking corrective steps to ameliorate the stress is an important attribute of a successful residency candidate.

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