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Keck Medicine of USC Software Engineer Interview Guide

Keck Medicine of USC Software Engineer interview guide: reported rounds, questions and how candidates describe the process.

The 60-second brief

The role of Software Engineer at Keck Medicine of USC is pivotal in developing and maintaining the technological backbone that supports patient care and medical research. As a Software Engineer, you will be responsible for creating innovative software solutions that enhance the functionality of medical imaging applications and other essential platforms. This role directly impacts users—patients, healthcare professionals, and researchers—by ensuring that crucial information is accessible and reliable, thereby contributing to improved healthcare outcomes. This position involves working on complex and high-impact projects within a collaborative environment that values creativity and technical excellence. You will engage with cutting-edge technologies, addressing challenges that require both technical skill and a deep understanding of the healthcare context.

This guide is scoped to a Software Engineer candidate at Keck Medicine of USC.

Focus areas

  • Software Engineering (General)
  • Imaging Applications Domain
  • Technical Interviewing

The Keck Medicine of USC interview process

Keck Medicine of USC candidates report 2 rounds over 2-4 weeks. The stages below are what candidates describe, not a published process.

Technical Interview

First round assessing coding skills and problem-solving capabilities conducted over Zoom.

What to demonstrate

  • First round assessing coding skills and problem-solving capabilities conducted over Zoom
  • Depth in Software Engineering (General)

How to prepare

  • Answer aloud and timed: How do you approach debugging a complex software issue?
  • Answer aloud and timed: Describe a challenging software project you worked on and the technologies you used.

Cultural Fit Interview

Second round focusing on behavioral questions and experiences related to team values.

What to demonstrate

  • Second round focusing on behavioral questions and experiences related to team values
  • Depth in Software Engineering (General)

How to prepare

  • Answer aloud and timed: Explain the differences between synchronous and asynchronous programming.
  • Answer aloud and timed: What strategies do you employ for optimizing code performance?

Where candidates lose points

Prepare for Behavioral Questions

Use the STAR method (Situation, Task, Action, Result) to structure your answers effectively.

Understand the Healthcare Context

Familiarize yourself with common challenges in healthcare software to demonstrate your relevance and insight during interviews.

Practice Coding Problems

Regularly solve coding challenges on platforms like LeetCode or HackerRank to refine your skills.

Show Enthusiasm for the Mission

Express your interest in how technology can improve patient care and healthcare delivery.

Questions & practice

Explain the differences between synchronous and asynchronous programming.

Medium · Technical / Domain Questions

Approach

  1. Say what the runtime actually does before reasoning about the code.
  2. Name what is shared across threads and what owns each piece of state.
  3. Identify the window where an invariant is briefly untrue.
  4. Distinguish a value from a reference to it, and say which one you handed out.

Follow-up

  • What happens if two callers reach this at the same time?
  • Where could this allocate more than you expect?

Write a function to reverse a linked list. Explain your approach.

Medium · Coding / Algorithms

Approach

  1. Restate the input: its shape, its size, and what is guaranteed about it.
  2. Name the brute-force solution and its complexity before improving on it.
  3. Choose the data structure from the access pattern, not from familiarity.
  4. State the target complexity and say which constraint rules the naive version out.

Follow-up

  • How does this change if the input no longer fits in memory?
  • What is the worst case, and how likely is it on real data?

How would you implement a binary search algorithm?

Medium · Coding / Algorithms

Approach

  1. Restate the input: its shape, its size, and what is guaranteed about it.
  2. Name the brute-force solution and its complexity before improving on it.
  3. Choose the data structure from the access pattern, not from familiarity.
  4. State the target complexity and say which constraint rules the naive version out.

Follow-up

  • How does this change if the input no longer fits in memory?
  • What is the worst case, and how likely is it on real data?

Find version gaps and relay lag with window functions

Medium · window functions · event tables · frame semantics

outbox_event holds event_id, aggregate_type, aggregate_id, aggregate_version, event_type, payload, status ('pending','published','dead'), attempts, created_at, published_at. A projection is missing rows and you must decide whether the relay skipped events or the consumer dropped them. Write three queries over the last seven days: one listing every aggregate_id whose published aggregate_version sequence has a hole, one giving per-day counts with a running total, and one returning the newest published event per aggregate. For each, say where the window function is evaluated relative to WHERE and LIMIT. PostgreSQL 16.

Approach

  1. Gaps: compute lead(aggregate_version) OVER (PARTITION BY aggregate_id ORDER BY aggregate_version) in a subquery, then filter next_version <> aggregate_version + 1 in the outer query. Window functions are evaluated after WHERE, GROUP BY and HAVING and before the outer ORDER BY and LIMIT, so the predicate cannot sit in the same WHERE clause and PostgreSQL 16 has no QUALIFY.
  2. Say what the seven-day filter does to the answer: it truncates every partition, so the first row per aggregate has no predecessor inside the window and a hole spanning the boundary is invisible. Widen the window, or join to resource.version as the authority for the true maximum.
  3. Running total: SELECT date_trunc('day', created_at) AS d, count() AS n, sum(count()) OVER (ORDER BY date_trunc('day', created_at) ROWS UNBOUNDED PRECEDING). An aggregate inside a window call is legal because grouping runs before windowing. The grouping key is unique per row here so ROWS and RANGE agree, but write the frame anyway — over ungrouped rows with tied timestamps the default RANGE frame pulls in every peer row and the total jumps.
  4. Newest per aggregate: DISTINCT ON (aggregate_id) ... ORDER BY aggregate_id, aggregate_version DESC is the cheap PostgreSQL-only form when an index matches that order; row_number() OVER (PARTITION BY aggregate_id ORDER BY aggregate_version DESC) = 1 is the portable form and needs a subquery for the same evaluation-order reason as the gap query.

Follow-up

  • Relay failover redelivers events. Does a duplicate break the gap query, and how would you detect one from this table alone?
  • Turn the gap check into a continuous monitor rather than a query someone runs after an incident. What does it watch?

Replace offset paging on the resource feed with keyset

Easy · keyset pagination · composite index · sort order

resource holds resource_id, tenant_id, owner_user_id, title, body_ref, version, status ('draft','active','archived','deleted'), created_at, updated_at, deleted_at, with an index on (tenant_id, status, updated_at DESC, resource_id DESC). The listing endpoint returns active resources for one tenant, newest update first, 50 per page, today with LIMIT 50 OFFSET n. Tenants reach page 400 and rows are created while they read. Write the keyset query, define what the cursor carries and how it is encoded, and say which part of the index each predicate uses. Assume PostgreSQL 16.

Approach

  1. Name the two failures separately. OFFSET 20000 makes the server produce and discard 20,000 rows, so page cost grows with depth rather than with page size. Independently, any write that changes how many rows sort above the offset moves the window between two fetches, and the direction decides which anomaly you get: an insert lands at the head of updated_at DESC and pushes already-returned rows down past the boundary, so they are returned a second time; a delete above the offset, or a row whose updated_at is bumped above the cursor, pulls rows up and one is never returned at all. Nothing in the response reveals either.
  2. Write the seek: WHERE tenant_id = $1 AND status = 'active' AND (updated_at, resource_id) < ($2, $3) ORDER BY updated_at DESC, resource_id DESC LIMIT 50. The row-value comparison is one index range rather than a disjunction, and both columns are NOT NULL, which is what makes that comparison well defined.
  3. Map each predicate onto the index: tenant_id and status are equality on the leading columns, (updated_at, resource_id) is the range, and the ORDER BY matches the index order so no Sort node appears and the scan stops after 50 rows. The DESC in the definition only matters for mixed directions — a plain ascending btree on the same columns is read backwards for this query.
  4. Put both sort columns in the cursor and nothing the client can tamper with into another tenant: base64 of (updated_at, resource_id), validated server-side, with tenant_id taken from the principal.

Follow-up

  • The client asks for 'jump to page 400'. What do you offer instead, and what does the honest version cost?
  • Sort order becomes user-selectable across four columns. How many indexes is that, and which would you refuse to add?

Describe a challenging software project you worked on and the technologies you used.

Medium · Technical / Domain Questions

Approach

  1. Clarify what is being asked and what a complete answer contains.
  2. State your assumptions explicitly before working the problem.
  3. Say what you would check first and why it is the highest-information step.
  4. Work from the requirement backwards to the design.

Follow-up

  • What assumption would you test first?
  • How would you know your answer was wrong?

What strategies do you employ for optimizing code performance?

Medium · Technical / Domain Questions

Approach

  1. Clarify what is being asked and what a complete answer contains.
  2. State your assumptions explicitly before working the problem.
  3. Say what you would check first and why it is the highest-information step.
  4. Work from the requirement backwards to the design.

Follow-up

  • What assumption would you test first?
  • How would you know your answer was wrong?

Discuss how you ensure code quality and maintainability.

Medium · Technical / Domain Questions

Approach

  1. Clarify what is being asked and what a complete answer contains.
  2. State your assumptions explicitly before working the problem.
  3. Say what you would check first and why it is the highest-information step.
  4. Work from the requirement backwards to the design.

Follow-up

  • What assumption would you test first?
  • How would you know your answer was wrong?

How would you design a system to handle real-time data processing?

Medium · System Design / Architecture

Approach

  1. Fix the scope first: who calls this, how often, and what they do when it fails.
  2. Name the read and write paths separately; they rarely have the same bottleneck.
  3. Choose a partition key and say what query it makes expensive.
  4. State the consistency you need, and where you are willing to be stale.

Follow-up

  • What breaks first when traffic grows ten times?
  • How does this behave when that dependency is down for an hour?

What factors do you consider when designing a RESTful API?

Medium · System Design / Architecture

Approach

  1. Say who the caller is and what they do when the call fails halfway.
  2. Define the identity of a request so a retry cannot double-apply it.
  3. Separate accepted, pending, failed and confirmed; they are different facts.
  4. Design the error taxonomy before the success shape; callers branch on it.

Follow-up

  • What happens if the caller retries after a timeout?
  • How does a client discover it is on an old version of this contract?

Given a dataset, how would you identify and address anomalies?

Medium · Problem-solving / Case Studies

Approach

  1. Clarify what is being asked and what a complete answer contains.
  2. State your assumptions explicitly before working the problem.
  3. Say what you would check first and why it is the highest-information step.
  4. Work from the requirement backwards to the design.

Follow-up

  • What assumption would you test first?
  • How would you know your answer was wrong?

How would you approach a situation where a project is falling behind schedule?

Medium · Problem-solving / Case Studies

Approach

  1. Clarify what is being asked and what a complete answer contains.
  2. State your assumptions explicitly before working the problem.
  3. Say what you would check first and why it is the highest-information step.
  4. Work from the requirement backwards to the design.

Follow-up

  • What assumption would you test first?
  • How would you know your answer was wrong?

How do you approach debugging a complex software issue?

Medium · Technical / Domain Questions

Approach

  1. Establish what changed and when, before forming any theory.
  2. Pick a bisection that eliminates candidates whichever way it turns out.
  3. Check the instrumentation before believing the symptom.
  4. Separate the trigger from the cause; the deploy is rarely the bug.

Follow-up

  • What would you look at first, and what would it rule out?
  • How would you tell a cause from a coincidence here?

Suggested practice checklist

Built from the rounds and topics Keck Medicine of USC candidates report.

Day 1 — Map the Keck Medicine of USC loop

  • Write out the reported sequence: Technical Interview, Cultural Fit Interview.
  • For each round, write one sentence on what it is judging, from the description above, and mark the one you are least ready for.

Deliverable: A one-page map of the 2 reported rounds, with the weakest marked.

Day 2 — Work Software Engineering (General)

  • Spend the session on Software Engineering (General), which Keck Medicine of USC candidates report being tested on.
  • Write one worked example in Software Engineering (General) and time yourself on it.

Deliverable: One timed worked example in Software Engineering (General).

Day 3 — Work Imaging Applications Domain

  • Spend the session on Imaging Applications Domain, which Keck Medicine of USC candidates report being tested on.
  • Write one worked example in Imaging Applications Domain and time yourself on it.

Deliverable: One timed worked example in Imaging Applications Domain.

Day 4 — Work Technical Interviewing

  • Spend the session on Technical Interviewing, which Keck Medicine of USC candidates report being tested on.
  • Write one worked example in Technical Interviewing and time yourself on it.

Deliverable: One timed worked example in Technical Interviewing.

Day 5 — Answer out loud: Technical / Domain Questions

  • Answer aloud, timed: How do you approach debugging a complex software issue?
  • Answer aloud, timed: Describe a challenging software project you worked on and the technologies you used.

Deliverable: Spoken answers to 2 reported Technical / Domain Questions question(s), under time.

Day 6 — Answer out loud: System Design / Architecture

  • Answer aloud, timed: How would you design a system to handle real-time data processing?
  • Answer aloud, timed: What factors do you consider when designing a RESTful API?

Deliverable: Spoken answers to 2 reported System Design / Architecture question(s), under time.

Day 7 — Answer out loud: Behavioral / Leadership

  • Answer aloud, timed: Tell me about a time you faced a conflict within your team. How did you resolve it?
  • Answer aloud, timed: How do you prioritize tasks when managing multiple projects?

Deliverable: Spoken answers to 2 reported Behavioral / Leadership question(s), under time.

Behavioural preparation

Behavioural rounds judge the decision you made and what it cost.

Describe a time when you had to refactor a system or application for better performance or scalability.

Medium · System Design / Architecture

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?

Tell me about a time you faced a conflict within your team. How did you resolve it?

Medium · Behavioral / Leadership

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?

How do you prioritize tasks when managing multiple projects?

Medium · Behavioral / Leadership

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?

Describe a situation where you took the lead on a project. What was the outcome?

Medium · Behavioral / Leadership

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?