Essential Questions for DO Graduates in EM-IM Residency Interviews

As a DO graduate applying to Emergency Medicine–Internal Medicine (EM-IM) combined programs, your interview questions are not just a formality—they are one of your most powerful tools. Well-crafted questions show you understand the unique demands of a five-year dual residency, that you’re thinking ahead about your career, and that you know how to advocate for your education and well-being.

This guide walks you through strategic questions to ask residency programs, tailored specifically for EM-IM and for DO graduates. Use it to build your own question list, not to memorize scripts. Program directors and residents can tell when you’re genuinely curious versus reading off a checklist.

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Understanding Your Goals as a DO Graduate in EM-IM

Before deciding what to ask program directors or residents, get clear on your goals as a DO graduate pursuing EM-IM.

Clarify your priorities

Ask yourself:

• Why EM-IM specifically, rather than EM alone or IM alone?
• How important are:
  • Procedural volume?
  • Critical care training?
  • Primary care vs. hospitalist opportunities?
  • Academic vs. community environment?
  • Geographic location and family needs?
• Do you anticipate:
  • Fellowship (e.g., critical care, ultrasound, toxicology, cardiology, palliative)?
  • Academic career or community practice?
  • Urban vs. rural practice?

Write down your top 5 priorities before interview season. This will guide which interview questions for them are most important and help you compare programs meaningfully.

DO-specific considerations

As a DO graduate, you should also think about:

• How osteopathic-friendly the program and institution are
• Whether your osteopathic training will be valued, integrated, or overlooked
• Opportunities to use and maintain OMT skills (even though EM-IM isn’t an “OMM-heavy” field)
• Any past bias you’ve encountered and what you’d like to avoid

These priorities will help you decide which questions are non-negotiable during the osteopathic residency match process.

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Core Questions for EM-IM Combined Structure and Curriculum

The EM-IM combined format is demanding and structurally complex. You must deeply understand how the program is organized. These questions help you compare how different EM-IM programs balance five intense years of training.

Questions to ask about rotation structure and schedule

These are best directed to program leadership and chief residents:

1. How is the five-year curriculum structured between Emergency Medicine and Internal Medicine?

   • Follow-up: Is it block-based (e.g., 3 months EM, 3 months IM), or does it alternate more frequently?

2. How many months of Emergency Medicine vs. Internal Medicine do residents complete over the five years?

   • Follow-up: Are there minimums required for EM board eligibility and IM board eligibility clearly met by your schedule?

3. How much critical care exposure do EM-IM residents get, and in which settings (MICU, SICU, CVICU, Neuro ICU, ED critical care)?

4. How are EM-IM residents integrated into categorical EM and categorical IM schedules?

   • Follow-up: Do we rotate as part of both categorical classes, or mostly as a separate EM-IM group?

5. Are there dedicated EM-IM rotations that blend both skill sets (e.g., observation units, ED-based admit service, medical step-down units)?

6. How flexible is the schedule for tailoring experiences to our career goals (e.g., more ICU, more ED, more clinic, more electives)?

7. How are transitions between EM and IM blocks handled, especially regarding continuity clinic and patient follow-up?

These questions help you understand the reality of combining emergency medicine internal medicine training in one integrated program.

Questions about continuity clinic and longitudinal IM training

IM training requires continuity of care, which can be tricky when you’re frequently on EM months.

8. How is continuity clinic structured for EM-IM residents?

   • Half-day per week, X weeks per year? Block clinics? Dedicated IM months?

9. How do you maintain continuity during ED-heavy months or off-service rotations?

10. Are EM-IM residents assigned to specific panels of patients that they follow over five years?

11. Does the clinic support osteopathic manipulative treatment (OMT) or other DO-specific practices if I want to offer them?

These questions are crucial for understanding how the program handles core IM requirements while you’re juggling ED responsibilities.

Questions about scholarly activity and academic requirements

The dual degree nature of EM-IM often means more expectations for scholarship.

12. What are the scholarly activity requirements for EM-IM residents?

    • Case reports, QI projects, original research, presentations, teaching?

13. Are there EM-IM–specific research mentors or formal scholar tracks (e.g., ultrasound, administration, education, global health)?

14. How often do EM-IM residents present at national meetings, and is there funding/support to attend?

15. If I’m interested in academic medicine, what dedicated support structures exist for EM-IM residents (e.g., protected time, mentorship committees)?

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Questions to Ask About Training Environment, Culture, and Wellness

The same five-year program can feel completely different depending on its culture. Ask targeted questions to see how you’ll fit as a DO graduate in a high-intensity EM-IM environment.

Questions for residents about culture and support

These are ideal for the resident-only portions of the interview day.

16. Why did you choose EM-IM at this program specifically, and has it matched your expectations?

17. How would you describe the relationship between EM and IM departments? Is there true collaboration or more of a “tug-of-war” over residents?

18. As an EM-IM resident, do you feel fully part of both EM and IM resident communities, or more attached to one than the other?

19. How approachable and responsive is leadership when residents raise concerns about schedules, wellness, or educational issues?

20. What are the biggest challenges unique to being EM-IM here, and how has the program addressed them?

21. Have there been any major changes in the program (schedule, leadership, hospital ownership, ED volume) in the past few years, and how were residents involved?

These questions help you assess whether the program’s culture aligns with your style and support needs over five demanding years.

Questions about DO friendliness and osteopathic identity

As a DO graduate in a historically MD-heavy landscape, it’s fair and important to ask:

22. How many DO graduates are in the program currently, both in EM-IM and in the categorical EM and IM tracks?

23. Do DO graduates hold leadership roles (chief residents, academic chiefs, committee leaders) in the program?

24. How does the program view and incorporate osteopathic training? Is OMT used in clinic or inpatient settings?

25. Have DO graduates from this program had any difficulty with fellowship placement or employment compared to MD graduates?

26. Is there any structured education on OMT for interested residents, or flexibility to incorporate it into clinic or teaching sessions?

The responses will give you a sense of how truly osteopathic-friendly the environment is, beyond what’s written in the brochure.

Questions about wellness, burnout, and work-life balance

Five years of combined residency is a marathon. You need to know if the program will support your wellness.

27. What specific wellness resources exist for EM-IM residents—counseling, protected wellness days, retreats, or peer support groups?

28. How does the program monitor and address burnout, especially given the intensity of EM-IM training?

29. Are EM-IM residents more likely to feel overextended compared to categorical residents? How does the program mitigate that?

30. Is moonlighting allowed for EM-IM residents? If so, at what level of training and in what settings?

31. How are vacation and time off scheduled? Can EM-IM residents coordinate time off for major life events?

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Questions about Clinical Experience, Autonomy, and Career Outcomes

To choose well, you must understand both the day-to-day clinical experience and longer-term outcomes for graduates.

Questions about ED and inpatient exposure

32. What is the ED patient volume and acuity like at your main site? Are EM-IM residents primarily at the main academic ED or also at community sites?

33. How much hands-on procedural experience do EM-IM residents get (intubations, central lines, chest tubes, ultrasound-guided procedures)?

34. Are EM-IM residents ever “pulled” more toward ward service to fill IM gaps, or toward ED shifts to fill EM gaps, at the expense of education?

35. How is resident autonomy structured in both departments? At what level of training do EM-IM residents function as senior residents in the ED and on IM wards?

36. Do EM-IM residents get exposure to specialized services like cardiology, nephrology, infectious disease, or hospital administration?

These questions help you distinguish between programs that truly value EM-IM residents versus those that use them as flexible coverage.

Questions about fellowship and career paths

EM-IM training opens many doors, but you want to know what doors this particular program has historically opened.

37. What are the most common career paths your EM-IM graduates pursue (ED only, inpatient IM only, combined ED + inpatient roles, critical care, administration, academic medicine)?

38. Which fellowships have recent EM-IM graduates matched into?

    • Critical care? Ultrasound? Toxicology? Cardiology? Pulm/crit? Palliative care? Other?

39. How well supported are EM-IM residents who want to pursue dual board certification and then subspecialty training?

40. Are there faculty who completed EM-IM themselves? If so, how involved are they in mentorship and career planning?

41. Do graduates report feeling well-prepared for independent practice in both ED and inpatient settings?

These outcome-based questions are among the most important interview questions for them, especially if you’re on the fence between EM-IM and single-specialty tracks.

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Strategic Questions to Ask the Program Director

Knowing what to ask a program director is essential. This is your chance to think like a future colleague, not only as an applicant.

High-yield questions for PDs and APDs

Use these to understand philosophy, stability, and expectations:

42. How would you describe the “ideal” EM-IM resident for your program, and what characteristics do your most successful graduates share?

43. What changes or improvements do you foresee for the EM-IM program in the next 3–5 years?

    • New sites, expanded ICU, ED remodel, changes in duty hours, faculty hires?

44. How does the program advocate for EM-IM residents at the institutional level, given they are dually owned by EM and IM?

45. In what ways do EM-IM residents differ from categorical residents in terms of expectations, support, and leadership opportunities?

46. Have there been any residents who struggled or did not complete the program? If so, what patterns or lessons did you take from those situations?

47. How transparent is the program about feedback—how often is it given, and how is resident input incorporated into program changes?

48. If I matched here, what advice would you give me for thriving in this EM-IM program, specifically as a DO graduate?

That last question often elicits candid, practical advice. It also signals maturity and self-awareness.

Questions about the institution and long-term fit

49. How stable is the hospital system and ED contract, and how would any anticipated changes affect residents?

50. How does the institution view and support combined programs like EM-IM compared to categorical residencies?

51. Are there any upcoming changes in leadership (e.g., new PD, new chair) that I should know about?

These questions help you identify red flags related to program instability or institutional politics that could affect your training.

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How to Use These Questions Effectively on Interview Day

Having strong questions is only half the battle. How you ask and prioritize them matters.

Prioritize, don’t interrogate

You will not have time to ask all 50+ questions. Before each interview day:

• Pick 5–7 “must-ask” questions that directly address your top priorities.
• Pick 3–5 backup questions to use if time and conversation allow.
• Tailor your list based on what is already answered in:
  • The program website
  • Pre-interview materials
  • The information session or presentation

Avoid asking questions that are clearly answered in their brochure—those can make you appear unprepared.

Direct the right questions to the right people

• Program Director / Associate PD
  • Long-term vision, outcomes, culture, expectations, institutional support, DO friendliness
• Chief Residents / Senior EM-IM Residents
  • Schedule logistics, workload, call, EM vs. IM identity, wellness, real culture
• Categorical EM and IM Residents
  • Integration of EM-IM residents, perceptions of dual trainees, team dynamics
• Coordinator / Administrative Staff
  • Logistics, scheduling, coverage, vacation policies

This targeted approach respects everyone’s time and yields better, more honest answers.

Phrase questions to invite candor

Use open-ended, non-accusatory wording:

• Instead of:
  “Is this a malignant program?”
  Try:
  “How would you describe the culture here when residents are under stress or during high-volume months?”

• Instead of:
  “Do you overwork EM-IM residents more than categoricals?”
  Try:
  “How does the workload and call schedule for EM-IM residents compare with categorical EM and IM residents?”

Tone matters. You want honest answers without putting people on the defensive.

Take notes and debrief after each interview

Right after the interview day:

• Jot down:
  • Rotation structure details
  • Responses that stood out
  • Red flags or major positives
• Rate the program on your key priorities (e.g., 1–5 for wellness, procedural volume, DO friendliness, EM-IM support)

These notes become invaluable when it’s time to build your rank list for the osteopathic residency match.

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FAQs: Questions to Ask Programs for DO Graduates in EM-IM

1. As a DO graduate, should I specifically ask if EM-IM graduates face any challenges in board certification or credentialing?
Yes. While EM-IM is well-established, it’s wise to ask:

• “Have any EM-IM or DO graduates had difficulty with board certification, hospital privileging, or state licensing?”
  This is usually not an issue at reputable programs, but a clear answer will give you peace of mind and may reveal how organized the program is regarding combined training requirements.

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2. How many questions should I realistically plan to ask at each interview?
Aim for 3–5 high-quality questions per major conversation (e.g., PD session, resident panel, one-on-one). Over a full interview day, you might ask 10–15 total, spread across different people. Quality and relevance matter much more than quantity. Always adapt based on time and what’s already been covered.

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3. Is it appropriate to ask directly about job prospects or dual practice (ED + inpatient) after EM-IM training?
Absolutely—and it is highly relevant to EM-IM. A strong way to ask is:

• “What types of positions are your EM-IM graduates working in now—primarily ED, primarily inpatient IM, or combined roles?”
• “Do local or regional employers understand and value EM-IM dual training?”
  These questions show that you’re thinking about the long-term utility of your training, not just getting through residency.

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4. What if the program doesn’t leave much time for applicant questions? Is that a red flag?
Not always, but it can be informative. Some days are tightly scheduled. If you consistently notice:

• Very limited time for questions
• Evasive or rushed answers
• No resident-only space to ask candid questions

That could suggest issues with transparency or culture. If a program is truly high on your list but you still have key unanswered questions, you can send a polite, concise follow-up email to the coordinator or PD with 2–3 remaining questions—especially around EM-IM structure, DO friendliness, and career outcomes.

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Thoughtful, specific questions are one of the strongest signals you can send that you understand the realities of emergency medicine internal medicine combined training and that you’re ready to be a proactive partner in your own education. Use them strategically, adapt them to your goals as a DO graduate, and let the answers guide you toward programs that will support you—clinically, academically, and personally—over five challenging and rewarding years.