Essential Questions for IMGs in Pediatrics Residency: A Comprehensive Guide

Why Your Questions Matter as an IMG in Pediatrics

As an international medical graduate (IMG) applying to pediatrics, the questions you ask residency programs are just as important as the answers you give.

Thoughtful, well‑researched questions:

• Show programs that you understand pediatrics in the U.S. context
• Demonstrate maturity, insight, and genuine interest
• Help you decide if a program truly fits your goals and challenges as an IMG
• Provide critical information you cannot easily find on websites or in brochures

This IMG residency guide focuses specifically on questions to ask programs—including what to ask program directors, faculty, chief residents, and current residents—so you can enter the peds match with a clear strategy.

The goal is not to overwhelm programs with dozens of questions, but to ask targeted, high‑yield questions that reflect who you are and what you need as an IMG in pediatrics.

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Strategy First: How IMGs Should Approach Asking Questions

Before diving into question lists, you need a strategy. Asking strong questions in a pediatrics residency interview is less about memorizing a script and more about:

• Knowing what matters to you
• Tailoring to each program
• Showing insight into life as a pediatric resident

Step 1: Define Your Priorities as an IMG

Common priorities for international medical graduates in pediatrics include:

• Visa support and institutional experience with IMGs
• Hands-on supervision and feedback in early months
• Educational support (US clinical norms, documentation, EMR)
• Board preparation and pass rates
• Fellowship opportunities (e.g., NICU, PICU, Peds Cardiology, Heme/Onc)
• Cultural support and wellness resources
• Geography and community (especially if you have family abroad or dependents)

Write down your top 5 priorities before interview season starts. This will guide your interview questions for them (program leadership and residents).

Step 2: Avoid “Website Questions”

If the answer is clearly listed on the website (number of residents, call schedule basics, available fellowships), do not ask it directly. Instead, ask questions that:

• Go beyond the brochure, or
• Ask for context or interpretation of information you already read

Example – Weak Question:
“What is your call schedule?”

Example – Strong Question:
“I saw on your website that interns do night float during their first year. How do you support interns during that transition, especially those who are new to the U.S. healthcare system?”

Step 3: Balance between Program Fit and IMG-Specific Concerns

You are not “just an IMG.” You are a future pediatrician. Programs want to see both:

1. That you understand the general demands of pediatrics, and
2. That you are thoughtful about your specific needs as an IMG

Structure your questions so some are universal peds questions, and some are IMG-focused.

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High-Yield Questions to Ask the Program Director or APD

Program directors (PDs) and associate program directors (APDs) can explain the vision, structure, and philosophy of the program. This is where you ask deeper questions about training, evaluation, and support.

1. Questions About Educational Philosophy and Training

These questions help you understand how you will grow from intern to independent pediatrician.

• “How would you describe the type of pediatrician your program aims to graduate? What qualities do you intentionally cultivate in residents?”
• “What do your graduates say your program prepared them especially well for? Are there any areas they wish had been stronger?”
• “How do you balance service needs with education—especially on busy inpatient or NICU rotations?”
• “How is supervision structured for interns in the first 3–6 months? How does this evolve as we become senior residents?”

IMG Angle:
As an international medical graduate, you may be adapting to new systems, documentation norms, and communication styles. Asking about supervision and feedback reassures you that the program understands this transition.

2. Questions About Evaluation, Feedback, and Support

• “How often do residents receive formal feedback, and in what format?”
• “How do you support residents who may be struggling—whether clinically, academically, or with communication skills?”
• “Can you share an example of a resident who had difficulty at some point and how the program helped them improve?”
• “What are your policies or practices around remediation, and how is it framed to residents?”

Why this matters for IMGs:
If you’re transitioning from a different medical education culture, clear, structured feedback is essential. You want a place where feedback is routine and constructive, not only given during crises.

3. Questions About IMGs and Diversity Experience

You shouldn’t be shy about clarifying the program’s experience with international medical graduates.

• “How many current residents or recent graduates are international medical graduates?”
• “What strengths do you see IMGs bringing to your pediatrics residency?”
• “How does the program help IMGs adjust to the U.S. healthcare system, documentation, and communication expectations?”
• “Are there any formal or informal mentorship structures for IMGs or residents from non‑U.S. medical schools?”

Red flag: If leadership cannot recall any IMGs in recent years or seems uncomfortable answering, consider carefully if this is the right environment for you.

4. Questions About Board Preparation and Outcomes

Board certification is essential for your career. Ask:

• “How do you support residents in preparing for the pediatrics board exam?”
• “What is your recent board pass rate, and have there been any trends over the last few years?”
• “Are there specific resources, in‑training exams, or dedicated board review sessions the program provides?”

IMG-Specific Follow-Up:
“As an IMG I may have trained with a different exam style. How do you help residents learn how to take U.S.-style standardized exams like the pediatrics boards?”

5. Questions About Career Paths and Fellowships

Whether or not you are certain about fellowship, you should understand your options.

• “What are the most common career paths of your graduates—general pediatrics vs subspecialty vs hospital medicine?”
• “Which fellowships have your graduates matched into over the last 3–5 years?”
• “How does the program support residents with research, mentorship, or letters for fellowship applications?”
• “Does being an IMG affect fellowship placement in any way that you’ve noticed, and how do you support IMGs in that process?”

Tip: If you are interested in a specific area (e.g., NICU, PICU, heme/onc, outpatient general pediatrics), tailor your questions.

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Questions to Ask Current Residents (Especially IMG Residents)

Current residents give you the real story of the program. This is where you can be more personal and candid.

These questions are high-yield during resident-only sessions, meet‑and‑greets, or virtual socials.

1. Questions About Day-to-Day Life and Workload

• “What does a typical day on inpatient pediatrics look like for an intern? For a senior?”
• “On your hardest rotations, what makes the workload manageable—or unmanageable?”
• “Do you feel you have enough time to read and study outside of work?”
• “How often do you stay late beyond your scheduled hours?”

IMG Perspective:

• “As someone who trained outside the U.S., I’m curious: how easy was it to learn the EMR and U.S. documentation style here?”
• “Did you feel comfortable asking questions as a new intern, especially when you weren’t sure about local protocols?”

2. Questions About Culture, Support, and Wellness

• “How would you describe the culture among residents—collaborative, competitive, supportive?”
• “Do you feel comfortable reaching out to your co‑residents or seniors when you are overwhelmed?”
• “How do attendings respond when you say, ‘I don’t know’ or ask for help?”
• “Have you ever felt mistreated, and if so, how did the program respond?”

IMG-Focused Questions:

• “As an IMG, have you felt included in the residency community?”
• “How do people handle language or accent differences—does the culture feel respectful?”
• “Did anyone help you understand U.S. cultural norms with families, or ‘unwritten rules’ in pediatrics practice?”

You will learn a great deal from their tone and honesty, not just the words.

3. Questions About Teaching and Learning

• “Do seniors and attendings actively teach on rounds, or does teaching mostly happen in didactics?”
• “Are there regular case conferences, morbidity and mortality, or board‑style review sessions?”
• “Do you have protected time for didactics that is truly respected by the clinical services?”
• “If you need extra help with a topic or skill, how easy is it to get one‑on‑one teaching?”

For IMGs Who May Need More Orientation:

• “Did the program offer any orientation or ‘boot camp’ at the beginning of PGY‑1, especially for residents new to the U.S. system?”

4. Questions About Life Outside the Hospital

Residency is not only about work.

• “Where do most residents live? Is the commute manageable?”
• “What do you and your co‑residents do for fun on your days off?”
• “How family‑friendly is the program for residents with partners or children?”
• “Do residents generally feel they can use their vacation time as planned?”

If you have family abroad:

• “Has it been feasible for residents to travel internationally during vacation, especially for visa renewals or family visits?”

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IMG-Specific Topics: Visa, Orientation, and Transition to U.S. Pediatrics

As an international medical graduate, some issues are unique and must be addressed clearly and professionally. This is where what to ask program director becomes especially crucial.

1. Visa Sponsorship and Institutional Experience

These questions are essential and should be asked early—ideally before interview day or during it if not clearly stated.

• “Which visas do you sponsor (J‑1, H‑1B) for residents?”
• “How many current residents are on visas, and have there been any recent issues with visa processing or renewals?”
• “Does your institution have a dedicated office or staff who help with visa and immigration matters?”

If you already know your visa needs:

• “I will require an [H‑1B/J‑1] visa. Are there any additional exam or licensing requirements for that visa at your institution?”

2. Orientation, Onboarding, and Early Support

Transitioning into a U.S. pediatrics program can be intense. You want to know if they will set you up to succeed.

• “What does your orientation for new interns look like?”
• “Is there specific training on EMR use, billing, documentation, and communication with nurses and families?”
• “Do you offer any simulation sessions (codes, emergencies, procedures) early in intern year?”

For IMGs specifically:

• “Do you have any extra support or extended orientation for residents who are new to the U.S. healthcare system?”

3. Communication, Culture, and Patient Interaction

Pediatrics is communication‑heavy: with children, parents, and multidisciplinary teams.

• “How do you help residents develop skills in having difficult conversations with families (bad news, chronic disease, end‑of‑life)?”
• “Are there any workshops on cross‑cultural communication or working with interpreters?”

As an IMG:

• “For residents whose first language is not English, how does the program support refining communication skills for family discussions and presentations?”

4. Long-Term Career Support for IMGs

• “Do you have alumni who were IMGs and have gone on to academic positions, fellowships, or leadership roles?”
• “Are faculty generally aware of the additional barriers IMGs may face, such as visa issues or fewer local contacts?”
• “How does the program help residents build a professional network in U.S. pediatrics?”

These questions send a clear message: you are serious about building a sustainable career in pediatrics, not just “getting any residency spot.”

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Smart Ways to Phrase Questions (and What to Avoid)

The same question can come across very differently depending on how you ask it. The best interview questions for them show curiosity, not entitlement or negativity.

1. Turn Concerns into Open-Ended, Neutral Questions

Instead of:

• “Are you malignant?”

Try:

• “How would you describe the culture of the program, especially in terms of how residents feel supported on difficult rotations?”
• “When a resident is overwhelmed or struggling, what typically happens next?”

Instead of:

• “How bad are the hours?”

Try:

• “On your busiest rotations, what helps you manage the workload?”
• “How does the program monitor duty hours and prevent burnout?”

2. Show That You Did Your Homework

Program directors appreciate that you reviewed their website or materials.

• “I saw that your program has a strong emphasis on community pediatrics with multiple clinic sites. How does that variety prepare residents for different career paths in pediatrics?”
• “I noticed your graduates have matched into several competitive fellowships. How early in training do interested residents get involved in research or mentorship?”

This transforms your questions from generic to program-specific, which is critical in a competitive peds match.

3. Avoid Overly Personal or Risky Topics Too Early

Avoid questions that sound like you are focused only on your convenience:

• “How many days off will I get to travel back home each year?” (Instead, ask about vacation policy and flexibility.)
• “Can I moonlight as an intern?” (This can sound premature; save moonlighting questions for later years unless clearly allowed and relevant.)

You can still clarify important issues, but frame them professionally.

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Putting It All Together: Building Your Own Question List

Use this framework to create a personalized question list for each interview.

Step 1: Prepare a “Core” List (Used at Most Programs)

Core topics:

• Educational philosophy & training
• Supervision and feedback
• Support for IMGs
• Board prep and outcomes
• Resident culture and wellness

Prepare 8–10 questions total, knowing you may only use 4–6 per interview depending on time.

Step 2: Add 3–4 Program-Specific Questions

Examples:

• Reference a unique rotation (e.g., large NICU, advocacy track, global health, refugee clinic).
• Ask about a research center or children’s hospital feature you saw online.
• Mention a fellowship that many of their graduates pursue.

This shows genuine interest in that specific pediatrics residency.

Step 3: Tailor Questions to the Person You’re Speaking To

• Program Director/APD: Program vision, outcomes, policies, challenges, IMG support philosophy
• Chief Residents: Scheduling, rotation structure, conflict resolution, resident advocacy
• Current Residents: Daily life, workload, wellness, real culture, how IMGs feel day-to-day
• Faculty/Subspecialists: Mentorship, research, fellowship prep, subspecialty exposure

Step 4: Practice Asking Questions Out Loud

This is often overlooked, especially by IMGs.

• Practice pronouncing key terms (e.g., “NICU,” “PICU,” “continuity clinic,” “M&M conference”).
• Time yourself so questions are concise.
• Ask a friend or mentor to role-play an interview.

Remember: confident delivery makes your questions more impactful.

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FAQs: Questions to Ask Programs as an IMG in Pediatrics

1. How many questions should I ask during a pediatrics residency interview?
Typically, you will have time for 2–4 questions per formal interview (PD, faculty), plus more in resident-only sessions. Prepare around 8–12 high-quality questions total, then choose the best ones based on what has already been discussed. Do not feel pressure to ask a question if everything has been answered meaningfully; a simple “You’ve answered many of my questions already, thank you” is acceptable.

2. Is it okay to ask directly about visa sponsorship and IMGs?
Yes. As an international medical graduate, clarity about visa support is essential. You can ask professionally: “I will require a [J‑1/H‑1B] visa. Could you share how your institution supports residents with visas and if there are any specific requirements?” Asking early helps avoid mismatched expectations later in the peds match.

3. What are good questions to ask residency programs if I’m unsure about fellowship vs general pediatrics?
You don’t need a fixed career plan. You might ask: “How does your program support residents in exploring different career paths in pediatrics?” or “What kind of exposure do residents get to both general outpatient pediatrics and subspecialties?” This shows insight and openness, not confusion.

4. Can asking the ‘wrong’ questions hurt my chances in the match?
Thoughtful questions almost never hurt you. Problems arise when questions sound unprepared (“What is your program known for?” when that’s clear online), self-focused in a narrow way (“How quickly can I get vacation to travel?”), or negative (“Are you malignant?”). If you use this IMG residency guide to frame respectful, informed questions, your questions will generally help rather than harm your application.

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By preparing intentional, well-phrased questions tailored to pediatrics and to your experience as an international medical graduate, you not only gather essential information—you also present yourself as a thoughtful future colleague who will contribute meaningfully to any residency program you join.