S01E15 - Illegal Questions

Jun 28, 2022
Dr. Myers Hurt
S01E15 - Illegal Questions

Illegal questions are always a hot topic surrounding interviews. As you all know, the NRMP sets very strict communication rules surrounding the Match process, and have very specific requirements of what constitutes “legal” communication. 

From the proverbial horse’s mouth, the NRMP Code of Conduct reads:

“To promote the highest ethical standards during the interview, ranking, and matching processes, program directors participating in a Match shall commit to:

Refraining from asking illegal or coercive questions Program directors shall recognize the negative consequences that can result from questions about age, gender, religion, sexual orientation, and family status, and shall ensure that communication with applicants remains focused on the applicant’s goodness of fit within their programs”.

Furthermore, federal law prohibits most of these questions for any job, not just residency, and it is illegal to make hiring and firing decisions based on this information. 

SDN, reddit, ValueMD, the usual forums people frequent usually have some version of “is this an illegal question” threads with arguments for and against.

My personal and professional thought are that they will happen. Overall - it will happen - these things come up in casual conversation all the time, and usually work their way into conversations that are comfortable during an interview session. Sometimes it is not the interviewer, but the applicant who brings it up, and the conversation flows from there.

Just a quick PubMed search has a 2016 study from Academic Medicine with a sample size of 11,000 applicants - Two-thirds of applicants reported being asked potentially illegal questions. Their data revealed that more women than men reported receiving questions about marital status or family planning in that study.  Similar results were reported in the initial study in 2013 in the same journal - about two-thirds report an illegal questions, and questions about marriage and childhood were a large majority of those questions.

There is no red light, no button, no siren that goes off, and no red phone you pick up to report the incident when these topics slip out, and my recommendation is to just keep rolling and try to redirect to more topical issues.

The rules are there to protect YOU, so you can offer the information, hospitals are just not allowed to ask you. Conspiracy theorists will say that you will give too much away by asking these loaded questions - and that may be true, but I’d say you are reading too much into it.

Often these are not brought up in a malicious way. Some examples of how they can work their way into conversation:

The real Catch-22 in my opinion is that they are important issues to you as an individual - if you have kids childcare is important - if you are a specific religion, perhaps being close to a specific house of worship is important - lots of decisions can hinge on these so called “illegal” topics and could help you pick one program over another, or at least give you some comfort about your overall “fit” with a program. . 

If you feel you have been targeted - discuss first with the PD, then the NRMP / ACGME.

Thanks for listening, hope you enjoyed the content and find it useful.

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