Residency Advisor
Essential Questions DO Graduates Must Ask for Internal Medicine Residency
Why Your Questions Matter as a DO Graduate in Internal Medicine
As a DO graduate aiming for an internal medicine residency, the questions you ask programs can significantly influence:
- How you’re perceived as a candidate
- The information you gather for your rank list
- Whether a program is truly DO-friendly and supportive of your training needs
For DO graduates, the osteopathic residency match landscape has changed since the ACGME single accreditation system, but issues remain: not all internal medicine residency programs value OMM/OMT, some have limited COMLEX familiarity, and others have structural barriers to DO advancement. Asking the right questions—at the right times and to the right people—helps you identify programs where you will thrive.
This guide will give you targeted, high-yield questions to ask residency programs during interviews, pre-interview socials, and second looks—specifically tailored for a DO applying to internal medicine residency. You’ll also learn what to ask program directors, chiefs, and residents; how to interpret their answers; and how to avoid red flags.
Strategy First: How to Approach Asking Questions
Before diving into specific questions, you need a framework. Your goal is not to ask every possible question, but to ask the right questions to the right person at the right time.
1. Know Your Priorities as a DO Applicant
Clarify what matters most to you:
- DO-friendliness & culture
- Academic vs community training
- Fellowship opportunities (cards, GI, pulm/crit, heme/onc, hospitalist, primary care)
- Location & lifestyle
- Schedule and workload
- OMM/OMT integration (if important to you)
- Support for COMLEX, Step 3, and board prep
Write down your top 6–8 priorities. Every key question you ask should help you evaluate at least one of these priorities.
2. Match Question to Audience
Not every question should go to the program director. Use this guide:
Program Director (PD)
Big-picture philosophy, educational structure, DO support, promotion, fellowships, remediation processes, how they view COMLEX vs USMLE.Associate PD / Core Faculty
Curriculum design, teaching, research, mentorship, evaluation systems.Chief Residents / Current Residents
Day-to-day life, call schedule, culture, how DOs are treated, workload, moonlighting, wellness, real fellowship outcomes.Coordinator / Administrative Staff
Logistics, licensing, visas (if relevant), contract details, schedule templates, orientation.
3. Avoid “Googleable” Questions
Do not ask about things clearly stated on the website (e.g., “How many residents do you have?”). Instead, build on that info:
- “I saw you have 10 categorical positions per year—how does that size impact resident camaraderie and teaching on the wards?”
4. Use Open-Ended, Insight-Seeking Questions
You want specific stories and examples, not generic answers.
Compare:
- Weak: “Is this a DO-friendly program?”
- Strong: “Can you share examples of how DO residents have been supported in leadership or fellowship pursuits here?”
DO-Specific Questions to Ask During Internal Medicine Interviews
As a DO graduate, you must deliberately probe how the program values and integrates DO training. These questions are especially important in the current osteopathic residency match environment.
A. Questions to Ask About DO-Friendliness & Culture
Good to ask PD, APD, and residents:
“How many DO residents are currently in the program, and in what roles (chiefs, leadership, research, committees)?”
- Why it matters: Pure numbers are less important than seeing DOs in leadership/academic roles.
- Green flag: Specific examples of DO chiefs, fellows, QI leaders.
- Red flag: “We’ve had one DO in the last 5 years” or vague, evasive responses.
“How has your program historically supported DO residents in achieving their career goals, whether fellowship or general internal medicine?”
- Look for: Named DO graduates and their outcomes, structured mentorship.
“How do faculty and residents perceive DO training here? Are there any differences in expectations or support between DO and MD residents?”
- Green flag: “No difference in expectations; we treat DOs and MDs identically in opportunities and support.”
- Red flag: Comments implying DOs must “prove” themselves more, or “we don’t really see DOs go into competitive fellowships.”
“Have there been DO chief residents, and how are chiefs selected?”
- Why it matters: Chief positions often correlate with institutional respect, mentorship, and visibility.
B. Questions About OMM/OMT and Osteopathic Identity
If OMM/OMT is important to you:
“Are there opportunities to incorporate OMM/OMT into patient care or teaching here, formally or informally?”
- Green flag: Elective time in OMM, inpatient consults, outpatient continuity clinic integration.
“Would the program support me in teaching OMM to interested colleagues or students—for example, giving a workshop or mini-lecture?”
- Signal: Programs that welcome osteopathic teaching tend to be more genuinely DO-friendly.
“Is there any faculty with osteopathic training or OMM certification on staff?”
- Not a deal-breaker if no, but DO faculty presence is a strong plus.
C. Questions About Board Exams: COMLEX and USMLE
For many DOs, this is a critical part of the internal medicine residency and IM match decision.
“How does the program view COMLEX scores in comparison to USMLE for resident evaluation and fellowship letters?”
- Green flag: “We recognize COMLEX as equivalent. We know how to interpret those scores and advocate for DO residents in fellowship applications.”
- Red flag: “We really focus more on USMLE—even for DOs.”
“What support do residents receive in preparing for ABIM/board exams, and are there any differences in how DO residents are guided if they took only COMLEX or both exam series?”
- Look for: Paid review courses, paid time off, in-training exam review.
“Do you require DO residents to take USMLE Step 3, or is COMLEX Level 3 sufficient for licensing and internal tracking?”
- Clarify expectations early, especially if you have not taken USMLE.
High-Yield Questions for Program Directors in Internal Medicine
Your time with the PD is precious. Plan 3–5 high-impact questions that align with your priorities and demonstrate insight. This is where what to ask program director matters most.
A. Questions That Show Insight and Maturity
“What characteristics distinguish residents who truly thrive in this internal medicine residency from those who struggle?”
- Why it works: Signals self-awareness, gives you insight into culture and expectations.
“How has the program changed in the last 3–5 years, and what major changes do you anticipate in the next few years?”
- Green flag: Clear vision, concrete initiatives (curriculum redesign, wellness, research).
- Red flag: Vague or defensive comments; “We don’t really change much.”
“What are you most proud of about this program, and what are you currently working to improve?”
- Good PDs will be transparent about strengths and areas of active growth.
B. Questions About Education, Autonomy, and Supervision
“How do you balance resident autonomy and supervision, particularly on night float and ICU rotations?”
- Look for: Graduated responsibility, clear policies, attending back-up.
“How are residents involved in shaping the curriculum? Can you give a recent example where resident feedback led to a concrete change?”
- Signals whether your voice will matter.
“What does your program do particularly well in preparing graduates for both general internal medicine and competitive fellowships?”
- Green flag: Concrete metrics: fellowship match lists, hospitalist roles, academic positions.
C. Questions About Evaluation, Feedback, and Support
“How often do residents receive formal feedback, and what does your remediation process look like if someone is struggling?”
- You’re not saying you plan to struggle; you’re showing maturity and concern for training quality.
- Green flag: Structured mentorship, clear milestones, no shame-based language.
“In what ways are residents supported when they experience burnout or personal difficulties?”
- Look for: wellness resources, coverage for medical/mental health appointments, no retaliation for needing help.
“How do you advocate for your residents when they apply to fellowships, especially DO graduates who may face additional barriers at some academic centers?”
- Green flag: PD personally calls program directors, has strong relationships with fellowship PDs, can share specific examples.
Questions to Ask Residents: Real-Life Culture, Workload, and Support
Residents will give you the clearest window into what your life will actually look like.
A. Questions About Day-to-Day Life and Workload
“Can you walk me through a typical day on wards for an intern and for a senior?”
- You want specifics: start/end times, admissions, notes, teaching structure.
“On average, how many patients does an intern carry on wards? How often do you feel rushed vs. having time to think and learn?”
- Red flag: Consistent census in the high teens without support, or residents seeming chronically exhausted.
“What does your call and night float schedule look like across PGY1–3?”
- Ask about:
- Number of consecutive nights
- Weekend frequency
- ICU vs floor nights
- Ask about:
“How often do you work 6 or 7 days in a row, and how strictly is the 80-hour work week monitored?”
- Green flag: Honest acknowledgment of busy stretches + mechanisms to Protect duty hours.
- Red flag: “80 hours is more of a suggestion,” or residents laughing nervously.
B. Questions About Culture, Support, and DO Experience
“Do you feel comfortable asking for help from seniors and attendings? How is it received when you say, ‘I don’t know’?”
- You’re probing psychological safety and teaching culture.
“As a DO graduate applicant, I’m curious: how have DO residents been treated here? Do you see any differences in how DOs and MDs are perceived or supported?”
- Ask this when you’re alone with residents, not in front of leadership.
“What’s something about this program that pleasantly surprised you after starting?”
- Often reveals hidden strengths: supportive staff, strong nursing collaboration, tight resident community.
“What’s one thing you wish you had known about this program before you matched?”
- This can reveal pain points: commute, limited ancillary support, documentation burden.
C. Questions About Education, Mentorship, and Opportunities
“How strong is the teaching culture here—on rounds, morning report, and noon conference?”
- Ask for examples of high-yield teaching they’ve experienced recently.
“How easy is it to find mentors, especially for DO residents interested in competitive fellowships?”
- Green flag: Residents can list multiple approachable mentors by name.
“Are there structured research or QI opportunities? How many residents typically present posters or publications each year?”
- You don’t need to be research-heavy, but you want opportunities if your goals change.
“How supportive is the program when residents start applying to fellowships—do you get protected time, help with letters, or mock interviews?”
- Particularly important if you are eyeing cardiology, GI, pulm/crit, or heme/onc.
D. Questions About Wellness, Location, and Life Outside the Hospital
“Where do most residents live, and how is the commute and call-room situation?”
- Hidden burden: 45-minute commute after long calls adds up.
“How often do residents realistically get to exercise, see friends or family, and take real days off?”
- You want honest, not curated, answers.
“What do you do for fun around here, and do residents hang out with each other outside of work?”
- Helps you gauge community fit—important for your mental health.
Questions to Ask About Fellowship Outcomes and Career Paths
Internal medicine is a launchpad. Whether you’re thinking primary care, hospitalist, or subspecialty, you should ask about career support.
A. Questions for PD/Faculty About Fellowship and Career Outcomes
“Can you share a recent snapshot of your graduates’ career paths—fellowship types, hospitalist roles, primary care positions?”
- Green flag: Concrete data or recent match lists (even if de-identified).
“How are DO residents supported when they pursue competitive fellowships like cardiology, GI, or pulmonary/critical care?”
- Look for: early mentorship pairings, research pathways, letter-writing culture.
“Do you have any formal tracks—such as clinician-educator, hospitalist, primary care, or research—for residents with specific career goals?”
- Not required, but structured tracks can be a major plus.
“How involved are residents in teaching medical students, and do they receive any formal training in medical education?”
- Important if you’re considering academic medicine.
B. Questions for Residents About Real Fellowship Support
“Have residents had any difficulty matching into their desired fellowships, especially DO residents?”
- Ask for examples, both positive and negative.
“How proactive is the program in connecting you with mentors and letter writers once you declare fellowship interests?”
“Do people who choose to work as hospitalists or in primary care after residency feel well-prepared?”
- You want programs that don’t neglect non-fellowship-bound residents.
How to Customize and Prioritize Your Question List
You cannot—and should not—ask all of these questions in a single interview day. Here’s how to construct a focused, strategic list.
1. Create Three Separate Question Lists
Organize your questions into three columns:
- For Program Director / APDs (3–5 questions)
- For Residents (6–8 questions)
- For Coordinator/Staff (2–3 questions)
Then highlight 2–3 “must-ask” questions in each category that address your top priorities (e.g., DO-friendliness, fellowship outcomes, workload).
2. Tailor Questions to Each Program
Review each program’s website and materials before the interview. Then:
Adapt wording using specific program details:
- “I noticed you have a strong cardiology fellowship presence here…”
- “I saw that about a third of your graduates go into hospitalist roles…”
Avoid redundancy: don’t ask about something already answered in your pre-interview packet or slide deck unless you want clarification or deeper insight.
3. Ask Follow-Up Questions
Often, the best information comes from thoughtful follow-ups:
- “You mentioned that DO residents have done well here—can you share a recent example?”
- “You said you recently changed the call schedule; what prompted that change?”
Follow-ups show active listening and genuine interest.
4. Take Notes Immediately After
As soon as the interview day ends, jot down:
- Key impressions
- Specific answers that stood out
- Red flags and green flags
These notes will be invaluable when creating your rank list after the osteopathic residency match interview season.
Common Mistakes DO Graduates Make When Asking Questions
Being aware of pitfalls can help you avoid undermining an otherwise strong interview.
1. Asking “Checklist” Questions Without Context
Rattling off “How many ICU months? How many clinics per week?” in a mechanical way makes you sound unprepared and uninterested in the program as a unique place.
Better:
- “Given your mix of community and academic sites, how do your ICU and ward rotations complement each other in preparing residents for critical care and general internal medicine?”
2. Over-Focusing on Schedule and Time Off Early
Of course, schedule and wellness matter, but if your first questions are all about vacation and moonlighting, you risk sending the wrong message.
Balance your questions:
- Education and culture
- Fellowship and career support
- THEN schedule, lifestyle, and logistics
3. Asking Leading or Negative Questions About DO Prejudice
You may worry (understandably) about bias as a DO graduate in the IM match. Avoid accusatory phrasing.
Not ideal:
- “Why don’t you take more DOs?”
- “Do attendings here think DOs are less competent?”
Better:
- “Can you share how DO and MD residents have historically been integrated here, and whether there are any differences in career support or expectations?”
- “What has been your experience advocating for DO graduates during fellowship applications?”
4. Not Asking Any DO-Specific Questions
If you don’t ask, you may not realize you’re choosing a program with limited DO support until after you match. At minimum, ask:
- About current DO residents
- How COMLEX is interpreted
- How DOs have fared in fellowships and leadership
Putting It All Together: A Sample Question Set for One Program
Here’s an example of a focused, balanced list for a DO graduate applying to an internal medicine residency:
For the Program Director:
- “What characteristics distinguish residents who truly thrive in this program from those who have a harder time?”
- “How has the program evolved in the last few years, and what major changes do you anticipate next?”
- “Can you share how DO residents have done in terms of leadership roles and fellowship matches here?”
- “How do you view COMLEX scores in relation to USMLE, both for evaluation during residency and in letters for fellowship?”
For the Residents:
- “Can you walk me through a typical day on wards for an intern?”
- “How are DO residents integrated into the program, and have you noticed any differences in how DOs are treated or supported?”
- “What’s one thing about this program that you wish you had known before matching?”
- “How manageable is your patient load, and do you generally feel you have time to actually learn on shift?”
- “What are the strengths and weaknesses of your ICU and night float experiences?”
- “How supportive is the program when people start applying for fellowships, especially more competitive ones?”
For the Coordinator/Staff:
- “Could you tell me about the orientation process and how new interns are supported in their first weeks?”
- “Are there any unique logistical challenges—commute, parking, multiple sites—that new residents often underestimate?”
With a tailored list like this, you come across as thoughtful, serious, and genuinely interested—not just in matching, but in finding a program where you can thrive as a DO in internal medicine.
FAQs: Questions to Ask Programs for DO Graduate in Internal Medicine
1. As a DO graduate, should I directly ask if a program is DO-friendly?
You can, but it’s more informative to ask specific, concrete questions:
- “How many DO residents are currently in the program?”
- “Have there been DO chief residents or DO graduates in competitive fellowships?”
The answers (and tone) will tell you far more than a generic “Yes, we like DOs.”
2. What are some strong “interview questions for them” that also make me look like a serious candidate?
Aim for questions that show insight and forward-thinking, for example:
- “What differentiates your graduates as they enter practice or fellowship compared to graduates from other IM programs?”
- “How has resident feedback specifically shaped curriculum or schedule changes in the last few years?”
- “What opportunities are there for residents to develop as clinician-educators or leaders?”
These highlight your focus on growth and contribution rather than just surviving residency.
3. Is it appropriate to ask directly about fellowship match rates during interviews?
Yes—but frame it professionally. For instance:
- “Could you share a recent snapshot of your graduates’ fellowship and career outcomes, including DO graduates?”
Avoid sounding like you see residency only as a “stepping stone,” but it’s absolutely acceptable—and smart—to ask about outcomes.
4. How many questions should I ask in each interview session?
Aim for:
- PD/Faculty interviews: 2–4 thoughtful questions, leaving space for follow-ups
- Resident sessions: 4–6 questions across a group (not per resident)
- Socials/second look: More informal, but still targeted; use this time for culture, lifestyle, and DO-specific experiences
Quality matters far more than quantity. One excellent, well-timed question that leads to a rich discussion is better than five superficial ones.
By crafting strategic, thoughtful questions to ask residency programs, you’ll not only present yourself as a mature, engaged DO applicant, but you’ll also collect the nuanced information you need to build a rank list that aligns with your goals in internal medicine residency and beyond.
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