Mastering Residency Interview Questions: A Guide for Caribbean IMGs

Understanding the Residency Interview Landscape as a Caribbean IMG

Securing a residency position as a Caribbean international medical graduate (IMG) requires more than strong scores and solid clinical performance—it requires strategic, polished interviewing. Programs know that many Caribbean-trained students, including SGU, AUC, Ross, Saba, and other schools, have had to overcome additional hurdles to pursue U.S. training. The residency interview is where you prove you’re not just capable, but a safe, reliable, and collegial future colleague.

This article focuses on common interview questions and specific answer strategies tailored for Caribbean IMGs. Whether you’re targeting Internal Medicine, Family Medicine, Pediatrics, Psychiatry, or other fields, the underlying behavioral and communication skills are very similar.

We will cover:

• The core goals of residency interview questions
• A framework for answering “Tell me about yourself” and other openers
• Strategies for behavioral interview questions in medicine
• Commonly asked residency interview questions and sample answers
• Caribbean-specific challenges (gaps, attempts, Step timing, visas) and how to handle them
• Practical preparation tips and a brief FAQ

---

What Programs Are Really Assessing in Your Answers

Most questions—no matter how they are phrased—aim to evaluate a few key domains:

1. Clinical readiness and trainability

   • Can you function safely at an intern level?
   • Do you know how to ask for help?
   • Do your answers show sound judgment and insight?

2. Professionalism and reliability

   • Have you demonstrated accountability?
   • How do you respond to feedback or mistakes?
   • Are you organized, timely, and dependable?

3. Communication and teamwork

   • Can you communicate clearly with patients, nurses, and other physicians?
   • Do you show respect, empathy, and listening skills?
   • How do you handle conflict or disagreement?

4. Motivation and fit

   • Why this specialty?
   • Why this program and geographic area?
   • How do your long-term goals align with what the program offers?

5. Resilience and self-awareness

   • How do you respond to stress and failure?
   • Can you reflect on your behavior and grow from setbacks?
   • Do you have a realistic understanding of your strengths and weaknesses?

For Caribbean IMGs, there are a few additional unspoken questions programs may be considering:

• Did you choose a Caribbean medical school thoughtfully, and what did you learn from that path?
• Can you adapt quickly to U.S. hospital systems and documentation?
• If you’re from a school like SGU, are your SGU residency match outcomes and letters consistent with what they see from other SGU graduates?
• Are there any red flags (gaps, delayed exams, multiple attempts) you haven’t addressed clearly?

Your goal is to answer clearly, confidently, and concisely while proactively addressing these concerns when appropriate.

---

Mastering the Classic Opener: “Tell Me About Yourself”

For many Caribbean medical school residency applicants, the hardest part of the interview is the opening question. It often comes exactly as:

“So, tell me about yourself.”

This is not a casual icebreaker. It’s your first chance to structure how the interviewer sees your entire application.

Strategy: A 3-Part, 60–90 Second Answer

Aim for a 1–1.5 minute answer that follows this simple structure:

1. Brief background (10–20 seconds)
   • Who you are (name optional), where you’re from, and your training path.
2. Key highlights (30–45 seconds)
   • 2–3 strengths or experiences most relevant to the specialty/program.
3. Current focus and future direction (20–30 seconds)
   • Why this specialty, and how this program fits your goals.

Example (Internal Medicine, SGU graduate)

“I’m a Caribbean IMG originally from Trinidad and Tobago, and I completed my medical education at St. George’s University, with core clinical rotations in New York and New Jersey.

During my rotations, I was particularly drawn to Internal Medicine because I enjoy managing complex, multi-system problems and building long-term relationships with patients. My strengths include strong clinical reasoning, reliability, and communication with multidisciplinary teams. For example, on my IM core rotation at [Hospital Name], I was frequently trusted to pre-round independently, present concise patient summaries, and coordinate care with social workers and physical therapists.

Right now, I’m looking for a residency program that provides strong inpatient training, significant exposure to diverse, underserved populations, and a supportive teaching culture. Your program’s emphasis on mentorship and QI projects really aligns with my goal of becoming a well-rounded internist who can contribute to both patient care and system improvement.”

Why this works:

• Ties your Caribbean medical school residency path to U.S. clinical experiences.
• Highlights specific, observable behaviors (“pre-round independently,” “coordinate care”).
• Explicitly connects your goals to the program’s strengths.
• Confident and organized, without being memorized-sounding.

---

Behavioral Interview Questions in Medicine: The STAR Method

Many residency interview questions are behavioral interview medical style, built around prompts like:

• “Tell me about a time when…”
• “Give me an example of…”
• “Describe a situation where…”

Programs use these because past behavior is a strong predictor of future performance.

The STAR Framework (Your Default Answer Template)

Use STAR to structure most behavioral answers:

• S – Situation: Brief context (where/when, relevant background)
• T – Task: Your role and responsibility
• A – Action: What you did (focus here)
• R – Result: Outcome and what you learned

Aim for 90–120 seconds per answer, max. If you’re talking for more than 2 minutes, you’re probably giving too much background and not enough action.

Example: “Tell me about a time you dealt with a difficult patient.”

Situation: “During my Internal Medicine core rotation at a New York hospital, I cared for a middle-aged patient with uncontrolled diabetes and frequent admissions who was very frustrated and mistrustful of the medical team.”

Task: “As the medical student, my attending asked me to spend extra time understanding his concerns and help improve communication between him and the team.”

Action: “I sat down at eye level, introduced myself, and asked open-ended questions about his experiences. He shared that he felt judged for not taking his medications and worried about losing his job. I acknowledged his frustration, clarified the plan in plain language, and asked what he felt was realistic for him. I then communicated his concerns to the team and helped coordinate a meeting with social work to address his employment and insurance worries.”

Result: “By the end of his hospitalization, his tone with the team had improved; he agreed to a simplified medication regimen and follow-up with a community clinic. I learned that taking time to actively listen and address social factors can dramatically improve trust and adherence. Since then, I’ve been more intentional about exploring patients’ perspectives, especially when they seem resistant.”

This answer shows empathy, communication, understanding of social determinants, and your capacity to learn.

---

Common Residency Interview Questions and Targeted Strategies for Caribbean IMGs

Below are high-yield questions, with strategies and sample answers tailored to Caribbean-trained applicants.

1. “Why did you choose a Caribbean medical school?”

Many Caribbean IMGs fear this question, but if you handle it confidently and honestly, it can become a strength.

Strategy:

• Be straightforward and non-defensive.
• Emphasize maturity, resourcefulness, and what you gained.
• Do not blame others (admissions, test centers, etc.).
• End with how the experience prepared you for U.S. residency.

Example Answer:

“I went the Caribbean route because after completing my undergraduate degree, my academic record and timing limited my options for U.S. MD and DO schools. Rather than wait several years and lose momentum, I chose [School] because of its strong track record of placing graduates into U.S. residency programs and its established clinical affiliations.

The path has not been easy—I had to adapt quickly to a new country, high-volume coursework, and later to U.S. hospital systems. But this route has made me more resilient, self-directed, and grateful for learning opportunities. My core rotations in the U.S. confirmed that I can perform well in diverse clinical environments, and my evaluations reflect that. I believe this experience has prepared me to work hard, seek feedback, and contribute positively from day one of residency.”

This aligns your Caribbean medical school residency pathway with perseverance and adaptability, without sounding apologetic.

---

2. “What are your strengths?” / “What are your weaknesses?”

Programs want self-awareness, not perfection. Tie your strengths/weaknesses to behaviors, not vague personality traits.

Strengths Strategy

Choose 2–3 strengths highly relevant to residency:

• Reliability and follow-through
• Strong work ethic and resilience
• Patient communication
• Being a proactive learner
• Team collaboration

Example Strengths Answer:

“One of my key strengths is reliability. During my core rotations, I consistently arrived early, knew my patients thoroughly, and followed through on tasks. Attendings and residents often trusted me to pre-round and track pending labs or imaging.

Another strength is my communication with patients. Coming from the Caribbean, I’m used to interacting with people from diverse cultural and socioeconomic backgrounds. In my Family Medicine rotation, my preceptor frequently asked me to explain chronic disease management in simple terms to patients, and I received positive feedback for making them feel heard and understood.”

Weaknesses Strategy

Choose a real but safe weakness. Show:

• Insight into its impact
• Specific steps you’ve taken to improve
• Measurable progress

Avoid: “I’m a perfectionist” (unless you explain concretely) or anything suggesting major professionalism issues (chronic lateness, poor teamwork) unless you can show convincing remediation.

Example Weakness Answer (Time Management / Over-Preparation):

“Earlier in medical school, I struggled with over-preparing for everything, which sometimes made me slower in completing tasks. For example, during my early rotations, I would spend too much time perfecting my progress notes or reading extensively before seeing patients.

I realized this wasn’t sustainable in a busy clinical environment, so I started prioritizing tasks with to-do lists, setting time limits for note-writing, and asking residents for feedback on what level of detail they actually needed. Over time, I became more efficient while still maintaining accuracy. My later evaluations specifically commented on improved time management, and I continue to work on balancing thoroughness with efficiency.”

---

3. “Tell me about a time you made a mistake.”

Programs are not looking for perfection; they want safety, insight, and accountability.

Strategy:

• Choose a real but non-catastrophic mistake (communication lapse, near-miss, documentation error).
• Emphasize:
  • Immediate recognition and disclosure
  • Steps to fix it
  • Concrete lessons and changes in behavior

Example Answer:

“During my Internal Medicine sub-internship, I was responsible for following up on a patient’s pending lab results. I noted the labs were ordered, but I didn’t verify they had been drawn before leaving for the day. The next morning, I realized they hadn’t been collected because of a missing label, which delayed an important medication adjustment.

I immediately informed the resident, apologized, and went to the lab to ensure the blood was drawn promptly. We addressed the delay with the attending. Afterwards, I started double-checking that critical tests were not only ordered, but actually processed, and I kept a daily checklist for time-sensitive tasks.

The incident taught me that in clinical care, assuming something has been done isn’t enough—you need to verify, especially for critical items. Since then, I have been much more proactive with follow-up and communication with nursing and lab staff.”

---

4. “Why this specialty?” (e.g., Internal Medicine, Family Medicine, Pediatrics, Psychiatry)

Your answer should show:

• Authentic exposure to the field (rotations, electives, research, mentorship).
• Alignment with core values of the specialty (e.g., continuity for FM, complex inpatient care for IM).
• Reflection—not just “I like to help people.”

Example Answer (Family Medicine, Caribbean IMG):

“I chose Family Medicine because I’m drawn to the breadth of care and the opportunity to build long-term relationships with patients and families. Growing up in the Caribbean, I saw firsthand how a trusted family physician could impact an entire community, often being the first and sometimes only access point to healthcare.

During my U.S. clinical rotations, my Family Medicine experiences confirmed this interest. I enjoyed managing both acute issues and chronic diseases, and I appreciated how much preventive care and patient education is involved. I also value the flexibility of FM to work in underserved and rural settings, which aligns with my long-term goal of serving communities with limited access to care, both in the U.S. and potentially abroad.

The continuity and holistic approach of Family Medicine fits my communication style, my interest in patient education, and my desire to see the long-term impact of my care.”

---

5. “Why our program?” / “What are you looking for in a residency?”

You must be able to show you’ve done specific research about each program:

• Patient population
• Curriculum structure
• Unique tracks (global health, primary care, hospitalist, research)
• Culture (small vs. large program, mentorship style)

Strategy:

1. Start with 2–3 core things you want in a program.
2. Connect them to specific features of that program.
3. End with how you see yourself contributing.

Example Answer:

“I’m looking for a program that offers strong inpatient training, exposure to a diverse and underserved patient population, and a culture of close mentorship.

From speaking with your residents and reviewing your curriculum, I was impressed by your large county hospital, the integrated clinic serving a predominantly immigrant population, and the structured teaching on social determinants of health. I’m also drawn to your quality improvement curriculum and the opportunity to present at your annual resident research day.

As a Caribbean IMG who has trained in multiple healthcare systems, I believe I can bring adaptability and a strong work ethic to your team. I’m particularly interested in getting involved in QI projects focused on reducing readmissions for patients with limited resources and health literacy, which seems very aligned with your program’s mission.”

---

6. “Where do you see yourself in five to ten years?”

Your answer should be:

• Ambitious but realistic
• Compatible with what the program can offer
• Not overly rigid—residency is a time of growth

Example Answer (Internal Medicine):

“In five to ten years, I see myself practicing as a board-certified internist with a focus on caring for underserved populations, likely in an academic or community hospital setting. I hope to be involved in resident and medical student teaching, as well as quality improvement initiatives that improve transitions of care.

I’m open to subspecialty training if I find a particular field that strongly resonates with me during residency, but I know that I want a strong general IM foundation first. I believe your program’s mix of community and academic experiences, along with its emphasis on QI and teaching, will prepare me well for these goals.”

---

7. Questions Specific to Caribbean IMGs: Gaps, Attempts, and Visas

Many Caribbean IMGs must address:

• Gaps between graduation and application
• Multiple Step attempts
• Delays in exams
• Visa sponsorship needs

a. “Can you explain this gap in your CV?”

Strategy:

• Be honest, concise, and non-defensive.
• Emphasize productivity and growth during the gap.
• Show that the issue is resolved and you are ready for residency.

Example Answer (Study Gap / COVID-related):

“After completing my basic sciences, I had a gap of about eight months before starting clinical rotations. Part of this was due to scheduling delays during the COVID-19 pandemic, and part was my own need for additional preparation for Step 1.

During that time, I treated it like a full-time commitment: I studied systematically, took UWorld and NBME practice exams, and worked on my test-taking strategies. I also volunteered virtually with a patient education group in my home community. Ultimately, I passed Step 1 and began rotations with a stronger foundation.

I recognize that gaps can raise concerns, but I’ve demonstrated since then, through my consistent clinical performance and Step 2 success, that I can work reliably and maintain momentum.”

b. “Can you tell me about your Step exam performance?” (if there are failures/low scores)

Strategy:

• Take responsibility without self-sabotage.
• Identify specific factors and what you changed.
• Emphasize improved performance later (especially Step 2 CK, clinical evaluations).

Example Answer (Step Failure):

“I did have a setback with my first attempt at Step 1. I underestimated the exam and relied too heavily on passive studying. When I failed, it was a difficult but important wake-up call.

I took responsibility for my preparation, sought advice from mentors, and completely changed my study approach—focusing on active learning with question banks, spaced repetition, and regular self-assessment. I also adjusted my daily schedule to better manage fatigue and stress.

The result was a significant improvement in my Step 1 performance on the second attempt, and I carried those strategies into Step 2 CK, where I performed much better on the first attempt. I believe this experience has made me a more disciplined, reflective learner—qualities that I know are important in residency.”

---

Practical Preparation Tips for Caribbean IMGs

1. Build a Personal “Story Bank”

Before interviews, write out 8–10 STAR stories you can adapt:

• A time you:
  • Worked on a team
  • Dealt with a difficult patient/family
  • Handled conflict with a colleague/nurse
  • Showed leadership
  • Dealt with a mistake or failure
  • Adapted to a new environment (perfect for Caribbean IMGs)
  • Advocated for a patient
  • Managed stress or heavy workload

You can reuse these stories across multiple behavioral interview medical questions by adjusting how you frame them.

2. Practice Out Loud, Not Just in Your Head

• Record yourself answering “Tell me about yourself” and other common residency interview questions.
• Aim for clear, natural, and structured rather than robotic memorization.
• Ask a friend, mentor, or alumni from your school (e.g., SGU graduates with a strong SGU residency match history) to conduct mock interviews.

3. Anticipate and Normalize Caribbean-Specific Questions

Prepare polished answers for:

• Why Caribbean / why your specific school
• How you adapted to U.S. clinical environments
• Any academic or exam challenges
• Visa situation (if applicable)

The more you rehearse these, the less defensive you will sound.

4. Prepare Insightful Questions to Ask Programs

Near the end, you’ll be asked: “Do you have any questions for us?” Always say yes.

Good topics:

• Resident support and wellness
• Teaching and feedback processes
• Opportunities for QI, research, or leadership
• How they support IMGs in transitioning to U.S. training

Avoid questions easily answered on their website.

---

FAQ: Common Questions from Caribbean IMGs About Residency Interviews

1. Do interviewers know or care that I’m a Caribbean IMG?

Yes, they are aware, and it can affect how they interpret your file. However, many programs have had excellent experiences with Caribbean graduates, particularly from schools with strong match histories. Your job is to:

• Demonstrate clinical competence and professionalism.
• Show that you understand U.S. healthcare systems.
• Present your path confidently, without apology.

2. How long should my answers be?

For most residency interview questions:

• “Tell me about yourself”: 60–90 seconds.
• Behavioral questions: 90–120 seconds using STAR.
• Short factual answers (e.g., “Why this city?”): 30–60 seconds.

If you find yourself talking more than 2 minutes, practice tightening your structure.

3. Can I use the same stories across different interviews?

Absolutely. In fact, developing a consistent “story bank” is essential. Just make sure you:

• Adapt each story to the specific question asked.
• Avoid sounding rehearsed—focus on clear structure and natural delivery.
• Rotate stories so you’re not repeating the same example multiple times with the same interviewer.

4. How do I handle virtual interviews compared to in-person?

For virtual interviews:

• Test your camera, microphone, and internet in advance.
• Use a neutral, uncluttered background and good lighting.
• Dress exactly as you would for an in-person interview.
• Maintain eye contact by looking at the camera, not the screen.
• Have your notes nearby, but avoid reading from them.

The content of your answers doesn’t change, but nonverbal communication and technical preparation matter even more.

---

A successful residency interview for a Caribbean IMG is about owning your journey, presenting your experiences with clarity and confidence, and consistently demonstrating the attributes programs value most: reliability, teachability, teamwork, and commitment to patient care. With deliberate practice, thoughtful stories, and tailored strategies for common questions, you can transform your interviews from stressful interrogations into genuine professional conversations that showcase your readiness for residency.