Essential Questions MD Graduates Should Ask for Preliminary Surgery Residency

Understanding the Goals of a Preliminary Surgery Year

For an MD graduate interested in a preliminary surgery year, your interview day is not just about being evaluated—it is your opportunity to evaluate the program. Asking the right questions helps you determine whether a prelim surgery residency will support your long-term goals, whether that’s:

• Matching into a categorical general surgery position
• Transitioning to another surgical specialty (e.g., orthopedics, ENT, urology, neurosurgery)
• Moving into an advanced program (e.g., anesthesiology, radiology)
• Strengthening your portfolio for a future allopathic medical school match cycle

Before crafting your questions, clarify your top priorities:

• Do you want maximum operative experience?
• Are you focused on research and networking to re-enter the match?
• Do you need strong mentorship and support for visa or geographic constraints?
• Are you open to staying at that institution as a categorical resident?

Once you know your goals, you can tailor your questions to ask residency programs to get precise, useful information instead of generic reassurances.

Core Themes Your Questions Should Cover

For a prelim surgery residency, you should aim to ask questions in these areas:

1. Structure and expectations of the prelim year
2. Operative and clinical experience
3. Education, evaluation, and feedback
4. Support for your next match cycle and career goals
5. Program culture, workload, and wellness
6. Logistics: call, schedules, pay, and benefits

The sections below provide specific, high-yield interview questions for them, with explanations and examples of what different answers might mean.

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Questions About the Structure and Role of Preliminary Surgery Residents

Understanding how the program views and uses preliminary residents is critical. In some places, prelims are integrated and mentored; in others, they are simply used to plug service gaps.

Questions to Ask the Program Director About Structure and Expectations

These are important questions to ask the program director or chair, as they set the tone for how prelims are treated.

1. “How are preliminary residents integrated into the program compared with categorical residents?”

Why it matters:
You want to know if prelims are:

• Included in the same didactics, conferences, and rotations
• Given similar operative opportunities
• Seen as full team members rather than short-term labor

Red flag answer: “Prelims mostly help with floor work so categoricals can get into the OR.”
Positive sign: “We treat prelims identically in terms of rotations, conferences, and access to the OR, and we track their progress closely.”

2. “How many preliminary positions do you have, and how many categorical positions?”

Why it matters:
A program with a very high number of prelims relative to categorical spots may be more service-heavy and less invested in each prelim’s future.

Follow-up:

• “How many of your prelim residents in the last 3–5 years have transitioned to categorical surgery at your institution or elsewhere?”

This gives you real data about outcomes.

3. “Are there defined pathways or opportunities for prelims to move into categorical positions here if they become available?”

Why it matters:
Some programs explicitly consider strong prelims first when unanticipated categorical spots open. Others do not.

Clarifying follow-ups:

• “What criteria do you use when considering a prelim for a categorical spot?”
• “Have any prelims transitioned to categorical roles here in the last few years?”

Look for clear, structured answers rather than vague optimism.

4. “What are the expectations for prelim residents in terms of workload, research, and participation in educational activities?”

Why it matters:
You need to understand if the workload will allow time to prepare for board exams, research, and the next application cycle.

Look for:

• Required conferences and attendance expectations
• Research expectations (if any)
• Typical number of duty hours per week
• Culture around duty-hour compliance

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Questions About Operative Experience and Clinical Exposure

As an MD graduate, your preliminary surgery year is often about building strong clinical and operative credentials. You need specific details, not general reassurances like “we get a lot of cases.”

Questions for Residents About Operative Experience

Residents are often your most honest source about actual day-to-day experience.

5. “On average, how many cases do prelim residents log by the end of the year, and how does that compare to categorical interns?”

Why it matters:
You want real numbers. Large discrepancies between categorical and prelim case logs suggest prelims may be sidelined.

Follow-up:

• “Are prelims able to act as primary surgeon on basic cases, or mostly first assist?”

6. “Which rotations are the most operative for prelims, and which tend to be more floor-heavy?”

Why it matters:
Some rotations (e.g., trauma, acute care surgery, vascular) may be more OR-intense. Others (ICU, consults) are less operative but still valuable.

Use this to get a balanced sense of your year:

• “Do prelims consistently get time in the OR on those rotations?”
• “Are there rotators (fellows, PA/NPs, medical students) who usually take precedence over prelims in the OR?”

7. “How easy or difficult is it to get into the OR if you’re efficient with your floor work?”

Why it matters:
Good programs will reward efficiency with operative opportunities. If the answer suggests you are always tied to the pager, your operative development may be limited.

Questions to Ask the Program Director or Faculty About Training Quality

8. “How do you ensure that preliminary residents receive adequate operative experience and not just service work?”

Why it matters:
Look for evidence of intentional planning:

• Dedicated OR days for interns
• Clear guidelines about who gets cases
• Monitoring of case logs with intervention if a resident is falling behind

9. “What exposure do prelims get to subspecialties (e.g., vascular, colorectal, trauma, surgical oncology)?”

Why it matters:
If you’re considering a subspecialty, having rotations or elective time in those areas can be invaluable both for skills and letters of recommendation.

Follow-up:

• “Are prelims eligible for the same elective rotations as categorical interns?”

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Questions About Education, Feedback, and Evaluation

A strong prelim surgery residency should include structured teaching and regular, constructive feedback—not just running from task to task.

Questions About Teaching and Curriculum

10. “What does the formal educational curriculum look like for interns, and are prelims required or encouraged to attend?”

Why it matters:
Ask specifically about:

• Weekly didactic sessions
• Morbidity and Mortality conferences
• Simulation labs (central lines, laparoscopic skills, etc.)
• ABSITE preparation sessions

Ensure prelims are not excluded from education or treated as optional attendees.

11. “How is ABSITE preparation handled for preliminary residents?”

Why it matters:
Even as a prelim, a strong ABSITE score can significantly help your allopathic medical school match re-application and your competitiveness for categorical surgery.

Follow-up:

• “Do prelims take the ABSITE here?”
• “Are scores shared with you and used to help guide your next steps?”

Questions About Evaluation and Feedback

12. “How frequently do faculty formally evaluate prelim residents, and how is feedback shared?”

Why it matters:
You want:

• Clear expectations from the start
• Mid-rotation or quarterly feedback
• A chance to correct course before evaluations become permanent

Strong programs might have:

• Regular meetings with a faculty advisor
• Use of milestone-based evaluation
• Data shared with you in writing

13. “Who will be my primary mentor or advisor during the prelim year?”

Why it matters:
A named advisor increases the chance you’ll get real career guidance, letters of recommendation, and honest advice.

Follow-up questions:

• “How often do prelims meet with their advisors?”
• “Are advisors expected to help with letters and strategy for the next match?”

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Questions About Support for Future Match and Career Goals

For most MD graduates, the primary reason to do a preliminary surgery year is to strengthen their application for a future match—either in surgery or another specialty. You need to know exactly how the program will support you.

Questions to Ask the Program Director About Match Outcomes

These are some of the most important questions to ask residency leaders; ask them early in your conversation.

14. “Over the last 3–5 years, where have your preliminary residents matched after this program?”

Why it matters:
Request specific, recent data:

• How many matched into categorical general surgery?
• How many matched into other surgical fields?
• How many switched into nonsurgical specialties?
• How many did not match?

This is your best predictor of whether the program actively helps prelims succeed.

15. “How does the program assist prelim residents with the next application cycle?”

Look for concrete support:

• Dedicated time or schedule flexibility for interviews
• Guidance with ERAS, program list selection, and strategy
• Opportunities for strong letters of recommendation from faculty
• Practice interview sessions or mock interviews

Red flag answer: “We encourage them to apply widely, but it’s really up to them.”

16. “Are prelim residents given time or flexibility to attend interviews during the year?”

Why it matters:
If the program makes it difficult to attend interviews, you may miss critical chances to secure a future position.

Follow-up:

• “How is coverage handled when a resident is away for interviews?”

Questions About Research and Scholarly Support

17. “What opportunities do prelim residents have for research, and is there protected time?”

Why it matters:
Not all prelim years provide robust research opportunities, but any chance to participate in clinical projects, quality improvement, or case reports can strengthen your CV.

Ask specifically:

• “Is there a research coordinator or mentor prelims can work with?”
• “Have previous prelims published or presented work during or soon after their year here?”

18. “Do faculty here commonly write letters of recommendation for prelims, and how early in the year can those be arranged?”

Why it matters:
You need time to impress faculty and then secure letters early enough for ERAS deadlines, especially if you are re-entering the match that same academic year.

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Questions About Culture, Workload, and Wellness

Even as a short-term trainee, your well-being and ability to function at a high level matter. Burnout in a prelim year can make everything—patient care, exam prep, and applications—much harder.

Questions to Ask Current Residents About Culture

Residents are your most reliable source for this area.

19. “How would you describe the culture toward preliminary residents here?”

Why it matters:
Look for words like “supportive,” “included,” “mentored,” and wariness if you hear “they just keep the ship running,” “they do most of the scut,” or “depends on the rotation.”

20. “Do prelims feel like second-class residents compared to categoricals, or are they treated the same day to day?”

Why it matters:
Some programs unintentionally create a hierarchy where prelims receive fewer opportunities, less teaching, and are less visible to leadership. You want candid opinions.

21. “How approachable are attendings and senior residents for questions or help?”

Why it matters:
As a new MD graduate in a high-pressure environment, you need a culture where you can safely ask for guidance without fear of ridicule or retaliation.

Questions About Workload and Schedules

22. “What does a typical week look like in terms of hours, call frequency, and weekend coverage for prelims?”

Why it matters:
You need realistic expectations. If residents hesitate or laugh and say “we don’t count,” consider that a warning sign.

Clarify:

• In-house vs home call
• Average number of 24-hour calls per month
• Post-call policies and enforcement

23. “How often do prelims get protected days off, and is duty-hour compliance taken seriously?”

Why it matters:
Programs that skirt or openly ignore duty-hour rules are more likely to burn out residents and compromise your ability to study and apply.

24. “Is there any formal wellness program or resources available to residents?”

Look for:

• Access to mental health services
• Wellness days or activities
• Peer support or mentorship groups

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Questions About Logistics, Benefits, and Practical Considerations

These may seem secondary, but for an intense year, practical support can significantly affect your performance and satisfaction.

Questions About Salary, Benefits, and Housing

25. “What is the salary and what benefits do prelim residents receive, and is it the same as categorical interns?”

Why it matters:
Prelims should generally receive comparable pay and benefits to categorical interns at the same PGY level.

Ask specifically about:

• Health, dental, and vision coverage
• Disability and malpractice coverage
• Parking, meal stipends, and educational funds

26. “Is there support for relocation, housing recommendations, or institutional housing?”

Why it matters:
Moving for a one-year position can be challenging. Some programs provide transitional housing or have partnerships with nearby apartments.

Questions Important for International or Visa-Needing Graduates

If you are an international MD graduate or require a visa, ask directly and early.

27. “Does your program sponsor visas, and if so, which types (J-1, H-1B) for preliminary residents?”

Why it matters:
Not all programs sponsor visas for prelim spots, or they may only support certain types of visas.

Follow-up:

• “Have previous prelim residents here been on visas, and did they encounter any specific challenges?”

Questions About Orientation and Transition

28. “What does orientation look like for new interns, and do prelim residents get the same preparation?”

Why it matters:
You want a structured start that covers:

• EMR training
• Order entry
• Key hospital policies
• Basic procedural training (e.g., central lines, arterial lines)

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How to Strategically Use These Questions on Interview Day

Knowing what to ask program directors and residents is only half the battle; how you ask matters just as much.

Prioritize Your Questions

You won’t have time to ask everything. Before each interview, select:

• 4–5 questions for the program director
• 4–5 questions for current residents
• 1–2 questions for faculty interviewers

Prioritize based on your goals: categorical conversion vs. research vs. operative volume vs. culture.

Ask Open-Ended, Non-Adversarial Questions

Frame your questions to invite discussion, not defensiveness. For example:

• Instead of: “Do you overwork your prelims?”
• Try: “How do you balance service needs with educational and career development for prelim residents?”

Keep your tone curious and professional.

Cross-Check Answers

Use your time with different people to subtly cross-check key points:

• If the program director says prelims have strong OR exposure, ask residents:
  “How does OR time compare for prelim and categorical interns?”

• If leadership claims strong match outcomes, ask:
  “Do you know where the last couple of prelim classes ended up after their year here?”

Consistency (or inconsistency) between answers is very telling.

Take Notes Immediately After Each Interview

After leaving a room or finishing a virtual interview, jot down:

• How genuinely your questions were answered
• Any numbers or specific examples provided
• Your overall impression of transparency and culture

These notes will be invaluable when ranking programs later.

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Sample Question Sets You Can Use Directly

To make preparation easier, here’s a consolidated list of questions you can adapt or bring with you. These align with common interview questions for them that PDs and residents expect and respect.

For the Program Director or Associate Program Director

• “How are preliminary residents integrated into your program compared with categorical interns?”
• “Over the last 3–5 years, what have been the typical outcomes for your prelims in terms of subsequent residency matches?”
• “When categorical spots open unexpectedly, how do you decide whether to offer them to prelim residents?”
• “How does your program support prelims during the next application cycle—ERAS, letters, interviews, and advising?”
• “What steps do you take to ensure that prelims receive adequate operative and educational experiences rather than only service duties?”
• “What would you say distinguishes your preliminary surgery year from others in this region or at similar institutions?”

For Current Residents (Prelim and Categorical)

• “As a prelim here, what does your typical month look like in terms of hours, call, and OR time?”
• “Do prelims feel supported and included, or more like temporary help?”
• “How approachable are attendings and seniors if you’re struggling or need extra teaching?”
• “Has the program been flexible and supportive regarding interview schedules for prelims applying again?”
• “Would you choose this program again for a preliminary surgery year, and why or why not?”

For Faculty Interviewers

• “How do you view the role of preliminary residents on your service?”
• “What qualities distinguish prelims who are successful here and go on to strong positions afterward?”
• “How often do you have the opportunity to write letters or mentor prelims?”
• “From your perspective, what are the program’s greatest strengths and areas for growth when it comes to training prelim residents?”

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FAQs: Questions to Ask Programs for MD Graduate in Preliminary Surgery

1. As an MD graduate, should I tell programs I want to stay on as categorical, or is that risky?
Be honest but measured. It’s reasonable to say: “My goal is to become a categorical general surgery resident, and I would be very interested in opportunities here if they arise. At the same time, I understand prelim spots don’t guarantee that, so I’m focused on maximizing my training and match prospects overall.” Programs appreciate clear goals without unrealistic expectations.

2. How many questions should I realistically ask in each interview?
Typically 2–4 questions per 20–30-minute interview is appropriate. Prioritize deeper, open-ended questions that matter most to you. You can save more detailed or sensitive questions—like exact match statistics or concerns about workload—for a longer group Q&A or resident-only session.

3. Is it appropriate to ask directly about how many prelims matched into categorical surgery after this program?
Yes. That is a core purpose of a preliminary surgery year. Phrase it professionally: “Could you share, over the last several years, how many of your prelims have successfully matched into categorical general surgery or related fields?” Most transparent programs will be ready with this information.

4. What if a program avoids or gives vague answers to my questions?
Take that as meaningful data. Evasive or overly general answers—especially about operative experience, duty hours, or match outcomes—can signal issues with transparency or support. Document your impressions and weigh them heavily when you create your rank list.

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By going into interviews with thoughtful, targeted questions to ask residency programs, you shift from a passive applicant to an informed future colleague. As an MD graduate pursuing a prelim surgery residency, your questions are one of the most powerful tools you have to assess training quality, culture, and your chances of advancing toward your ultimate surgical or subspecialty goals.