Essential Questions for IMGs Applying to Med-Peds Residency Programs

Why Your Questions Matter as an IMG Applying to Med-Peds

As an international medical graduate (IMG) applying to Medicine-Pediatrics (Med-Peds), the questions you ask residency programs can significantly influence how you are perceived—and how you decide where to train. Programs are not only interviewing you; you are also interviewing them. Thoughtful, specific questions signal maturity, insight, and genuine interest in Med-Peds and in that particular institution.

This IMG residency guide focuses on questions to ask programs—especially what to ask program directors, faculty, and residents—so you can:

• Demonstrate that you understand the unique nature of Med-Peds
• Clarify how supportive the program is for IMGs
• Assess training quality, workload, and culture
• Evaluate your chances of thriving there as both a physician and a person

Throughout this article, you’ll find:

• Category-specific interview questions for them (program directors, chief residents, current residents, coordinators)
• Sample phrases you can adapt
• Red flags to watch for in answers
• Concrete strategies to align questions with your own goals as an IMG in the medicine pediatrics match

---

Strategy First: How IMGs Should Approach Asking Questions

Before looking at specific questions, it helps to have a strategy. Many applicants collect lists of questions to ask residency programs, but few think about why they are asking each one.

1. Have a Purpose for Every Question

Every question should help you:

• Assess fit (training style, culture, support for IMGs)
• Understand opportunities (research, leadership, visas, Med-Peds identity)
• Clarify expectations (workload, supervision, teaching, evaluations)

If a question does not help you make a ranking decision or learn something meaningful, replace it with one that does.

2. Adapt Questions Specifically for Med-Peds

Med-Peds is not just “Internal Medicine + Pediatrics.” It is a distinct identity with:

• Unique curriculum structure (switching between medicine and pediatrics blocks)
• Dual-board preparation
• Dual-career options (hospitalist, primary care, subspecialty in either field, med-peds hospitalist, complex care, transition medicine, etc.)

Your questions should show that you recognize this and are genuinely committed to Med-Peds, not using it as a backup.

3. Highlight Your IMG Perspective—Without Apology

You bring valuable strengths as an international medical graduate:

• Experience with different health systems and patient populations
• Adaptability and resilience
• Often, strong work ethic and broad clinical exposure

Ask questions that reflect confidence and self-awareness, such as:

• How can I best leverage my international experience here?
• What support do you provide for IMGs adapting to US clinical culture and documentation?

This frames your IMG status as an asset, not a disadvantage.

4. Prioritize Depth Over Quantity

You will not have time to ask every possible question. Aim for:

• 3–5 targeted questions for the program director
• 3–5 for residents
• 1–2 for chief residents or faculty, if available
• 1–2 for the program coordinator (especially about logistics/visas)

Prioritize what truly matters to you: location, academic vs community focus, fellowship plans, family needs, visa type, etc.

---

Core Questions to Ask the Program Director (and Why They Matter)

When applicants ask, “What to ask the program director?” they often think of generic items about curriculum. As an IMG, you should go deeper—into vision, support, and outcomes.

Here are targeted questions with explanations and sample phrasing.

1. Questions About Program Philosophy and Med-Peds Identity

Goal: Understand how the program views Med-Peds and what kind of physician they aim to graduate.

Questions to ask:

1. “How would you describe the identity of your Med-Peds program within the institution?”

   • Listen for: Recognition as a distinct program, support from both departments, clear role models.
   • Caution if: Med-Peds seems invisible or constantly overshadowed by categorical programs.

2. “What qualities do you value most in successful Med-Peds residents here?”

   • Helps you understand what they truly reward: independence, teamwork, scholarship, advocacy, etc.
   • Use answer to highlight your own strengths in later conversations.

3. “How do you see your program evolving in the next 3–5 years?”

   • Shows long-term thinking and commitment.
   • Good programs will mention growth areas: new rotations, transition of care clinics, global health, QI projects, etc.

2. Questions About IMG Support and Integration

As an IMG residency guide, this is critical. You must understand how IMGs are supported, not just whether they are accepted.

Questions to ask:

1. “How many current residents are international medical graduates, and how have they done in terms of performance and careers after residency?”

   • Favorable answer: PD describes IMGs positively and gives concrete examples of their success (chief year, fellowships, academic roles).

2. “What kind of support do you specifically offer IMGs adjusting to the US system (documentation, communication style, cultural expectations, etc.)?”

   • Look for: Formal orientation, mentorship, coaching, feedback structures.

3. “Are there any common challenges that IMGs face in your program, and how do you help them overcome those?”

   • Strong programs are honest and solution-focused, not dismissive.

4. Visa-specific (if applicable):

   • “Which visa types do you sponsor for residents (J-1, H-1B) and have there been any recent changes in this policy?”
   • “Do you have institutional support for visa-related legal issues or renewals during training?”
   • You want clarity and stability, not vague or evasive responses.

3. Questions About Curriculum and Training Experience

Focus on aspects uniquely important for Med-Peds and for you as an IMG.

Questions to ask:

1. “How do you structure the switch between medicine and pediatrics blocks, and how do residents handle that transition?”

   • Helps you understand rhythm of training and how quickly you adapt.

2. “Are there Med-Peds–specific rotations or clinics, such as transition-of-care clinics or combined inpatient services?”

   • Strong Med-Peds programs often have at least some combined experiences.

3. “How are residents supported when they feel overwhelmed or experience burnout? Are there mechanisms in place to monitor workload and well-being?”

   • Important as you adjust to a different system and workload style.

4. “How often do residents receive formal feedback, and in what format?”

   • As an IMG, you may need more structured feedback early on to calibrate your practice to US expectations.

4. Questions About Outcomes: Fellowship, Jobs, and Career Paths

Outcome data is particularly important in the medicine pediatrics match, where career options are broad.

Questions to ask:

1. “Can you share recent graduates’ career paths—how many go into fellowship, hospitalist roles, primary care, or combined Med-Peds positions?”

   • Align this with your own goals (e.g., fellowship vs primary care vs academic Med-Peds).

2. “For residents pursuing fellowship, what does your support look like—such as mentorship, research opportunities, and letters?”

   • If you’re an IMG interested in subspecialty training, watch for track records of IMGs matching into fellowships.

3. “Do graduates feel well-prepared to practice independently in both internal medicine and pediatrics?”

   • Pay attention to whether they emphasize strong preparation for both boards.

5. Questions to Show Initiative and Self-Awareness

These questions demonstrate insight and maturity.

Questions to ask:

1. “Given my background as an international medical graduate, are there particular resources or opportunities you would recommend I focus on if I match here?”

   • Shows humility and a proactive mindset.

2. “Is there anything else you’d like to know about me that could help you better assess my fit for this Med-Peds program?”

   • Sometimes opens space for the PD to raise unspoken concerns you can address directly.

---

High-Yield Questions for Residents: Daily Life, Culture, and Hidden Curriculum

Residents often give the clearest picture of what it’s like to train in a program. During socials or Q&A sessions, prioritize questions that reveal the lived experience, not just the brochure content.

1. Questions About Culture and Support

Questions to ask current residents:

1. “How would you describe the relationship between Med-Peds residents and categorical residents in both medicine and pediatrics?”

   • Look for collaboration and respect rather than competition or isolation.

2. “Do you feel that attendings and fellows understand and value the Med-Peds role?”

   • A positive answer often includes: “They trust us,” “They know our training,” “We’re often leaders on teams.”

3. “Have you ever felt uncomfortable raising safety or workload concerns? How did the program respond?”

   • You want a culture where residents can speak up.

4. “As an IMG (if any residents are), what has your experience been, and what support have you found most helpful?”

   • Firsthand experiences matter more than policy statements.

2. Questions About Workload, Schedule, and Intern Year

For an IMG adjusting to the US system, interns’ workload and support are critical.

Questions to ask:

1. “What does a typical day look like on your busiest rotations for interns? For seniors?”

   • Ask for specific times and patient numbers.

2. “How manageable are night float and ICU rotations? Do you feel adequately supervised?”

   • A healthy balance is key; constant exhaustion is a red flag.

3. “How easy or difficult is it to schedule days off for important life events?”

   • This reflects respect for resident well-being.

4. “Do you feel the program truly adheres to duty hour regulations?”

   • Watch for hesitations or nervous laughter.

3. Questions About Education and Board Preparation

As an IMG, you may be extra conscious of board exams and standardized testing.

Questions to ask:

1. “How strong is the didactic teaching? Are conferences consistently protected, or does clinical duty frequently pull you away?”

2. “What structured support does the program offer for board preparation for both IM and Pediatrics?”

   • Look for question banks, review sessions, or board review budgets.

3. “Do residents feel there is enough time to read and study outside of work?”

   • Training should include both clinical exposure and protected time to learn.

4. Questions About Mentorship, Research, and Career Development

These are especially important if you aim for competitive fellowships.

Questions to ask:

1. “How easy is it to find mentors in areas like research, advocacy, or quality improvement?”

2. “Have you personally been able to work on scholarly projects or present at conferences? How supported did you feel?”

3. “Is there any difference in mentorship access or expectations for IMGs compared with US graduates?”

   • You are looking for equity in opportunities and honest acknowledgment of any additional needs.

5. Questions About Life Outside the Hospital

Your well-being affects your performance and satisfaction.

Questions to ask:

1. “What do you and your co-residents do for fun outside of work?”

   • Reveals camaraderie and work-life balance.

2. “How livable is the salary in this city, especially for those supporting a family or sending money abroad?”

3. “If you had to choose again, would you still rank this program highly? Why or why not?”

   • One of the most powerful “summary” questions to ask residency trainees.

---

Special Topics for IMGs: Visas, Licensure, and System Navigation

In addition to general questions to ask residency programs, IMGs must clarify logistical issues that can affect not only training but also future career options.

1. Visa and Immigration Questions

These are more appropriate for program directors and/or coordinators, not residents.

Targeted questions:

1. “Which visa categories do you currently sponsor for residents, and has this policy been stable over time?”

2. “Have there been recent residents on my intended visa type (e.g., J-1 or H-1B)? Were there any difficulties with renewals or transitions?”

3. “Does the institution provide in-house legal or HR support for visa-related matters?”

4. “For past IMG graduates, what has been their path after residency in terms of visas and employment?”

2. State Licensure, USMLE, and Credentialing

Especially if you have older graduation dates or non-traditional pathways.

Questions to consider:

1. “Are there any state licensure or credentialing challenges that IMGs commonly face here, and how does the program help navigate them?”

2. “Do you require Step 3 before starting residency, and if not, when do most residents complete it?”

3. “How do you support residents who need additional test preparation, such as for Step 3 or board exams?”

3. Adapting to the US Clinical Environment

Your transition can be smoother if the program has well-established systems.

Questions to ask:

1. “Is there any additional orientation or onboarding tailored to international graduates—for example, in documentation, electronic medical records, and communication with nursing staff and patients?”

2. “How do attendings and seniors typically provide real-time feedback to help IMGs adjust to practice expectations?”

3. “Are there specific faculty or mentors assigned to IMGs to help them during the first year?”

4. Family, Community, and Long-Term Integration

If you are moving from another country, you are not just changing jobs—you are rebuilding your life.

Questions to ask:

1. “Do many residents have families, and how supportive is the program of residents with children or spouses?”

2. “Are there communities of people from my home region/country in the area, and how connected are IMGs socially?”

3. “What resources exist at your institution or in the community for new international physicians—such as cultural orientation, language support for spouses, or housing advice?”

These questions not only help you evaluate support systems but also demonstrate that you are planning for a stable, sustainable life while training.

---

How to Ask Smart Questions: Practical Tips and Example Scripts

Knowing good questions is not enough; you must deliver them well. Here’s how to do that.

1. Do Your Homework First

Never ask something that is clearly answered on the program’s website or in their brochure, such as:

• “How many residents are in each class?”
• “Do you have a continuity clinic?”

Instead, use your research to ask deeper follow-up questions:

• “I saw on your website that you have a combined Med-Peds continuity clinic. How does that clinic differ from the categorical clinics, and what kind of patients do residents typically follow there?”

This shows genuine interest and preparation.

2. Prioritize and Personalize

Before each interview day:

1. Write down 8–10 questions that really matter for your decision.
2. Star the top 3–5 you absolutely must ask that program.
3. Tailor at least 2–3 questions specifically to that site.

Example:

• “I noticed your strong emphasis on transition of care for adolescents with chronic disease. As an IMG, I’m very interested in learning US-based models of transitional care. How involved are residents in designing or improving those transition processes?”

3. Phrase Questions Positively and Professionally

Avoid questions that sound confrontational, such as:

• “Why are your board pass rates lower than other programs?”
• “Do residents here work too hard?”

Instead:

• “I noticed board pass rates fluctuate year to year. What changes have you made recently to support residents in exam preparation?”
• “How does the program monitor workload and protect residents from burnout, especially on high-intensity rotations?”

4. Use Questions to Reinforce Your Strengths and Goals

You can embed brief information about yourself in the question:

• “I have a strong interest in global health from my training abroad. Are there opportunities to stay involved in global or underserved care during residency?”
• “Back home, I did research in diabetes management. How easy is it to connect with faculty here who are doing similar work?”

This keeps the conversation two-directional and memorable.

5. Take Notes and Reflect After Each Interview

Right after the interview day:

• Jot down brief answers to your key questions.
• Write how you felt about residents’ honesty, PD’s transparency, and overall culture.
• Later, use these notes when creating your rank list.

Over time, patterns will emerge—programs where you felt heard and supported vs places that raised concerns.

---

FAQs: Questions IMGs Commonly Ask About Med-Peds Residency Interviews

1. How many questions should I ask during each Med-Peds interview?

Aim for 3–5 well-chosen questions for the program director and 3–5 for residents, depending on the time allowed. It is better to ask a few thoughtful, program-specific questions than a long list of generic ones. If time is short, prioritize:

• IMG-related support and visas
• Med-Peds identity and curriculum
• Resident culture and well-being

2. Are there questions I should avoid asking during interviews?

Yes. As an IMG, you should avoid:

• Questions clearly answered on the website (looks unprepared)
• Overly personal questions about individual faculty or residents
• Very detailed salary or moonlighting questions early in the process (unless the program brings it up)
• Questions that sound like complaints or comparisons with other programs

Instead, focus on how you can grow within the program and how well they support resident development.

3. Should I directly ask how IMGs are perceived in the program?

You can and you should, but phrase it constructively. For example:

• “How have IMGs historically integrated into your program, and what has helped them be successful?”
• “Are there any additional resources for international medical graduates in terms of academic support or cultural adaptation?”

This way, you show insight and openness rather than anxiety.

4. What are the best final questions to end an interview with a program director?

Consider one of these strong closing questions:

• “Is there anything about my background or application that you’d like me to clarify, or any concerns about my fit for your Med-Peds program?”
• “Based on my interests and goals as an international medical graduate, are there particular strengths of your program that you think would be especially valuable for me?”
• “What distinguishes a resident who thrives in this program from one who struggles, and how can I best prepare if I match here?”

These questions show maturity, insight, and genuine interest—traits that stand out in the medicine pediatrics match.

---

Thoughtful, targeted questions are one of the most powerful tools you have as an IMG seeking a Med-Peds residency. Used well, they will not only help you choose the right program, but also allow programs to see you as a prepared, reflective, and committed future Med-Peds physician.