Columbia University VP&S (MD) Medicine InterviewFormat, Questions & Prep Tips

What drew you to Columbia VP&S — how does the Washington Heights and Harlem community context fit with where you are headed as a physician?

Reference the Harlem/Washington Heights community health centre network and Columbia's Dominican health studies. Avoid prestige framing.

Narrative medicine asks physicians to attend closely to patients' stories. Describe a moment when listening to someone's story — not their symptoms, but their story — changed how you understood their situation.

VP&S narrative medicine is distinctive. Show you have reflected on the difference between a biomedical history and a lived narrative.

A patient with opioid use disorder is admitted after an overdose and discloses that the person who sold him heroin also deals to his teenage daughter. What are your obligations?

Multiple layers: Tarasoff-type duty to warn vs. confidentiality, mandatory reporting of child abuse, harm reduction approach, and substance use disorder as a medical condition.

New York State recently expanded its Medical Aid in Dying law. How do you feel about physician participation, and what role should personal belief play in a physician's decisions?

Conscience clauses, patient access to legal services, professional obligation to refer, and the limits of conscientious objection.

Tell me about a time you realised you had misunderstood something important about another person's experience. How did you find out, and what changed?

Self-awareness and cultural humility. Choose a real moment of misunderstanding, not a triumphal awareness narrative.

Columbia shares a campus with the Zuckerman Institute for Mind, Brain & Behavior. Tell me about a question in neuroscience or the mind sciences that genuinely fascinates you and why.

VP&S rewards applicants who can speak at length on intellectual passions. Show genuine curiosity and some depth rather than name-dropping the institute — connect the question to your own reading, research, or experience.

Describe a research or scholarly project where the most interesting part was a result you did not expect. What did you do with the surprise?

Intellectual curiosity and rigour. The unexpected finding is the signal — show how it changed your thinking or generated a new question, and how you guarded against fooling yourself.

A patient in your Washington Heights clinic, recently arrived from the Dominican Republic, has stopped taking her diabetes medication. She tells you, through your halting Spanish, that she trusts her family's remedies more. Talk with her.

Cultural humility, not correction. Use a professional interpreter, explore her beliefs without dismissing them, find common ground, and negotiate a plan that respects her framework. Columbia's narrative-medicine ethos rewards attending to her story, not just her labs.

Your closest friend in your first-year class confides that they have been struggling badly with their mental health and are thinking about taking a leave. They ask you not to tell anyone. Respond to them.

Hold the tension between confidence and concern for safety. Listen, validate, encourage them toward support and resources, and be honest about the limits of secrecy if safety is at risk. Presence and empathy matter more than fixing it.

You are shown data showing markedly higher rates of uncontrolled hypertension in Upper Manhattan neighbourhoods compared to wealthier parts of the city. What might explain this and what would you want to know?

Read it through social determinants — access, food environment, medication cost, chronic stress, mistrust — and distinguish association from causation. Identify what further data would clarify drivers, in keeping with VP&S's community focus.

Narrative medicine asks physicians to read a patient's story closely. A patient hands you a one-page letter about their illness instead of answering your history questions. Walk me through how you would respond.

Honour the chosen form of communication, read it attentively, reflect it back to confirm understanding, and weave it into the clinical encounter rather than redirecting to a checklist. This is the heart of Columbia's distinctive curriculum.

New York permits medical aid in dying under recent legislation. A patient asks you about it and you have personal reservations. What are your obligations?

Patient access to a legal option, the duty to provide full information or a timely referral, conscience clauses and their limits, and non-abandonment. Keep the patient's autonomy central.

A patient with opioid use disorder discloses, during a harm-reduction visit, information that suggests a child in the home may be at risk. How do you weigh confidentiality, mandated reporting, and the therapeutic relationship?

Layer the obligations: mandatory child-abuse reporting, the limits of confidentiality, a harm-reduction (non-punitive) frame for the patient's addiction, and how to preserve trust while meeting legal duties.

VP&S sits in one of the most diverse and unequal parts of New York. What in your own background has prepared you to care for patients whose lives are very different from yours?

Post-SFFA holistic review — draw on lived experience, language, community work, or socioeconomic background concretely. Avoid tokenising; show genuine reflection on what you still have to learn.

Tell me about a time listening carefully revealed that the real problem was completely different from what you first assumed. What changed your understanding?

Choose a genuine moment of reframing through listening — the narrative-medicine skill VP&S prizes. Focus on the cues you initially missed and what you did differently once you understood.