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Upstate Medical University Software Engineer Interview Guide

Upstate Medical University Software Engineer interview guide: reported rounds, questions and how candidates describe the process.

The 60-second brief

The role of a Software Engineer at Upstate Medical University is pivotal in driving innovation and efficiency within the healthcare environment. This position plays a crucial role in developing, maintaining, and optimizing applications that support clinical and administrative functions, ultimately enhancing patient care and operational efficiency. You will work alongside multidisciplinary teams, contributing to projects that impact both the internal workflows of the university and the experiences of healthcare professionals and patients alike. As a Software Engineer, you will have the opportunity to engage in complex problem-solving, develop scalable solutions, and contribute to strategic initiatives that leverage technology to improve healthcare delivery.

This guide is scoped to a Software Engineer candidate at Upstate Medical University.

Focus areas

Communication (technical conversation)
Problem solving for IT operations
IT Department domain understanding

The Upstate Medical University interview process

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

Phone Screening

Initial call to assess candidate's background and fit for the role.

What to demonstrate

Initial call to assess candidate's background and fit for the role
Depth in Communication (technical conversation)

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.

Team Interviews

One or two rounds of interviews with team members focusing on technical skills and collaboration.

What to demonstrate

One or two rounds of interviews with team members focusing on technical skills and collaboration
Depth in Communication (technical conversation)

How to prepare

Answer aloud and timed: What do you feel has been your greatest work-related accomplishment?
Answer aloud and timed: What is your greatest strength?

Leadership Interview

Interview with leadership to evaluate cultural fit and communication skills.

What to demonstrate

Interview with leadership to evaluate cultural fit and communication skills
Depth in Communication (technical conversation)

How to prepare

Answer aloud and timed: What would be your priority on the first day in this position?
Answer aloud and timed: Explain a challenging technical problem you’ve solved.

Where candidates lose points

Understand the Healthcare Environment

Familiarize yourself with the unique challenges and considerations in healthcare technology, as this knowledge will be beneficial during discussions.

Practice Behavioral Questions

Prepare specific examples that demonstrate your problem-solving abilities and teamwork experiences, as these are likely to be focal points in interviews.

Show Enthusiasm for Learning

Highlight your willingness to learn new technologies and adapt to changing environments, which is highly valued at Upstate Medical University.

Network with Current Employees

If possible, connect with current or former employees to gain insights into the culture and expectations, providing you with an edge in your interviews.

Questions & practice

Find overlapping job attempts and peak concurrency from lease records

Medium · sweep line · intervals · leases

A day of job_run history yields about 50,000,000 attempt records: (job_run_id, job_type, attempt, started_at, finished_at which is NULL when the worker died, lease_expires_at). Leases expire on a clock, so a job that outran its lease ran twice. Produce (a) every job_run_id whose attempts overlapped in wall-clock time and (b) the peak number of simultaneously running attempts per job_type with the minute it occurred. Target O(n log n). State how you treat a NULL finished_at and what clock skew does to your answer.

Approach

Define the interval before sorting anything: an attempt occupies [started_at, COALESCE(finished_at, lease_expires_at)). finished_at is observed and lease_expires_at is only a promise, so every attempt without a finish contributes an estimate and the whole result is a lower bound on overlap rather than an exact count.
For peak concurrency, sweep: emit 2n endpoints, sort by (timestamp, kind) with ends ordered before starts at equal timestamps, then walk the sequence maintaining a counter per job_type and record each type's maximum with its timestamp. O(n log n) dominated by the sort, O(n) space, or O(1) extra if the sort is external and the walk streams.
For overlap detection, do not compare attempts pairwise. A single global sort by (job_run_id, started_at) gives both the grouping and the order; within a group, keep the maximum end seen so far and report an overlap exactly when the next start is less than that running maximum, which is one linear pass after the sort.
Half-open intervals matter and are easy to get wrong: with closed intervals an attempt ending at the same millisecond another begins reads as concurrency two, and across 50,000,000 records that artefact swamps the real signal.

Follow-up

A handler is not idempotent and you have found 400 overlapping jobs. Which of them actually caused damage, and what would you query to find out?
Peak concurrency for one job_type is 4 against a configured cap of 4. Is the cap working, or is the data hiding attempts that never started?

Collapse a redelivered event batch into per-aggregate high-water marks

Easy · hashing · at-least-once · aggregation

You drain a batch of up to 5,000,000 events, each (aggregate_id BIGINT, aggregate_version INT, event_type, payload). The log guarantees order within one aggregate only; the batch merges 64 partitions, and a relay failover has redelivered a range, so an older version for an aggregate can appear after a newer one. Given a map of last_applied_version per aggregate, produce the events worth applying, at most one per (aggregate_id, version), plus the count discarded. Target O(n) time. State the memory for 2,000,000 distinct aggregates and what you do when it does not fit.

Approach

One pass, one hash map from aggregate_id to the highest version kept, and a discard counter. An event whose version is at or below last_applied_version for its aggregate is dropped without further work, which is the whole reason the event carries its version rather than a delta. O(n) expected time, O(d) space in distinct aggregates.
Keep the maximum, never the last occurrence. The redelivered range means the final appearance of an aggregate in the batch can be an older version than one seen earlier in the same batch, so last-wins applies stale state over newer state and the projection regresses with no error anywhere.
Cost the memory instead of calling it large: an 8-byte key plus a 4-byte version is 12 bytes of payload, and an open-addressed table held at a 0.7 load factor costs roughly 17 bytes per entry before per-slot metadata, so 2,000,000 aggregates is tens of megabytes in a native layout and several times that in a runtime that boxes both key and value.
If the distinct set exceeds memory, partition on hash(aggregate_id) mod P and reduce each partition independently. Every event for one aggregate hashes to the same partition, so the per-partition result is exact and the merge is concatenation rather than a second reduction.

Follow-up

The payload is a patch rather than a snapshot, so applying only the highest version loses the intermediate changes. What changes in your reduction?
How do you detect that version 7 arrived while version 6 was never delivered, and what should the consumer do about the gap?

Diff a projection against the primary without per-row point reads

Hard · reconciliation · range hashing · throttling

The listing projection has drifted and some rows show a stale version. The primary holds 40,000,000 resource rows across 12,000 tenants while serving 1,200 writes and 14,000 reads per second. The obvious repair, reading each resource row and comparing its version against the projection, is correct and would eventually finish. Explain precisely why it is unacceptable here, then give a diff that finds the differing rows, state its complexity, and make it safe to run against a live primary. Replication lag is usually under 100 ms and is not bounded.

Approach

Quantify the naive cost rather than calling it slow: 40,000,000 point reads at even 0.5 ms each is over five hours serialised, and the only lever is concurrency, which is exactly what you cannot spend. The primary's pool is sized for the write path, and 40,000,000 random reads evict the buffer cache that sustains the 85 percent cache hit rate, so the audit degrades the system it is auditing.
Replace random access with one ordered pass per side. Both sides can be read in (tenant_id, resource_id) order, which is a sequential scan on each and a merge join in O(n) time and O(1) memory. For a dense diff that is the whole answer, and it reads the primary once instead of 40,000,000 times.
For the expected sparse case, compare range hashes instead of rows: partition the key space, compute per range an order-independent aggregate over hash(resource_id, version), compare aggregates, and descend only into ranges that differ. With d differing rows and branching factor B, at most d ranges mismatch per level, so the drill-down examines O(d log_B(n/d)) ranges and reads full rows only in mismatching leaves.
Aggregate with a sum modulo 2^64 or a multiset hash, never XOR. XOR is order-independent but self-cancelling, so two rows wrong in the same way, or a row duplicated on one side, leave the range aggregate matching and the range is declared clean.

Follow-up

The diff reports 900 stale rows. How do you decide between patching those rows and rebuilding the projection from resource_revision?
Same job, but the projection lives in a search index that cannot be scanned in key order. What changes?

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

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.
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.
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.
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?

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

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.
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.
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.
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?

Explain a challenging technical problem you’ve solved.

Medium · Technical Questions

Approach

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

Follow-up

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

Can you describe a software project you led or contributed to significantly?

Medium · Technical Questions

Approach

Clarify what is being asked and what a complete answer contains.
State your assumptions explicitly before working the problem.
Say what you would check first and why it is the highest-information step.
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 programming languages are you proficient in, and which do you prefer for specific tasks?

Medium · Technical Questions

Approach

Clarify what is being asked and what a complete answer contains.
State your assumptions explicitly before working the problem.
Say what you would check first and why it is the highest-information step.
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 optimize a slow-running application?

Medium · Problem-Solving Questions

Approach

Clarify what is being asked and what a complete answer contains.
State your assumptions explicitly before working the problem.
Say what you would check first and why it is the highest-information step.
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 how you would handle a situation where a project deadline is at risk.

Medium · Problem-Solving Questions

Approach

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

Follow-up

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

Give an example of a complex problem you solved and the steps you took to reach a solution.

Medium · Problem-Solving Questions

Approach

Clarify what is being asked and what a complete answer contains.
State your assumptions explicitly before working the problem.
Say what you would check first and why it is the highest-information step.
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 simple application for managing patient records.

Medium · System Design Questions

Approach

Fix the scope first: who calls this, how often, and what they do when it fails.
Name the read and write paths separately; they rarely have the same bottleneck.
Choose a partition key and say what query it makes expensive.
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 ensure your application is scalable and maintainable?

Medium · System Design Questions

Approach

Fix the scope first: who calls this, how often, and what they do when it fails.
Name the read and write paths separately; they rarely have the same bottleneck.
Choose a partition key and say what query it makes expensive.
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 considerations would you take into account for data security in a healthcare application?

Medium · System Design Questions

Approach

Fix the scope first: who calls this, how often, and what they do when it fails.
Name the read and write paths separately; they rarely have the same bottleneck.
Choose a partition key and say what query it makes expensive.
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 do you approach debugging an application?

Medium · Technical Questions

Approach

Establish what changed and when, before forming any theory.
Pick a bisection that eliminates candidates whichever way it turns out.
Check the instrumentation before believing the symptom.
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 Upstate Medical University candidates report.

Day 1 — Map the Upstate Medical University loop

Write out the reported sequence: Phone Screening, Team Interviews, Leadership 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 Communication (technical conversation)

Spend the session on Communication (technical conversation), which Upstate Medical University candidates report being tested on.
Write one worked example in Communication (technical conversation) and time yourself on it.

Deliverable: One timed worked example in Communication (technical conversation).

Day 3 — Work Problem solving for IT operations

Spend the session on Problem solving for IT operations, which Upstate Medical University candidates report being tested on.
Write one worked example in Problem solving for IT operations and time yourself on it.

Deliverable: One timed worked example in Problem solving for IT operations.

Day 4 — Work IT Department domain understanding

Spend the session on IT Department domain understanding, which Upstate Medical University candidates report being tested on.
Write one worked example in IT Department domain understanding and time yourself on it.

Deliverable: One timed worked example in IT Department domain understanding.

Day 5 — Answer out loud: Behavioral Questions

Answer aloud, timed: Please tell us about yourself.
Answer aloud, timed: Why do you want to work for us?

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

Day 6 — Answer out loud: Technical Questions

Answer aloud, timed: Explain a challenging technical problem you’ve solved.
Answer aloud, timed: How do you approach debugging an application?

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

Day 7 — Answer out loud: Problem-Solving Questions

Answer aloud, timed: How would you optimize a slow-running application?
Answer aloud, timed: Describe how you would handle a situation where a project deadline is at risk.

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