Essential Questions for IMGs in Emergency Medicine Residency Interviews

Why Your Questions Matter as an IMG in Emergency Medicine

The questions you ask programs are as important as the answers you give.

For an international medical graduate, especially in a competitive field like emergency medicine (EM), thoughtful questions:

• Show you understand the U.S. system and EM culture
• Demonstrate maturity, insight, and professionalism
• Help you assess if a program truly supports IMGs
• Clarify visa, support, and career issues that directly affect you
• Create memorable, meaningful conversations with faculty, residents, and program leadership

This IMG residency guide focuses on what to ask programs—and how to ask—so you can approach each interview day with confidence and a clear strategy tailored to Emergency Medicine.

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Strategy: How an IMG Should Approach Asking Questions

Before diving into specific questions, you need a framework.

1. Goals of Your Questions

On each interview day, your questions should help you:

1. Evaluate fit:

   • Clinical environment
   • Teaching style
   • Team culture and support for diversity and IMGs

2. Clarify logistics and stability:

   • Visa sponsorship
   • Board pass rates
   • EM match track record
   • Patient volume and acuity

3. Signal what kind of resident you will be:

   • Curious, prepared, and invested in learning
   • A team player who thinks about wellness and support
   • Someone who plans for long-term success (fellowship, jobs, visas)

Think of each question as a small “signal” about your priorities and professionalism.

2. Who You Should Ask

Different people are best suited for different types of questions:

• Program Director (PD)
  Big-picture, vision, program changes, academic performance, EM match outcomes for graduates, what they value in residents.

• Assistant/Associate PDs, Core Faculty
  Curriculum details, evaluation, remediation, feedback culture, simulation, scholarly work.

• Current Residents (especially other IMGs)
  Day-to-day life, workload, schedule, culture, wellness, undocumented realities, and how IMGs are truly supported.

• Program Coordinator
  Visa processes, interview logistics, orientation, onboarding, housing, and practical life questions.

• Chair/Department Leadership (if you meet them)
  Department stability, resources, political climate, support for residency, future growth.

A key part of mastering interview questions for them is directing each question to the person most likely to give you honest and detailed insight.

3. How Many Questions to Ask

Aim for:

• 2–3 strong questions per formal interview (faculty/PD)
• 3–5 questions per resident session (panel, lunch, or social event)

Always have more prepared than you expect to use, in case your questions get answered earlier in the day.

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Core Questions Every IMG Should Ask EM Programs

Below are categorized questions you can adapt and personalize. Don’t ask all of them—you’ll choose the ones most relevant to you and what isn’t obvious from the website.

A. Questions About Program Culture & Support for IMGs

These questions are critical for an international medical graduate to understand whether a program truly welcomes IMGs or merely “tolerates” them.

To current residents (especially IMGs):

• “As an IMG, did you feel fully integrated into the team from the beginning? What helped or made it difficult?”
• “Have IMGs in this program held leadership roles, such as chief resident, committee positions, or QI leadership?”
• “Do you feel that IMGs here get equal opportunities for procedures, fellowships, and jobs compared to U.S. grads?”
• “Were there any unspoken challenges as an IMG that you wish you had known before coming here?”
• “How does the program support residents who might need extra help with U.S. clinical norms or documentation?”

To faculty or PD:

• “Historically, how have IMGs done in your program in terms of performance, board pass rates, and career outcomes?”
• “What specific supports do you have in place for IMGs, especially early in PGY-1, as they adjust to U.S. EM practice?”
• “Can you share a recent example of how the program supported an IMG resident facing a major challenge—clinical, personal, or visa-related?”

These questions show that you are serious, realistic, and committed to succeeding as an IMG in emergency medicine.

B. Questions About Clinical Training, Volume, and Acuity

As an EM applicant, clinical exposure is central. You want to ensure you will graduate truly ready to practice independently.

To PD or core faculty:

• “What do you see as the main strengths of your emergency medicine training compared to other programs in the region?”
• “How would you describe the balance between autonomy and supervision in the ED for residents at different PGY levels?”
• “How are sick, high-acuity patients distributed among residents, APPs, and attendings? Do residents consistently get critical care exposure?”
• “What systems are in place to ensure residents get sufficient procedural experience—for example intubations, central lines, trauma resuscitations, and pediatric emergencies?”

To residents:

• “On a typical ED shift, how many patients do you see, and how many are high acuity?”
• “Do you feel confident in your procedural skills for independent practice? Are there any gaps you think new residents should know about?”
• “Are there any rotations where you feel overused as a ‘workhorse’ and underused as a learner? How does the program respond to that feedback?”

These questions help you gauge if the program will make you a safe, confident emergency physician.

C. Questions to Ask About Curriculum, Teaching, and Feedback

The IMG residency guide must emphasize: you are not only a worker—you are a learner. You need to know how EM residency programs structure teaching.

To PD or academic leadership:

• “How would you describe your educational philosophy? What skills do you most want residents to have when they graduate from this EM program?”
• “How is formal teaching integrated into shifts—for example, bedside teaching, mini-lectures, or protected time for learning?”
• “Can you walk me through your conference structure? How often is conference protected from clinical duties?”
• “How are residents evaluated and given feedback? How soon after shifts, and in what format?”
• “If a resident is struggling—clinically, in documentation, or with test-taking—what specific supports or remediation processes do you have?”

To residents:

• “Do attendings give you real-time feedback, or do you mostly get it at formal evaluations?”
• “Are lectures and conferences high-yield for boards and real-life EM practice?”
• “Do you feel comfortable asking questions on shift without being judged?”

These questions signal that you are invested in your own growth and want to take advantage of the program’s academic resources.

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High-Impact Questions Specifically for EM Program Directors

When you think about what to ask program director during an EM interview, prioritize questions that reveal:

• How the PD thinks
• Where the program is going
• How they define a “successful” resident and graduate

A. Vision, Stability, and Program Direction

These are sophisticated interview questions for them that leave a strong impression.

• “What changes have you made to the program in the past 3–5 years, and what changes do you anticipate in the next few years?”
• “How do you see emergency medicine evolving in this hospital system, and how is the residency adapting to those changes?”
• “What would you say distinguishes your graduates from those of other EM programs?”
• “How does the department leadership (Chair, hospital administration) support the residency’s mission?”

These questions convey that you care about program stability, growth, and long-term viability—particularly important in the current EM job market.

B. Expectations and Support

• “What qualities do your most successful residents typically share?”
• “If a resident is struggling—whether clinically, personally, or with exams—how does the program respond? Can you share a concrete example?”
• “What are your expectations for resident involvement in scholarly work or QI projects? How do you support residents to meet those expectations?”

As an international medical graduate, it is wise to ask questions that reveal how flexible and supportive leadership is in the face of real-life difficulties.

C. Outcomes: Board Pass Rates, Jobs, and Fellowships

• “How have your graduates fared on the ABEM written and oral boards over the last several years?”
• “Where have your recent graduates gone—community jobs, academic positions, fellowships? Are you able to share examples?”
• “For residents who are interested in fellowships (toxicology, ultrasound, critical care, peds EM, etc.), how does the program help them prepare and match?”

These EM match–oriented questions show that you are thinking beyond residency and planning for your long-term career.

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Practical Questions About Visas, Logistics, and Life as an IMG

Many IMGs hesitate to ask about visas or “practical” issues, but they are critical. These topics are best approached politely and factually.

A. Visa Sponsorship and Immigration Issues

Usually best asked to the program coordinator or PD, either during the interview day or via email if time is limited.

• “What types of visas does your institution currently sponsor for residents (e.g., J-1, H-1B)?”
• “Have there been any recent changes in your visa policies or institutional rules that IMGs should be aware of?”
• “Do you have dedicated legal or GME support staff who help with visa processing and renewals?”
• “Have any of your IMG residents faced visa-related delays or issues recently, and how were those handled?”

Ask these in a calm, professional manner. You are not demanding guarantees; you’re gathering information to make an informed decision.

B. Support for Transition to the U.S. System

• “For incoming IMGs, what orientation or early support do you provide to help them adjust to U.S. documentation, EMR, and communication norms?”
• “Do new residents get time with social work, case management, or ancillary services to understand the U.S. system better?”
• “How does the program support residents who may not have family or social support nearby?”

C. Lifestyle, Wellness, and Burnout

Emergency medicine can be intense—especially for an IMG without an established local support network.

To residents:

• “What is your schedule like in terms of nights, weekends, and holidays—especially in PGY-1?”
• “Do you feel you have time for sleep, basic self-care, and non-medical life?”
• “How does the program respond when residents are struggling with burnout or personal crises?”
• “How supportive is the program when residents need time off for illness, family emergencies, or visa-related travel?”

To PD or wellness leadership:

• “What formal wellness initiatives or mental health resources are available to residents?”
• “How do you monitor and address resident workload and burnout?”

These questions show you take your wellbeing seriously, which programs increasingly value.

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Example Question Sets You Can Use on Interview Day

To make this IMG residency guide actionable, here are sample “bundles” tailored to different parts of the interview day.

1. For the Program Director

• “How has your program adapted to recent changes in the emergency medicine job market?”
• “What characteristics make a resident stand out—in a positive way—in this program?”
• “Can you share how your graduates have done with board pass rates and job placement over the past few years?”

If needed, add a visa question:

• “As an IMG, I’m also thinking about visa stability. Could you tell me how the institution currently approaches visa sponsorship for residents?”

2. For a Core Faculty Interview

• “How would you describe the balance between resident autonomy and supervision in your ED?”
• “What are the strengths and weaknesses of your clinical curriculum, honestly, from a faculty perspective?”
• “How do you personally like to teach on shift, and what do you expect from residents during your shifts?”

3. For a Resident Panel/Social

• “What has surprised you the most about working here, in a good way and in a challenging way?”
• “Do you feel comfortable going to your chiefs or PD with problems?”
• “As an IMG, have you ever felt treated differently—positively or negatively—by staff, consultants, or patients?”
• “If you had to choose again, would you rank this program first? Why or why not?”

4. For the Program Coordinator

• “Could you tell me about the timeline and typical process for visa paperwork and onboarding?”
• “Are there any issues past IMGs have run into with relocation, housing, or credentialing that I should plan for early?”

Having these sets written in your notebook or notes app ensures you never run out of thoughtful interview questions for them during a busy EM interview day.

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Common Mistakes IMGs Make When Asking Questions (and How to Avoid Them)

1. Asking Questions Easily Answered on the Website

Avoid:

• “How many ED shifts do residents work per month?” (if clearly listed)
• “Do you have ultrasound training?” (if there’s a full page on it)

Instead, build on what you already know:

• “I saw on your website that you have a structured ultrasound curriculum. How integrated is POCUS into everyday ED practice, and how do residents get real-time feedback on their scans?”

2. Asking Only About Visa and Not About Training

Programs want to see that you chose them for educational value, not just visa sponsorship. Balance your questions.

Bad impression: Only asking, “Do you sponsor H-1B?”

Better sequence:

1. Ask about clinical training, culture, and teaching
2. Later ask: “As an IMG, I’m also considering long-term legal stability. Could you share how your institution currently approaches visas and whether there have been any recent changes?”

3. Asking Questions That Sound Demanding or Entitled

Avoid questions framed as demands (“Will you guarantee me…”).
Use neutral, information-seeking language:

• “How have you handled…”
• “What is your typical approach to…”
• “Historically, what has been your experience with…”

4. Asking No Questions

Not asking any questions can be interpreted as disinterest or lack of preparation. Even if everything seems clear, ask:

• Clarifying questions about what you’ve heard that day
• Perspective questions: “From your point of view…,” “In your experience…”

That way, you still engage the interviewer and show curiosity.

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Frequently Asked Questions (FAQ)

1. As an IMG, is it safe to ask directly about visa sponsorship during the interview?

Yes, it is both appropriate and necessary. Programs expect IMGs to care about this. The key is tone and timing:

• First, ask about training, education, and culture.
• Then ask, in a calm and professional way:
  “As an international medical graduate, visa sponsorship is an important factor for me. Could you tell me what visas your institution currently sponsors for residents and whether that has been stable over recent years?”

This shows you are serious about your career and planning realistically.

2. How many questions should I prepare for each emergency medicine residency program?

Prepare:

• 8–12 questions total for each interview day, knowing you will only use 4–6
• Group them by audience: program director, faculty, residents, coordinator

Some may be answered during presentations or tours; cross them out and move to others. Over-preparation ensures you always have strong, relevant questions to ask programs.

3. What are the best “last questions” to end an interview with the PD or faculty?

Use questions that invite advice or perspective:

• “Is there anything you think an IMG applicant like myself should especially consider when choosing an emergency medicine residency?”
• “What do you wish more applicants understood about your program before ranking?”
• “Is there anything in my background you’d like me to clarify or expand on?”

These leave a professional, thoughtful final impression.

4. Should I ask residents about negative aspects of the program?

Yes—but do it respectfully and neutrally:

• “Every program has areas they’re working to improve. What do you think this program is still trying to get better at?”
• “If a close friend were applying here, what would you tell them to be aware of?”

Residents often answer candidly when you frame the question non-aggressively. Their answers are invaluable for building a realistic EM match rank list.

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Thoughtful, well-directed questions are one of the most powerful tools you have as an international medical graduate applying to emergency medicine. Use them to gather real information, demonstrate insight, and show programs you’re ready to be not just an EM resident, but a future EM colleague.