I’m sure everyone has experienced the awkward first few moments of an interview - it’s painful. Now, imagine that awkwardness amplified by the nerves associated with what could be your most important interview to date. Seems like a recipe for disaster. The aim of this post is to hopefully provide you a way to avoid disaster and transition into the interview seamlessly. To do that, I will be sharing my opinion on a key tool, the handshake.

To do this we have to look at three possible situations. These situations involve keen observation and quick decision making. By carefully analyzing your interviewer, you must determine if they are: eager to make an introduction, ambivalent or totally avoidant of personal contact.

Starting off with the avoidant interviewer. If you see someone arms crossed, avoiding direct eye contact and making you feel a little more awkward, chances are they are not keen to shake your hand. There could be many reasons for this, such as hygienic or religious reasons, to name a few. As such, you should simply begin the interview and allow them to guide the initial interaction. In my experience, most interviewers recognized  how stressful the process can be, and tried to compensate by being very friendly.

Next, we have the eager interviewer. These individuals will often make it easy for you. You will find them waiting with a smile, and can often make the first move. Shake their hand, introduce yourself, and see if they share their name with you. This is an easy way to establish rapport early on. In the context of medicine, a warm introduction (whether or not a handshake is part of the mix) is essential to the doctor-patient relationship, as it is the start to an effective therapeutic alliance. Bonus points for demonstrating this quality even before you start medical school.

Finally, the dreaded ambivalent interviewer. This one requires a lot of situational judgement. I often like to feel this situation out by starting off with an introduction. This puts the onus on the interviewer to respond, either by introducing themselves (followed by a handshake) or a direct transition into the actual question. Either way you have your answer.

As it may have been clear, I am big proponent of a handshake to start the interview, and this why. In an interview the content is important, but what will likely permeate with an interviewer is the impression you leave. A handshake, with proper firmness, eye contact and a small smile, goes a long way towards this goal. In addition, it can serve as an effective way to dissipate some of your own stress and allow for an overall more effective interview.

That being said, there are some exceptions. In the event that you or the interviewer is not comfortable shaking hands (for hygienic or religious reasons or otherwise), do not feel obligated to force the situation. However, if you are reading body language correctly, this will likely be evident so that you can avoid an awkward encounter. If someone refuses to shake hands, move on - as you can’t focus on what you can’t control. Role playing stations in the MMI are the exception. In these stations, you should enter the room in character, and as such, unless the role demands it, you should not shake hands.

In summary, do what you are comfortable with. This post is meant to give you some food for thought. Personally, I believe in the power of an effective handshake, however, try it out and find an approach that works for you. After all, you are the one in the interview, so do what makes you feel the most comfortable.