Essential Questions for DO Graduates Pursuing General Surgery Residency

Choosing the right general surgery residency as a DO graduate is about much more than “getting a spot.” The questions you ask programs will shape how well you understand their training, culture, and how successful—and happy—you’ll be there for 5+ years.

Below is a comprehensive guide to high-yield, strategic questions to ask programs during the general surgery residency match process, tailored specifically for DO graduates. Use these to prepare for interviews, pre-interview dinners, and post-interview follow‑up calls.

---

Why Your Questions Matter Even More as a DO Graduate

As a DO graduate entering the surgery residency match, you’re evaluating two things simultaneously:

1. Is this program a good fit for me as a future surgeon?
2. Is this program a good fit for me as a DO graduate?

The transition to a single accreditation system has improved access for DO applicants, but there are still real differences in:

• How programs view and integrate DO graduates
• Support for COMLEX vs USMLE
• Opportunities for fellowship placement from DO-friendly environments

Thoughtful questions help you:

• Identify genuine DO-friendly programs
• Clarify training quality and operative experience
• Understand culture, wellness, and support
• Avoid red flags like chronic under-staffing, malignant culture, or poor outcomes

Use interviews as two-way conversations—this is your chance to gather data. The best interview questions for them show insight, maturity, and an understanding of general surgery training.

---

Core Strategy: How to Ask Smart, High-Yield Questions

Before diving into specific examples, keep these guiding principles in mind:

• Be specific, not generic. Instead of “What is your program like?” ask, “How early do interns start performing basic laparoscopic cases as primary surgeon?”
• Tailor questions to the person. Ask residents about culture and workload; ask faculty about operative expectations, teaching, and career development; ask the program director (PD) about program vision and outcomes.
• Avoid questions easily answered on the website. Show you’ve done your homework and want deeper insight.
• Anchor questions to your identity as a DO and future surgeon. E.g., “As a DO graduate interested in general surgery, how does your program support DO residents pursuing competitive fellowships?”

Below are organized lists of questions to ask residency programs, broken down by topic, with notes on who to ask and why it matters.

---

1. Questions About DO-Friendliness and Program Attitude

For a DO graduate residency applicant, the first priority is whether you’ll be respected, supported, and set up for success. These questions help clarify that.

For the Program Director or Associate PD

1. “How many of your current residents are DO graduates, and how have they done in your program?”
Why it matters: Past behavior predicts future behavior. If multiple DOs are thriving—with leadership roles, fellowships, and positive outcomes—it’s a good sign.

2. “How do you view COMLEX vs USMLE in your evaluation of residents’ performance and fellowship potential?”
If you’ve only taken COMLEX, this question is critical. Ask:

• Whether the program is comfortable interpreting COMLEX scores
• Whether they support DOs who apply to fellowships that historically expect USMLE

3. “Have your DO graduates matched into competitive fellowships? Can you share a few recent examples?”
This directly addresses long-term outcomes and whether your degree is a non-issue at the program.

4. “Are there any structural differences in how DO and MD residents are supported or evaluated?”
You want to hear a clear “No—everyone follows the same structure,” plus examples of DOs in chief positions, QI, research, or leadership.

For Current Residents (Especially DOs)

5. “As a DO in this program, have you ever felt treated differently—positively or negatively?”
You’re looking for honest answers. Slight hesitations or vague responses might indicate unspoken issues.

6. “How did the program support you during the transition from osteopathic medical school to this residency—clinically and culturally?”
This reveals how intentional the program is about onboarding DOs into an environment that may be heavily MD-dominated.

Subtle Red Flags

• “You’re our first DO” with no clear plan for support or mentorship
• “We don’t really pay attention to COMLEX” if you didn’t take USMLE
• Programs that can’t name a single DO graduate who matched into a competitive fellowship or leadership role

---

2. Questions About Operative Volume, Training, and Case Autonomy

You’re not just matching into a name—you’re matching into your surgical skillset for life. For a general surgery residency, the quality and structure of operative experience are non-negotiable.

For the Program Director or Surgical Faculty

7. “How is operative autonomy structured across PGY levels?”
Ask for concrete examples:

• What cases interns perform (hernia repairs, port placements, appendectomies)
• When residents become primary surgeon for laparoscopic cholecystectomies
• How complex cases are assigned (oncologic resections, vascular, thoracic, etc.)

8. “Can you walk me through a typical operative week for a PGY-2 and PGY-3?”
You want specifics, not generalities. Ask:

• How many days are OR vs clinic vs floor
• How often juniors scrub in as primary vs assistant

9. “How do you ensure residents meet or exceed ACGME case minimums without compromising case quality or autonomy?”
Programs should track cases closely and intervene early if someone is behind.

10. “Will I have exposure to a breadth of cases—trauma, critical care, oncologic, vascular, endocrine, colorectal, MIS, and bread-and-butter general surgery?”
Verify that no major area is missing. Ask specifically if there are:

• Level I or II trauma rotations
• Dedicated SICU rotations with procedural autonomy

For Residents

11. “At your current level, what are the typical cases you’re performing as primary surgeon?”
Compare answers across PGY levels. A strong program will show a clear progression.

12. “Do you ever feel like there are too many residents or fellows competing for cases?”
Fellows can be excellent teachers—but in some programs, they displace resident operative opportunities.

13. “Do seniors ever graduate feeling underprepared in certain areas? If so, which and why?”
If multiple residents point to the same weak area (e.g., limited vascular or oncologic experience), interpret cautiously.

Special Consideration for DO Applicants

If there are former AOA osteopathic programs now in the single accreditation, ask:

14. “Has the transition from AOA to ACGME changed operative volume or how autonomy is granted?”
Some former osteopathic programs historically offered very high case volume and early autonomy—this can be a huge advantage, but you want to ensure it’s preserved under the unified system.

---

3. Questions About Education, Evaluation, and ABSITE/Board Support

You’re not just training to operate—you’re training to be board-certified and competitive for fellowships or practice. Structured education and feedback matter.

For the Program Director, APD, or Clerkship Director

15. “How is your didactic curriculum structured, and what expectations do you have for resident participation?”
Ask if they have:

• Weekly protected didactics
• Morbidity & Mortality (M&M) conference
• Tumor board, journal clubs
• Skills labs (simulators, laparoscopic trainers, endoscopy labs)

16. “How do you support residents’ performance on the ABSITE?”
Follow up with:

• Do you provide structured ABSITE review sessions?
• Access to question banks or review materials?
• Remediation plans for low scores?

17. “What is your recent board pass rate, both first-time written and oral?”
Board outcomes are critical. For a surgery residency match decision, you want high and stable pass rates, not variable or declining performance.

18. “How is resident performance evaluated and fed back to us throughout the year?”
Look for:

• Regular evaluations after each rotation
• Semi-annual meetings with PD or advisor
• Clear milestones and expectations

For Residents

19. “Do you feel the didactics and teaching actually prepare you for ABSITE and boards?”
Residents will tell you if didactics are protected—versus constantly interrupted by pages, consults, or staffing shortages.

20. “When someone struggles academically or clinically, how does the program respond?”
You want a supportive, structured plan, not a punitive or neglectful culture.

---

4. Questions About Culture, Wellness, and Workload

General surgery is demanding everywhere. You’re not looking for an “easy” program; you’re looking for a sustainable one that produces excellent surgeons without burning them out or tolerating abuse.

For Residents (Your Best Source Here)

21. “How would you describe the culture between residents and attendings?”
Ask for concrete examples: How do attendings respond to questions? How do they handle mistakes?

22. “Have you ever witnessed or experienced bullying, harassment, or unprofessional behavior? How was it handled?”
You want honesty. One incident handled well is less concerning than repeated incidents ignored or minimized.

23. “What does a typical week look like for you in terms of hours, call, and post-call expectations?”
Clarify:

• Average hours per week
• In-house vs home call
• Whether post-call days are truly post-call (i.e., do you actually leave?)

24. “Do you consistently log under 80 hours, or do residents frequently exceed duty hour limits?”
Chronic violations with no system changes = major red flag.

25. “What wellness resources exist, and do residents actually use them?”
This includes:

• Access to mental health services
• Wellness days or stipends
• Mentorship programs
• Social events that residents genuinely attend

26. “Do people have lives outside of the hospital? What do your co-residents do for fun?”
You’re not looking for a vacation program—but you want some semblance of balance.

For Programs With a History of Osteopathic Training

27. “How has the program maintained its historically strong operative and community culture while meeting new accreditation standards?”
This can reveal whether previously positive aspects of an osteopathic residency model have been preserved or lost.

---

5. Questions About Research, Fellowships, and Career Outcomes

Even if you think you’ll be a community general surgeon, your program’s academic and career support matters. For DO graduates in general surgery, this is especially important when competing for fellowships in fields like surgical oncology, MIS, vascular, or trauma.

For Program Leadership

28. “What types of research are residents typically involved in—clinical, outcomes, basic science, QI?”
Clarify:

• How many residents produce at least one presentation or publication per year
• Whether there’s structured support for IRB, statistics, or writing

29. “Is there a dedicated research year or option for a research track?”
If you’re strongly fellowship-focused, a structured research year can be valuable—ask how often residents actually use it and what outcomes they achieve.

30. “What percentage of graduates go directly into fellowship vs general practice?”
Follow up with:

• “Can you share where recent graduates matched for fellowship, including any DO graduates?”

This reveals whether DOs are achieving the same fellowship outcomes as MDs.

31. “How does the program support fellowship applications—letters, networking, tailoring rotations?”
You’re looking for active, intentional advocacy from faculty.

For Residents (Especially Seniors)

32. “If you were applying to fellowship from this program as a DO graduate, did you feel fully supported and competitive?”
Ask for specific stories of recent DO graduates applying to:

• Surgical oncology
• MIS/bariatric
• Vascular
• Trauma/critical care
• Colorectal

33. “How easy is it to get involved in research here—do attendings actively invite residents to collaborate?”
A program can claim to be “research-friendly,” but the real test is whether residents feel supported and have actual output.

---

6. Questions to Ask Program Directors Specifically

You’ll often have limited direct time with the PD, so prioritize high-value, big-picture questions.

Here are targeted “what to ask program director” questions that show insight and help you assess fit:

34. “What qualities do you value most in your residents, and how does your program help them grow into independent surgeons?”
This reveals the PD’s core philosophy—and lets you see if it matches your values.

35. “How has your program changed over the last 5–10 years, and what changes do you anticipate in the next 5?”
You want a program that is evolving thoughtfully, not static or reactive.

36. “What do you see as this program’s biggest strength and its biggest area for growth?”
Balanced answers suggest self-awareness and honesty.

37. “Where have your graduates struggled historically, and what have you done to address those gaps?”
Look for concrete actions, not vague reassurances.

38. “As a DO graduate specifically, are there any unique ways you see me contributing to or benefiting from this program?”
This gives the PD a chance to explicitly voice support for DO residents and speak to how they’re integrated.

---

7. Strategic Tips on When and How to Ask These Questions

Before Interview Day

• Study the website so you don’t waste rare face time asking for basic information.
• Prepare a short list of 5–7 priority questions you want answered at each program.
• Customize based on the program’s profile (size, academic vs community, former AOA vs historically ACGME).

During Interview Day

• Use your one-on-ones for intentional, higher-level questions:

  • With PD/APD: program vision, outcomes, DO support, board performance
  • With faculty: operative autonomy, mentorship, fellowships
  • With residents: culture, daily reality, call, workload, wellness

• Avoid negatively framed or confrontational questions. Instead of:

  • “Are you malignant?”
    Try:
  • “How does your program balance high expectations with support and feedback?”

After the Interview (Second Looks, Follow-Up Emails or Calls)

If there are remaining gaps:

• Email the coordinator to connect you with a DO resident or senior resident if you haven’t met one yet.
• Ask more specific questions about contract details, benefits, moonlighting, and call structure if not previously addressed.
• Use this time for clarification, not entirely new topics.

---

Sample Question Lists You Can Use Directly

Here are condensed, ready-to-use lists tailored to different people you’ll meet.

For the Program Director

• “How have DO graduates historically done in your program and in fellowship placement?”
• “What do you consider the core strengths and weaknesses of this residency?”
• “How do you support residents who struggle academically or clinically?”
• “What changes are you planning for the residency over the next few years?”

For a Senior Resident

• “What cases are you performing independently now, and do you feel ready for practice/fellowship?”
• “How would you describe the culture between residents and attendings?”
• “Do you feel this program has prepared you well for ABSITE, boards, and your next step?”
• “If you had to choose again, would you rank this program first—and why?”

For a DO Resident (If Available)

• “As a DO graduate, have you felt supported and treated equitably here?”
• “Have there been any challenges unique to being a DO, and how did the program respond?”
• “How have DO graduates from this program done in terms of leadership roles and fellowships?”

---

Putting It All Together: Building Your Rank List as a DO Applicant

As you move through the osteopathic residency match within the unified system, track answers in a structured way:

• Create a spreadsheet with columns like:

  • DO representation + DO friendliness
  • Operative volume & autonomy
  • ABSITE/board support and outcomes
  • Culture & wellness
  • Fellowship placement (including DOs)
  • Your overall “gut feel”

• After each interview, write brief, honest reflections the same day:

  • How did residents seem—honest, tired, bitter, enthusiastic?
  • Did you feel like your DO background was valued or merely tolerated?
  • Could you see yourself functioning and growing there for 5–7 years?

The best general surgery residency for you as a DO graduate is where you can:

1. Become an excellent, confident surgeon with strong operative skills
2. Be fully supported as a DO—academically, culturally, and in career development
3. Maintain enough wellness to stay safe, learn effectively, and sustain your career

Thoughtful, targeted questions are one of your most powerful tools to find that fit.

---

FAQs: Questions to Ask Programs for DO Graduates in General Surgery

1. As a DO graduate, should I specifically ask if a program is DO-friendly?
Instead of asking directly, use targeted questions that reveal actual behavior:

• “How many current residents and recent graduates are DOs?”
• “Where have DO graduates matched for fellowship or taken jobs?”
• “Are there any DO faculty or DO chiefs in the program?”

The answers will tell you more than a generic “We’re DO-friendly.”

---

2. What if a program has no current DO residents—should I be worried?
Not necessarily, but you should probe further:

• If they’ve never had DO residents and seem unfamiliar with COMLEX, that’s more concerning.
• If the program recently began interviewing DOs and is clearly enthusiastic and informed, it may still be a good option.
  Focus on how they talk about DOs, not just the numbers.

---

3. Are there any questions I should avoid asking on interview day?
Yes. Avoid:

• Anything easily answered on the website (vacation days, basic call structure, etc.).
• Questions about salary or moonlighting as your first or only question.
• Negatively framed questions like, “I heard your program is malignant—is that true?”

You can still get this information by asking residents more neutral but revealing questions about culture, support, and workload.

---

4. How many questions should I ask during each interview?
Quality matters more than quantity. Aim for:

• 2–3 thoughtful questions for each faculty or PD interview
• 3–5 deeper questions during resident interactions (lunch, social events, tours)

Have more prepared than you’ll use, but be ready to adjust based on what’s already been discussed.

---

By preparing insightful, targeted questions to ask residency programs, you’ll not only impress interviewers—you’ll gather the information you need to confidently build your rank list as a DO graduate pursuing general surgery residency.