Abstract
Background:
Access to mentorship and interview preparation resources remains inconsistent across Canadian medical schools, potentially disadvantaging students applying to diagnostic radiology. The Canadian Association of Radiologists’ Medical Student Network (CAR MSN) hosts an annual virtual mock interview program pairing fourth-year and third-year medical students with diagnostic radiology residents for structured practice interviews and individualized feedback.
Methods:
This study used a pre- and post-survey design to evaluate the program’s impact on self-reported interview preparedness across 5 annual cycles (2022-2026). A total of 315 registrants from all 17 Canadian medical schools completed pre-event surveys, and 157 participated in the mock interviews. Paired pre- and post-event data were available from 54 participants and their level of preparedness for the Canadian Resident Matching Service (CaRMS) interviews was analyzed using the Wilcoxon signed-rank test.
Results:
Self-reported preparedness scores improved significantly, with median scores increasing from 3 (IQR 2-3) to 4 (IQR 4-4) on a 5-point Likert scale (r = .85, P < .001). However, a 65.6% attrition rate was observed between surveys. Participants rated the mock interview as highly helpful, and 96.3% felt the questions were representative of CaRMS interviews. General perceived stressors related to the unfamiliarity with the programs and the interview process decreased after participation.
Conclusion:
Despite the attrition rate, these findings suggest that nationally accessible, resident-led mock interview programs can meaningfully improve interview preparedness and confidence for radiology applicants. Future implementation of mentorship-based initiatives may promote equitable access to radiology-specific career guidance.
Introduction
In medicine, mentorship plays a critical role in helping medical students navigate an unfamiliar career path. Mentorship allows for an experienced mentor to share their knowledge with a mentee with less experience, ultimately supporting their professional, academic, or personal growth. 1 Especially in a specialized field like radiology, radiologists and radiology residents can introduce students to the specialty and provide them with benefits such as providing them with research opportunities, guidance when it comes to career decisions, and feedback on how to navigate the Canadian Resident Matching Service (CaRMS) application process.2,3 Despite the well-documented benefits of mentorship, access to radiology mentorship programs and opportunities remains limited and inconsistent across Canada, with one-third of Canadian medical schools not offering a radiology mentorship program for medical students.1,4 This unequal access to mentorship threatens equity in the CaRMS process and may be particularly disadvantageous to medical students from under-resourced backgrounds due to fewer opportunities for interview preparation resources.
Previous literature highlights a gap in access to career guidance and advice for interested students across the country. To help address this gap, the Canadian Association of Radiologists’ Medical Student Network (CAR MSN), a trainee-led initiative, began hosting an annual mock interview session where medical students are paired with diagnostic radiology residents across Canada. 5 The program was originally developed in 2022 as a learner-led national mock interview initiative providing structured interview practice, individualized feedback, and peer mentorship for Canadian medical students applying to diagnostic radiology through CaRMS. Although not initially designed as a formal longitudinal mentor-mentee relationship, it was mentorship-informed in that students were paired with residents who served as near-peer role models and provided feedback and, when time permitted, informal advice about the CaRMS process. Early evaluation of the inaugural session demonstrated improved participant confidence, with students 4.2 times more likely to feel confident for CaRMS interviews following participation (n = 17).6,7 Through structured virtual interviews, mentees can gain practical exposure to an interview format in a lower-stakes environment, setting them up for future success. Students are placed into 1 to 2 sessions, each lasting 30 minutes where they undergo a mock interview followed by personalized feedback from a diagnostic radiology resident before their official CaRMS interviews.
This study evaluates the effectiveness of structured mock interviews as a mentorship-based educational intervention for Canadian medical students interested in radiology and assesses their impact on interview preparedness. Specifically, it assessed whether participation was associated with improved self-reported interview preparedness and confidence, while also assessing the potential value of nationally accessible mentorship initiatives in promoting more equitable access to radiology career support. This study builds upon the evaluation from the inaugural CAR MSN Mock Interview sessions by providing a 5-year longitudinal assessment with a larger sample size.
Methods
This study used a pre-post survey design to evaluate the effectiveness of the CAR MSN mock interview event. After reaching out to radiology resident volunteers who agreed to act as interviewers, the CAR MSN distributed a sign-up form for mock interviews to medical students across Canada using Google Forms. Registration for this event was made available to all medical students across all 17 Canadian medical schools, via the CAR newsletter and school-specific promotion methods as facilitated by the Radiology Interest Group leads at each school. Preference was shown toward fourth-year medical students who were participating in that year’s CaRMS cycle. Students were scheduled into one or more virtual mock interview sessions and participated in a standardized 30-minute practice interview with a diagnostic radiology resident followed by individualized feedback. In addition to interview coaching, residents could provide informal near-peer guidance when time permitted, including advice on program selection and rank list advice. The event was therefore conceptualized as a near-peer, mentorship-informed intervention rather than a formal longitudinal mentorship program. The event was delivered virtually using Zoom breakout rooms to facilitate one-on-one interviewing and allow rapid changes in interviewees and interviewers. This was done to simulate the online nature of the CaRMS interviews.
To standardize the experience, a bank of sample interview questions was initially developed in 2022 by diagnostic radiology residents and medical students that were part of the inaugural CAR MSN mock interview leadership team. These questions were designed to reflect common themes encountered during radiology CaRMS interviews and were organized into 5 categories: personal, radiology-specific, ethics, clerkship/elective, and image-based questions. Each year, radiology resident interviewers are provided with this question bank and instructed to select 3 questions for each participant, with flexibility to use their own questions if preferred. Guidance accompanying the question bank emphasizes that there are no single “correct” answers and that feedback should focus on helping students structure responses aligned with their own experiences and perspectives. Although a standardized feedback form was not used, the interviewer guide provided before the session included suggested feedback points for each sample question to facilitate formative, individualized feedback. As such, feedback was delivered in a consistent yet flexible manner based on the student’s responses and could address areas that could potentially show up in CaRMS interviews, such as answer structure, communication, professionalism, ethics, and approach to image-guided procedures. This individualized feedback allowed resident interviewers to identify areas for improvement while reinforcing students’ strengths.
At registration, participants completed a pre-event survey that collected demographic characteristics and asked students about their level of confidence, methods for preparation, and stressors regarding the CaRMS interviews. Participants were invited to complete a post-event survey containing both qualitative and quantitative portions, which was distributed to all participants to re-evaluate their level of preparedness after the mock interviews and the overall efficacy of the CAR MSN event. Primary outcome measures included self-reported preparedness for CaRMS interviews on a 5-point Likert scale (1 = not at all prepared, 5 = very prepared). Additional outcomes were collected in the form of multiple-response close-ended questions, including perceived stressors in the CaRMS process, resources that would improve preparedness, and other variables including perceived helpfulness of the mock interview, representativeness of questions relative to CaRMS interviews, usefulness of the virtual Zoom format, and quality of resident feedback. Participation in the event and surveys was optional, and participants had the choice to withdraw from the survey at any point. Data was collected from the annual mock interview events held between 2022 and 2026. This initiative was originally developed as a quality improvement project rather than a research study. As such, formal research ethics board approval was not obtained or necessary.
Statistical Analysis
Categorical variables were summarized using frequencies and percentages. Because of the paired nature of the data, the Wilcoxon signed-rank test was used to compare self-reported preparedness scores before and after the mock interview. Only complete paired responses were included in this analysis. A two-sided P-value of less than .05 was considered statistically significant.
Results
A total of 315 registrants completed the pre-interview survey between 2022 and 2026. Due to limited resident interviewer availability, a total of 157 registrants were able to participate in the mock interviews. Of the 157 participants, 54 completed both pre- and post-interview surveys and were included in the paired analysis.
Demographical data of the 54 participants were included in Table 1. Most of the students who signed up to be interviewed were fourth-year medical students (n = 49, 90.7%) with smaller representation from third-year medical students (9.3%; Table 1). Nearly a third of the respondents self-identified as a visible minority (37.0%) and participants who identified as male made up 51.9% of all interviewees, 46.3% identified as female, and 1.9% chose not to disclose. Mock interview participants represented 14 Canadian medical schools supporting the national reach of the initiative. Among 315 of those that completed the pre-interview survey, nearly all indicated plans to apply to radiology through CaRMS (n = 307, 97.5%), with 5 (1.6%) responding no and 3 (1.0%) responding unsure. Most respondents were considering residency programs outside of their home institution (n = 257, 81.6%), while 49 (15.6%) were unsure, and 9 (2.9%) were not considering. The respondents were asked how the online nature of the CaRMS interviews affected how prepared they felt. Most reported no change in preparedness (n = 155, 49.2%), whereas 62 (19.7%) felt less prepared. 56 (17.8%) felt more prepared, and 42 (13.3%) were unsure.
Pre-Interview Respondent Characteristics (n = 54).
Note. Descriptive statistics were reported as frequencies and percentages. Most pre-interview respondents were in their fourth-year of medical school, with the largest proportion from UBC.
After the mock interview, 49 (90.7%) reported that their medical school offered formal CaRMS interview preparation. Participants rated the mock interview as very helpful, with a median helpfulness score of 5 (IQR 5-5) on a 5-point Likert scale (1 = not at all helpful, 5 = very helpful). Most participants (n = 52, 96.3%) felt that the questions asked may be representative of what might be asked during CaRMS. All of the participants (n = 54) found the Zoom breakout-room format for the mock interviews was very useful and all the participants reported receiving helpful feedback from their resident interviewer.
The self-reported preparedness for the 54 respondents before and after the mock interview is shown in Figure 1. The data from Figure 1 showed that the median score in preparedness of those that completed the pre-interview survey was 3 (IQR 2-3), while the median score of the post-interview group was 4 (IQR 4-4). The results of the Wilcoxon signed rank test (r = .85, P < .001) indicated that the scores of radiology applicants significantly differed after the practice mock interviews compared to before.
Self-reported preparedness for online CaRMS interviews before and after a mock interview event (paired respondents, n = 54).
The factors contributing to medical student stress during the CaRMS interview process are detailed in Table 2. Main perceived stressors included uncertainty about match results, including specialty choice and location, preparation for the interview, the feeling of not being well prepared and not knowing enough about the program. All of the perceived stressors subjectively decreased after the intervention. Notably, stress related to not knowing enough about the program and about the application process decreased from 25 students pre-interview to 19 students post-interview and 10 students pre-interview to 3 students post-interview, respectively, after the mock interviews. Resources reported as likely to improve CaRMS interview preparedness are detailed in Figure 2. Across both timepoints, respondents frequently endorsed additional practice interview sessions as a main resource that participants believed would most improve CaRMS interview preparedness (Figure 2). Other resources like having a list of practice questions and questions to ask during the interview decreased from a count of 28 students pre-interview to 18 students post-interview and 22 students pre-interview to 11 students post-interview, respectively, after the mock interview.
Factors of the CaRMS Interview Process Contributing to Medical Student Stress.
Note. Data are from paired respondents pre and post-interview (n = 54). Participants could select more than one stressor so percentages do not sum to 100%. Match results were the most commonly reported source of stress, both before and after the mock interview.
Resources reported that would most improve CaRMS interview preparedness before and after the mock interview event (n = 54).
Discussion
Among participants who completed both pre- and post-interview surveys, this national, resident-led mock interview program was associated with improved self-reported interview preparedness and confidence for CaRMS interviews. Participants also rated the program highly and found the interview format and feedback useful. Together, these findings suggest that initiatives led by residents and organized through national organizations may be a practical way to support medical students interested in radiology, particularly in institutions where access to specialty-specific mentorship is limited.
Mentorship is an essential component of guiding trainees throughout their career development and facilitating their professional goals. Although the CAR MSN Mock Interview program did not always provide longitudinal mentor-mentee relationships, it incorporated several mentorship-informed elements, such as mentor-mentee pairing and individualized feedback to help prepare for the CaRMS process. Therefore, this program not only functioned as an interview skills preparation session but also a structured opportunity for students to engage with residents and receive practical advice. Further, the program fostered connections between students and residents across the country with some pairs continuing to meet after the end of the program, expanding opportunities for networking and professional support. With CaRMS applications increasing in competitiveness, residency program interviews are an anxiety-provoking time and challenging milestone for medical students as they navigate the beginning of their career. 8 Medical students often report feeling unprepared and lacking confidence for their interviews which may hinder their CaRMS application; however, this also presents as an opportunity for support through mentorship.9,10 It’s at this critical stage of medical training where mentorship can act as an intervention to increase the likelihood of a mentee to match into their preferred specialty. 11 Our study demonstrates that mentorship-based mock interviews significantly improved students’ confidence and preparation for their residency match interview which supports the findings from other studies. A study that designed a residency interview training program with didactic and simulated interview training showed significantly improved student confidence and knowledge about the interview process. 12 Another study created a mock interview series for residents applying for fellowship programs where 92% of students reported positive feedback about the helpfulness of the practice opportunity. 13 Collectively, these findings further highlight the value of mock interviews and mentorship programs during the CaRMS process, a period that is often marked by uncertainty and anxiety for medical students.
Mentorship is one of the central components in medicine to provide guidance, understanding about the specialty, and expand opportunities for students to engage in research, leadership, and network with others. However, access to mentorship is not uniform across institutions as a study that conducted a national survey across Canadian medical schools found that 25% of medical students have reported that they do not have access to a mentorship program at their school. 1 While some institutions have well-established radiology interest or mentorship opportunities, others have limited radiology exposure, and some institutions don’t offer a radiology residency program. This variability in access to residents and radiology-specific advice is concerning for students interested in radiology; students without established local networks or opportunities to connect with radiologists and residents may be disadvantaged during the radiology residency application process, have less insight into the specialty, and miss opportunities. For example, mentees often go on to publish manuscripts and present at national conferences with the help of mentors, experiences that bolster one’s CaRMS applications. 14 National initiatives, such as the CAR MSN Mock Interview, can help address disparities in access by providing standardized interview preparation, mentorship opportunities, and networking experiences that are accessible to medical students across Canada. In doing so, such programs help create a more equitable playing field for students applying to radiology, especially for those who may not have access to a robust local network of radiologists and residents. This is especially true for students from marginalized or underrepresented backgrounds who face additional barriers to finding relatable mentors that can connect with the mentees’ personal needs.15,16 Similarly, the Canadian Federation of Medical Students (CFMS) has also hosted national mentorship programs to facilitate students in finding mentors of their interest, enrolling 291 final-year medical students of which 83.2% valued interview preparation and 80.4% endorsed wanting an available mentor. 17 National mentorship programs therefore represent an important strategy to not only act as a skills-building exercise, but also a way to reduce institutional disparities and promote equitable access to mentorship for students who are left to navigate one of the most important stages of medical training alone. This may be particularly relevant in radiology, where mentorship opportunities remain inconsistent across institutions, in order to train a diverse future workforce that can enhance inclusivity and patient-centred care.
There were several practical lessons from 5 iterations of the CAR MSN Mock Interview program. Firstly, scheduling the sessions shortly before CaRMS interviews, specifically 2 to 4 weeks before, maximized relevance as students could actively prepare and almost immediately apply resident feedback during CaRMS. Secondly, the largest obstacle to the program is adequate resident recruitment. Given the demands of residency training, interview availability of resident volunteers was the main factor limiting the number of students who could participate. To help address this, recruitment is conducted nationally through the CAR Resident and Fellow Section, the CAR newsletter, and local Resident Interest Group leads, as well as through word-of-mouth promotion and former participants who subsequently return to the program as resident volunteers. Furthermore, available interviewers were prioritized to fourth-year medical students to ensure that those actively participating in the current CaRMS cycles received interview preparation at the time of greatest need. Third, it was unclear whether matching students with residents from different or same institutions was more beneficial. While it could be practical to build further connections and insights from the student’s home institution, residents from other parts of the country may provide broader, regional perspectives which may especially be helpful when students are seeking out advice about particular programs. During CAR MSN Mock Interview sign-ups, students were asked if they were considering attending a residency program outside of their own institution to potentially guide the matching process. Finally, the future iteration of the program would benefit from using a standardized feedback form to ensure consistency while preserving individualized mentorship. These considerations may help other radiology interest groups of residency programs adapt the model of mock interviews to their own institutions.
This study had limitations. Firstly, there is a modest number of participants which may limit the generalizability of these findings, as the observed improvement may reflect response bias. However, it is encouraging that the results of the mock interviews were strongly positive, consistent across multiple years, and from students across the nation; despite the small sample size, these robustly positive results suggest that this initiative does provide meaningful benefit for medical students. There is a high attrition rate (65.6%) between the pre- and post-interview surveys. This raises the possibility of non-response bias, as participants who completed the post-interview survey may differ from non-responders. Those who have filled out the post-event survey may have been more motivated to prepare for CaRMS or more likely to view the mock interview as beneficial which would ultimately overestimate the observed improvement in self-reported preparedness. However, the broader pre-interview dataset still provides meaningful insight into the reach and perceived needs of most applicants, with respondents representing all Canadian medical schools and highlighting concerns related to interview preparedness and match outcomes. Future iterations should aim to reduce loss to follow-up by administering the post-event survey immediately after the mock interview session.
Conclusions
This study showed that a resident-led mock interview program is an effective strategy to support Canadian medical students preparing for radiology residency and provides evidence for the investment into similar programs. Accessible, specialty-specific mentorship initiatives can play a critical role in closing gaps in guidance and interview preparation, ensuring that students are not disadvantaged by limited local support.
Footnotes
Acknowledgements
We thank the resident volunteers who dedicated their time to conducting mock interviews and providing thoughtful feedback to participating medical students. We also acknowledge the medical student leaders who organized and led this event, the Canadian Association of Radiologists staff, and the Canadian Association of Radiologists Resident and Fellow Section (RFS) for their support in delivering this national initiative. Their efforts were critical to the success of the program.
Ethical Considerations
Formal research ethics board approval was not necessary.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.