Larner College of Medicine, University of Vermont (MD) Medicine InterviewFormat, Questions & Prep Tips

Why Larner College of Medicine? What about training in Vermont appeals to you as a future physician?

Reference the CONNECT curriculum, the primary care focus, rural and community medicine opportunities, and the UVM Medical Center as the region's sole academic medical centre. Avoid generic "small class size" answers.

Primary care physicians are significantly underpaid relative to specialists. Despite this, do you see yourself practising primary care? Why or why not?

Honest engagement is valued here. If primary care is genuinely your path, articulate why with specific motivating experiences. If not, show you understand the primary care shortage and have thought carefully about your role.

A patient with opioid use disorder on medication-assisted treatment (buprenorphine) relapses and requests continued treatment. Some members of your team believe treatment should be discontinued. How do you approach this?

Vermont has one of the most progressive opioid treatment frameworks in the US. Discuss addiction as a chronic disease, evidence base for MAT continuation after relapse, the harm reduction principle, and the risk of discontinuing treatment abruptly.

A teenager arrives at the clinic requesting treatment for depression and specifically asks that you not inform her parents. What are your obligations?

Vermont minor consent laws allow minors to consent to mental health treatment without parental involvement. Discuss HIPAA, Vermont statute, the clinical rationale for confidentiality in adolescent mental health, and the limits (imminent danger).

You are working in a rural Vermont clinic. A patient has not followed through with a specialist referral because the specialist is two hours away and they cannot take time off work. What do you do?

Explore barriers without judgement. Discuss telehealth options, social work referral for transportation assistance, whether a closer alternative exists, and re-evaluating whether the referral's urgency changes the approach. Show structural systems thinking.

Vermont has significantly expanded access to medication-assisted treatment for opioid use disorder compared to most US states. What policy factors made this possible, and what can other states learn?

Reference Vermont's "Hub and Spoke" model (specialty hubs for complex cases, primary care spokes for stable patients), state-level legislative support, and the role of primary care physicians as MAT prescribers. Shows genuine engagement with Vermont health policy.

A patient asks you to prescribe cannabis for anxiety. Vermont has legalised recreational cannabis use. What do you do?

Discuss the distinction between legalisation and medical evidence, the lack of FDA approval for cannabis for anxiety, your prescribing authority limits, evidence for anxiety management alternatives, and how to engage the patient without dismissing their request.

Tell me about an experience working with someone experiencing mental illness. How did it shape your understanding of what mental healthcare in the US lacks?

Show authentic engagement with mental health — not just as a clinical topic but as a human and systemic issue. Reference access gaps, stigma, fragmented insurance coverage for mental health (Mental Health Parity Act compliance issues), and the integration of behavioural health with primary care.

A colleague makes a stigmatising joke about a patient with alcohol use disorder in the break room. How do you respond?

In-the-moment professional response: calm, non-confrontational acknowledgment of the harm. Follow-up: private conversation with the colleague about the impact on team culture and patient care. Reference bystander intervention frameworks.

Vermont is considering mandating that all physicians maintain a minimum percentage of Medicaid patients. Do you support this policy? What are the trade-offs?

Engage substantively with both sides: access equity argument vs. physician autonomy, Medicaid reimbursement shortfalls that make this economically challenging, and alternative incentive-based approaches. Take a position.

Role-play: I am a patient on buprenorphine who just told you I relapsed last weekend and I am terrified you will discharge me from the programme. The assessor will play the patient — respond to me directly.

This station scores interaction, not theory. Lead with reassurance that relapse is part of recovery and does not end treatment, ask what triggered it, and collaboratively adjust the plan. Avoid lecturing about MAT mechanics — meet the patient's fear first. Vermont's Hub and Spoke model treats opioid use disorder as a chronic relapsing condition.

You are shown data indicating Vermont has among the highest rates of patients receiving medication for opioid use disorder per capita in the US, yet overdose deaths have still risen in recent years. How do you reconcile these two facts?

Resist the assumption that high treatment access should automatically lower deaths. Discuss the role of fentanyl contamination of the drug supply, that treatment access and overdose mortality are influenced by different forces, and what data you would examine (treatment retention, fentanyl test-strip use, naloxone distribution). Vermont's experience illustrates that access is necessary but not sufficient.

The CONNECT curriculum integrates patient contact and population-health thinking from the first weeks. What is the educational argument for early clinical immersion, and what are the risks?

Benefits: contextualises basic science, builds professional identity, and habituates social-determinants thinking early. Risks: students encountering complex patients before they have clinical or emotional frameworks. Show you have researched CONNECT specifically rather than speaking generically about integrated curricula.

A new mother in a rural Vermont town screens positive for postpartum depression but insists she is 'just tired' and does not want it in her record. How do you respond?

Normalise postpartum depression as common and treatable, explore her specific fears about documentation and stigma in a small community, and explain confidentiality protections. Offer options — counselling, peer support, primary-care follow-up — without coercing disclosure. Mental-health access and stigma are central Larner themes.

A critical-access hospital in rural Vermont is losing money on its obstetric unit and is considering closing it, which would mean a two-hour drive for delivering mothers. As a physician on staff, what is your responsibility in this decision?

Engage with rural-hospital sustainability versus access and safety. Discuss the maternal-outcome evidence on obstetric-unit closures, your duty to advocate for patients and surface safety data, the legitimacy of financial constraints, and creative alternatives (telehealth, regionalisation, transfer protocols). Take a reasoned position.