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Steward Health Care System Software Engineer Interview Guide

Steward Health Care System Software Engineer interview guide: reported rounds, questions and how candidates describe the process.

The 60-second brief

As a Software Engineer at Steward Health Care System, you play a crucial role in developing and maintaining software solutions that enhance healthcare delivery. Your work impacts a wide range of users, from healthcare professionals to patients, ensuring they have reliable access to critical information and tools. This role is not just about writing code; it's about contributing to solutions that can significantly improve the quality of care and operational efficiency within the healthcare system. The Software Engineer position is critical as it drives innovation in various projects aimed at integrating technology into healthcare services. You will collaborate with cross-functional teams to develop applications that support patient care, data management, and operational workflows.

This guide is scoped to a Software Engineer candidate at Steward Health Care System.

Focus areas

  • Citrix
  • Network Engineering
  • JavaScript (jQuery)

The Steward Health Care System interview process

Steward Health Care System candidates report 2 rounds over 2-4 weeks. The stages below are what candidates describe, not a published process.

Initial Phone Screen

Candidates typically experience an initial phone screen to discuss their background and fit for the role.

What to demonstrate

  • Candidates typically experience an initial phone screen to discuss their background and fit for the role
  • Depth in Citrix

How to prepare

  • Be able to walk your CV end to end in two minutes, and say why this company specifically.
  • Have your salary expectations, notice period and location constraints ready, and ask for the rest of the loop in writing.

Technical Interviews

One or more technical interviews focusing on past experiences, coding challenges, and problem-solving scenarios.

What to demonstrate

  • One or more technical interviews focusing on past experiences, coding challenges, and problem-solving scenarios
  • Depth in Citrix

How to prepare

  • Answer aloud and timed: How do you ensure the quality and reliability of your code?
  • Answer aloud and timed: Describe a challenging technical problem you faced and how you solved it.

Where candidates lose points

Understand the Healthcare Context

Familiarize yourself with the healthcare industry and its challenges. Showing awareness of how technology can address these issues will enhance your responses.

Practice Coding Problems

Regularly practice coding problems on platforms like LeetCode or HackerRank to sharpen your skills for technical interviews.

Prepare for Behavioral Questions

Reflect on your past experiences and prepare to discuss how they relate to the role, focusing on specific outcomes.

Be Ready to Demonstrate Learning

Highlight any new technologies or methodologies you have learned recently, as this shows your commitment to growth.

Questions & practice

Write a function to reverse a string.

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 basic 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?

Can you explain the concept of recursion with an example?

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?

Denormalise tenant onto revisions and backfill it live

Hard · denormalisation · online migration · backfill

resource_revision (revision_id, resource_id, version, actor_user_id, change_kind, patch, request_id, created_at) has 400M rows and no tenant column; tenant_id lives only on resource. Two reads need it: a tenant-scoped audit feed ordered by created_at DESC, and an offboarding purge. Both join back to resource today. Justify adding tenant_id to resource_revision against those two reads, name the anomaly the copy introduces and the constraint that prevents it, then give the ordered migration for a live table taking 1.2k writes/second — the lock each step takes, how the backfill is batched, and where each step stops being reversible. PostgreSQL 16.

Approach

  1. Justify from the access path rather than from taste. Without the column, the audit feed either scans resource_revision by created_at and discards other tenants' rows, or resolves the tenant's resource_ids first and probes with them — both proportional to the tenant's whole history rather than to one page. With (tenant_id, created_at DESC, revision_id DESC) it is a seek that stops at 50 rows, and the purge becomes a ranged delete instead of a join.
  2. Name the cost exactly: a second copy of a fact can disagree with the first. Make the disagreement unwritable rather than documented — add UNIQUE (resource_id, tenant_id) on resource so it can serve as a foreign-key target, then FOREIGN KEY (resource_id, tenant_id) REFERENCES resource (resource_id, tenant_id) on the revision table. A revision can then only ever carry its parent's tenant.
  3. Step one, expand: ALTER TABLE resource_revision ADD COLUMN tenant_id BIGINT NULL, with no default, so it is a catalogue change and no rewrite. It still needs ACCESS EXCLUSIVE for an instant, and that instant queues behind the longest open transaction on the table while every later query queues behind it — set lock_timeout to 2s and retry rather than wait.
  4. Step two, dual-write: deploy the writer that populates tenant_id on every new revision while reads still use the join. Reversible by redeploying the previous build, because nothing reads the column yet.

Follow-up

  • The backfill is half finished and a rollback is required. What state is the table in, and what does the previous build do with a half-populated column?
  • How do you verify the backfill actually finished, given rows are still being inserted while it runs?

Write the update path that detects a concurrent edit

Medium · optimistic concurrency · transactional outbox · audit history

resource carries version INT NOT NULL DEFAULT 1. resource_revision holds revision_id, resource_id, version, actor_user_id, change_kind, patch JSONB, request_id, created_at with UNIQUE (resource_id, version). outbox_event holds aggregate_type, aggregate_id, aggregate_version, event_type, payload, status. A PUT carries the version the client read. Write the exact statements for the single transaction that applies the edit, records the revision and enqueues 'resource.updated', and give the handler's branch on zero affected rows. Then say what PostgreSQL 16 does under READ COMMITTED when two of these updates hit one row at once.

Approach

  1. One transaction, three writes, no network call inside it: UPDATE resource SET title = $3, version = version + 1, updated_at = now() WHERE resource_id = $1 AND tenant_id = $4 AND version = $2; then INSERT the resource_revision row at version $2 + 1; then INSERT the outbox_event row at the same aggregate_version. The event goes to a table rather than a broker because no transaction spans both.
  2. Branch on the affected-row count before doing anything else. Zero has three causes — stale version, wrong tenant, row gone — so re-read once and map to 409 carrying the current version, or 404 for an id outside the caller's tenant, which also stops the endpoint confirming that another tenant's id exists.
  3. State the engine behaviour instead of assuming it. Under READ COMMITTED the second UPDATE blocks on the row lock, and when the first commits PostgreSQL re-evaluates the WHERE clause against the newly committed row, so the version predicate now fails and the statement reports zero rows. Under REPEATABLE READ the identical collision raises SQLSTATE 40001 instead, so the handler must fold both shapes into one conflict response.
  4. Keep UNIQUE (resource_id, version) even though the predicate already serialises writers. It is what makes a lost update unwritable if any other path ever reaches the revision table, and it converts a logic bug into 23505 rather than into a silently missing history row.

Follow-up

  • A client sends the version it read ten minutes ago and the resource has moved three versions. What is in your 409 so it can resolve the conflict without a full re-fetch?
  • Two editors, two disjoint fields, no overlap. Does your answer still refuse the second write, and should it?

Can you describe a recent project where you utilized a specific technology?

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 do you ensure the quality and reliability of your code?

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?

Describe a challenging technical problem you faced and how you solved it.

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 improving an existing system's performance?

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?

What steps would you take to troubleshoot a software issue?

Medium · Problem-Solving / Case Studies

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 Steward Health Care System candidates report.

Day 1 — Map the Steward Health Care System loop

  • Write out the reported sequence: Initial Phone Screen, Technical Interviews.
  • 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 Citrix

  • Spend the session on Citrix, which Steward Health Care System candidates report being tested on.
  • Write one worked example in Citrix and time yourself on it.

Deliverable: One timed worked example in Citrix.

Day 3 — Work Network Engineering

  • Spend the session on Network Engineering, which Steward Health Care System candidates report being tested on.
  • Write one worked example in Network Engineering and time yourself on it.

Deliverable: One timed worked example in Network Engineering.

Day 4 — Work JavaScript (jQuery)

  • Spend the session on JavaScript (jQuery), which Steward Health Care System candidates report being tested on.
  • Write one worked example in JavaScript (jQuery) and time yourself on it.

Deliverable: One timed worked example in JavaScript (jQuery).

Day 5 — Answer out loud: Technical / Domain Questions

  • Answer aloud, timed: What is your experience with jQuery, PHP, or PowerShell?
  • Answer aloud, timed: Can you describe a recent project where you utilized a specific technology?

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

Day 6 — Answer out loud: Problem-Solving / Case Studies

  • Answer aloud, timed: Describe a challenging technical problem you faced and how you solved it.
  • Answer aloud, timed: How would you approach improving an existing system's performance?

Deliverable: Spoken answers to 2 reported Problem-Solving / Case Studies question(s), under time.

Day 7 — Answer out loud: Behavioral / Leadership

  • Answer aloud, timed: Tell me about a time you had to work with a difficult team member.
  • Answer aloud, timed: How do you prioritize tasks when working on 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.

What is your experience with jQuery, PHP, or PowerShell?

Medium · Technical / Domain Questions

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 had to work with a difficult team member.

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 working on 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 had to advocate for a technical solution.

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?