Essential Questions to Ask Urology Residency Programs as an IMG

Why Your Questions Matter as an IMG in Urology

For an international medical graduate (IMG), every urology residency interview is more than a chance to impress—it’s an opportunity to gather specific, practical information to decide whether a program is truly the right fit. A focused, thoughtful list of questions to ask programs can help you:

• Understand how supportive a program is toward IMGs
• Assess the quality and breadth of surgical training
• Evaluate how well graduates match into fellowships or jobs
• Clarify visa, licensing, and support issues unique to IMGs
• Demonstrate genuine interest and maturity as a candidate

This IMG residency guide focuses specifically on questions to ask residency programs—faculty, residents, and program directors—as an international medical graduate interested in urology. It goes beyond generic interview questions for them and highlights nuances of the urology match, cultural adaptation, and training structure.

Think of this as your structured “question bank” to customize before each interview.

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Strategy: How to Use Questions Effectively in Interviews

Before diving into specific examples, it’s important to understand how and when to use your questions during the urology residency interview day.

1. Prepare a Core List + Program-Specific List

Create two sets of questions:

• Core questions you will ask at almost every program
• Program-specific questions tailored to that institution (based on their website, current residents, case logs, or research profile)

Bring both lists (written neatly in a notebook or portfolio). Glancing briefly at them during conversations is perfectly acceptable and shows you are organized.

2. Match Questions to the Right Person

Not every question belongs to the program director (PD). Asking the right person increases your chance of getting honest and detailed answers:

• Program Director / Associate PD

  • Program philosophy, curriculum, institutional support, urology match statistics, and policy issues
  • Visa, contract, wellness, remediation, and performance evaluation

• Faculty Interviewers

  • Surgical training quality, operative autonomy, mentorship style, subspecialty exposure

• Chief Residents / Senior Residents

  • Day-to-day life, call schedule, culture, actual autonomy vs. stated autonomy

• Junior Residents

  • Intern year experience, early support, teaching style, transition to US culture/healthcare

• Program Coordinator

  • Logistics, orientation, visa timing, onboarding issues, licensing and paperwork

3. Avoid “Website-Level” Questions

Do not ask questions that can be easily answered on the program’s website (e.g., “How many residents per year?”). Instead:

• Reference what you’ve read:
  • “I saw that your program has three residents per year and a strong robotics volume…”
• Then ask deeper questions:
  • “…How does that case volume get distributed among junior versus senior residents?”

This shows you’ve done your homework and are using your time wisely.

4. Aim for Conversation, Not an Interrogation

You do not need to ask every question on your list. Prioritize:

• 4–6 thoughtful questions per interviewer
• Different sets of questions for different people
• Follow-up questions that emerge naturally from their answers

Quality is more important than quantity.

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Key Questions to Ask the Program Director (PD) and Leadership

As an IMG in urology, you should focus on areas that strongly influence your training, especially policy, support, and long-term outcomes. These “what to ask program director” topics are central to your decision-making.

A. Program Philosophy, Culture, and IMG Support

1. “How would you describe the culture of your urology program, especially in terms of supporting international medical graduates?”

• Purpose: Understand whether IMGs are integrated, valued, and successful.
• Listen for: Specific examples of IMG residents and alumni, not just generic positivity.

2. “What qualities have you seen in successful IMG residents here, and what challenges have they faced?”

• Purpose: Identify expectations and potential hurdles.
• Bonus: Shows insight and self-awareness about your IMG status.

3. “Can you share how the program has adapted or improved to better support residents from diverse educational and cultural backgrounds?”

• Purpose: Understand whether the program is reflective and improving, or rigid and static.

B. Surgical Training, Case Volume, and Autonomy

4. “How do you balance early supervision with progressive autonomy in the operating room, especially for residents who may have had different levels of prior surgical experience as IMGs?”

• Purpose: Clarify how they individualize training based on your background.
• Follow-up:
  • “Do you use specific milestones or evaluations to decide when residents can perform parts of cases independently?”

5. “How does the case mix and volume prepare graduates for independent practice or competitive fellowships?”

• Purpose: Link training directly to your future goals.
• Ask for examples:
  • “Can you share recent examples of complex cases that senior residents regularly perform?”

C. Curriculum, Evaluation, and Remediation

6. “How is resident performance evaluated, and what support systems are in place if someone is struggling academically, clinically, or surgically?”

• Purpose: Identify whether the culture is punitive or developmental.

7. “Do you provide structured preparation for the American Board of Urology exams, and how have your graduates performed in recent years?”

• Purpose: You want a solid foundation for board eligibility and success.
• Follow-up:
  • “Are there dedicated didactics, mock orals, or in-service review sessions?”

D. Fellowship and Career Outcomes

8. “Where have your recent graduates gone after residency—both academically and in community practice—and how do you support those seeking fellowships like oncology, endourology, or pediatrics?”

• Purpose: Concrete measure of program quality and networking strength.
• Listen for:
  • Specific institutions, faculty letters, and mentorship process.

9. “For residents interested in returning to their home country after training, how do you help them navigate that pathway?”

• Purpose: IMG-specific concern for those not planning long-term US practice.

E. Visa, Contract, and Institutional Support (IMG-Specific)

10. “Does your institution currently sponsor J-1 and/or H-1B visas for urology residents, and have there been any recent changes in policy?”

• Purpose: Get precise information about visa sponsorship before ranking.
• Clarify:
  • Processing timelines
  • Institutional immigration support

11. “Have your IMG residents experienced any difficulties with licensing, visas, or credentialing, and how has the program supported them?”

• Purpose: Gauge real-life experience rather than theoretical policy.

12. “Are there any contractual or visa-related limitations on moonlighting, research time, or fellowship applications that I should be aware of?”

• Purpose: Anticipate restrictions that could affect your long-term plan.

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Essential Questions to Ask Current Residents

Residents—especially other IMGs—are often your most honest and practical source of information. Frame your questions to get specifics, not just “It’s good” or “It’s busy.”

A. Daily Workflow, Call, and Workload

13. “What does a typical day look like for you on a busy urology service—from arrival to leaving the hospital?”

• Purpose: Understand practical realities and whether expectations align with your stamina and lifestyle.

14. “How is call structured (in-house vs home call), and how often are you on call as a PGY-1, PGY-2, and senior?”

• Purpose: Clarify intensity and fairness across years.
• Follow-up:
  • “How manageable is post-call work, and do people generally feel safe and supported when they’re very busy?”

15. “When things get overwhelming—late cases, consults, emergencies—how do residents and attendings respond? Do you feel supported or left alone?”

• Purpose: Assess crisis culture and teamwork.

B. Operative Experience and Teaching

16. “At your current level, what parts of common cases do you typically perform—such as TURP, ureteroscopy, robotic prostatectomy, or nephrectomy?”

• Purpose: Verify real operative autonomy.

17. “Do you feel that the stated case volume and autonomy on the website matches what you actually experience?”

• Purpose: Compare marketing vs reality.

18. “How approachable are faculty when you have questions during cases or clinics? Do you feel safe admitting when you don’t know something?”

• Purpose: Patient safety and psychological safety are critical, especially for IMGs who may worry about being judged.

C. IMG Integration and Support

19. “As an IMG (or from what you’ve seen of IMGs here), what were the biggest challenges in the first year, and how did the program support that transition?”

• Purpose: Firsthand insight into orientation and adaptation.

20. “Do IMGs here have equal access to competitive rotations, research projects, and leadership positions such as chief resident?”

• Purpose: Detect subtle bias or inequity.

21. “Have you ever felt treated differently because of your background, accent, or medical school? If so, how did the program respond?”

• Purpose: Gauge the honesty and inclusivity of the environment.

D. Wellness, Mentorship, and Life Outside the Hospital

22. “Do you feel the program respects time off and vacation, and can people realistically maintain relationships, hobbies, or family life?”

• Purpose: Identify burnout risk and schedule flexibility.

23. “How easy is it to get mentorship here—for both clinical training and long-term career goals?”

• Purpose: Residency is short; you need structured, not accidental, mentorship.

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

• Purpose: Revealing, especially if multiple residents hesitate or give guarded answers.

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Targeted Questions for Faculty and Subspecialists

Urology is highly subspecialized, and as an international medical graduate, your exposure to advanced technologies (robotics, lasers, complex reconstruction) may have been variable. Use faculty interviews to probe depth and quality of training.

A. Subspecialty Exposure and Fellowships

25. “How is time divided among subspecialties—oncology, endourology, female pelvic medicine, pediatric urology, reconstructive urology, and andrology—and how early do residents get exposure?”

• Purpose: Ensure well-rounded training, particularly at smaller programs.

26. “For residents who want fellowships, what kind of mentorship and guidance do you provide for the urology match into subspecialties?”

• Purpose: You want clear processes for letters, networking, and research.

27. “Do faculty actively involve residents in national meetings or society activities (AUA, SUO, etc.), and how are those opportunities funded?”

• Purpose: Conferences are crucial for networking, especially for IMGs.

B. Research and Academic Development

28. “What types of research projects are available for residents—clinical outcomes, translational work, quality improvement—and how do you help IMGs new to US research systems get started?”

• Purpose: IMG-specific support for IRB processes and manuscript writing.

29. “How many residents typically present at national or regional meetings each year?”

• Purpose: Concrete indicator of academic productivity.

30. “Is there protected research time, and is it truly respected in practice?”

• Purpose: Separate policy from reality.

C. Teaching Style and Expectations

31. “How would you describe your approach to teaching in the OR and clinic, especially with trainees who might have strong prior experience from another country?”

• Purpose: Avoid mismatched expectations or ego clashes.

32. “When a resident struggles with a technical skill or clinical decision-making, what does your remediation process look like from a faculty perspective?”

• Purpose: Understand whether faculty buy into supportive remediation.

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Unique Questions IMGs Should Ask (Beyond the Usual)

IMGs often face additional layers of complexity in the urology match and in daily training. These targeted questions help uncover aspects that might not be obvious to US graduates.

A. Transition to the US Healthcare System

33. “What formal orientation or ‘boot camp’ do you provide for new interns, and does it cover US documentation, billing, EMR use, and communication standards?”

• Purpose: The first months can be overwhelming if support is lacking.

34. “Do you offer any resources or coaching for improving communication skills with patients and staff, especially for those with accents or different communication styles?”

• Purpose: Communication challenges can impact evaluations and confidence.

B. Legal, Licensing, and Visa Realities

35. “Is there a dedicated staff member or office that helps residents navigate state licensing, DEA, and visa paperwork, and how early is this process started?”

• Purpose: Delays can jeopardize start dates or moonlighting.

36. “Have any residents in recent years run into visa or credentialing problems that affected their ability to complete training or start fellowships?”

• Purpose: Identify red flags and institutional stability.

C. Financial and Practical Considerations

37. “Is the salary and benefits package sufficient to live reasonably in this area, and have IMGs with families had particular challenges?”

• Purpose: Budgeting is critical, especially if you’re supporting relatives abroad.

38. “Are there institutional systems for housing assistance, transportation, or childcare that residents commonly use?”

• Purpose: Especially important if you’re moving from overseas.

D. Diversity, Inclusion, and Psychological Safety

39. “How does the department foster diversity and inclusion among residents and staff, and are there specific initiatives or groups that support international or minority physicians?”

• Purpose: Generic statements are less reassuring than specific programs.

40. “If a resident experiences discrimination—from patients or staff—what is the formal and informal process for addressing it?”

• Purpose: You’ll likely face some bias as an IMG; you need to know how it’s handled.

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Putting It All Together: Building Your Personal Question List

To turn this into a functional IMG residency guide for your urology interviews, follow this step-by-step strategy.

Step 1: Identify Your Top 5 Priorities

For example:

1. Visa security and institutional support
2. Strong surgical autonomy, especially in endourology and robotics
3. Fellowship placement or job opportunities after graduation
4. Support for IMGs adapting to US culture and healthcare
5. Resident wellness and humane scheduling

Your priorities may differ, but they should guide which questions you emphasize.

Step 2: Select 10–15 Core Questions

From the list above, choose questions that:

• Directly relate to your priorities
• Are unlikely to be fully answered on the website
• Can be adapted easily to each program

Example core set (abbreviated):

• Culture and IMG support (#1, #2, #19, #20)
• Surgical autonomy (#4, #16, #17)
• Outcomes (#8, #21, #24)
• Visa and institutional support (#10, #11, #35, #36)

Step 3: Customize 3–5 Program-Specific Questions

Use:

• Program website
• Case logs or ACGME data
• Research profiles or recent publications

For example:

• “I noticed your residents have a high robotic case volume. How early do juniors get primary console time?”
• “Your website highlights global surgery initiatives. Have any IMG residents been involved in those projects?”

Step 4: Practice Asking Questions Aloud

IMGs sometimes worry about phrasing or accent. Practicing aloud:

• Reduces anxiety
• Helps you keep questions concise
• Lets you adjust tone to sound curious, not confrontational

Record yourself or practice with a mentor, friend, or advisor familiar with US culture.

Step 5: Take Notes Immediately After Interviews

After each urology residency interview:

• Write down key impressions and answers while they’re fresh.
• Use a simple template:
  • Program strengths
  • Concerns or red flags
  • Fit for your priorities
  • Notes on visa, support, and IMG experiences

These notes will be invaluable when building your rank list for the urology match.

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FAQ: Common Questions from IMGs About Asking Programs

1. Is it okay to ask directly about visa sponsorship and IMG support?

Yes, and you should. Visa status is a core logistical issue. Ask politely and early in the conversation with the PD or coordinator:

• “Could you clarify your current policy on J-1/H-1B sponsorship for urology residents?”
• “How has the program supported IMGs with visa and licensing issues in the past?”

You are not being difficult; you are being responsible.

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2. How many questions should I ask during each interview?

Aim for:

• 3–5 well-chosen questions per individual interviewer
• Additional questions during resident Q&A or socials

Do not feel pressured to “empty your list.” If an interviewer is short on time, prioritize your top 1–2 questions. Quality, specificity, and relevance matter more than quantity.

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3. Are there questions I should avoid asking?

Avoid:

• Anything easily found on the website (“How many residents do you have?”)
• Questions that sound like you’re trying to work less (“How little call can I get?”)
• Highly personal questions that make residents uncomfortable
• Aggressive or confrontational wording, even if your concern is valid

Instead, reframe concerns constructively:

• “How does the program work to prevent burnout among residents, especially during heavy rotations?”

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4. What if I’m nervous about my English or accent when asking questions?

You’re not alone; many IMGs share this concern. Strategies:

• Write your questions in bullet form, not full sentences—this keeps your delivery more natural.
• Practice saying them aloud with someone familiar with US communication styles.
• Slow down slightly when speaking; clarity is more important than speed.
• Remember: Programs that value diversity will be patient and supportive.

Your thoughtful, well-structured questions will likely impress interviewers more than flawless language.

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Thoughtful, targeted questions are one of your strongest tools as an international medical graduate pursuing urology residency. Used well, they help you evaluate programs honestly, present yourself as a mature and insightful applicant, and ultimately build a rank list aligned with your goals in the urology match.