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Tempus AI Software Engineer Interview Guide

Tempus AI Software Engineer interview guide: reported rounds, questions and how candidates describe the process.

The 60-second brief

A Software Engineer at Tempus AI sits at the critical intersection of technology, data science, and precision medicine. The company's mission is to gather, structure, and analyze clinical and genomic data to help physicians make real-time, data-driven decisions for cancer care and other therapeutic areas. In this role, you will be responsible for building the scalable platforms, robust APIs, and data pipelines that make this massive library of clinical data accessible and actionable. The impact of your work in this position is direct and profound. By writing clean, efficient, and highly secure code, you enable healthcare providers to match patients with personalized clinical trials and targeted therapies.

This guide is scoped to a Software Engineer candidate at Tempus AI.

Focus areas

  • Coding interviews (timed exercises)
  • JavaScript
  • System design

The Tempus AI interview process

Tempus AI candidates report 4 rounds over 3-5 weeks. The stages below are what candidates describe, not a published process.

Recruiter Screen

Initial screening call with a recruiter to assess your fit for the role.

What to demonstrate

  • Initial screening call with a recruiter to assess your fit for the role
  • Depth in Coding interviews (timed exercises)

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.

Online Technical Assessment

Rigorous online assessment testing coding capabilities, serving as a critical gatekeeper.

What to demonstrate

  • Rigorous online assessment testing coding capabilities, serving as a critical gatekeeper
  • Depth in Coding interviews (timed exercises)

How to prepare

  • Answer aloud and timed: Implement a function that processes an input stream of genomic coordinates and merges overlapping intervals.
  • Answer aloud and timed: Write a program in JavaScript that displays specific text patterns based on dynamic input parameters and edge-case constraints.

Hiring Manager Screen

Discussion with the hiring manager to evaluate your qualifications and fit for the team.

What to demonstrate

  • Discussion with the hiring manager to evaluate your qualifications and fit for the team
  • Depth in Coding interviews (timed exercises)

How to prepare

  • Prepare two projects you led end to end, each with the decision you owned and what it cost.
  • Have three questions about the team's roadmap and how success is measured in the first six months.

Multi-Stage Virtual Onsite

Series of virtual interviews focusing on coding, API design, and system architecture.

What to demonstrate

  • Series of virtual interviews focusing on coding, API design, and system architecture
  • Depth in Coding interviews (timed exercises)

How to prepare

  • Answer aloud and timed: Given a schema of medical tests and results, write a query to find the top three most frequently ordered tests per hospital department.
  • Answer aloud and timed: Explain the performance differences between SQL and NoSQL databases when storing unstructured clinical notes versus structured patient records.

Where candidates lose points

Master SQL Querying

Do not underestimate the database portion of the evaluation. Brush up on complex joins, aggregations, window functions, and indexing strategies, as SQL is a core component of the initial online assessment.

Be Prepared for JavaScript Specifics

If you are interviewing for a full-stack or frontend-heavy role, expect deep-dive questions on JavaScript quirks, asynchronous behavior, and React state management. Ensure you are comfortable writing functional JS code without relying on external libraries.

Communicate Your Architectural Trade-offs

During the system design interview, do not just present a single solution. Discuss the pros and cons of your design decisions, such as choosing SQL over NoSQL, or synchronous APIs over event-driven architectures, particularly in the context of scaling healthcare data.

Connect with the Mission

Tempus AI is deeply committed to precision medicine. Take time to understand their products, their data-driven approach to oncology, and be ready to articulate why you want to apply your engineering skills to this specific domain space.

Questions & practice

Write a function to calculate the TF-IDF (Term Frequency-Inverse Document Frequency) score for a set of clinic

Medium · Coding & Algorithms

Write a function to calculate the TF-IDF (Term Frequency-Inverse Document Frequency) score for a set of clinical documents.

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?

Given a string of brackets and characters, determine if the input string is valid and correctly balanced.

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?

Implement a function that processes an input stream of genomic coordinates and merges overlapping intervals.

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?

Write a program in JavaScript that displays specific text patterns based on dynamic input parameters and edge-

Medium · Coding & Algorithms

Write a program in JavaScript that displays specific text patterns based on dynamic input parameters and edge-case constraints.

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?

Solve a medium-level array manipulation problem, focusing on optimizing time complexity while keeping space us

Medium · Coding & Algorithms

Solve a medium-level array manipulation problem, focusing on optimizing time complexity while keeping space usage minimal.

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?

Write a SQL query to join a patient demographics table with a clinical trials table, filtering for specific ge

Medium · Database & SQL

Write a SQL query to join a patient demographics table with a clinical trials table, filtering for specific genetic mutations and grouping by age.

Approach

  1. Name the grain you start from and join outward from it.
  2. Check whether any join is one-to-many before aggregating, or the sums inflate.
  3. Say which index the query would use, and what makes it unusable.
  4. Handle the rows that do not match: that is usually the actual question.

Follow-up

  • How does the query change if that join becomes one-to-many?
  • What happens to this when the table is ten times larger?

Given a schema of medical tests and results, write a query to find the top three most frequently ordered tests

Medium · Database & SQL

Given a schema of medical tests and results, write a query to find the top three most frequently ordered tests per hospital department.

Approach

  1. Name the grain you start from and join outward from it.
  2. Check whether any join is one-to-many before aggregating, or the sums inflate.
  3. Say which index the query would use, and what makes it unusable.
  4. Handle the rows that do not match: that is usually the actual question.

Follow-up

  • How does the query change if that join becomes one-to-many?
  • What happens to this when the table is ten times larger?

Explain the performance differences between SQL and NoSQL databases when storing unstructured clinical notes v

Medium · Database & SQL

Explain the performance differences between SQL and NoSQL databases when storing unstructured clinical notes versus structured patient records.

Approach

  1. Name the grain you start from and join outward from it.
  2. Check whether any join is one-to-many before aggregating, or the sums inflate.
  3. Say which index the query would use, and what makes it unusable.
  4. Handle the rows that do not match: that is usually the actual question.

Follow-up

  • How does the query change if that join becomes one-to-many?
  • What happens to this when the table is ten times larger?

Optimize a slow-running SQL query that utilizes multiple subqueries and window functions.

Medium · Database & SQL

Approach

  1. Name the grain you start from and join outward from it.
  2. Check whether any join is one-to-many before aggregating, or the sums inflate.
  3. Say which index the query would use, and what makes it unusable.
  4. Handle the rows that do not match: that is usually the actual question.

Follow-up

  • How does the query change if that join becomes one-to-many?
  • What happens to this when the table is ten times larger?

Design a scalable web service (REST API) using Node.js and Express that allows doctors to query patient record

Medium · System Design & Architecture

Design a scalable web service (REST API) using Node.js and Express that allows doctors to query patient records securely.

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?

Walk through the architecture of a real-time data ingestion pipeline that processes high-throughput genomic se

Medium · System Design & Architecture

Walk through the architecture of a real-time data ingestion pipeline that processes high-throughput genomic sequencing files.

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?

Design a notification service that alerts clinical research coordinators when a patient matches a new clinical

Medium · System Design & Architecture

Design a notification service that alerts clinical research coordinators when a patient matches a new clinical trial protocol.

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?

How would you handle state management and performance optimization in a complex, data-heavy dashboard built wi

Medium · System Design & Architecture

How would you handle state management and performance optimization in a complex, data-heavy dashboard built with React?

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?

Edge instances grow 400 MB per hour until the nightly restart

Hard · memory leak · heap analysis · metric cardinality

Edge API instances start at 700 MB resident and grow about 400 MB/hour; a nightly rolling restart has hidden it for weeks. Growth continues unchanged when request rate halves overnight, p99 degrades in the last hours before an instance is recycled, and heap used immediately after a forced full GC rises monotonically. The service holds no product state. Name the discriminating measurement that separates the plausible causes, give the most likely cause, and give the fix and how you would verify it.

Approach

  1. Separate resident memory from live heap first, because they fail differently. Resident size can grow from fragmentation, native buffers or thread stacks while the heap is flat; heap used after a full GC rising monotonically is the measurement that says objects are reachable and not being released. You already have it, so this is retention, not fragmentation, and that closes off half the candidate list.
  2. Use the rate's independence from traffic as the discriminator. Growth that continues at half the request rate rules out per-request objects that are merely slow to collect and points at a structure that grows with distinct values observed rather than with call volume. Write the candidates that have that property: a metrics registry keyed on a high-cardinality label, an unevicted cache, an interner, a per-key lock map.
  3. Take two heap snapshots an hour apart and diff by retained size, reading the dominator tree, not by allocation count or instance count. Expect one root holding a map with millions of entries, then follow the reference chain to the code that inserts and never removes. Allocation profilers point at churn, which is the wrong signal here.
  4. The candidate that fits this service is an observability label carrying an identifier, such as a request path recorded before templating so that /v1/resources/48213 becomes its own metric series. That grows with distinct ids seen, is independent of rate, and explains the late p99 degradation, since GC cost rises with the size of the live set.

Follow-up

  • Post-GC heap is now flat but resident size still creeps. What are you looking at, and does it matter?
  • How would you have detected this before an OOM, given the nightly restart masked the trend?

Suggested practice checklist

Built from the rounds and topics Tempus AI candidates report.

Day 1 — Map the Tempus AI loop

  • Write out the reported sequence: Recruiter Screen, Online Technical Assessment, Hiring Manager Screen, Multi-Stage Virtual Onsite.
  • 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 4 reported rounds, with the weakest marked.

Day 2 — Work Coding interviews (timed exercises)

  • Spend the session on Coding interviews (timed exercises), which Tempus AI candidates report being tested on.
  • Write one worked example in Coding interviews (timed exercises) and time yourself on it.

Deliverable: One timed worked example in Coding interviews (timed exercises).

Day 3 — Work JavaScript

  • Spend the session on JavaScript, which Tempus AI candidates report being tested on.
  • Write one worked example in JavaScript and time yourself on it.

Deliverable: One timed worked example in JavaScript.

Day 4 — Work System design

  • Spend the session on System design, which Tempus AI candidates report being tested on.
  • Write one worked example in System design and time yourself on it.

Deliverable: One timed worked example in System design.

Day 5 — Answer out loud: Coding & Algorithms

  • Answer aloud, timed: Write a function to calculate the TF-IDF (Term Frequency-Inverse Document Frequency) score for a set of clinical documents.
  • Answer aloud, timed: Given a string of brackets and characters, determine if the input string is valid and correctly balanced.

Deliverable: Spoken answers to 2 reported Coding & Algorithms question(s), under time.

Day 6 — Answer out loud: Database & SQL

  • Answer aloud, timed: Write a SQL query to join a patient demographics table with a clinical trials table, filtering for specific genetic mutations and grouping by age.
  • Answer aloud, timed: Given a schema of medical tests and results, write a query to find the top three most frequently ordered tests per hospital department.

Deliverable: Spoken answers to 2 reported Database & SQL question(s), under time.

Day 7 — Answer out loud: System Design & Architecture

  • Answer aloud, timed: Design a scalable web service (REST API) using Node.js and Express that allows doctors to query patient records securely.
  • Answer aloud, timed: Walk through the architecture of a real-time data ingestion pipeline that processes high-throughput genomic sequencing files.

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

Behavioural preparation

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

Why do you want to work at Tempus AI, and how does your background align with our mission in precision medicin

Medium · Behavioral & Leadership

Why do you want to work at Tempus AI, and how does your background align with our mission in precision medicine?

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 time when you had to work with shifting priorities and tight deadlines. How did you ensure the qual

Medium · Behavioral & Leadership

Describe a time when you had to work with shifting priorities and tight deadlines. How did you ensure the quality of your deliverables?

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?

Talk about a challenging technical conflict you had with a teammate. How did you resolve it, and what was the

Medium · Behavioral & Leadership

Talk about a challenging technical conflict you had with a teammate. How did you resolve it, and what was the outcome?

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 past project where you had to quickly learn a new technology or domain space to deliver a feat

Medium · Behavioral & Leadership

Tell me about a past project where you had to quickly learn a new technology or domain space to deliver a feature.

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?