Essential Questions for Caribbean IMGs: A Guide to Med-Peds Residency Success

Why Your Questions Matter Even More as a Caribbean IMG in Med-Peds

As a Caribbean international medical graduate (IMG) applying to Medicine-Pediatrics (Med-Peds), the questions you ask during interviews are not a formality—they’re strategy.

For many program directors, Caribbean medical school residency applicants are less familiar than U.S. MDs. Strong Step scores and solid letters help, but your questions in interviews and resident socials are often what convince them that:

• You understand what a Med-Peds career actually looks like
• You know what you need to succeed as an IMG
• You’re doing your homework, not just applying everywhere
• You’re someone they could trust to handle both adult and pediatric patients from day one

This article focuses on practical, high-yield questions to ask programs—tailored to a Caribbean IMG targeting a Medicine-Pediatrics residency. You’ll find:

• Core question themes for Med-Peds specifically
• IMG-focused questions about support, visas, and transition to U.S. training
• Program director vs resident-specific questions
• Sample follow-up questions that show insight, not insecurity
• A short section on what not to ask and how to avoid red flags

Throughout, you’ll see how to adapt your questions whether you’re coming from SGU (with a strong SGU residency match track record) or another Caribbean school, and how to position yourself for a strong medicine pediatrics match.

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Core Strategy: How to Build a Smart Question List

Before diving into specific examples, you need a strategy. Not every program needs the same questions, and not every interviewer should get the same ones.

The 4 Pillars of Effective Questions

As a Caribbean IMG, prioritize questions that help you assess:

1. Training Quality & Reputation

   • Will this program truly prepare you to practice both medicine and pediatrics confidently?
   • Does it have a track record with Caribbean medical school residency applicants?

2. Support & Culture

   • Will you be supported as an IMG?
   • Do residents look burned out—or balanced and functional?

3. Career Outcomes

   • Where do graduates go?
   • Will you be able to get fellowships or jobs in the U.S.?

4. Logistics & Fit

   • Visa, contracts, time off, geography, cost of living, transportation, and housing.

Matching Your Questions to the Interviewer

• Program Director / APD / Core Faculty
  Focus on: curriculum, vision, board performance, fellowship placement, policies, and long-term outcomes. These are the best people to ask “what to ask program director”–type questions about structure and strategy.

• Chief Residents / Current Residents
  Focus on: daily workflow, call structure, support, culture, reality versus brochure, red flags.

• Fellows / Alumni (if available)
  Focus on: how well training prepared them, how the program is viewed externally.

• Coordinators
  Focus on: logistics, onboarding, visas, housing, schedules, pay, EMR access.

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High-Value Questions About Med-Peds Training & Curriculum

You are applying for two full specialties in four years. Your questions must signal you understand that complexity.

Questions for Program Directors and Faculty

1. Structure & Identity of the Med-Peds Program

• “How is Med-Peds integrated into both the Internal Medicine and Pediatrics departments? Are Med-Peds residents treated similarly to categorical residents in each department?”
• “What unique opportunities are offered specifically to Med-Peds residents that categorical residents may not have?”

These questions show you are thinking about how your Med-Peds identity will be developed, not just whether you will “get through” residency.

2. Adult vs Pediatric Time Balance

• “How is the time divided between Medicine and Pediatrics each year, and how flexible is the schedule if my career goals shift more toward one side?”
• “How do you ensure continuity of learning when we switch between adult and pediatric rotations so frequently?”

Follow-up:

• “Can you share an example of how the schedule was adjusted for a resident with a strong interest in [ID, Cards, NICU, hospital medicine, etc.]?”

3. Continuity Clinic and Ambulatory Experience

• “How are continuity clinics structured for Med-Peds residents? Do we have separate adult and pediatrics clinics, or combined Med-Peds clinic?”
• “How often do Med-Peds residents have continuity clinic and how long do they follow their patient panels?”

This is crucial because your future Med-Peds practice may be heavily ambulatory.

4. Rotations, Electives, and Individualization

• “How much elective time do Med-Peds residents usually get, and what are some recent electives that residents have chosen?”
• “If I’m interested in a subspecialty fellowship, how does the program support tailoring electives or research time toward that goal?”

For Caribbean IMG applicants, this helps you understand whether you’ll have the opportunities that may not have been available during medical school.

5. Board Preparation and Pass Rates

As an IMG, board performance is heavily scrutinized. You must know how the program supports you.

• “Can you share recent board pass rates for both ABIM and ABP among Med-Peds residents?”
• “What structured support do residents receive for board preparation—such as protected board review time, question banks, or in-training exam review?”

Follow-up:

• “How do you support residents who may need extra help with test-taking, especially if they come from non-U.S. medical schools?”

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Questions for Residents About Training Reality

6. Real-Life Workload and Teaching

• “On a typical ward month, what does your day actually look like—rounds, notes, sign-out, teaching, and admissions?”
• “Do you feel you get enough bedside teaching from attendings and fellows on both Medicine and Pediatrics?”

7. Strengths and Weaknesses of the Program

• “What do you see as the greatest strengths of this Med-Peds program?”
• “If you could change one or two things about the program, what would they be?”

This often reveals more about hidden issues than any brochure.

8. Integration with Categorical Residents

• “Do you feel fully integrated with the categorical Medicine and Pediatrics programs, or do Med-Peds residents sometimes feel ‘stuck in the middle’?”
• “How do categorical residents and faculty view the Med-Peds residents here?”

Strong programs will have clear, respectful integration.

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IMG-Focused Questions: Support, Visas, and Transition to U.S. Training

As a Caribbean IMG, you must be explicit but professional about your unique needs. Thoughtful questions here signal maturity, not weakness.

Questions for Program Directors about IMG Experience

9. Track Record with Caribbean IMGs

• “How many current residents or recent graduates are international medical graduates, particularly from Caribbean medical schools?”
• “What has been your experience with Caribbean IMGs in terms of performance and support needs, and how have you adapted the program to help them thrive?”

If you’re from SGU (St. George’s University), you might ask:

• “I know SGU graduates have a strong SGU residency match history nationally. Have you had SGU or other Caribbean graduates in your Med-Peds program, and how have they done?”

10. Formal Support for Transition

• “Do you offer any structured orientation or bootcamp—especially for IMGs—to help with EMR use, documentation expectations, and U.S. hospital workflow?”
• “How does the program support residents who may need additional time at the beginning of PGY-1 to adjust to the U.S. system?”

This is especially important if you had limited U.S. clinical experience.

Questions About Visa and Administrative Support

11. Visa Sponsorship and Experience

• “What types of visas do you sponsor (J-1, H-1B) and how many residents per year are typically on visas?”
• “Do you have an institutional GME office or legal team that helps manage the visa process and renewals?”

Ask specifics, not vague “Do you sponsor visas?”:

• “Have your visa-holding residents ever had issues with delays or renewals that impacted their training?”

12. Career Planning for IMG Graduates

• “For past IMGs who have graduated from this program, where do they usually end up—fellowships, hospitalist positions, primary care, or academic roles?”
• “Do you notice any particular challenges that IMGs face in job or fellowship applications, and how does the program help address them?”

These questions show you understand the broader journey, not just the match.

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Questions to Ask About Culture, Wellness, and Day-to-Day Life

Programs are used to applicants asking about “wellness,” but generic wellness questions sound rehearsed. Focus on specifics that reveal the true culture.

Questions for Residents About Culture and Support

13. Resident Support and Psychological Safety

• “When someone is struggling—personally, academically, or clinically—how does the program typically respond?”
• “Do you feel comfortable asking for help on busy calls or in tough clinical situations?”

You’re looking for examples of actions, not just “We’re like a family.”

14. Evaluations and Feedback

• “How is feedback given to residents—formally and informally—and how often?”
• “Have you felt that evaluations are fair and that concerns are communicated early enough to improve?”

As an IMG, you want a program that gives transparent, constructive feedback—not surprises.

15. Work-Life Balance and Burnout

• “On average, how many hours per week do you work on your busier months and on your lighter months?”
• “What do residents actually do for fun around here, and do people realistically have time for that?”

Follow-up:

• “Do you see residents here burning out, or do people generally seem able to sustain this workload over four years?”

Questions About Diversity and Inclusion

As a Caribbean IMG, cultural and racial diversity can strongly affect your comfort and growth.

• “How diverse is the resident cohort in terms of background, nationality, and culture, and do you feel that diversity is genuinely valued?”
• “Has the program taken any concrete steps to support residents from underrepresented or international backgrounds?”

If you are worried about discrimination or bias, you can ask diplomatically:

• “If a resident experiences bias from a patient or staff member, how does the program handle that situation?”

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Career Outcomes, Fellowship, and Long-Term Fit

Med-Peds opens many doors—but only if your training allows you to walk through them. You must ask about the medicine pediatrics match from residency to post-training positions.

Questions About Fellowship and Job Placement

16. Graduate Outcomes and Reputation

• “Over the last 5–10 years, what proportion of Med-Peds graduates have gone into fellowship versus hospital medicine versus primary care?”
• “Do you have a list or sense of where recent graduates have matched for subspecialty fellowships?”

Follow-up:

• “How is the reputation of this Med-Peds program perceived by fellowship programs or employers in this region?”

17. Support for Career Exploration

• “How early in residency do residents start getting guidance on career planning, and who typically mentors them in that process?”
• “Are there Med-Peds trained faculty in leadership roles or subspecialties who can serve as mentors?”

For a Caribbean IMG, strong mentorship can help offset any initial disadvantages in networking.

Questions About Research and Scholarship

• “What opportunities exist for Med-Peds residents to get involved in research or quality improvement, and how many residents typically participate?”
• “Is there structured support—such as a research director or time protected during electives—for residents aiming for competitive fellowships?”

You don’t need to be heavily research-oriented, but you should know what’s available.

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Smart “Questions to Ask Residency” by Interviewer Type

To make this practical, here’s a targeted list of interview questions for them—divided by whom you’re speaking with. You can adapt and rotate these across interviews.

What to Ask Program Directors

These are ideal “what to ask program director” questions that show maturity and big-picture thinking:

1. “Where do you see this Med-Peds program in five years, and what changes are you most excited about implementing?”
2. “What characteristics have you seen in residents who thrive here, and what kinds of residents tend to struggle?”
3. “How do you balance service needs with education, especially on the busiest inpatient rotations?”
4. “How has the program evolved in response to resident feedback in the last few years?”
5. “As a Caribbean IMG, I value clear expectations and support in transitioning to U.S. training. How does your program help residents from varied training backgrounds integrate successfully?”

What to Ask Residents

1. “Why did you choose this Med-Peds program over others, and has it lived up to your expectations?”
2. “How approachable are faculty and program leadership when concerns arise?”
3. “Do Med-Peds residents feel they have a clear ‘home base’ in the hospital, or do you feel pulled between departments?”
4. “How are night shifts and cross-cover handled, and do you feel appropriately supervised on nights?”
5. “If you could go back in time, would you choose this program again—why or why not?”

What to Ask Coordinators or Administrative Staff

1. “What does the onboarding process look like for new residents, especially for those coming from outside the U.S.?”
2. “Are there institutional supports such as immigration assistance, housing resources, or financial counseling for residents?”
3. “How are vacation requests managed, and how often do residents get their preferred vacation blocks?”

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Pitfalls: Questions You Should Avoid or Reframe

Some questions send the wrong message, especially for a Caribbean IMG trying to counter any bias.

Avoid These Types of Questions

1. Easily Googleable Facts

   • E.g., “How many residents per year?” or “Do you have a PICU?”
     These make it seem like you didn’t research the program.

2. Overly Self-Focused Logistics Too Early

   • E.g., “Can I moonlight?” “How soon can I take vacation?”
     These can make you seem more interested in time off than training if asked too soon or without context.

3. Salary-Only Questions

   • Asking only, “What’s the salary?” without broader questions about cost of living or benefits can feel superficial.
     Instead: “How does your salary and benefits package compare to other programs in the region, and how do residents manage the cost of living here?”

4. Overly Negative Questions

   • E.g., “What’s the worst thing about this program?”
     Reframe: “What are some current challenges the program is working on improving?”

How to Reframe Sensitive Topics

• Instead of: “I’m worried about discrimination as a Caribbean IMG. Will I face bias here?”
  Try: “How does the program work to create an inclusive environment for international graduates and residents from diverse backgrounds?”

• Instead of: “Is this a malignant program?”
  Try: “Can you tell me about how the program responds when work hours, wellness, or educational needs come into conflict with service demands?”

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Putting It All Together: Example Question Sets for Different Goals

To help you prepare, here are sample “bundles” of questions depending on what you care about most.

If Your Top Priority Is Fellowship

Ask PD/faculty:

• “What is the typical fellowship match list like over the past few years for Med-Peds graduates?”
• “How does the program support residents in presenting at conferences or publishing research?”
• “Are there specific subspecialties for which your graduates are particularly successful in matching?”

Ask residents:

• “How easy is it to find research mentors in both Medicine and Pediatrics?”
• “Do residents get protected time for interviews during fellowship season?”

If Your Top Priority Is Support as a Caribbean IMG

Ask PD/faculty:

• “How have you successfully supported IMGs and Caribbean graduates in your program historically?”
• “Are there any additional orientation resources, simulation sessions, or early supervision structures for residents transitioning from non-U.S. schools?”

Ask residents (especially IMGs):

• “As an IMG, did you feel supported in adjusting to documentation, EMR, and communication styles here?”
• “Have you ever felt that your background affected how you were evaluated or treated, positively or negatively?”

If Your Top Priority Is Lifestyle and Culture

Ask residents:

• “Realistically, how many days off do you have per month, and do you feel they’re protected?”
• “What do people typically do on a post-call day?”
• “Is there a sense of camaraderie across Med-Peds classes, or do people mostly keep to themselves?”

Ask PD/faculty:

• “How does the program monitor resident workload and burnout, and what changes have you made in response to those data?”

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FAQs: Questions Caribbean IMGs Commonly Ask About Med-Peds Interviews

1. How many questions should I ask in each interview?

Aim for 2–4 thoughtful questions per interviewer. Quality matters more than quantity. Have a list of 10–15 prepared, but use them flexibly depending on time and what’s already been covered. If multiple interviews happen in one day, don’t repeat the same questions to everyone unless you want different perspectives (e.g., “How would you describe the culture here?”).

2. Should I tell programs I’m a Caribbean IMG when I frame my questions?

Program leadership can see your school on your application, so you don’t need to “announce” it. However, it’s appropriate to reference your background when asking context-specific questions, such as:

• “Coming from a Caribbean medical school with strong clinical training but varied exposure to U.S. systems, I really value structured orientation. How does your program support that transition?”

This shows insight and self-awareness, not insecurity.

3. Do I need different questions for virtual vs in-person interviews?

The content of your questions can be the same, but you may need to add questions about community, housing, and city life if you cannot physically visit:

• “Since this is virtual, could you describe the surrounding community and where residents typically live?”
• “How do residents commute, and is having a car essential?”

For in-person interviews, you can ask more about hospital layout, clinics, and physical spaces because you’ll see them directly.

4. Can I ask about my chances of matching at a specific program?

Avoid directly asking, “What are my chances of matching here?” Programs cannot and will not give precise answers, and it can be uncomfortable. Instead, you can ask:

• “What qualities do you prioritize when building your rank list?”
• “What advice would you have for an applicant like me—coming from a Caribbean medical school and pursuing Med-Peds—who is particularly interested in a program like yours?”

This invites constructive feedback without putting them on the spot.

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By building a targeted, thoughtful list of questions to ask residency programs—and tailoring them to Med-Peds and your identity as a Caribbean IMG—you demonstrate maturity, insight, and a genuine commitment to finding the right fit. That impression can be as powerful as any score or transcript in helping you secure the medicine pediatrics match that will shape your career.