Essential Questions Caribbean IMGs Must Ask for Preliminary Surgery Residency

As a Caribbean IMG applying for a preliminary surgery year in the U.S., what you ask during interviews can strongly influence how programs see you—and how you evaluate them. Thoughtful, specific questions show maturity, insight, and genuine interest, and they help you decide whether a program will truly support your goals: a solid surgical foundation and, for most, eventual entry into a categorical surgery residency or another desired specialty.

This guide is tailored specifically for Caribbean medical school residency applicants (e.g., SGU, AUC, Ross, etc.) aiming for prelim surgery residency positions. You’ll find:

• High-yield questions to ask residency programs, faculty, residents, and program leadership
• Special focus on prelim-specific issues (e.g., conversion to categorical, support for reapplication)
• Guidance on what to ask program director vs. what to ask residents
• Example phrases and how to prioritize your questions
• Sample interview questions for them that make you stand out as a prepared, focused Caribbean IMG

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Understanding the Unique Nature of a Preliminary Surgery Year

Before deciding what to ask programs, you need clarity on what a preliminary surgery year truly is and how it intersects with your longer-term goals.

What is a Preliminary Surgery Residency?

A prelim surgery residency is typically a 1-year non-categorical position. Common pathways:

• Surgical prelim for categorical surgery: One-year spot, often with hope of transitioning into a categorical general surgery position (at the same or another institution).
• Prelim year toward another specialty: e.g., radiology, anesthesiology, urology, PM&R, or neurology that requires a preliminary or transitional year.
• Gap-bridging year: For applicants (often IMGs) who did not initially match into their desired categorical specialty and are trying to strengthen their applications.

As a Caribbean IMG, you must be especially intentional in selecting programs that:

• Have a track record with IMGs (including graduates of Caribbean schools like SGU)
• Offer structured teaching, feedback, and mentorship
• Provide realistic opportunities to secure a categorical spot or improve your match prospects for the next cycle

Your questions should be designed to uncover these details.

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Core Strategy: How to Approach Asking Questions

You’ll have multiple chances to ask questions:

• Formal interview with the Program Director (PD) or Associate PD
• Interviews with faculty and chief residents
• Resident Q&A sessions (often without faculty present)
• Pre-interview dinners or socials (in-person or virtual)

You should prepare:

• 3–5 strong questions for the Program Director
• 2–3 targeted questions for faculty
• 5–7 practical, honest questions for current residents, especially prelims

Avoid questions that can be easily answered by the website or brochure (e.g., “How many beds does the hospital have?”). Use your limited time to ask questions that reveal real culture, expectations, and opportunities, and that highlight you as a thoughtful, serious applicant.

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High-Yield Questions for Program Directors and Leadership

When you think about what to ask program director, focus on big-picture issues: program philosophy, use of prelims, support for IMGs, advancement to categorical position, and how they measure success.

1. Questions About the Role and Future of Prelims in the Program

You want to understand how the program views preliminary residents.

Examples:

1. “How do preliminary surgery residents fit into the overall structure of the residency here?”

   • Shows you’re interested in integration, not just filling service needs.

2. “Historically, what have your preliminary residents gone on to do after their year here?”

   • Listen for concrete outcomes: matched categorical surgery, matched into other specialties, or “not sure.”

3. “Do you see your preliminary positions primarily as service roles, or do you view them as training positions with potential for advancement?”

   • This question can reveal if they truly value prelims.

4. “How do you define a successful preliminary year for your residents?”

   • Their answer shows whether they value education, growth, and career development—or just coverage.

2. Questions About Conversion to Categorical Spots

For many Caribbean medical school residency applicants, a key goal is to convert to a categorical surgery position. This needs to be addressed clearly and professionally.

Examples:

1. “In the past 3–5 years, how many preliminary residents have transitioned into categorical surgery positions here?”
2. “If a prelim resident is performing very well, what is the realistic pathway for them to be considered for a categorical position at this institution?”
3. “Do you advocate for high-performing prelim residents when categorical positions open, either here or at your affiliated hospitals?”

You’re looking for:

• Specific numbers, not vague statements: “Several in the last few years” is less reassuring than “3 of 5 last year.”
• Clear process: Is there a formal review or just informal word-of-mouth?
• Evidence they actually promote prelims when opportunities arise.

3. Questions About Support for Reapplication and Career Development

As a Caribbean IMG, it’s critical you understand how the program supports your career beyond the one-year prelim.

Examples:

1. “What kind of structured support do preliminary residents receive when they reapply through ERAS—such as letter-writing, advising, or mock interviews?”
2. “Are there faculty members who serve as dedicated mentors for preliminary residents, especially those planning to reapply to categorical surgery?”
3. “For Caribbean IMGs, what have been some successful strategies you’ve seen here that helped them secure interviews and matches in the next cycle?”

This signals you’re thinking long-term and want to grow—not just survive the year.

4. Questions About Education, Not Just Service

You want to be taught, not just used as a warm body.

Examples:

1. “How do you ensure that preliminary residents receive operative experience and teaching comparable to categorical interns?”
2. “How do you balance service needs with educational goals for your PGY-1s, including prelims?”
3. “What formal feedback mechanisms are in place for PGY-1s, and how often do you meet with them individually to review progress?”

Good programs will have:

• Weekly didactics and simulation sessions
• Structured feedback (e.g., quarterly reviews)
• IOversight of prelims’ operative logs and progression

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Questions to Ask Current Residents (Especially Prelims)

Residents—particularly current or former prelims—will often give you the clearest picture of reality. This is where your interview questions for them should dig into workload, culture, and actual outcomes.

1. Day-to-Day Reality: Workload and Support

You need to know what your life will look like for 12 months.

Examples:

1. “On a typical day, what time do you usually arrive and leave?”
2. “How many patients are you responsible for on your busiest rotations?”
3. “When things get overwhelming, do seniors and attendings step in to help, or are intern-level tasks just expected to get done no matter what?”
4. “How approachable are the senior residents and attendings when you need help or have questions?”

You’re looking for realistic descriptions (yes, it’s busy) but also real support and teaching.

2. Prelim vs. Categorical Experience

One of the most critical sets of questions to ask residency programs where you might be treated differently as a prelim.

Examples:

1. “As a prelim, do you feel you are treated differently from the categorical interns—in terms of operative opportunities, conferences, or evaluations?”
2. “Are there rotations or cases that are mainly reserved for categorical residents?”
3. “Is there any tension or competition between prelim and categorical residents when it comes to cases or educational opportunities?”

You want to avoid programs where prelims are consistently sidelined from meaningful operative exposure or education.

3. Culture, Wellness, and Mistreatment

Surgery is demanding, but there is a difference between being pushed and being mistreated.

Examples:

1. “Have you witnessed or experienced mistreatment or bullying, and if so, how was it handled?”
2. “When residents struggle—whether clinically or personally—does the program step in to support them or tend to see it as a weakness?”
3. “How receptive is leadership to feedback from residents?”

For an IMG, especially a Caribbean IMG who may already feel more vulnerable, a respectful environment is crucial.

4. Outcomes for Prelims: The Honest Version

Residents will often share more candid details than leadership.

Examples:

1. “Among the prelims you’ve seen come through, what have most of them ended up doing after their year here?”
2. “Do you know of any Caribbean IMGs who matched into categorical surgery or other specialties after doing a prelim year here?”
3. “If you were in my position—Caribbean IMG applying for prelim surgery—would you choose this program again?”

Listen for specific stories (“Last year, two prelims matched categorical, including one from SGU”) rather than only general statements.

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Targeted Questions for Caribbean IMGs and SGU Graduates

As an applicant from a Caribbean medical school (SGU or similar), your path has particular nuances. You want to identify programs familiar with and supportive of IMGs from your background.

1. Questions About the Program’s Experience with Caribbean IMGs

Examples (for PDs or senior faculty):

1. “How familiar is your team with Caribbean medical school residency applicants, such as those from SGU or other Caribbean schools?”
2. “Do you currently have or have you recently had residents from Caribbean schools in your surgery program?”
3. “Are there any additional steps or documentation you expect from Caribbean IMGs that I should be aware of?”

Programs that have multiple IMGs (especially Caribbean-trained) are often more structured and experienced in mentoring them.

2. Questions About Letters, Advocacy, and Networking

Your prelim year should strengthen your candidacy.

Examples:

1. “Do attending surgeons here frequently write strong letters of recommendation for prelims, and what tends to distinguish someone who earns an outstanding letter?”
2. “Are there opportunities to work closely with faculty who are well known in the field and can advocate for Caribbean IMG prelims?”
3. “Does the program help prelims connect with other institutions or specialties where they may want to apply next cycle?”

For a Caribbean IMG, this kind of structured advocacy can be a major differentiator in the next match cycle.

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Practical and Logistics-Focused Questions (That Still Show Insight)

You’ll also need to ask about schedules, rotations, research, and call—but try to frame them in a way that shows you’re thinking like a future surgeon, not just someone worried about hours.

1. Schedule, Rotations, and Call

Examples (for PDs or residents):

1. “What are the key rotations for preliminary interns, and how do they differ from categorical interns’ rotations?”
2. “How is night float or overnight call structured for PGY-1s, and what kind of supervision is available?”
3. “Where do prelims typically get the most operative experience—in terms of specific rotations or services?”

You’re trying to understand:

• How much floor vs. OR vs. ICU time you’ll have
• Whether prelims ever get “stuck” on heavy, non-operative services all year

2. Research and Academic Opportunities

Even in a one-year prelim, research can help your next application—especially as a Caribbean IMG.

Examples:

1. “Are there realistic opportunities for preliminary residents to be involved in research or quality improvement projects during the year?”
2. “Have any of your prelims successfully completed or submitted projects that strengthened their residency applications?”
3. “Are there mentors who are particularly supportive of IMG residents interested in academic projects?”

Look for structured (not just theoretical) opportunities—e.g., ongoing QI projects you can join.

3. Evaluation, Feedback, and Remediation

You want to know how you’ll be evaluated and supported.

Examples:

1. “How often do interns receive formal written feedback, and who is involved in that process?”
2. “If an intern is struggling clinically or personally, what support systems or remediation processes do you have?”
3. “How transparent is the program about performance expectations for prelim residents?”

For a prelim surgery residency, transparency is key: you need to know what it takes to be considered “strong,” especially if you’re hoping for a future categorical slot.

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How to Prioritize and Personalize Your Questions

You can’t ask every question at every interview. You should:

1. Research each program beforehand

   • Know their size, hospital type, basic rotation structure, and any data about SGU residency match or other IMG pathways.
   • Avoid asking something that’s clearly answered on the website.

2. Group your questions by audience

   • Program Director: philosophy, role of prelims, conversion to categorical, support for applying again.
   • Faculty: operative exposure, teaching style, research.
   • Residents: culture, day-to-day life, true experiences of prelims and IMGs.

3. Lead with your top 1–2 priorities
   For many Caribbean IMGs in preliminary surgery, these priorities are often:

   • Reasonable chance at strong mentorship and letters
   • Realistic operative and educational exposure
   • Genuine history of supporting prelims into categorical or other competitive specialties

4. Tailor at least one question to your personal story
   For example, if you’re applying as an SGU grad planning to pursue categorical surgery:

   • “As someone from SGU who hopes to ultimately secure a categorical general surgery position, what would you recommend I focus on during a prelim year in your program?”

This kind of question allows them to offer targeted advice and indicates self-awareness and motivation.

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Common Pitfalls: Questions You Should Avoid or Reframe

Some questions can unintentionally send the wrong signal. Be mindful of:

1. Over-focusing on hours or moonlighting

   • Instead of: “How many hours exactly do you work?”
   • Try: “How does the program help residents stay within duty hours while still ensuring they get adequate operative exposure and learning?”

2. Questions that sound like you want the easiest path

   • Instead of: “Is this an easier prelim compared to others?”
   • Try: “What makes interns who thrive here successful, and what qualities are most important?”

3. Overly confrontational questions about being ‘used as scut’

   • Instead of: “Are prelims just used as scut workers?”
   • Try residents-only: “Do prelim residents feel they have a balance of learning and service, or is it mostly service?”

4. Questions about salary, vacation, or benefits too early

   • You can and should know these—but they’re better asked after you’ve already shown you care about education and growth, or simply read the contract/website when available.

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Putting It All Together: Sample Question Sets for a Caribbean IMG Prelim Applicant

Below are example “bundles” of questions to ask programs that you can adapt to your style.

A. For the Program Director

• “How do preliminary surgery residents fit into the structure of your program, and what do you see as their primary educational goals for the year?”
• “Over the past few years, how many prelims have moved into categorical surgery positions here or elsewhere?”
• “What specific support does your program provide prelims when they reapply to residency—especially Caribbean IMGs?”
• “How do you ensure that prelims are included in operative and educational opportunities similarly to categorical PGY-1s?”

B. For Faculty Interviewers

• “On your service, what distinguishes a high-performing PGY-1 prelim from an average one?”
• “Are there research or QI projects that you feel are realistic for prelims to join and complete within one year?”
• “How do you typically mentor prelims who want to strengthen their candidacy for a future categorical surgery match?”

C. For Current Residents (Categorical and Prelim)

• “What does a typical day look like for a prelim intern on your busiest rotation?”
• “Do prelims here feel like full members of the team, or is there a noticeable divide between prelim and categorical roles?”
• “Have you seen Caribbean graduates here successfully match into categorical surgery or other specialties after their prelim year?”
• “If you could give one piece of advice to a new prelim from a Caribbean school starting here, what would it be?”

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FAQ: Questions About Asking Questions

1. How many questions should I ask each interviewer?

Aim for 2–3 thoughtful questions per interviewer. It’s better to ask fewer, well-prepared questions and really listen to the answers than to rush through a long list. Prioritize items that:

• Are not easily found online
• Reflect your seriousness about growth and education
• Address your specific situation as a Caribbean IMG in preliminary surgery

2. Is it okay to ask directly about conversion to categorical positions?

Yes—this is both appropriate and expected for prelim applicants. The key is to be professional and data-oriented:

• “In the past 3–5 years, how many prelims have transitioned into categorical positions here or elsewhere?”

Avoid sounding entitled (“Will you make me categorical?”) and instead focus on history, pathway, and what performance level is needed.

3. Should I mention that I’m from a Caribbean school (e.g., SGU)?

You don’t need to overemphasize it, but you also shouldn’t hide it—it’s part of your story. Many programs have successful SGU residency match outcomes and are familiar with Caribbean IMGs. You can frame it positively:

• “As a graduate of a Caribbean school, I’ve often found I need to be very proactive about mentorship and opportunities. How can a prelim here best connect with mentors and advocates?”

4. Can I reuse the same questions at different programs?

Yes, but customize them slightly based on each program’s structure and your research. For example:

• At a large academic center with many IMGs: ask more about research and academic advocacy.
• At a smaller community hospital: focus more on hands-on operative experience and close mentorship.

Keep a core list of 10–15 strong questions and select the 3–5 most relevant for each interview day.

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By approaching your interviews with clear, targeted questions, you demonstrate maturity, insight, and a long-term vision—exactly what programs want in a preliminary surgery residency applicant. As a Caribbean IMG, the quality of your prelim year can dramatically influence your trajectory. Use your questions to identify programs that will not only train you hard, but also advocate for you, teach you, and open doors for the next step in your career.