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The Ohio State University Wexner Medical Center Software Engineer Interview Guide

The Ohio State University Wexner Medical Center Software Engineer interview guide: reported rounds, questions and how candidates describe the process.

The 60-second brief

As a Software Engineer at The Ohio State University Wexner Medical Center, you will play a pivotal role in developing and maintaining software solutions that support critical healthcare operations. This position is crucial for enhancing patient care through technology, ensuring that the medical center's systems are efficient, secure, and user-friendly. You will be involved in designing and implementing software that impacts both clinical and administrative functions, thereby directly influencing the quality of healthcare delivery. The complexity of the projects you will engage in ranges from developing electronic health record systems to creating applications that streamline patient management processes. You will collaborate with multidisciplinary teams, including healthcare professionals, to understand their needs and translate them into technical requirements.

This guide is scoped to a Software Engineer candidate at The Ohio State University Wexner Medical Center.

Focus areas

  • Technical Interview Questioning
  • Preparation for Interview Domain Knowledge
  • Problem Solving

The The Ohio State University Wexner Medical Center interview process

The Ohio State University Wexner Medical Center candidates report 3 rounds over 3-5 weeks. The stages below are what candidates describe, not a published process.

Screening Interview

Initial interview conducted via video call, discussing your resume and technical questions.

What to demonstrate

  • Initial interview conducted via video call, discussing your resume and technical questions
  • Depth in Technical Interview Questioning

How to prepare

  • Answer aloud and timed: What programming languages are you most comfortable with, and why?
  • Answer aloud and timed: Explain the difference between object-oriented and functional programming.

Technical Assessment

In-depth technical assessments including coding exercises and system design interviews.

What to demonstrate

  • In-depth technical assessments including coding exercises and system design interviews
  • Depth in Technical Interview Questioning

How to prepare

  • Answer aloud and timed: Can you describe a project where you implemented a complex algorithm? What challenges did you face?
  • Answer aloud and timed: How do you ensure the scalability and maintainability of your code?

Behavioral Interview

Interviews focusing on your leadership and teamwork experiences.

What to demonstrate

  • Interviews focusing on your leadership and teamwork experiences
  • Depth in Technical Interview Questioning

How to prepare

  • Prepare three examples from your own work, each with a decision you made and an outcome you can quantify.
  • Re-read the description of the behavioral interview above and write down what you would ask to confirm before it.

Where candidates lose points

Tailor Your Responses

Align your answers with the mission and values of The Ohio State University Wexner Medical Center. Demonstrating your understanding of their goals will resonate well with interviewers.

Practice Coding

Be prepared to solve coding problems in real-time. Use platforms like LeetCode or HackerRank to sharpen your skills before the interview.

Engage with Interviewers

Ask questions that show your interest in the role and the organization. This not only demonstrates your enthusiasm but can also provide valuable insight into the team dynamics.

Showcase Teamwork

Emphasize your collaborative experiences, especially those involving multidisciplinary teams. Highlight how you have successfully worked with diverse groups in the past.

Questions & practice

Can you describe a project where you implemented a complex algorithm? What challenges did you face?

Medium · Technical / Domain Questions

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 function to reverse a linked list.

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 search algorithm in a sorted array?

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 time complexity of your solution?

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 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?

Stop tag and share joins from fanning out a page

Medium · join fan-out · semi-joins · many-to-many

resource_tag is (resource_id, tag_id) with PK (resource_id, tag_id); resource_share is (resource_id, shared_with_user_id, permission). The tagged-and-shared listing inner-joins resource to both, filters tenant_id, tag_id = ANY($2) and shared_with_user_id = $3, orders by updated_at DESC and takes 50. Pages come back with fewer than 50 distinct resources and the total in the header is far too high. Explain the row multiplication, rewrite both the page query and the count query so each is correct, and name the index each one needs. PostgreSQL 16.

Approach

  1. Do the arithmetic against the predicates that are actually there. An inner join emits one row per matching child row, and both joins are filtered: tag_id = ANY($2) admits only the requested tags, shared_with_user_id = $3 admits one user's share rows. So a resource holding three of the requested tags and shared with $3 once yields three rows, not one — the multiplier is its count of matching tags times its share rows for that single user, and that second factor is 1 unless the table admits duplicate (resource_id, shared_with_user_id) pairs. LIMIT 50 then limits rows rather than resources, and COUNT(*) counts pairs — the header is the product, not the population.
  2. Reject DISTINCT as the fix. It deduplicates after the product has been built, so the planner must materialise and sort the fanned-out set before the LIMIT can apply, and it leaves any SUM or AVG in the same select list wrong.
  3. Rewrite both filters as semi-joins, keeping resource as the only row source: AND EXISTS (SELECT 1 FROM resource_tag rt WHERE rt.resource_id = r.resource_id AND rt.tag_id = ANY($2)) and the same shape against resource_share. A semi-join stops at the first match per resource and preserves the driving index order, so ORDER BY updated_at DESC, resource_id DESC LIMIT 50 still stops after 50 rows.
  4. Count with the same predicates and no join at all: SELECT count(*) FROM resource r WHERE r.tenant_id = $1 AND r.status = 'active' AND EXISTS (...) AND EXISTS (...). Nothing multiplies a resource, so the number is the population.

Follow-up

  • The filter changes from 'any of these tags' to 'all of these tags'. Rewrite it and state what it costs relative to the ANY form.
  • A resource can be shared with the same user twice under different permissions. Does your count change, and should it?

What programming languages are you most comfortable with, and why?

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?

Explain the difference between object-oriented and functional programming.

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 scalability and maintainability of your code?

Medium · Technical / Domain Questions

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 tools do you use for version control and project management?

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?

Design a system for a patient management application. What key components would you include?

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?

How would you approach integrating new software with existing medical systems?

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?

What considerations would you take into account when designing a high-availability system?

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?

Discuss how you would ensure data security and compliance in your designs.

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?

Given a scenario where a system is underperforming, how would you diagnose the issue?

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?

Propose a solution to improve the efficiency of a legacy system.

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 prioritize multiple urgent project requests from different stakeholders?

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?

p99 jumped on one listing filter while p50 stayed flat

Medium · query planning · composite index · percentiles

After a release that added an owner_user_id filter to the resource listing, p99 rose from 90 ms to 1.9 s while p50 stayed at 40 ms. Traffic and row counts are unchanged. resource carries the index (tenant_id, status, updated_at DESC, resource_id DESC). The new query filters tenant_id and owner_user_id, orders by updated_at DESC, resource_id DESC, and takes 20 rows. On PostgreSQL, explain the shape of the regression, prove it from a query plan, and give the index you would add.

Approach

  1. Start from the shape. A flat p50 with a moved p99 means a subset of requests changed cost, not all of them, so the first job is naming the subset. Bucket the endpoint's latency by the tenant's row count; the natural hypothesis is that large tenants are a small share of requests and all of the tail.
  2. Get the plan for the new query on a large tenant with EXPLAIN (ANALYZE, BUFFERS). Expect an index scan over the tenant's range, a filter discarding most of it, then a Sort feeding the Limit, possibly reporting Sort Method: external merge Disk. Read actual rows on the scan node, not estimated.
  3. Explain why the existing index cannot serve it. A composite B-tree is seekable only as a left prefix, and with no equality predicate on status the scan cannot treat updated_at as an ordering, because rows in the tenant's range are ordered by status first. Everything matching must be read and sorted before LIMIT 20 can apply, so a tenant with 400,000 rows pays 400,000 rows to return 20.
  4. Add (tenant_id, owner_user_id, updated_at DESC, resource_id DESC). Equality on the first two columns leaves the index ordered by updated_at within that pair, so the plan becomes an index scan that stops after 20 rows with no Sort node. PostgreSQL can scan a B-tree backwards, so the DESC markers matter only if the two sort columns ever disagree in direction; keeping them explicit documents the order the keyset cursor depends on.

Follow-up

  • The endpoint paginates with OFFSET. What does page 500 cost with your index, and what does the keyset version cost?
  • How would you have caught this before release, given that a 10,000-row seed database produces the same plan shape at an unnoticeable cost?

Suggested practice checklist

Built from the rounds and topics The Ohio State University Wexner Medical Center candidates report.

Day 1 — Map the The Ohio State University Wexner Medical Center loop

  • Write out the reported sequence: Screening Interview, Technical Assessment, Behavioral 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 3 reported rounds, with the weakest marked.

Day 2 — Work Technical Interview Questioning

  • Spend the session on Technical Interview Questioning, which The Ohio State University Wexner Medical Center candidates report being tested on.
  • Write one worked example in Technical Interview Questioning and time yourself on it.

Deliverable: One timed worked example in Technical Interview Questioning.

Day 3 — Work Preparation for Interview Domain Knowledge

  • Spend the session on Preparation for Interview Domain Knowledge, which The Ohio State University Wexner Medical Center candidates report being tested on.
  • Write one worked example in Preparation for Interview Domain Knowledge and time yourself on it.

Deliverable: One timed worked example in Preparation for Interview Domain Knowledge.

Day 4 — Work Problem Solving

  • Spend the session on Problem Solving, which The Ohio State University Wexner Medical Center candidates report being tested on.
  • Write one worked example in Problem Solving and time yourself on it.

Deliverable: One timed worked example in Problem Solving.

Day 5 — Answer out loud: Technical / Domain Questions

  • Answer aloud, timed: What programming languages are you most comfortable with, and why?
  • Answer aloud, timed: Explain the difference between object-oriented and functional programming.

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

Day 6 — Answer out loud: System Design / Architecture

  • Answer aloud, timed: Design a system for a patient management application. What key components would you include?
  • Answer aloud, timed: How would you approach integrating new software with existing medical systems?

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

Day 7 — Answer out loud: Behavioral / Leadership

  • Answer aloud, timed: Share an instance where you had to lead a team through a challenging project.
  • Answer aloud, timed: How do you handle conflicts within a team?

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.

Share an instance where you had to lead a team through a challenging project.

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 handle conflicts within a team?

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 time when you had to advocate for a technical decision.

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?

What motivates you to work in the healthcare technology space?

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?