Essential Questions to Ask Residency Programs: A Guide for IMGs

As an international medical graduate (IMG), the questions you ask residency programs can be just as important as the answers you give. Thoughtful, well‑researched questions show programs that you are prepared, serious, and genuinely interested in finding the right fit. This IMG residency guide will help you build a smart strategy for what to ask programs, what to ask the program director, and how to adapt your questions across different interviewers.

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Understanding Why Your Questions Matter So Much for IMGs

For many IMGs, residency interviews are your first in‑person (or on‑screen) interaction with a U.S. program. Your questions serve several critical purposes:

1. Signal professionalism and preparation
   Strong, specific questions show you have done your homework and are thinking like a future resident, not just a hopeful applicant.

2. Clarify support for IMGs
   Programs vary tremendously in how experienced they are with international medical graduates. Your questions can reveal:

   • How many IMGs are currently in the program
   • How they support visa processing
   • How they help with cultural and system adaptation

3. Check true program culture vs. marketing language
   Every program says they value education, wellness, and diversity. Targeted questions to ask residents and faculty will help you understand what daily life actually looks like.

4. Protect your future success
   As an IMG, you may be relocating countries, investing in costly exams, and committing to a long training path. Asking the right questions reduces the risk of landing in a program that doesn’t support your growth or long‑term goals.

5. Stand out from other applicants
   Many applicants ask generic questions like “What are the strengths of your program?” Effective interview questions for them should be:

   • Specific
   • Personalized to the program
   • Focused on how you can contribute and grow

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Core Strategy: How to Build Your Question List as an IMG

Instead of memorizing a long list of questions, build a strategy. Think in layers:

1. Research first, then question
   Before each interview:

   • Review the program website thoroughly
   • Check current resident bios
   • Look at recent publications and program news
   • Note any unique tracks (hospitalist, global health, research, etc.)

   Do not ask questions that the website clearly answers. Instead, build on that information.

2. Group questions by audience
   You should have different types of questions for:

   • Program director (PD)
   • Associate program directors / core faculty
   • Current residents (especially IMGs)
   • Program coordinator (often by email or casual conversations)

3. Cover these essential domains
   Especially important for IMGs:

   • Visa and IMG support
   • Clinical training and supervision
   • Educational culture and feedback
   • Wellness and workload
   • Research and career development
   • Life outside the hospital (community, cost of living)
   • Program stability and leadership vision

4. Prepare 15–20 questions, use 5–10
   You will not ask every question in every interview. Have a menu of questions and choose the best ones depending on:

   • How much time you have
   • What has already been covered
   • Who you are speaking with

5. Prioritize depth over quantity
   A few thoughtful, targeted questions are far more impressive than rapidly firing through a long list.

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High‑Value Questions to Ask the Program Director (PD)

Your time with the PD is precious. Use it for high‑level, strategic topics that only leadership can answer well. Here are structured examples of what to ask program director interviewers, especially tailored for international medical graduates.

1. Questions about the Program’s Vision and Culture

These questions show that you think beyond “Will I match?” and care about long‑term growth.

• “How has the program evolved over the last 3–5 years, and what major changes do you anticipate in the next few years?”
  Why this works: Reveals program stability, leadership style, and upcoming shifts that could affect your training.

• “How would you describe the residents who thrive in this program, and what qualities do you look for, especially in IMGs?”
  Why this works: Helps you understand expectations and whether your background and strengths align.

• “What are the key priorities for the residency program over the next few years?”
  Why this works: Shows you are thinking like a future member of the team, not just a trainee.

2. IMG‑Specific Questions (Asked Professionally)

Avoid asking, “Do you take IMGs?” – they already offered you an interview. Instead, aim for depth and support:

• “Can you share how the program supports international medical graduates as they transition into the U.S. clinical system?”
  Follow‑up: “Are there any structured orientations, buddy systems, or mentorship programs specifically helpful for IMGs?”

• “Approximately what proportion of your residents are IMGs, and how have they performed in board pass rates and fellowship or job placement?”
  This gives you real data on outcomes for residents with a background similar to yours.

• “How experienced is the institution with visa sponsorship, and who typically helps residents navigate the process?”
  This reframes the visa issue as a logistics/process question rather than a nervous plea.

3. Questions about Education and Evaluation

For an IMG residency guide, educational structure is critical—many IMGs come from very different systems.

• “How is resident performance evaluated, and how often do residents receive formal feedback?”
  Follow‑up: “Is there a process to support residents who may be struggling with communication or system‑based practice early on?”

• “What opportunities do you see for residents to get involved in curriculum development, quality improvement, or teaching medical students?”
  Shows you’re already thinking about contributing to the program.

• “How do you ensure that clinical workload doesn’t compromise resident education?”
  This is diplomatic, but it probes the balance between service and learning.

4. Questions about Career Development and Post‑Residency Outcomes

Your future beyond residency is extremely important, especially if you hope to stay and practice or pursue fellowship in the U.S.

• “Where have your graduates gone in the last few years? How many pursue fellowships versus primary practice?”
  Try to get specifics by specialty if applicable.

• “What kind of mentorship structure exists around career planning, especially for residents interested in fellowship or academic careers?”

• “Are there particular strengths of this institution—for example, in hospital medicine, research, or underserved care—that shape resident career choices?”

5. Questions about Program Strengths & Challenges (Asked Maturely)

Programs respect applicants who can handle honest discussion.

• “What are you most proud of about this program, and what are one or two areas you are actively working to improve?”
  This invites an honest, nuanced response and shows maturity.

• “If you could change one thing about the program immediately, what would it be?”
  Use this carefully and only if the conversation allows; it can reveal internal limitations (e.g., EMR issues, patient volume, space).

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Questions to Ask Residents: Getting the Real Story

Current residents—especially IMGs—are your best source for understanding daily reality. These interview questions for them should focus on granular, practical details that are hard to see from outside.

1. Day‑to‑Day Workload and Support

• “What does a typical day on wards look like for an intern here—from sign‑in to sign‑out?”
  Listen for:

  • Average patient load
  • Rounding style
  • Time for notes and teaching
  • Late stay frequency

• “When you feel overwhelmed on a busy call night, what kind of support do you actually receive from seniors and attendings?”

• “How often do you violate duty hours, even unofficially?”
  If multiple residents subtly confirm frequent violations, be cautious.

2. IMG‑Relevant Questions on Transition and Integration

• “As an international medical graduate, how was your transition into this program? What were the biggest challenges, and how did the program help?”
  You want specific examples, not just “It was fine.”

• “How comfortable did you feel with attending expectations and communication in your first few months? Did you receive any structured feedback or coaching?”

• “How is the social environment for IMGs here—do you feel included in the resident community?”
  This is important for your well‑being.

3. Education, Teaching, and Feedback

• “How consistent is formal teaching (morning report, noon conference, bedside teaching)? Do residents actually get to attend?”

• “How useful is the feedback you receive? Is it mostly end‑of‑rotation forms, or do attendings sit down with you regularly?”

• “Do you feel comfortable approaching faculty with questions or concerns?”

4. Fellowship, Jobs, and Career Support

• “What kind of support do residents get for fellowship applications—letters, research, networking, interview prep?”

• “Do you feel the program’s reputation helps when you apply for jobs or fellowships?”

• “For IMGs, have there been any challenges in getting licensed or hired after graduation?”
  Try to understand visa timing and any institutional barriers.

5. Life Outside the Hospital

• “How livable is your salary here, considering housing and cost of living?”

• “How is the city/area for someone moving from overseas? Are there cultural or ethnic communities, international groceries, places of worship, etc.?”

• “Do you have time and energy for hobbies, family, or friends outside work?”
  Listen for hesitation—this often tells you more than the words.

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Questions for Faculty Interviewers: Clinical Training, Teaching, and Fit

Faculty members can discuss teaching style, patient population, and how they see residents in action.

1. Clinical Exposure and Supervision

• “How would you describe the patient population here in terms of complexity and diversity?”
  For IMGs, this is important to understand the range of pathology and social issues you’ll encounter.

• “What is the balance between resident autonomy and supervision on your service?”
  Follow‑up: “How does that change between PGY‑1 and PGY‑3?”

• “How do you approach teaching on busy clinical days?”
  You want to know whether education is consistently prioritized.

2. Feedback and Professional Development

• “From your perspective, what differentiates a resident who just meets expectations from one who truly excels in this program?”

• “How do you typically provide feedback to residents during or after a rotation?”

• “Have you noticed any common challenges that IMGs face in their first year here, and what strategies seem to help the most?”
  This not only gives you insight but also signals your self‑awareness and openness to growth.

3. Research and Scholarly Opportunities

• “What types of scholarly projects are most accessible for residents—quality improvement, case reports, clinical research, education projects?”

• “If a resident has limited prior research experience, how do you help them get started?”

• “Are there ongoing projects where residents are typically able to join during their training?”

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Questions for Program Coordinators and Administrative Staff

Program coordinators are often the operational backbone of a residency. Their answers help you understand logistics and support.

• “How does the program support residents with visa processing and renewals?”
  Ask about:

  • Who handles paperwork
  • Typical timelines
  • Common challenges

• “What is the process for scheduling time off, and how flexible is the program with personal or family emergencies?”

• “How are orientation and onboarding structured for new residents, particularly those who may be new to the U.S. healthcare system?”

• “What resources are available for residents who may need housing help, relocation support, or guidance on local services?”

These questions to ask residency coordinators can often be sent via email before or after the interview day if time is limited.

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Adapting and Asking Questions Strategically as an IMG

Having a list is only step one. How you use it matters just as much.

1. Customize for Each Program

Use the program’s strengths and website language to tailor your questions:

• If a program highlights global health:

  • “I noticed your global health track—how have IMGs been involved in those opportunities, given visa or travel considerations?”

• If they emphasize research:

  • “I saw that the program has strong research in cardiology. How have residents been integrated into these projects, especially those with less prior research experience like many IMGs?”

This shows genuine interest and preparation.

2. Avoid Redundant or Website‑Level Questions

Do not ask:

• “Do you have research?” when there’s a full research page.
• “Do you support H‑1B visas?” if it’s already clearly stated online.

Instead, go deeper:

• “I saw that your website mentions support for J‑1 visas. In practice, how often have residents had issues with processing or timing, and how has the department helped?”

3. Be Mindful of Tone

Discussing IMG status and visas can be sensitive. Use:

• Professional, neutral language
• Future‑oriented framing
• Curiosity rather than anxiety

For example:

• Less ideal: “Will I have trouble getting a visa here?”
• Better: “Could you share how the institution typically handles visa processing for residents and any common challenges IMGs should be aware of early?”

4. Prioritize Your Deal‑Breakers

Before interview season, write down your top 3–5 non‑negotiables. For many IMGs, these might include:

• Reliable and timely visa sponsorship
• Supportive environment for residents new to the U.S. system
• Reasonable workload and wellness support
• Strong board preparation and pass rates
• Program history of supporting IMGs into fellowships or jobs

Your highest‑priority questions should target these directly.

5. Take Notes Immediately After Each Interview

Right after the interview day (or virtual session), write a brief summary:

• Key points from answers to your questions
• Red or yellow flags you noticed (e.g., evasive answers about duty hours)
• What residents seemed genuinely happy—or stressed—about
• Your overall comfort level with leadership and culture

These notes will be crucial when creating your rank list.

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Common Pitfalls IMGs Should Avoid When Asking Questions

Even strong candidates make mistakes during interviews. Avoid these common traps:

1. Over‑focusing on visas too early
   Visa issues are critical, but don’t let them dominate every conversation. Aim for:

   • 1–2 well‑phrased questions to program leadership or coordinator
   • Balance with questions about education, culture, and training

2. Asking about salary or moonlighting as a first or only topic
   It’s reasonable to care about finances, but:

   • Confirm basic details from official sources first
   • If you ask, frame it as part of a broader question about wellness and cost of living

3. Using yes/no questions
   Avoid “Do you have X?” questions. Instead:

   • “How does the program handle X?”
   • “In what ways do residents participate in Y?”

4. Sounding like you just want any spot
   Saying “I will go anywhere that gives me a chance” may be honest, but it can unintentionally weaken your impression. Focus on:

   • Why this program’s features align with your goals
   • How you hope to contribute to their team

5. Neglecting to ask any questions
   If you say, “I don’t have any questions,” you might appear:

   • Unprepared
   • Disinterested
   • Overly passive

   Always have at least 2–3 strong questions ready, even for your final interview of the day.

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Putting It All Together: Sample Question Sets by Interviewer

Here are sample, ready‑to‑use question sets you can adapt for your own interviews.

For Program Director (choose 3–4)

• “How has the program changed in recent years, and what are your priorities for the next few years?”
• “How do you see international medical graduates contributing to the diversity and strengths of your residency?”
• “What structures are in place to support resident well‑being and prevent burnout, especially on demanding rotations?”
• “Could you share how your graduates—particularly IMGs—have done in terms of boards, fellowship placement, or job opportunities?”
• “What are one or two areas of the program you are actively working to improve right now?”

For Residents (choose 4–6)

• “What has surprised you most about training here, in a good or challenging way?”
• “How manageable is the workload across different rotations, and does it allow time for learning and rest?”
• “For those of you who are IMGs, how was your transition into the U.S. system at this program?”
• “Do you feel the program listens and responds when residents bring up concerns?”
• “How would you describe the relationship between residents and faculty?”
• “If you had to decide again, would you still choose this program—and why or why not?”

For Faculty

• “On your service, how do you typically structure rounds and teaching?”
• “How have you seen residents grow from PGY‑1 to PGY‑3 in this program?”
• “What research or quality improvement projects have residents recently completed with your division?”

For Coordinator / Admin

• “What does the timeline and process for onboarding new residents look like, especially for those moving internationally?”
• “How far in advance do you usually start visa paperwork, and what should IMGs do to avoid delays?”
• “Are there institutional resources to help new residents with relocation, housing, or adjusting to the area?”

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FAQ: Questions to Ask Programs – Strategies for IMGs

1. How many questions should I ask in each interview?
Aim for:

• 2–4 thoughtful questions per interviewer (depending on time)
• 6–10 total over the entire interview day
  Quality is more important than quantity. If an interviewer already covered one of your planned questions, skip it and move to another.

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2. Is it okay to ask directly about visa sponsorship during the interview?
Yes, but be professional and concise. For example:

• “Could you share how the program currently handles J‑1/H‑1B visas for residents?”
  Ideally, confirm basic information beforehand from the website or FREIDA, then ask deeper process‑oriented questions if needed.

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3. What if my questions are already answered during the program presentation?
Always prepare more questions than you think you’ll need. If one is answered, you can say:

• “Thank you, the presentation addressed several of my questions. I do have one additional question about…”
  Then pivot to a different area (education, support for IMGs, career development).

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4. Can I reuse the same questions for different programs?
Yes, but customize the wording to each program.
Instead of:

• “What are your program’s strengths?”
  Try:
• “From my reading, your program seems particularly strong in community‑based care. How do you see that shaping the resident experience?”
  Personalization shows genuine interest and preparation.

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By approaching interviews with a clear strategy and a thoughtful set of questions to ask residency programs, you will not only impress interviewers but also gather the information you need to choose the best possible training environment as an international medical graduate.