Akumin · Software Engineer
Updated · 2026-09-24

Akumin Software Engineer
Interview Questions & Guide 2026

THE 60-SECOND BRIEF

As a Software Engineer at Akumin, you are at the intersection of advanced healthcare technology and operational excellence. This role is critical to the company’s mission of providing high-quality diagnostic imaging and cancer care services, where your software solutions directly impact the efficiency of clinicians and the experience of patients. You are not just writing code; you are building the digital infrastructure that powers complex medical workflows.

Find out what you will be typing into. A shared plain-text editor with no autocomplete, compiler or test runner changes what you have to hold in your head, and practising inside your own configured environment hides exactly that gap.

Akumin candidates report 2 rounds · ≈ 2-4 weeks. The stages below are what candidates describe, not a published process.

Choose indexes from the query's access pathBound every outbound call with a timeoutPaginate large result sets with keyset cursors

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15Practice promptsAcross five skill areas
3With worked solutionsIncluded in the practice prompts

As a Software Engineer at Akumin, you are at the intersection of advanced healthcare technology and operational excellence. This role is critical to the company’s mission of providing high-quality diagnostic imaging and cancer care services, where your software solutions directly impact the efficiency of clinicians and the experience of patients. You are not just writing code; you are building the digital infrastructure that powers complex medical workflows.

You will likely focus on specialized systems such as Radiology Information Systems (RIS) or Salesforce Revenue Cloud integrations. Your work ensures that data flows seamlessly across the organization, allowing healthcare providers to focus on patient outcomes rather than administrative hurdles. This role demands a balance of technical precision and the ability to translate complex business requirements into scalable, reliable software.

Expect to work in an environment where your contributions have high visibility. Whether you are managing revenue cloud architectures or optimizing application performance for diagnostic tools, you will be a key contributor to the technological backbone of. This is a role for engineers who thrive on solving complex, mission-critical problems in a fast-paced healthcare environment.

01

Initial Screening

reported

The person on this call usually cannot evaluate your code and does not need to. They write a short paragraph, and that paragraph is what a hiring manager skims when deciding who to put on your loop. So the test is not whether your work was hard, it is whether a non-engineer can repeat it correctly. Name systems by what they did rather than by their internal codename, give each project a shape (what was breaking, what you changed, what happened after), and keep the whole walkthrough near ninety seconds. Depth that cannot survive a paraphrase reads as vagueness.

What to demonstrate

  • Whether a non-engineer can restate your projects without distorting them, since their paraphrase is what travels to the hiring manager, not your sentences
  • Whether each project has a shape rather than a stack list: the failure or constraint, the change you made, the result and how it was measured
  • Whether you can say what was yours inside a team project without either inflating it or disappearing into the plural

How to prepare

  • Rewrite each headline project as two sentences with no internal system names and no acronyms outside your company, then say them to someone outside engineering and have them repeat them back. Fix whatever came back wrong
  • Attach one measured number to each project: the baseline, the change, and the window it was measured over. Where nothing was ever measured, say that plainly rather than reaching for a plausible percentage
  • Time the background walkthrough against a clock. If it runs past two minutes, compress the earliest role to a single clause and spend the recovered time on the most recent one
PracHub interview research ↗
02

Technical Evaluations

reported

Input bounds are the part of the prompt most often skimmed, and they usually contain the answer. They tell you which complexity class is admissible, which narrows the search before you have thought about the problem itself. As a rough planning figure, a compiled language does on the order of 10^8 simple operations per second and an interpreted one roughly an order of magnitude less. So n up to about twenty admits enumerating subsets, a few thousand admits a quadratic pass, and a million admits neither: you need near-linear, or linear with a log factor. If the bounds are missing, ask for them.

What to demonstrate

  • Whether the approach is justified by the stated input size rather than by whichever pattern you recognised first
  • Whether you ask about the properties that change the algorithm: whether the input arrives sorted, whether duplicates occur, whether values are bounded integers, whether it all fits in memory
  • Whether you can name the bottleneck in your own solution and what would remove it, even when you deliberately leave it in place
  • Whether a claimed speedup is real, since memoising a recursion only helps when subproblems genuinely overlap and the state can be keyed cheaply

How to prepare

  • For each algorithm you rely on, write down the largest n it handles in roughly a second, then check two of those figures by timing them in the language you will actually type in
  • For two weeks, write one line naming your target complexity and the bound that justifies it before you write any code, then compare that line with what you ended up submitting
  • Practise the conversion backwards: given a required O(n log n), list the mechanisms that get you there (sorting, a heap, an ordered map, divide and conquer) and choose by what the problem needs to query, not by what you used last
PracHub interview research ↗

PracHub editorial advice for the preparation topics above.

01

Running a schema change as though the lock lasts as long as the statement

In PostgreSQL an ALTER TABLE that needs an ACCESS EXCLUSIVE lock must first wait for every open transaction touching that table, and while it waits, later queries needing a conflicting lock queue behind it rather than overtaking it. A DDL statement that would execute in milliseconds, issued while a thirty-second analytics query is open, therefore stalls all traffic on that table for thirty seconds: the outage length is set by the longest open transaction, not by the change. The defences are specific and worth knowing by name - set lock_timeout low and retry rather than queue, add columns without a volatile default so no table rewrite occurs (from version 11 a non-volatile default is a metadata-only change), build indexes with CREATE INDEX CONCURRENTLY while accepting that it cannot run inside a transaction block and leaves an invalid index behind if it fails, and add constraints as NOT VALID followed by a separate VALIDATE CONSTRAINT, which takes a weaker lock.

02

Choosing an index from the columns a query mentions rather than from how it filters and orders

A composite B-tree index on (a, b, c) can be seeked only as a left prefix: equality on a, then equality on b, then a range or an ordering on c. A query that filters on b alone cannot seek into it at all and at best gets a full scan of the index; a query that filters a and ranges on b gets no benefit from c, because the index is only sorted by c within a fixed (a, b) pair. The practical consequence is that one index per column is close to useless for multi-predicate queries while a single correctly ordered composite index turns a scan into a lookup. The ordering half is what gets missed: if the index cannot satisfy the ORDER BY, the database must read every matching row and sort before the limit can apply, so a LIMIT 20 over a million matching rows still reads a million rows.

03

Saying 'eventually consistent' without naming the anomaly a user would see

Describe the concrete symptom you are choosing to accept: the author reloads and their own comment is missing for two seconds, or two devices show different balances for a minute. The class of consistency model is a technical label; the tolerable anomaly is the actual product decision.

04

A cache with no invalidation story

Say how an entry goes stale, how long you can serve it stale, and what happens when many requests miss the same key at the same instant. One popular key expiring under load sends every concurrent request to the origin together; single-flight coalescing, jittered expiry, or serving stale while revalidating are the standard answers.

Choose a category, try a prompt, then open its approach, worked solution or follow-up when you need it.

12 technical prompts3 include a worked solution

Track a rolling failure rate per destination for circuit decisions

easy
sliding windowring buffercircuit breaker

The egress service delivers about 1,500 webhooks per second across roughly 40,000 destinations, each call bounded by a 10 second timeout. Maintain, per destination, the failure rate over the trailing 60 seconds so a caller can ask before dispatch whether the circuit should open. Attempts arrive as (destination_id, finished_at_ms, outcome). Requirement: amortised O(1) per attempt, with total memory bounded by the destination count rather than by traffic. Give the structure, its exact memory, and the rule that stops a destination with three attempts from opening a circuit.

Approach
  1. Name the exact-deque version and then reject it as the default. Holding timestamps and advancing a tail pointer past anything older than now minus 60 seconds is a correct two-pointer window at amortised O(1) per attempt, but its memory tracks in-window traffic, so one destination in a retry storm holds hundreds of thousands of entries while thousands of quiet destinations hold none.
  2. Use a ring of 60 one-second buckets per destination, each bucket a pair of counters for attempts and failures. On an attempt, advance the ring by the elapsed whole seconds, zeroing at most min(elapsed, 60) buckets, then increment the head. That is amortised O(1) with a fixed footprint per destination.
  3. State the footprint: 60 buckets times two 4-byte counters is 480 bytes of payload per destination, so 40,000 destinations is roughly 20 to 25 MB with per-entry overhead, bounded by the catalogue rather than by the rate. The cost is granularity, since the oldest bucket ages out in whole seconds, which is far tighter than the decision needs.
  4. Require a minimum sample before the circuit may open. A destination with three attempts and three failures reads as 100 percent and is not evidence; a floor of roughly 20 attempts in the window makes the ratio meaningful, and below that floor use a run of consecutive failures as the trigger instead.
  5. Expire idle destinations, or memory grows with every destination ever seen rather than with the live set. Hold the rings in a bounded LRU keyed on destination_id and treat a miss as no history, which is the correct default for an endpoint that has been silent for a minute.
  6. Keep the half-open probe out of the window arithmetic. After the circuit opens, one probe per interval decides whether to close it, and folding that single success into a window that still holds a 100 percent failure history would reopen the destination on one data point.
Follow-up
  • The fleet is 30 instances and each sees roughly a thirtieth of a destination's traffic. Where does the rate actually live, and what does a per-instance answer get wrong?
  • A destination answers in 9.5 seconds and succeeds. It is not failing but it is consuming your per-destination concurrency. What signal should open the circuit here?
  • How would you make the window survive a process restart, and is it worth the cost?

Find overlapping job attempts and peak concurrency from lease records

mediumWorked solution
sweep lineintervalsleases

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
  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. State the clock caveat: started_at and finished_at are written by different workers, so under skew of a few hundred milliseconds an apparent overlap shorter than that bound is not evidence. Filter reported overlaps by a minimum duration, or prefer timestamps written by whichever component heartbeats the lease.
  6. Scale the sort rather than assuming it fits: the sweep emits two endpoints per attempt, so 50,000,000 records become 100,000,000 endpoints, and at roughly 24 bytes each, an 8-byte timestamp plus a 4-byte job_type plus a kind flag padded to alignment, that is about 2.4 GB of sort keys before any scratch space. Either push the ordering into the database behind an index on (job_type, started_at) or run an external merge sort in chunks; the overlap pass sorts n records rather than 2n, so it is the cheaper of the two.
Worked solution 30 min
  1. Write the interval derivation with the COALESCE and state in one line which of the two end sources is observed and which is assumed.
  2. Write the concurrency sweep: the endpoint tuples, the sort key including the end-before-start tie-break, and the per-job_type counter.
  3. Hand-trace four attempts of one job, two disjoint and two overlapping by three seconds, and confirm the overlap detector fires exactly once.
  4. Add the skew filter as a minimum overlap duration, state the value you chose, and justify it from how the timestamps are written.
EXPECTED RESULTOne global sort by (job_run_id, started_at) driving a running-maximum-end check for overlaps, plus a sweep over 2n endpoints with ends ordered before starts for per-job_type peak concurrency, both O(n log n), with half-open intervals, NULL finished_at falling back to lease_expires_at, and overlaps shorter than the clock-skew bound excluded.
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?
  • How would you compute both answers incrementally as records arrive rather than in a daily batch?

Merge partitioned event streams into one ordered feed with bounded lateness

hard
k-way mergewatermarksout-of-order streams

The read-model service consumes 64 log partitions carrying about 4,000 events per second in total. Each partition is ordered within itself, but partitions drift by up to 30 seconds, and the activity feed must present a tenant's events in occurred_at order. Produce the merge. State its complexity, the buffer it requires in events and in bytes, what happens when one partition is idle, and what you do with an event that arrives after you have already emitted its position. Payloads average 1 KB.

Approach
  1. Merge with a min-heap over the 64 partition heads keyed on (occurred_at, event_id): O(log P) per event and O(n log P) overall. The tie-break on event_id is what makes the output deterministic when two partitions carry the same millisecond, which matters because the feed is paginated and a non-deterministic order reorders pages under the reader.
  2. Emitting the heap head is only correct once every partition has produced everything up to that timestamp, so the emit condition is a watermark: the minimum across partitions of the highest occurred_at seen, less the allowed lateness. Events are held until the watermark passes them, which is what turns individually ordered streams into a jointly ordered one.
  3. Size the buffer from the lateness rather than guessing: 4,000 events per second times 30 seconds is 120,000 buffered events, and at 1 KB each about 120 MB of heap. That number is the real price of the ordering guarantee and belongs in front of whoever asked for it.
  4. Handle the idle partition explicitly, because it fails the feed rather than corrupting it: a partition with no traffic never advances its own maximum, so the watermark freezes and output stops entirely. Either every partition emits a periodic idle marker carrying the broker's current time, or the watermark falls back to wall clock for a partition silent beyond a threshold.
  5. Choose the late-event policy from what the projection is keyed on. The projection upserts on (aggregate_id, aggregate_version) and discards a version it has already applied, so a late event is safe to apply out of order and correctness never depended on the merge at all. Apply it, recompute the affected feed page, and count lateness so the 30-second budget can be re-derived from data rather than folklore.
  6. Say what the merge does not buy: ordering is guaranteed within one aggregate by the log's partitioning, and no watermark makes the cross-aggregate order authoritative. Two events from different aggregates in the same millisecond have no true order, so the feed's order is a presentation choice that must be stable rather than correct.
Follow-up
  • The lateness budget is raised to five minutes. What is the new buffer, and what besides memory changes?
  • The consumer restarts. Where does it resume from, and what does the feed look like for the first 30 seconds?
  • One partition is ten minutes behind because its producer is slow. Do you stall the feed or emit without it?

Roughly ninety minutes on weeknights with one longer weekend block. The plan cuts scope rather than compressing everything, on the assumption that one thing finished per night beats four half-started.

Small steps. Visible outcomes.0 / 7 completed
ONE WEEK · YOUR PACE

Prepare, practise & reflect

One practical outcome each day. Spend longer where you need it.

0 / 7 done
01Fix the scope and take a cold baseline
  • Read the role description and write the three things the loop will almost certainly test, then write an explicit not-doing list and keep it visible all week.
  • Take one twenty-five-minute coding problem and one fifteen-minute design prompt cold, and write the single sentence naming what blocked each, because those two sentences decide where the remaining evenings go.
  • Set the week's rule: one thing finished every night, including the night you only have forty minutes.

Deliverable: A one-page scope with a not-doing list and two cold attempts, each carrying one sentence on what blocked it.

Practice prompt ↗Practice prompt ↗Practice prompt ↗Worked solution ↗
02One pattern, written three times from blank
  • Choose the single pattern most likely to appear in your loop and write it three times from an empty file rather than editing the previous attempt.
  • On the third pass, write the invariant as a comment before the loop body and the complexity before the first line of code.
  • Stop at ninety minutes even if the third version is imperfect, and write the one thing you would fix given another hour.

Deliverable: Three independent implementations of the same pattern plus a note on what changed between them.

Practice prompt ↗Practice prompt ↗
03One design, only to the depth you can defend
  • Take one system shape and go only as far as requirements, interface and data model, refusing to draw a box you could not survive a follow-up about.
  • Attach one number to each non-functional requirement, deriving it rather than asserting it, and write the assumption the number rests on.
  • Write the one tradeoff you are choosing against and the observation that would make you reverse it.

Deliverable: One design at interface-and-schema depth with derived numbers and one written reversible tradeoff.

Practice prompt ↗Practice prompt ↗
04Only the fundamentals you will have to defend
  • Write, in under two hundred words each, the answers to the two questions that follow almost any implementation: why this structure and not the obvious alternative, and what happens to this code at a hundred times the input.
  • Write what an index actually costs: faster lookups on the indexed columns against a write that now maintains a second structure, plus the cases where the planner declines to use it anyway, low selectivity, or a predicate wrapping the column in a function.
  • Delete any answer you cannot deliver aloud in under a minute, since an answer that needs reading is not an answer you have.

Deliverable: Three written answers, each under two hundred words and each timed aloud.

Practice prompt ↗Practice prompt ↗Worked solution ↗
05Your own work, timed
  • Write a ninety-second and a four-minute version of your main project and time both aloud rather than reading them.
  • Prepare the two follow-ups that always come: what you would do differently, and how you knew it worked.
  • Put one number in the first sentence and be ready to say exactly where it came from and what it excludes.

Deliverable: Two timed narratives with one defensible number in the opening line.

Practice prompt ↗Practice prompt ↗
06The one full rehearsal, in the weekend block
  • Run a sixty-minute mock covering a coding round and a design round in one sitting with no break, because sustained attention is the thing evenings have not trained.
  • Immediately afterwards, and before hearing any feedback, write the three moments you lost the thread.
  • Spend the rest of the block only on those three moments, and on nothing you merely feel shaky about.

Deliverable: Mock notes naming three failure moments with a specific fix written under each.

Practice prompt ↗Practice prompt ↗
07Taper
  • Write the twenty-minute warm-up you will actually do on the morning: one problem you can already solve from a blank file, one design you can narrate, and nothing you have never seen.
  • Re-read only your own notes from this week and open no new material.
  • Write the logistics down: the editor or shared document you will be working in, whether execution and lookups are permitted, and the sentence you will use when you do not know something.

Deliverable: A one-page card holding the design structure, the project numbers, and the logistics.

Practice prompt ↗Practice prompt ↗Worked solution ↗

Expand any day for tasks and deliverables. Your progress is saved on this device.

Conflict answers where you were right and everyone came round are the weakest ones. Stronger: the evidence you went and collected, what would have changed your mind, and what you did in the weeks after the call went against you. Implementing a design you argued against, properly, is a specific and checkable behaviour.

Tell me about a time you had to explain a technical issue to a non-tec…

medium
behavioural and engineering judgement

Tell me about a time you had to explain a technical issue to a non-technical stakeholder.

Approach
  1. State the situation in two sentences and spend the rest on the reasoning.
  2. Pick a story where you made the decision, not one where you watched it.
  3. Name the disagreement and how you resolved it with evidence.
Follow-up
  • What did you decide not to do, and why?
  • What would you do differently if you ran that again?

How do you handle conflicting priorities between product requirements …

medium
behavioural and engineering judgement

How do you handle conflicting priorities between product requirements and technical limitations?

Approach
  1. Name the disagreement and how you resolved it with evidence.
  2. Pick a story where you made the decision, not one where you watched it.
  3. Close with what you would do differently, concretely.
Follow-up
  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?

Describe your experience working in an Agile or cross-functional team …

medium
behavioural and engineering judgement

Describe your experience working in an Agile or cross-functional team environment.

Approach
  1. Pick a story where you made the decision, not one where you watched it.
  2. Name the disagreement and how you resolved it with evidence.
  3. State the situation in two sentences and spend the rest on the reasoning.
Follow-up
  • What did you decide not to do, and why?
  • How did you know your change caused the improvement?
  • 01

    Tell me about a time you had to explain a technical issue to a non-technical stakeholder.

  • 02

    How do you handle conflicting priorities between product requirements and technical limitations?

  • 03

    Describe your experience working in an Agile or cross-functional team environment.

PracHub interview preparation framework ↗
Is this an official Akumin interview guide?

No. It is PracHub's own research and practice material for the Software Engineer role at Akumin. Rounds and questions reflect what candidates have reported, not a process Akumin has published, and they change over time. Confirm the current format and scope with your recruiter.

PracHub interview research ↗
How long does the interview process typically take?

The timeline can vary based on team needs, but generally, it moves at a steady, professional pace. You can expect the process to span a few weeks from the initial screen to a final decision.

PracHub interview research ↗
What is the most important thing to emphasize during the interview?

Focus on your ability to solve real-world problems and your willingness to work collaboratively. Akumin values engineers who can take ownership of their work and communicate effectively with stakeholders.

PracHub interview research ↗
Is prior healthcare experience mandatory?

While healthcare experience is a significant plus, it is not always mandatory if you can demonstrate strong technical aptitude and a quick ability to learn domain-specific requirements.

PracHub interview research ↗
What is the work environment like?

The environment is collaborative and results-oriented. You will be working on systems that have a direct impact on patient care, which fosters a sense of purpose and high accountability.

PracHub interview research ↗
Sources & methodology 3 sources ↗

No official company page is cited. Rounds and questions come from candidate reports and PracHub editorial material; each source shows the date it was read.