Essential Questions for Caribbean IMGs Pursuing OB/GYN Residency

Why Your Questions Matter as a Caribbean IMG in OB/GYN

As a Caribbean medical school graduate aiming for an Obstetrics & Gynecology residency in the U.S., your interview questions are not a formality—they are strategy.

Program directors expect you to ask thoughtful, specific questions that show:

• You understand the realities of OB/GYN training
• You know your strengths and challenges as a Caribbean IMG
• You are evaluating fit just as much as they are evaluating you

For Caribbean IMGs, especially from schools like SGU, AUC, Ross, etc., shaped by the Caribbean medical school residency pathway, good questions can:

• Demonstrate insight and maturity
• Signal that you are ready for a demanding surgical and continuity-based specialty
• Help you differentiate programs that truly support IMGs from those that only occasionally match them

This guide breaks down targeted questions to ask programs—for program directors, residents, and coordinators—along with what their answers actually mean for your training and future obstetrics match prospects.

---

Core Strategy: How a Caribbean IMG Should Approach Questions

Before getting into specific lists, it helps to have a framework for what you’re trying to learn. For OB/GYN and for an IMG specifically, you want to uncover information in these areas:

1. IMG-Friendliness and Support
2. Surgical and Obstetric Volume and Autonomy
3. Education Quality and Board Prep
4. Fellowship and Career Outcomes
5. Wellness, Culture, and Workload
6. Visa, Licensing, and Logistics

Think of your questions as tools to gather data in each of these domains. Your goal is not to “impress with big words” but to show you ask the right questions and can think like a future OB/GYN colleague.

General Tips for Asking Questions

• Have 10–15 questions prepared, but only plan to ask 3–5 per person depending on time.
• Prioritize different questions for different interviewers (PD vs residents vs faculty).
• Avoid “Google-able” questions (e.g., number of residents per year) unless you’re clarifying something complex.
• Use open-ended questions that invite discussion (start with “How,” “What,” “Can you tell me about…”).
• Tailor questions to your background: reference your Caribbean medical school residency context and interests when relevant.

---

Questions to Ask the Program Director (and What Their Answers Reveal)

Your time with the Program Director (PD) is the most important opportunity to ask high-yield questions. These are questions to ask the program director that communicate you are serious, thoughtful, and aware of the realities of OB/GYN training.

1. IMG-Friendliness and Support

Key goal: Understand how the program views and supports Caribbean IMGs.

Questions to ask:

• “Can you tell me about the experience your program has had with Caribbean IMGs, particularly from schools like SGU or similar Caribbean medical school residency pathways?”
• “How do you support residents who may need a little extra transition time from an international medical school background, especially early in PGY-1?”
• “What qualities have you seen in successful IMGs here, and what challenges have they faced?”

What to listen for:

• Do they speak positively and specifically about IMGs, or vaguely and cautiously?
• Can they name specific examples of successful Caribbean grads (chiefs, fellows, attendings)?
• Do they mention structured orientation, mentorship, or extra support for documentation, EMR, or U.S. systems?

If the program has had a consistent SGU residency match history or other Caribbean matches, they should be able to share specific stories, not just general platitudes.

2. Surgical and Obstetric Training

OB/GYN is procedure-heavy. As a Caribbean IMG, you must show that you understand the importance of real operative and delivery experience.

Questions to ask:

• “How do you ensure residents achieve strong surgical competency, especially in hysterectomy, cesarean sections, and minimally invasive procedures?”
• “By the end of PGY-2, what level of independence do residents typically have with common OB and GYN procedures?”
• “Can you share how operative cases are distributed between residents and fellows?”

What the answers tell you:

• Programs that value resident autonomy will talk about graduated responsibility, clear case logs, and deliberate exposure to complex cases.
• If fellows take the majority of cases, residents may struggle to become confident surgeons.
• Strong responses will reference ACGME case minimums, data tracking, and ensuring no resident falls behind.

---

3. Educational Structure and Board Success

Given that some Caribbean grads worry about standardized exams, it’s appropriate to ask about structured teaching and board prep.

Questions to ask:

• “Can you describe the formal educational curriculum—didactics, simulation, ultrasound training, and how they’re protected from clinical interruptions?”
• “What does your program do specifically to prepare residents for CREOG and ABOG written and oral exams?”
• “How have your graduates performed on board exams over the past several years, and what changes have you made if performance was not where you wanted it?”

Why this matters for you:

• Regular, protected didactic time signals the program prioritizes learning, not just service.
• Simulation for shoulder dystocia, postpartum hemorrhage, and laparoscopic skills is critical.
• Ask follow-up: “Are there any additional supports available for residents who might struggle with standardized exams?”—this is especially relevant for IMGs.

4. Fellowship and Career Outcomes

Even if you’re not yet sure about a subspecialty, you should still ask about future paths. It signals long-term thinking.

Questions to ask:

• “What proportion of your graduates go into general OB/GYN practice versus pursuing fellowships?”
• “Can you share examples of recent fellowship placements, and how the program supports residents applying to MFM, REI, Gyn Onc, or MIGS?”
• “For residents who want to be strong generalists, what unique strengths does this program offer for community-based or hospitalist careers?”

What to watch for:

• Look for a balanced answer: strong support for both fellowship-bound and generalist residents.
• Programs should know where their graduates go—if they don’t, that’s a red flag for mentorship and tracking.
• For a Caribbean IMG, precedent matters: have IMGs from this program matched into competitive fellowships?

5. Program Culture, Well-Being, and Safety

OB/GYN can be intense: high risk, high emotion, high litigation. You need a culture that supports you.

Questions to ask:

• “How would you describe the culture of your program when residents are under stress—what does support look like, practically?”
• “Can you share how you’ve responded when a resident was struggling—either clinically, emotionally, or academically?”
• “How does the program monitor for resident burnout, and what changes have you made in response to resident feedback?”

Why this matters:

You want specific examples, not generic “we support wellness.” Look for:

• Access to counseling/mental health
• Changes made from resident surveys
• A PD who can share concrete stories (with anonymity preserved) of supporting residents through difficulty

---

Questions to Ask Current Residents (Your Most Honest Source)

Residents—especially current Caribbean IMGs or other international grads—are the best source for authentic program insight. Your interview questions for them can be more informal but still strategic.

1. Daily Reality and Autonomy

Questions to ask residents:

• “What does a typical week look like on labor and delivery for a PGY-1? For a PGY-3?”
• “How early did you feel comfortable managing triage independently or running a labor floor with indirect supervision?”
• “Do you feel you have enough hands-on time in the OR? Are there ever conflicts between residents and fellows for cases?”

What to listen for:

• Are schedules sustainable, or are there chronic 80-hour-week violations?
• Do senior residents truly run the floor and ORs, or are attendings/fellows always primary?
• How they describe autonomy vs support tells you how you’ll grow.

2. Education vs. Service

This is critical in OB/GYN, where service demands are high.

Questions to ask:

• “When you’re on busy rotations, how reliably is didactic time protected? Do you actually get to attend, or are you often pulled away?”
• “Do you feel your clinical responsibilities sometimes compromise your learning, or is there a good balance?”
• “How much time do you realistically have to study or prepare for CREOGs during a typical month?”

Red flags:

• Residents routinely miss conference
• Little to no time for study
• Comments like “You learn on the job; there isn’t really time for formal teaching”

3. Support for Caribbean IMGs and New Interns

Asking other IMGs directly is incredibly valuable.

Questions to ask:

• “As an IMG, how was your transition into this program? Were there any unique challenges, and how did the program respond?”
• “Do you feel evaluated fairly, without bias about your medical school background?”
• “Were there any surprises about being a Caribbean IMG in this program that you wish you had known before matching here?”

Why this matters:

Listen for:

• Stories of mentorship and inclusion versus isolation or bias
• Whether IMGs are represented among chiefs, leaders, and fellowship matches
• Subtle signs of “othering” or unsupported gaps

---

4. Resident Life, Morale, and Retention

Programs with high attrition or low morale can be especially challenging for IMGs.

Questions to ask:

• “How many residents have left the program in the last few years, and what were the reasons if you’re aware?”
• “What do people here do to decompress—do residents spend time together outside of work?”
• “When things get really busy or chaotic, how do residents and attendings handle it? Does it feel like a team?”

What you’re assessing:

• High attrition may indicate serious issues with culture or workload.
• If residents avoid this question, that’s a sign in itself.
• A supportive, team-oriented environment is vital for high-stress OB events like shoulder dystocia or maternal hemorrhage.

5. Career Placement and Mentorship

Your peers can tell you how real mentorship is—not just what’s on the brochure.

Questions to ask:

• “How involved are faculty in helping with fellowship applications, research, or job placement?”
• “Do you feel like attendings know your goals and strengths?”
• “Are there residents from this program who’ve recently matched into MFM, Gyn Onc, REI, MIGS, or competitive generalist jobs? How were they supported?”

Pay attention to:

• Whether residents can easily list examples of successful graduates
• If support seems equally available to IMGs and U.S. grads
• Whether research or leadership opportunities are accessible or reserved for a small group

---

OB/GYN-Specific Questions Every Caribbean IMG Should Consider

Obstetrics & Gynecology has unique features you should explicitly ask about, especially in the context of the obstetrics match and your long-term training.

1. Labor and Delivery Exposure and Risk Management

High-yield questions:

• “How is time on labor and delivery structured through the four years? Do residents consistently get primary delivery experience?”
• “Can you tell me about how your program handles high-risk obstetrics cases and maternal emergencies? How are residents trained and supported during those situations?”
• “Do residents participate in drills or simulation for obstetric emergencies, such as shoulder dystocia, eclampsia, postpartum hemorrhage, and maternal code scenarios?”

Why this matters:

• Strong OB training is non-negotiable: you need volume, complexity, and systems training.
• Programs invested in safety will mention multidisciplinary drills and clear protocols.
• Ask yourself: would you feel comfortable managing a busy L&D floor after completing this program?

2. Gynecologic Surgery and Minimally Invasive Training

Questions to ask:

• “What is the typical experience with laparoscopic and minimally invasive gynecologic surgery by graduation?”
• “How early do residents get hands-on experience with basic laparoscopic skills—camera holding, port placement, simple cases?”
• “Do you use simulation or skills labs for laparoscopic and robotic training, and how often are residents able to use them?”

Meaning for your future:

• Inadequate MIGS exposure may limit competitiveness for some jobs or fellowships.
• Programs that prioritize surgical training will reference case tracking, simulation, and graduated responsibility.

3. Continuity Clinic and Outpatient Experience

OB/GYN is not just OR and L&D—clinic skills matter.

Questions to ask:

• “How is continuity clinic structured, and what types of patients and procedures do residents typically see and perform there?”
• “Do residents have exposure to family planning, office procedures (e.g., colposcopy, LEEP, IUDs, Nexplanons), and early pregnancy management?”
• “How much autonomy do senior residents have in managing their own clinic schedule and decision-making?”

Key points:

• Solid clinic experience prepares you for real-world practice.
• Be aware of your own goals: if you’re interested in a family planning focus or underserved populations, ask specifically about those services.

---

Questions About Logistics, Visas, and Being a Caribbean IMG

As a Caribbean IMG, you must also be practical. These may feel more sensitive, but they are entirely appropriate—especially toward the end of the interview day or with the coordinator or PD if time allows.

1. Visa Sponsorship and Licensing

Questions to ask:

• “Can you share your program’s experience with visa sponsorship for residents over the last several match cycles?”
• “Have there been any changes recently in how the institution handles visas, such as J-1 or H-1B?”
• “For IMGs, do you provide any institutional support for state licensing processes or documentation?”

Why this is crucial:

• Don’t assume all programs sponsor visas every year. Policies change.
• You want programs with clear, consistent, and recent experience supporting IMG residents.

2. Performance Evaluation and Feedback

The transition from Caribbean medical school to U.S. residency can feel abrupt. Programs that invest in feedback will support your growth.

Questions to ask:

• “How are residents evaluated, and how often do they receive structured feedback?”
• “Is there a formal remediation or support process for residents who are struggling clinically or academically?”
• “How transparent is communication about performance expectations during PGY-1?”

What this tells you:

• Programs with early feedback and clear milestones help IMGs adjust faster.
• Vague or punitive evaluation cultures can be particularly hard for international graduates who are still adapting to a new system.

3. Housing, Cost of Living, and Practical Life

These are great questions for residents or the coordinator.

Questions to ask:

• “Where do most residents live, and what is the typical commute like?”
• “How manageable is the cost of living on a resident salary here?”
• “Are there any institutional supports for things like childcare, parking, or night shift meals?”

While these aren’t unique to Caribbean IMGs, they matter significantly when you may be far from family or your usual support system.

---

How to Use Your Questions Strategically on Interview Day

Having a great list is one thing; using it effectively is another.

Before the Interview

• Research the program: website, social media, FREIDA, alumni outcomes.
• Cross off questions whose answers you can easily find online.
• Highlight 3–4 “must ask” questions tailored to each program and each interviewer type.

During the Interview

• Ask PDs more big-picture, strategy, and outcomes questions.
• Ask residents day-to-day, culture, and honesty questions.
• Keep each question concise, and listen actively—often answers will naturally open doors for deeper follow-ups.

After the Interview

• Jot down the answers immediately after each interview day.
• Use your notes later to compare programs when building your rank list:
  • Which programs were genuinely enthusiastic about Caribbean IMGs?
  • Where did you feel they had a strong track record of SGU residency match or similar Caribbean grads doing well?
  • Which OB/GYN residencies aligned most closely with your priorities—surgery, high-risk OB, fellowship, location, or culture?

---

Frequently Asked Questions (FAQ)

1. How many questions should I ask each interviewer?

Aim for 2–4 thoughtful questions per interviewer, depending on the time available. It’s better to ask a few well-chosen, in-depth questions than to rush through a long list. Prioritize questions that:

• Cannot be answered by the website
• Reveal something meaningful about training, culture, or IMG support
• Show your understanding of OB/GYN as a career

2. Is it okay to mention that I’m a Caribbean IMG when asking about support?

Yes—and it can actually be an advantage if done thoughtfully. You might say:

“As a Caribbean IMG, I’m particularly interested in how programs support residents transitioning from an international medical school environment. Can you tell me about any specific supports or experiences you’ve had with IMGs here?”

This frames your background as intentional and mature, not as a deficit.

3. What are some red flags I should pay attention to in answers?

Common red flags include:

• Vague or dismissive responses about IMG success (“We’ve had a few…” with no details)
• Residents consistently missing didactics or having no time to study
• High attrition with unclear or evasive explanations
• Overemphasis on service with little mention of teaching or mentorship
• Ambiguous or changing visa policies without clear guidance

If multiple red flags cluster in one program, consider that seriously when ranking.

4. Should I ask about fellowship opportunities even if I’m not sure I want one?

Yes. Asking about fellowship and career outcomes doesn’t lock you into that path; it shows you are thinking long-term and want strong training. You might phrase it as:

“I’m keeping an open mind about fellowship versus generalist practice. How does your program support residents along both paths?”

This signals ambition, flexibility, and maturity—all attractive qualities in an OB/GYN applicant.

---

By coming to interviews with targeted, thoughtful questions tailored to your identity as a Caribbean IMG in Obstetrics & Gynecology, you show programs that:

• You understand what high-quality OB/GYN training should look like
• You’re serious about growth, autonomy, and patient safety
• You’re evaluating them as carefully as they’re evaluating you

Use these questions to identify programs where you can thrive—clinically, academically, and personally—and to build a rank list that maximizes not just your obstetrics match chances, but your success as a future OB/GYN.