Essential Questions to Ask Medical Genetics Residency Programs for IMGs

Why Your Questions Matter as an IMG Applying to Medical Genetics

As an international medical graduate (IMG) targeting a medical genetics residency, what you ask programs is almost as important as how you answer their questions. Thoughtful, specific questions:

• Show that you understand the specialty beyond buzzwords
• Demonstrate maturity, insight, and clear goals
• Help you decide if a program truly fits you as an IMG

This IMG residency guide will walk you through what to ask program directors, faculty, residents, and coordinators in medical genetics—and why each question matters. You’ll leave with a structured list of interview questions for them that you can adapt to your style and priorities.

Throughout, we’ll highlight issues especially relevant for IMGs: visa, support, culture, board prep, and long-term career planning in medical genetics.

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Core Strategy: How to Choose and Phrase Your Questions

Before diving into lists, you need a strategy. Aim for questions that are:

• Specific to medical genetics (not generic internal medicine questions)
• Open-ended (invite explanation, not yes/no)
• Tailored to IMGs without sounding anxious or defensive
• Grounded in what you already know about the program

Principles for Strong Questions

1. Show you’ve done your homework

   • Weak: “So what kind of patients do you see?”
   • Strong: “I saw that your program has both pediatric and adult genetics clinics. Could you describe how residents’ time is divided between these, and how that shapes our overall training?”

2. Connect questions to your goals

   • “As someone interested in cancer genetics, how would my elective time be structured to gain more exposure to hereditary cancer clinics or molecular diagnostics?”

3. Always listen first

   If they already covered call structure in detail, don’t ask, “How is call structured?” Instead ask, “You mentioned home call and weekend coverage—could you walk me through how the call responsibilities change from first to final year?”

4. Prioritize

   You’ll never get through every possible question. Create three tiers:

   • Must-ask: Dealbreakers (visa, board eligibility, core training structure, IMG support)
   • Nice-to-ask: Clarifying details (clinic mix, teaching style, schedule nuances)
   • If-there’s-time: Deep-dive (research specifics, niche interests, long-term initiatives)

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Essential Questions to Ask the Program Director

The program director (PD) shapes the culture, curriculum, and expectations. This is where you ask the highest-level questions—especially those directly affecting your success as an IMG and future geneticist.

1. Training Structure & Educational Philosophy

• “How would you describe the overall philosophy of your medical genetics residency training?”
  Why it matters: Reveals whether they prioritize service vs education, clinical vs research, independence vs supervision.

• “What are the strengths of your program compared with other medical genetics programs?”
  Listen for: Specific strengths (e.g., strong lab exposure, combined pediatrics-genetics training, cancer genetics, biochemical genetics) rather than vague answers.

• “How is the curriculum structured across the years of training, particularly in terms of rotations in different subspecialties of genetics?”
  Look for:

  • Exposure to pediatric, adult, prenatal, cancer, metabolic, and neurogenetics
  • Dedicated time in biochemical genetics, cytogenetics, and molecular labs
  • Time in genetic counseling clinics and multidisciplinary teams

• “How do you ensure residents meet all ACGME medical genetics milestones, especially for procedural and lab-based competencies?”
  Indicates how intentional and systematic their training is.

2. Clinical Exposure & Case Mix

• “What is the typical patient mix for residents—pediatric vs adult genetics, inpatient vs outpatient, rare vs common conditions?”
  As an IMG, broad exposure is critical if your prior training didn’t include high volumes of genetic disorders.

• “How much direct patient care responsibility do residents have compared with genetic counselors and attendings?”
  Helps you understand your role in a team often strongly supported by counselors.

• “Can you describe the balance between face-to-face clinical time and other activities such as laboratory exposure, case conferences, and research?”

3. Support for International Medical Graduates

This is central for any IMG residency guide. Ask clearly but professionally:

• “What kind of support systems are in place for international medical graduates in your program?”
  Listen for:

  • Mentorship structures
  • Academic support (writing, presentations, US-style documentation)
  • Guidance for licensing and long-term career planning

• “How many of your current or recent residents are IMGs, and how have they typically performed and progressed after graduation?”
  You’re looking for reassurance that IMGs succeed here—not just that they’re accepted.

• “Are there any additional orientation or educational resources to help residents adapt to the U.S. healthcare system, particularly for those trained abroad?”

4. Board Preparation & Graduate Outcomes

Board certification is critical in the genetics match.

• “What has your board pass rate been over the last 5 years for medical genetics?”
  You want consistent, high pass rates—and honest explanation if there were outliers.

• “How do you integrate board preparation into the training program?”
  Strong answers might include:

  • Regular board-style conferences
  • Paid board review courses or question banks
  • Protected time close to exam time

• “Where have your graduates gone after finishing the program—fellowships, academic positions, private practice, industry?”
  As an IMG, you need to know if graduates (especially IMGs) are:

  • Getting subspecialty fellowships (e.g., biochemical genetics, cancer genetics)
  • Hired in academic medical centers
  • Transitioning into industry or laboratory roles

5. Program Culture & Expectations

• “How would you describe the culture of your program—what kind of resident tends to thrive here?”
  Use this to compare your personality and goals.

• “What are the biggest challenges residents typically face in this program, and how do you help them overcome these?”
  A candid PD is usually a good sign.

• “If I matched here, what would you hope I accomplish by the end of my first year? And by graduation?”
  This tells you what they truly value (clinical independence, scholarly work, teaching, etc.).

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Key Questions to Ask Faculty Interviewers

Faculty members can give you a more granular look at day-to-day training and mentorship opportunities, especially in niche areas of medical genetics.

1. Subspecialty Exposure & Depth

Tailor questions to their interests (e.g., metabolic, cancer, neurogenetics):

• “In your area of expertise, how are residents involved in patient care and decision-making?”
  You want to know if you’ll be an observer or an active participant.

• “For residents particularly interested in [cancer genetics/metabolic/genomic medicine], what additional opportunities are there beyond the required rotations?”
  This shows motivation and helps you assess flexibility in training.

• “How early in training can residents begin to focus on potential career tracks within genetics, such as lab-based roles, clinician-educator, or research-heavy positions?”

2. Teaching & Feedback

• “How do you typically give feedback to residents, and how frequently?”
  IMGs often benefit from intentional feedback while adapting to a new system.

• “Are there structured opportunities for residents to improve specific skills, such as genetic counseling communication, variant interpretation, or writing consult notes with complex recommendations?”

• “In your experience, what differentiates your top-performing residents?”
  Use this answer to calibrate your own goals.

3. Research & Scholarly Activity

Medical genetics is inherently academic, and many programs expect some scholarship.

• “What types of research or scholarly work are residents typically involved in, and how realistic is it for a resident—especially an IMG—to complete projects within the training period?”

• “Are there ongoing projects that residents can easily join, or is there support to develop our own ideas?”

• “How is protected time for research handled in practice? Are residents genuinely able to use that time?”

As an IMG, also clarify:

• “Have IMGs in your program successfully published or presented at national meetings, and what kind of mentorship was helpful for them?”

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Important Questions to Ask Current Residents (Especially Other IMGs)

Residents—particularly those who are IMGs—are often your most honest source of information. This is where you get real answers to “What is it actually like?”

1. Day-to-Day Life & Workload

• “Can you walk me through a typical day and a typical week in this program?”
  Ask follow-ups:

  • Clinic vs conference time
  • Documentation load
  • Patient volume

• “How manageable is the workload realistically, and how often do you feel you have time to read and study?”

• “What is the call schedule like—frequency, typical call issues in genetics, and how well supported you feel when you’re on call?”

• “Are there any hidden responsibilities that weren’t obvious when you first joined?”

2. Program Culture & Support

• “How approachable are the attendings and program leadership when you’re struggling or have questions?”

• “How would you describe the resident community here—collaborative, competitive, close-knit, or more independent?”

• “Have you ever considered leaving the program or specialty, and what factors made you stay?”
  A powerful way to test culture and satisfaction.

For IMGs specifically:

• “As an IMG, what was the most challenging part of adapting to this program, and how did the program help (or not help) you?”

• “Do you feel IMGs are treated any differently—positively or negatively—compared with US graduates?”

• “If you had to decide again, would you choose this program, and why or why not?”

3. Education Quality & Boards

• “How well do you feel the program is preparing you for the medical genetics boards?”

• “What does studying for boards look like here in reality—do you have time, resources, and guidance?”

• “Are conferences and didactics protected time, or do clinical demands frequently pull you away?”

4. Life Outside the Hospital

You are choosing a life, not only a program.

• “How is living in this city/area in terms of cost of living, safety, and community—especially for someone coming from abroad?”

• “Are there IMG or international resident networks here—within the hospital or in the community?”

• “How easy or difficult is it to manage family responsibilities (spouse, children) alongside the training demands?”

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Administrative, Visa, and Logistics Questions for Coordinators and Leadership

This section is especially critical for IMGs. Many candidates hesitate to ask, but these are foundational for your genetics match decision.

1. Visa Sponsorship & Policies

Ask these to the program coordinator, PD, or GME office (whoever is appropriate at that program):

• “What types of visas do you sponsor for residents (e.g., J-1, H-1B) in the medical genetics program?”
  Know your priorities:

  • J-1: Common, but with return-home or waiver requirements
  • H-1B: More complex, often limited, but can be better for long-term US plans

• “How many IMGs currently in the program are on visas, and has the program had any recent difficulties with visa processing?”

• “Are there institutional limitations or caps on IMG or visa positions that I should be aware of?”

2. Onboarding & Licensing

• “What does the onboarding process look like for IMGs, particularly regarding ECFMG verification, state licensing, and credentialing?”

• “How far in advance do you typically start the visa and credentialing process for matched residents?”
  As delays can significantly affect IMGs.

3. Salary, Benefits, and Practical Support

• “Are there any differences in salary or benefits between IMG and US graduates?” (There should not be, but asking signals awareness.)

• “What support is available for moving, housing, and initial settling in—especially for residents arriving from outside the US?”

• “Are there wellness or mental health resources that residents commonly use, and are they easily accessible?”

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Tailoring Questions to the Medical Genetics Specialty

Beyond generic residency questions to ask, you should show that you understand the unique aspects of a medical genetics residency.

1. Interdisciplinary Teams & Genetic Counselors

• “How do residents work with genetic counselors in clinic and inpatient consults, and how is responsibility shared?”

• “Are there structured opportunities to learn and practice genetic counseling communication skills, especially delivering complex or sensitive information?”
  As an IMG, this is particularly important if English is your second language or you trained in a different communication culture.

2. Laboratory & Genomic Medicine Integration

• “How much hands-on exposure do residents have to molecular, cytogenetic, and biochemical lab operations and test interpretation?”

• “Are there opportunities to sit with lab directors or molecular pathologists to review complex variants and test reports?”

• “Do residents gain experience with emerging technologies such as exome/genome sequencing, pharmacogenomics, and bioinformatics tools?”

3. Evolving Field & Future-Proofing Your Career

• “How is the program adapting to the rapid changes in genomic medicine—such as increased use of whole genome sequencing, AI-based variant interpretation, and population genomics?”

• “What opportunities are there to get involved in quality improvement or implementation projects related to integrating genetics into broader hospital care?”

• “How does the program help residents explore non-traditional genetics careers (e.g., industry, tele-genetics, laboratory directorship) if they are interested?”

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Putting It All Together: Planning Your Question List

To make this practical, here’s how you might structure your questions across a typical interview day in medical genetics:

For the Program Director (4–6 key questions)

Focus on:

• Training structure and philosophy
• IMG support and outcomes
• Board prep and graduate placements

Example PD question set:

1. “How would you describe the overarching philosophy of training in your medical genetics residency, and what types of residents thrive here?”
2. “What systems do you have in place to support international medical graduates as they adapt to the US healthcare system and to this specialty?”
3. “Could you describe the balance between different subspecialty exposures (pediatric, adult, prenatal, cancer, and metabolic genetics) over the course of training?”
4. “What is your recent board pass rate, and how do you integrate board preparation into the curriculum?”
5. “Where have your graduates—especially IMGs—typically gone after finishing the program, and how has the program helped them reach those goals?”

For Faculty (3–4 thoughtful questions)

Focus on:

• Subspecialty experience
• Teaching and mentorship
• Research opportunities

Example faculty question set:

1. “In your clinic, how do residents participate in patient care and decision-making, and how does that change as they progress through training?”
2. “What kinds of scholarly or research projects are residents typically involved in, and how realistic is it for busy residents to complete them?”
3. “From your perspective, what distinguishes residents who become particularly strong clinical geneticists by graduation?”

For Residents (5–7 candid questions)

Focus on:

• Reality of workload
• Culture & support
• IMG experiences

Example resident question set:

1. “What does a typical day look like for you on a busy rotation, and how much time do you realistically have for reading and board preparation?”
2. “How supported do you feel by attendings and leadership when you’re on call or facing a difficult case?”
3. “As an IMG, what were your biggest challenges starting here, and how did the program respond?”
4. “Do you feel that the training here is preparing you well for boards and for your next career step?”
5. “If you had to go through the match again, would you choose this program, and why?”

For Coordinators / GME / Admin (2–3 crucial questions)

Focus on:

• Visa details
• Onboarding
• Practical logistics

Example admin question set:

1. “What types of visas do you currently sponsor for residents in the medical genetics program, and how many residents are on visas now?”
2. “What does the timeline for visa processing and credentialing typically look like for IMGs after the match?”
3. “Are there institutional supports or resources specifically designed for international residents adjusting to life here?”

Using this structured approach will help you make the most of each interaction and ensure you cover the most important aspects for your genetics match decision as an international medical graduate.

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FAQ: Common Questions About What to Ask Medical Genetics Programs as an IMG

1. Is it okay to ask directly about visa sponsorship during interviews?
Yes. Visa sponsorship is a fundamental, practical concern for any international medical graduate. Phrase it professionally and usually ask the coordinator or PD:

• “Could you share your current policies on sponsoring J-1 or H-1B visas for medical genetics residents?”
  Most programs expect IMGs to ask this, and it does not hurt your candidacy when asked respectfully.

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2. How many questions should I ask each interviewer?
Aim for 2–4 thoughtful questions per interviewer. With the program director, you might ask slightly more (4–5). It’s better to ask fewer, deeper questions that lead to real conversation than to rush through a long checklist. Always prioritize your “must-know” topics in case time runs short.

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3. Are there any questions I should avoid asking?
Avoid:

• Questions easily answered on the website (e.g., “How long is your program?”)
• Overly personal questions (e.g., “Why did your last resident leave?” unless they raise it)
• Salary questions during faculty/resident interviews (better for coordinator or official materials)

Instead, phrase sensitive concerns broadly:

• “How does the program respond when residents are struggling academically or personally?”

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4. What if I forget to ask something important during the interview?
You can follow up politely by email, especially with the coordinator or PD:

• “Thank you again for the opportunity to interview. I realized afterward that I didn’t have a chance to ask about [topic]. Would you mind sharing … ?”

Alternatively, use second looks (if offered) or virtual Q&A sessions to clarify remaining questions. It’s better to ask late than not at all—your long-term fit in a medical genetics residency as an IMG depends on having complete information.

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By approaching your interviews with a clear strategy, specialty-informed insight, and well-crafted questions to ask residency programs, you demonstrate exactly the qualities medical genetics programs value: curiosity, critical thinking, and long-term commitment to the field. As an international medical graduate, your questions are one of your strongest tools—both to stand out and to find the program where you can thrive.