Residency Advisor
Essential Questions for Caribbean IMGs in Pediatrics-Psychiatry Residency
As a Caribbean IMG interested in Pediatrics-Psychiatry or a triple board program, the questions you ask during interviews can significantly influence how programs perceive you—and how you evaluate them. Thoughtful, targeted questions show maturity, insight into the specialty, and genuine interest in the residency’s training environment.
Below is a comprehensive guide to what to ask, why it matters, and how to adapt your questions as a Caribbean medical school graduate applying to peds-psych residency, combined programs, or triple board.
Understanding Your Goals Before You Ask Questions
Before you think about specific questions to ask residency programs, get clear on what you need from a training program—especially as a Caribbean IMG.
Clarify Your Priorities as a Caribbean IMG
Ask yourself:
- Do I want a triple board pathway (Pediatrics, General Psychiatry, and Child & Adolescent Psychiatry in five years) or a more traditional route (e.g., Pediatrics then Child Psychiatry)?
- Am I comfortable starting in a smaller community hospital, or do I strongly prefer a large academic center?
- How important is visa sponsorship (J-1 vs H-1B)?
- How much support will I need in US health system navigation, documentation, and EMR use?
- How important are board pass rates, fellowship prospects, or SGU residency match style outcomes (if you’re from SGU or a similar Caribbean medical school)?
Write your priorities down. You’ll use them to tailor your interview questions for them.
Align Questions With Each Stage of the Process
You should plan questions for different points in the interview season:
- Before interview: Questions for email or pre-interview info sessions (logistics, visa, IMG policies).
- During interview day: Questions for program director, faculty, and residents.
- Post-interview / second look: Clarifying questions that help you build your rank list.
Your goal is not to ask every question below, but to build a thoughtful, strategic list you can rotate and personalize.
Core Questions to Ask Program Leadership (PD, APD, Coordinator)
Your questions to the Program Director (PD) and Associate Program Director (APD) are critical. These should go beyond generic “tell me about your program” and show that you understand the unique nature of Pediatric-Psychiatry and triple board training.
1. Training Philosophy and Structure
Why this matters for you as a Caribbean IMG:
You want to know if the program is structured, supportive, and used to working with trainees from diverse backgrounds, including international graduates.
Questions to ask program director or leadership:
“How would you describe the program’s philosophy for training physicians in both pediatrics and psychiatry?”
- What you learn: Whether they see you as a future integrated physician (mind–body clinician), researcher, subspecialist, or generalist.
“Can you walk me through a typical year-by-year structure for residents in the combined or triple board program?”
- What you learn: The balance between pediatrics, psychiatry, and child psychiatry, and whether it matches your career goals (e.g., more outpatient, more inpatient, more developmental-behavioral).
“How flexible is the curriculum if my interests evolve during residency—for example, if I become more focused on neurodevelopmental disorders, adolescent psych, or consult-liaison?”
- What you learn: Their openness to customization and whether electives can be tailored.
“How do you ensure that residents maintain continuity and identity across both pediatrics and psychiatry rotations?”
- What you learn: How they help you feel like more than “a guest” on each service, a common challenge in combined/triple board programs.
2. Support for Caribbean IMGs and International Graduates
As a Caribbean IMG, you need direct information about how the program views and supports international graduates.
Targeted questions:
“How many current residents or recent graduates are international medical graduates or Caribbean IMGs?”
- What you learn: Whether you’ll have peers with a similar background and whether the program is accustomed to supporting IMGs.
“What structures are in place to support residents who may be newer to the U.S. healthcare system—for example, EMR training, documentation coaching, and feedback?”
- What you learn: How they help you adapt, especially in the early months of PGY-1.
“Can you share examples of how the program has supported residents who needed extra help in clinical skills, communication, or standardized exams?”
- What you learn: Whether “remediation” is stigmatizing or framed as development and how transparent they are about support.
(If relevant) “Does the program sponsor J-1 and/or H-1B visas, and how experienced is your GME office with visa processes?”
- What you learn: Logistics that can make or break your ability to train there.
3. Outcomes: Board Exams, Fellowships, and Careers
For Caribbean medical school graduates, strong outcomes help offset bias and show that the program trains solid, board-certified physicians.
Key questions:
“What have been your board pass rates over the past several years—for Pediatrics, Psychiatry, and Child & Adolescent Psychiatry for triple board graduates?”
- What you learn: Data on exam success, plus honesty and transparency.
“Where have your graduates gone after completing the program—fellowships, academic positions, community practice?”
- What you learn: Whether alumni match your personal career goals (e.g., consult-liaison psychiatry, developmental pediatrics, research in autism, global mental health).
“For residents interested in competitive fellowships or academic careers, what mentorship or scholarly productivity do they typically have by graduation?”
- What you learn: Research expectations and real-world outcomes.
“How do you support residents preparing for multiple board exams, especially given the demands of a triple board schedule?”
- What you learn: Access to board review materials, protected study time, guidance for managing overlapping responsibilities.
Questions to Ask Current Residents: The Real Picture
Residents will give you the clearest sense of culture, workload, and whether Caribbean IMGs truly thrive there.
1. Day-to-Day Life and Workload
Questions to ask residents:
“Can you describe a typical week on a pediatric inpatient month? What about on an adult or child psychiatry rotation?”
- What you learn: Reality of hours, patient load, call, and how intense different blocks are.
“How manageable is it to switch mindsets between pediatrics and psychiatry rotations? Do you feel supported in maintaining skills in both domains?”
- What you learn: Cognitive load and how realistically integrated the training is.
“How does call work for combined or triple board residents? Is it different from categorical pediatrics or psychiatry residents?”
- What you learn: Whether you’re overused as “flex” labor or treated equitably.
“What is documentation like here—are there standard templates, and do seniors or faculty help you learn efficient charting?”
- What you learn: Crucial for IMGs not fully accustomed to U.S. documentation standards.
2. Culture, Mentorship, and Wellness
For Caribbean IMGs, culture and support may matter as much as prestige.
Targeted questions:
“How would you describe the culture among residents—from both the pediatric and psychiatry sides? Are people collaborative?”
- What you learn: Whether you’ll feel caught between two departments or part of one integrated family.
“As a combined/triple board resident, do you ever feel like you don’t fully belong to either department? How does the program address that?”
- What you learn: Sense of identity and belonging.
“Have you ever struggled—personally, academically, or clinically—and how did the program respond?”
- What you learn: The difference between punitive vs supportive environments.
“Do you feel the program is welcoming to international graduates or Caribbean medical school graduates? Any challenges you’ve seen?”
- What you learn: Real experiences of IMGs, not just policy.
“What do you like least about the program, and what would you change if you could?”
- What you learn: Pain points that aren’t in brochures.
3. Education, Supervision, and Feedback
You want strong teaching in both pediatrics and psychiatry.
Important questions:
“How often do you receive formal feedback, and is it actually useful?”
- What you learn: Whether feedback is generic or specific enough to help you improve.
“Is there dedicated didactic time protected from clinical duties for combined/triple board residents?”
- What you learn: If teaching is regularly interrupted.
“Do you feel the teaching on pediatric rotations addresses behavioral health and psychosocial issues, and that psychiatry rotations acknowledge pediatric medical complexity?”
- What you learn: True integration vs siloed training.
“Can you think of examples when faculty really went out of their way to teach or mentor you?”
- What you learn: Culture of teaching.
Specialty-Specific Questions for Peds-Psych and Triple Board
Combined Pediatrics-Psychiatry and triple board programs are small and highly specialized. Your questions should show you understand what sets them apart.
1. Integrated Clinical Experiences
Questions tailored to peds-psych and triple board:
“What kinds of integrated clinics or services are available—for example, pediatric consult-liaison psychiatry, developmental-behavioral pediatrics, or co-located primary care and mental health?”
- What you learn: Opportunities to practice as a true mind–body clinician.
“Are there opportunities to follow the same medically and psychiatrically complex patients over several years—such as children with autism, eating disorders, or chronic illness and depression?”
- What you learn: Continuity of care, critical for learning integrated practice.
“Do combined/triple board residents have leadership roles in bridging pediatrics and psychiatry services—for example, quality improvement projects, care pathways, or liaison roles?”
- What you learn: Whether you’ll be groomed as a leader, not just a dual worker.
2. Research, Advocacy, and Niche Interests
Triple board and peds-psych attract residents with strong interests in advocacy and complex systems.
Questions:
“What types of research or quality improvement projects have prior triple board or combined residents completed?”
- What you learn: Feasibility of scholarly work within a busy schedule.
“Is there mentorship available if I’m interested in topics like trauma in foster youth, neurodevelopmental disorders, pediatric psychopharmacology, or global mental health in children?”
- What you learn: Alignment with your personal passions.
“Are there structured opportunities for advocacy—legislative visits, community programs, or school-based mental health initiatives?”
- What you learn: How much the program values child mental health beyond the hospital.
3. How They View Triple Board Graduates
You want a program that understands and values the triple board or peds-psych identity.
Ask:
“How do you see the role of a triple board or combined pediatrics-psychiatry graduate in the current healthcare system?”
- What you learn: Vision and realism about future careers.
“Do hospital leadership and departments recognize the unique skill set of your triple board graduates—for example, in creating roles or positions that use their full training?”
- What you learn: Whether their graduates end up in jobs that truly leverage all three boards.
Strategic Questioning: How, When, and What Not to Ask
Knowing what to ask residency programs is important—but how you ask matters just as much.
1. Make Your Questions Specific and Personal
Avoid generic questions like, “What are your strengths and weaknesses?” Instead, connect your question to your background and interests.
Example:
- Instead of: “Do you have good research?”
- Say: “Coming from a Caribbean medical school, I’ve had limited structured research exposure. If I wanted to work on a project related to child trauma in medically complex children, what kind of mentorship and support would be available?”
You’re communicating:
- Your background (Caribbean IMG)
- Your humility (limited research exposure)
- Your interest (specific clinical area)
- Your initiative (you’re already thinking about projects)
2. Avoid Questions You Should Already Know
Do not waste time asking about basic facts clearly stated on the website or ERAS page (e.g., salary, number of residents, generic benefits).
Instead, build deeper questions based on what you’ve read:
- “I saw that your curriculum includes an integrated behavioral health clinic in PGY-3. Can you tell me more about the patient population and supervision there?”
This shows preparation and genuine engagement.
3. Timing Your Questions
Pre-interview emails / info sessions:
- Visa sponsorship (J-1/H-1B)
- Deadline for rank list decisions on their side (if they have internal timelines)
- Clarification on interview format or peds-psych/triple board structure
Program director / faculty meetings:
- Big-picture training philosophy
- Outcomes (boards, fellowships, careers)
- How they view and support Caribbean IMGs
- Opportunities for leadership, research, advocacy
Resident-only sessions:
- Real schedule and workload
- Culture, support, burnout
- How IMGs and Caribbean grads truly fare
- Whether they would choose the program again
4. Questions to Avoid or Reframe
Some questions can raise red flags if asked too early or bluntly:
“How many days off do we get and how easy is it to call out?”
- Reframe as: “How does the program approach resident wellness and backup coverage when someone is sick or struggling?”
“How fast can I moonlight and make extra money?”
- Reframe as: “Is moonlighting available later in training, and how do you ensure it doesn’t interfere with education or well-being?”
“Will being a Caribbean IMG be a problem here?”
- Reframe as: “I’m a Caribbean IMG and very motivated to adapt quickly to the U.S. system. How has your program supported international or Caribbean graduates in that transition?”
Sample Question Lists You Can Use on Interview Day
Here are ready-made sets you can adapt, emphasizing peds-psych, triple board, and Caribbean IMG priorities.
For the Program Director / Associate Program Director
- “How do you envision the role of a combined pediatrics-psychiatry or triple board graduate in your institution and community?”
- “What qualities have you seen in your most successful residents, especially those coming from international or Caribbean medical schools?”
- “How do you help residents prepare for multiple board exams while balancing demanding rotations?”
- “For residents who develop a strong interest in a niche area—like autism, eating disorders, or integrated primary care—how flexible is your program in tailoring electives and mentorship?”
- “Where do you see the program in five to ten years, especially regarding peds-psych integration and triple board training?”
For Current Residents
- “What surprised you most about training here—both in a good way and a challenging way?”
- “On a practical level, how does it feel to switch between pediatrics and psychiatry rotations across the year?”
- “Do you feel supported as a person, not just as a worker? How does that show up in day-to-day life?”
- “How does the program respond when residents are overwhelmed or burned out?”
- “If you had to make your rank list again, would you still put this program in the same spot? Why or why not?”
For Child Psychiatry or Pediatric Psych Faculty
- “What do you think distinguishes your triple board or peds-psych graduates from categorical grads when they enter practice?”
- “What types of clinical or academic projects are you most excited to mentor residents on?”
- “How well does the hospital support integration of medical and psychiatric care for children—for example, shared clinics, consult teams, or co-management models?”
- “How have you seen Caribbean IMGs or other international graduates thrive here?”
Putting It All Together: Using Your Questions to Build a Rank List
Your end goal isn’t just to impress programs—it’s to decide where you will best thrive as a Caribbean IMG pursuing Pediatrics-Psychiatry or triple board training.
After each interview, jot down:
- Top three strengths you observed.
- Top three concerns or unanswered questions.
- One story or moment from the day that captured the program’s culture (good or bad).
- How supported you felt as a Caribbean IMG—based on actual answers, not assumptions.
Use your questions to compare:
- IMG support and visa experience
- Integration of pediatrics and psychiatry (vs two separate silos)
- Flexibility of curriculum
- Board results and career outcomes
- Resident happiness and authenticity during your conversations
The best program for you will be the one where your questions were welcomed, answered honestly, and left you feeling respected, excited, and realistically prepared for a demanding but deeply meaningful career.
FAQ: Questions to Ask Programs for Caribbean IMG in Pediatrics-Psychiatry
1. As a Caribbean IMG, should I directly ask if the program has had Caribbean graduates before?
Yes—but phrase it professionally. For example:
“How many of your current or recent residents have come from Caribbean medical schools or other international backgrounds, and how have you supported them?”
This is a fair, targeted question that helps you understand how familiar they are with Caribbean medical school residency applicants and their needs.
2. How many questions should I ask in each interview?
Aim for 2–4 thoughtful questions per conversation, depending on time. You don’t need to ask everything at once. Prioritize:
- 1–2 big-picture questions (training philosophy, outcomes)
- 1 question tied to your background (Caribbean IMG, peds-psych interest)
- 1 question about culture or support
If time is running short, always say: “I have more questions, but I want to be respectful of time. Could I email you any remaining ones later?”
3. Are there special questions for SGU or other large Caribbean schools related to match outcomes?
You can absolutely ask about outcomes similar to SGU residency match data, but focus on their program specifically. For example:
- “Do you track where your international or Caribbean IMG graduates go after training—in terms of fellowships, academic positions, and community practice?”
This frames your question around success and outcomes without centering on one specific school.
4. What are some “interview questions for them” that show I understand triple board training is demanding?
Good, advanced questions include:
- “How does the program help residents manage the cognitive and emotional load of training across three disciplines in five years?”
- “What systems are in place to ensure triple board residents don’t feel pulled in too many directions at once?”
- “Can you share examples of how triple board alumni are using all three parts of their training in their current roles?”
These questions signal insight into what triple board means and that you’re seriously thinking about the long-term implications of your career path.
Thoughtful, targeted questions are one of your strongest tools as a Caribbean IMG pursuing Pediatrics-Psychiatry or triple board training. Use them strategically to demonstrate your insight—and to find the program that will invest in your growth as both a pediatrician and a psychiatrist.
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