Essential Questions Caribbean IMGs Should Ask for PM&R Residency Success

Why Your Questions Matter as a Caribbean IMG in PM&R

As a Caribbean IMG interested in Physical Medicine & Rehabilitation (PM&R), the questions you ask residency programs are not just a formality—they are part of your evaluation as a future physiatrist. Programs judge how you think, what you value, and how prepared you are for this specialty based on the quality of your questions.

For many Caribbean medical school graduates, especially those from schools like SGU, Ross, AUC, Saba and others, the residency interview is both a chance to overcome biases and to highlight the strengths of your training. Thoughtful, targeted questions help you:

• Demonstrate genuine interest in PM&R as a career, not just “any residency spot”
• Signal that you understand what physiatry training should include
• Clarify whether the program is IMG-friendly, supportive, and realistic for your goals
• Gather concrete information to build your rank order list with confidence

This guide will walk you through what to ask program directors, faculty, residents, and coordinators, with a special focus on the unique perspective of Caribbean IMGs pursuing a PM&R residency.

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Core Strategy: How to Approach Asking Questions

Before diving into lists, you need a strategy. Asking questions is not about reciting a script—it’s about targeted, meaningful dialogue. Keep these principles in mind:

1. Aim for Depth, Not Volume

You don’t need 30 questions. You need 8–12 strong, adaptable questions you can rotate depending on who you’re talking to (PD vs resident vs coordinator).

What program directors notice:

• Questions showing you’ve researched the program
• Clear understanding of the field of physiatry
• Specific curiosity about how they train residents

What turns them off:

• Questions easily answered on the website
• “What’s your board pass rate?” as your first question, with no context
• Anything that sounds like you’re just trying to “game the system”

2. Tailor Questions to Your Situation as a Caribbean IMG

Your background shapes what you need to know. As a Caribbean IMG, you should subtly explore:

• IMG support and integration in the program
• Visa or sponsorship issues (if applicable)
• How they view graduates from Caribbean medical schools
• Extra expectations for USMLE performance and clinical skills

Frame questions neutrally and professionally—never apologetically.

3. Match Questions to the Person You’re Speaking With

• Program Director (PD): Big-picture, philosophy, outcomes, expectations
• Faculty: Clinical teaching, mentorship, specialization, research
• Residents: Culture, workload, reality vs brochure
• Coordinator: Logistics, schedule, system details, orientation, visas

Keep a mental (or written) list organized by audience.

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High-Impact Questions for Program Directors

The most critical “what to ask program director” decisions revolve around: training quality, graduate outcomes, and institutional support for IMGs. Here are PM&R-specific, nuanced questions with explanations and examples of what you’re actually trying to learn.

1. Training Quality and Program Vision

Question:
“What are the key strengths of your PM&R residency, and what aspects are you actively working to improve over the next 3–5 years?”

Why this works (especially for Caribbean IMGs):

• Shows you understand programs are evolving systems, not static products
• Gives insight into whether they’re innovative or stagnant
• Lets you assess if their direction aligns with your career goals (e.g., sports, interventional pain, brain injury, spinal cord injury)

Listen for:

• Concrete examples: new rotations, new faculty, new clinics
• Evidence of self-awareness and responsiveness to resident feedback

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2. Exposure to the Breadth of PM&R

Question:
“How do you ensure residents receive balanced exposure across core areas of PM&R—such as spinal cord injury, brain injury, stroke, MSK/sports, pediatrics, and pain—and how is that monitored or adjusted?”

Why this matters for physiatry match: As a candidate in a smaller or newer PM&R program, you must ensure you won’t graduate as a one-dimensional physiatrist. Some programs are heavily inpatient-focused; others are mostly outpatient. You need both.

Follow-up options:

• “Can you share an example of how the curriculum changed based on resident feedback about rotations or exposure?”
• “How much elective time do residents have to deepen experience in areas like pain or sports?”

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3. Evaluating Resident Outcomes

Question:
“Where have your graduates gone in the last few years in terms of fellowships vs general practice, and in what settings are they working now?”

Why this is better than “What’s your board pass rate?” alone: You care about outcomes, not just test scores. For a Caribbean medical school residency applicant, demonstrating you’re already thinking about your future practice is impressive.

Ask also:

• “How does the program support residents who are interested in fellowships (e.g., pain, sports, SCI, TBI, pedi rehab) versus those planning to enter practice directly after residency?”
• “Are there particular fellowships that frequently accept your graduates?”

Listen for:

• Recent examples
• Willingness to share data
• Whether Caribbean IMGs from their program have matched into fellowships

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4. Support and Expectations for IMGs

You don’t need to lead with “I’m a Caribbean IMG,” but you should clarify the environment.

Question:
“For residents who may have had non-traditional training paths or international medical education, what kinds of academic or clinical support systems are in place to help them succeed early in the program?”

What you’re really asking:

• Are they aware that IMGs can need extra orientation to US systems, documentation, EMR, and billing?
• Do they offer onboarding, mentorship, and feedback that’s structured?

You can later say:
“As a Caribbean IMG, I appreciate programs that are intentional about onboarding—can you share how you help new interns acclimate to your systems and expectations?”

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5. Academic Expectations and Feedback

Question:
“How do you structure feedback and remediation if a resident is struggling—whether that’s clinically, academically, or with exams like the PM&R boards?”

Why this matters: As a Caribbean IMG, you’ve already proven you can adapt and persist. You want to know that if you hit a bump, the program won’t just label you—they’ll support you.

Clarify:

• Who monitors progress?
• Are there formal remediation pathways?
• What is their track record of helping residents get back on track?

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6. Role of Residents in Teaching and Leadership

Question:
“What opportunities do residents have to take on leadership roles, teach students, or help shape the curriculum?”

For a Caribbean medical school residency candidate:

• Shows you’re already thinking of yourself as part of the academic community
• Allows you to highlight your own experiences teaching (e.g., small groups, tutoring for basic sciences or USMLE)

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Key Questions for Faculty and Subspecialists

Faculty tell you how your day-to-day education will look. They’re also people who may later write fellowship letters.

1. Clinical Autonomy and Supervision

Question:
“How does resident autonomy progress over the three or four years of PM&R training here, particularly in inpatient rehab versus outpatient clinics and procedures?”

Clarify:

• When do residents start leading rehab teams?
• When do they start independent evaluations in outpatient?
• What procedures are resident-performed vs attending-performed?

Caribbean IMGs can highlight: “I’m very interested in gaining strong clinical independence while still having reliable backup. How do you balance those two goals?”

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2. Procedural and EMG Training

PM&R is increasingly procedural—ultrasound-guided injections, EMG/NCS, botulinum toxin, etc.

Questions to ask residency faculty:

• “How is procedural training structured here—such as ultrasound-guided injections, EMG, and spasticity management—and how is competency assessed?”
• “By graduation, what procedural skills do you expect every resident to be independently comfortable performing?”

Red flags:

• Vague answers like “We do some injections” with no numbers
• No clear EMG curriculum or no requirement to reach a minimum number of studies

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3. Mentorship and Career Development

Question:
“How are mentors assigned or selected, particularly for residents who might be interested in fellowships or academic careers in PM&R?”

Things to listen for:

• Formal mentoring structure vs “You just find someone”
• Matching based on interests (peds rehab, SCI, brain injury, EMG, pain, sports)
• Inclusion of IMGs in academic and research opportunities

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Essential Questions for Residents: Culture, Workload, and Fit

Residents give the most honest, practical information. These are key interview questions for them that will help you understand real life in the program.

1. Day-to-Day Workload and Schedule

Questions:

• “What does a typical inpatient day look like for you in terms of patient load, notes, rounds, and team communication?”
• “How are weekends and call structured, and how does that change as you move through the years?”

Caribbean IMG lens: You want to ensure the workload is intense but educational, not exploitative, especially in smaller hospitals that heavily rely on residents.

Follow-ups:

• “Does the workload feel manageable, or do you find that education gets sacrificed for service?”
• “Do you have protected didactic time, and is it truly respected?”

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2. Culture, Inclusion, and IMG Experience

This is critical. You want to know if they integrate Caribbean graduates well into the team.

Questions:

• “How would you describe the culture among residents—collaborative, competitive, supportive?”
• “Are there other IMGs or Caribbean grads in the program now or recently? How have they integrated into the team?”

If an IMG is present:

• “As an IMG, have you felt supported academically and socially in this program?”
• “What were your biggest adjustments early on, and how did the program help?”

You’re listening for:

• Genuine support, not “We treat everyone the same” as the only answer
• Concrete examples: mentorship, check-ins, early guidance on documentation and systems

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3. Resident Autonomy and Education Quality

Questions:

• “Do you feel you’re getting enough hands-on PM&R experience versus being used for general medicine or cross-cover?”
• “How often do you work directly with attendings who enjoy teaching, versus just being left to ‘figure it out’?”

Red flags:

• Residents repeatedly say they’re doing a lot of non-PM&R scut
• Little contact with PM&R faculty on rotations
• Frequent cancellations of lectures or conferences for service coverage

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4. Wellness, Burnout, and Support

Questions:

• “How does the program respond when residents are overwhelmed or burned out?”
• “Have there been any recent changes made based on resident feedback about wellness or workload?”

For Caribbean IMGs who may be far from family and support systems, this matters a lot. Look for:

• Access to counseling or wellness resources
• Reasonable call systems
• Genuine attention to resident feedback

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5. Living in the Area and Long-Term Fit

Questions:

• “What do you wish you had known about living in this city/region before you started?”
• “Do most residents live close to the hospital, and what is commuting like during call or early rounds?”

As a Caribbean IMG, relocation may be more complex (visa, distance from home), so understanding this early helps.

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Smart Questions for Coordinators and Administrators

Program coordinators are the backbone of any residency. They’re often the most knowledgeable about logistics that directly impact Caribbean IMGs.

1. Logistics, Orientation, and Onboarding

Questions:

• “How is orientation structured for new residents, especially those who may not have rotated here as students?”
• “Is there any pre-start onboarding or online training that helps new residents get comfortable with the EMR and hospital systems?”

Explain: “As a Caribbean IMG, I really appreciate structured onboarding—it helps me hit the ground running.”

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2. Schedule, Rotations, and Flexibility

Questions:

• “How far in advance are block schedules and rotations typically finalized?”
• “Is there flexibility if a resident develops a new interest—for example, more exposure to pain, sports, or pedi rehab?”

You’re trying to understand how rigid vs flexible the training environment is.

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3. Visas and Administrative Support (If Applicable)

If you are on or will need a visa, ask directly and clearly.

Questions:

• “Does your institution sponsor J-1 and/or H-1B visas for PM&R residents?”
• “Have there been any recent issues or delays with visa processing for incoming residents?”

If possible, ask:

• “Do you have staff dedicated to GME/visa support?”
• “Have any recent residents on visas struggled with licensure or credentialing after graduation?”

This is crucial for Caribbean IMG planning.

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How to Organize and Personalize Your Question List

To use these questions effectively, don’t show up with a random list. Build a question bank and then customize for each program.

Step 1: Build a Master List

Create headings:

• Program Director
• Faculty/Subspecialists
• Residents
• Coordinator

Under each, include:

• 3–5 “must ask” questions
• 3–4 optional or follow-up questions

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Step 2: Research Each Program Before the Interview

Before asking questions to ask residency programs, read:

• Their website (curriculum, tracks, rotations, affiliated hospitals)
• Recent news or updates (expansion, new faculty, accreditation changes)
• Any published outcomes or resident profiles
• NRMP/FRIEDA data if available

Then adapt:

• “I noticed your program recently expanded its SCI service; how has that changed resident training?”
• “I saw that several graduates went into pain fellowships — how does your curriculum support that path?”

This transforms basic questions into tailored, impressive questions.

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Step 3: Prepare Program-Specific Talking Points as a Caribbean IMG

You can weave in your background naturally. For example:

• “As a Caribbean IMG, I’ve gained clinical experience across multiple sites. How does your program help residents integrate different clinical perspectives into their PM&R practice?”
• “Coming from a Caribbean medical school, I’ve relied heavily on mentorship. How does your program pair residents with faculty mentors in areas like sports or pain?”

This frames your IMG status as a strength and source of resilience.

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Step 4: Avoid These Common Question Mistakes

• Asking about salary or vacation as your first or only question
• Reading from a script without responding to what’s already been said
• Asking, “So, do you think I’ll match here?”
• Aggressive or confrontational questions like, “Why is your board pass rate lower than other programs?”

Instead, if there is a sensitive topic:

• “I’m curious how the program has responded to any challenges in board pass rates or accreditation in the past few years—could you share what changes were made?”

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Putting It Together: Example Question Sets by Interview Role

Here’s a sample of how you might structure your questions during a typical physiatry match interview day.

To the Program Director

1. “What do you see as the key strengths of your PM&R program, and what are you most focused on improving in the next few years?”
2. “How do you ensure residents get broad exposure across inpatient rehab, outpatient MSK/sports, pain, and neurorehab?”
3. “For residents coming from international or Caribbean medical schools, what kinds of support are in place during the transition into internship and early PM&R years?”
4. “Where have your recent graduates gone, and how does the program help residents position themselves for fellowships or their first jobs?”

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To Faculty / Subspecialists

1. “How is procedural and EMG training structured here, and what are your expectations for resident competency by graduation?”
2. “What are some recent curricular or clinical changes the department has made in response to feedback from residents or faculty?”
3. “How do you see the role of a physiatrist evolving in this institution over the next decade?”
4. “What opportunities are available for residents to get involved in research or quality improvement in your area of practice?”

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To Residents

1. “What does a typical week look like for you on inpatient and on outpatient rotations?”
2. “Do you feel your education in PM&R is prioritized, or do service demands sometimes overshadow teaching?”
3. “How would you describe the resident culture—are people close, do they help each other?”
4. “Are there other Caribbean or IMG residents here, and how has their experience been in terms of support and integration?”
5. “If you had to decide again, would you choose this PM&R program, and why?”

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To the Coordinator

1. “How does the program handle onboarding—especially for residents who haven’t rotated here before?”
2. “Does your institution sponsor J-1 and/or H-1B visas, and have there been any practical issues for residents in recent years?”
3. “How far in advance do residents typically receive their schedules, and how flexible can rotations be for specific interests like pain or sports?”

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Final Thoughts for Caribbean IMGs Targeting a PM&R Residency

As a Caribbean IMG pursuing Caribbean medical school residency pathways in PM&R, your interviews are an opportunity to:

• Show you understand what a strong PM&R education requires
• Demonstrate that you can think like a future physiatrist
• Clarify which programs will truly support your growth

The right questions to ask residency programs will also help you avoid mismatches, particularly in areas like IMG support, procedural exposure, and fellowship preparation. Remember: you are interviewing them as much as they are interviewing you.

Your background—from SGU or any other Caribbean school—can be a strength when framed as evidence of adaptability, resilience, and cross-cultural experience. Thoughtful, strategic questions are one of the most powerful ways to make that clear.

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FAQs: Questions to Ask Programs as a Caribbean IMG in PM&R

1. How many questions should I ask each program during my PM&R interview?

Aim for 2–4 strong questions per interview segment (PD, faculty, residents), and be ready to adapt. Over an entire interview day, you might ask 8–12 total. Focus on quality, depth, and relevance, not volume. If someone already answered one of your planned questions, don’t repeat it—pivot to another.

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

Yes—if you frame it professionally and positively. For example:
“As a Caribbean IMG, I’ve had diverse clinical experiences in different systems. How does your program help residents with varied backgrounds standardize their approach to documentation and US-based rehab care?”
This signals self-awareness, not insecurity.

3. What if my questions about visas or IMG support feel uncomfortable to ask?

You must ask them, especially if you require sponsorship. Direct these questions mainly to the program coordinator or PD in a logistical, professional tone. For example:
“Could you share how your program and institution have handled visa sponsorship for residents in recent years?”
Programs are used to these questions; it will not hurt you to clarify.

4. Are there any questions I should avoid asking entirely?

Avoid:

• Anything that sounds like you haven’t done basic research (“So…what kind of program are you?”)
• Questions about salary, moonlighting, or time off as your first priority
• Overly aggressive questions challenging their stats or reputation
• “Do you think I’ll match here?”

Instead, focus on training quality, support, and fit—the things that genuinely matter for your physiatry match and long-term career.