Essential Questions for Pediatrics-Psychiatry Residency Interviews

Understanding the Unique Nature of Pediatrics-Psychiatry Residencies

Pediatrics-Psychiatry-Child & Adolescent Psychiatry (often called peds psych residency, triple board, or Peds/Psych/Child Psych) is a small, highly specialized pathway. Because programs are few and structures vary, the questions you ask programs are critical for figuring out where you’ll thrive.

This pathway is intense: three board-eligible disciplines in five years, often with high expectations, variable support, and different cultures across pediatrics and psychiatry departments. You are not just asking “Do I like this place?”—you are assessing whether the structure, culture, and support systems will sustain you through five demanding years and launch you into a long-term career.

This guide focuses on:

• How to think strategically about questions to ask residency programs
• Sample interview questions for them (faculty, residents, and especially program directors)
• Tailored prompts specific to the triple board structure and the peds psych residency niche
• Practical examples of what answers might indicate—green flags and red flags

Use this as a menu, not a script. You won’t ask every question. Instead, pick those that align with your priorities and the stage of the interview (pre-interview social, formal day, second look, or follow-up emails).

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Core Strategy: How to Approach Questions in Peds-Psych Interviews

Before diving into lists, clarify your own goals. Your questions should help you answer:

1. Can I complete three board-eligible disciplines here without burning out?
2. Does the culture support my interests (e.g., integrated care, advocacy, neurodevelopment, research)?
3. Will I be mentored into the career I actually want, not just trained to pass boards?
4. Does the program understand and value triple board residents—or just tolerate them?

Step 1: Define Your Priorities

Common priorities among triple board applicants:

• Integration of pediatrics and psychiatry training vs siloed experiences
• Future career plans (e.g., integrated clinics, consult-liaison, academic medicine, primary mental health in pediatrics)
• Workload and wellness (night float structure, jeopardy coverage, call burden across three services)
• Mentorship and identity as a triple board physician
• Culture—how residents treat each other, how departments view psychiatry vs pediatrics
• Geography, partner/family needs, and cost of living

Make a short list of your top 3–5 priorities. Use your questions to target those.

Step 2: Tailor Questions to the Person in Front of You

Think about who you’re speaking with:

• Program Director / Associate PD – big-picture structure, vision, program culture, support mechanisms
• Current Triple Board Residents – day-to-day realities, informal culture, real workload, unfiltered pros/cons
• Pediatrics & Psychiatry Categorical Residents – how integrated triple board residents are socially and clinically
• Faculty in Your Areas of Interest – mentorship, scholarly work, special clinics, job placement

You can ask the same topic in different ways to different people. For example:

• To PD: “How does the program support triple board residents in developing an integrated career?”
• To residents: “In practice, do you feel like you’re seen and supported as a triple board doc, or pulled apart by three departments?”

Step 3: Aim for Conversation, Not Interrogation

Instead of reading off a list, ask open-ended questions, then follow up:

• “Can you tell me more about that?”
• “How has that changed over the last few years?”
• “If you could change one thing about that, what would it be?”

These follow-up questions are often more revealing than your initial prompt.

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Essential Questions to Ask the Program Director and Leadership

When you think about what to ask the program director, focus on structure, protection, and vision. The PD can speak to how the program is designed and how much authority they have to protect residents.

1. Questions About Program Structure and Integration

These help you understand the overall educational design.

• “How is the triple board curriculum structured over the five years, and how flexible is that structure?”

  • Follow-up: “Have you made any recent changes based on resident feedback?”
  • Green flag: Clear explanation, examples of iterative improvement.
  • Red flag: Vague answers, “It’s just the way we’ve always done it.”

• “How integrated is the training versus being three separate residencies stitched together?”

  • Look for: Dedicated integrated clinics, case conferences with both pediatrics and psychiatry faculty, combined teaching.

• “How do you ensure we meet all ACGME and board requirements for pediatrics, psychiatry, and child & adolescent psychiatry without overloading residents?”

  • You want acknowledgment of competing demands and specific strategies for balancing them.

• “Where are triple board residents physically and administratively ‘based’—in pediatrics, psychiatry, or equally in both?”

  • This signals whether you’ll feel at home in one department or constantly between worlds.

2. Questions About Culture and the Role of Triple Board Residents

These reveal how valued your pathway is within the institution.

• “How are triple board residents perceived by the pediatrics and psychiatry departments?”

  • Follow-up: “Can you share an example where triple board residents have added something unique to the institution?”

• “What spaces—formal or informal—exist for triple board residents to talk about their unique training experiences and challenges?”

  • Look for retreats, regular check-ins, mentorship groups.

• “When there are conflicts between service demands (e.g., pediatrics vs psych), who advocates for triple board residents and how are conflicts resolved?”

  • You’re looking for a specific process, not “We work it out case by case” with no detail.

3. Questions on Support, Wellness, and Workload

Given the intensity of triple board, ask directly about sustainability.

• “How do you monitor for and address burnout among triple board residents, given the complexity of training?”

  • Green flag: Regular check-ins, anonymous feedback, program changes in response.

• “What is the call schedule like across all three areas, and how do you prevent triple board residents from being overused as flexible coverage?”

• “If a resident is struggling—academically, clinically, or personally—what kinds of supports are available?”

  • Examples: reduced schedules, extra supervision, counseling, mentoring, remediation processes.

4. Questions About Outcomes and Career Preparation

Your path after residency is a key outcome measure.

• “What kinds of careers do recent graduates pursue, and how well do you think the program prepares residents for those paths?”

  • Ask for specific examples of alumni in integrated clinics, academic positions, primary care, etc.

• “How does the program support residents in shaping a triple-board-specific career identity rather than defaulting to only one discipline?”

  • Look for: opportunities in integrated clinics, projects bridging peds and psych, elective time.

• “Are there alumni I could speak with who are working in roles I might be interested in?”

  • Willingness to connect you with graduates is a good sign.

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Key Questions to Ask Current Triple Board Residents

Current residents will give you the clearest sense of how the program actually functions. This is where many of your highest-yield questions to ask residency programs should be directed.

1. Day-to-Day Life and Workload

• “Can you walk me through a typical day for you on a pediatrics month? How is that different from a psychiatry or child psych month?”

  • Look for realistic descriptions and whether they mention any safeguards around workload.

• “Do you feel that expectations of triple board residents differ from categorical peds or psych residents? How so?”

• “How many hours do you realistically work per week on different rotations? Are there rotations everyone dreads, and how has the program responded to that feedback?”

• “How is call shared between triple board and categorical residents? Do you ever feel overburdened because you can ‘fit in anywhere’?”

2. Culture, Belonging, and Identity

• “Do you feel like you ‘belong’ more to pediatrics, psychiatry, both, or neither? How does the program support you in that?”

• “How integrated are you into the resident communities—do you attend both peds and psych didactics, retreats, and social events?”

• “If conflicts come up between the demands of the three tracks, do you feel the program leadership has your back?”

• “How do you and your co-residents cope with the emotional load of working with medically and psychiatrically complex children?”

3. Education, Mentorship, and Supervision

• “Do you feel you get enough supervision and teaching in each of the three disciplines?”

• “Who do you see as your primary mentors—pediatricians, psychiatrists, child psychiatrists, or other triple board grads?”

• “Have you been able to find mentors for the specific career direction you’re considering?”

  • This is particularly important if you’re interested in niche areas (complex developmental disabilities, policy work, integrated primary care, etc.).

• “How responsive is leadership when residents ask for changes in the curriculum or schedule?”

  • Ask for an example: “Has anything changed recently because residents spoke up?”

4. Life Outside of Residency

• “What is it like to live here on a resident salary? Any neighborhoods you’d recommend or avoid?”

• “Do people have time for relationships, kids, hobbies? What does that look like in reality for triple board residents?”

• “If you could redo the match, would you choose this same program again for triple board?”

  • This can be very revealing—watch their facial expression and how quickly they answer.

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Targeted Questions for Pediatrics, Psychiatry, and Child Psych Faculty

You’ll often meet with leaders or faculty from each department. Use those moments to dig into how triple board residents fit into each world.

Questions for Pediatrics Leadership/Faculty

• “How are triple board residents integrated into inpatient and outpatient pediatrics teams?”

• “Do you see differences in how triple board residents approach patient care compared to categorical peds residents?”

  • Green flag: Appreciation for holistic, behavioral and family systems perspectives.

• “What opportunities exist for triple board residents to develop skills in behavioral and developmental pediatrics, integrated primary care, or complex care clinics?”

• “Are there established pathways for triple board residents to lead quality improvement or educational projects within pediatrics?”

Questions for Psychiatry and Child & Adolescent Psychiatry Leadership/Faculty

• “How do triple board residents participate in child psychiatry clinics, consultation services, or partial hospitalization programs?”

• “Are there any integrated or co-located clinics where pediatric and psychiatry faculty work side-by-side, and how are triple board residents involved?”

• “What types of psychotherapy training do triple board residents receive (CBT, family therapy, parent training, etc.), and how is that balanced with pediatric demands?”

• “How do you support triple board residents in sitting for adult psych and child/adolescent psych boards while also meeting pediatrics competencies?”

Questions on Scholarly Activity and Career Development

These are important if you are interested in academic medicine, research, or leadership roles.

• “What types of scholarly projects have triple board residents completed recently?”

  • Follow-up: “Are there infrastructure and protected time to support that work?”

• “Are triple board residents represented in leadership roles (e.g., chief resident, committee membership, GME councils)?”

• “What support exists for presenting at conferences (AACAP, APA, PAS, SPR), including funding and time off?”

Asking faculty these questions also shows you’re thinking beyond just surviving residency; you’re envisioning your long-term identity as a triple board physician.

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High-Yield Topic Areas and Sample Questions (Cheat Sheet)

Below is a structured “cheat sheet” to help you quickly plan interview questions for them across different topic areas. You can choose 1–2 from each based on what matters most to you.

1. Integration and Identity

• “How does your program help triple board residents build a cohesive professional identity rather than feeling like three-quarters of a pediatrician and three-quarters of a psychiatrist?”
• “What unique opportunities here exist only for triple board residents?”

2. Curriculum and Didactics

• “How are didactics handled for triple board residents—do we attend both pediatric and psychiatry conferences, and is there triple-board-specific teaching?”
• “During heavy rotations (e.g., NICU, inpatient psych), how do you protect didactic time?”

3. Evaluation, Feedback, and Promotion

• “How are triple board residents evaluated in each discipline, and how are those evaluations integrated across departments?”
• “What happens if someone is struggling in one area but thriving in others? How flexible is the program about remediation and progression?”

4. Flexibility and Individualization

• “How much elective time is there, and can triple board residents design integrated electives that span pediatrics and psychiatry?”
• “If my career interests evolve during training, how flexible can the schedule be to support that?”

5. Logistics and Practical Realities

• “Where are triple board residents usually housed (in terms of office or workspace), and how much will I be moving between sites?”
• “What does cross-cover look like—will I ever be covering both pediatrics and psychiatry during the same call shift?”

6. Program Growth and Future Direction

• “Where do you see this triple board program in 5–10 years? Are there plans to expand, add integrated clinics, or build new collaborations?”
• “What have you learned from previous cohorts of triple board residents, and what have you changed as a result?”

This kind of question signals that you’re looking for a program that learns and evolves, not one that’s static.

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Putting It All Together: Strategy for Interview Day

Use this framework to organize your approach:

Before Interviews

1. Research each program deeply

   • Look up the structure on their website: rotations, number of positions, affiliated hospitals.
   • Note anything unusual (e.g., heavy NICU exposure, early child psych months, rural rotations).

2. Identify program-specific questions

   • “I saw on your website that you have an integrated peds-psych clinic in the ED. How are triple board residents involved there?”
   • Customized questions show genuine interest and preparation.

3. Prepare 2–3 “anchor” questions for each category of person

   • For PD, residents, and faculty.
   • That way you’re not scrambling mid-interview.

During Interview Day

• Ask open-ended questions first, then clarify with more detailed or specific ones.
• Vary your questions—don’t ask every person the same thing unless you’re specifically looking for consistency.
• Note not only what they say, but how they say it: Are they enthusiastic about triple board? Defensive? Vague?

After Interviews

• Immediately jot down:

  • What you asked
  • What you learned
  • Your gut feeling about whether you’d trust this program with five intense years of your life.

• Use your notes to compare programs directly:

  • Which had the clearest structure?
  • Which showed the strongest advocacy for triple board residents?
  • Where did residents seem happiest and most supported?

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FAQs: Questions to Ask Programs in Pediatrics-Psychiatry (Triple Board)

1. How many questions should I ask during a residency interview?
Aim for 2–4 thoughtful questions per interviewer, depending on time. Quality matters more than quantity. You want to show engagement, not run through a checklist. Prioritize questions that genuinely help you decide how to rank the program.

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2. What if my main priorities are work-life balance and not burning out—what should I focus on?
Emphasize questions around:

• Call structure and average weekly hours on peds vs psych
• How often schedules change last-minute
• How the program monitors and responds to burnout in triple board residents
• Whether residents feel supported during personal crises or when struggling

Examples:

• “Can you share an example of a time the program adjusted something due to resident wellness concerns?”
• “How sustainable do residents feel the triple board schedule is over five years?”

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3. Is it okay to ask about fellowship or job prospects if I’m not sure what I want yet?
Yes. You can phrase it openly:

• “What range of careers have your graduates pursued?”
• “How does the program support triple board residents who are still exploring their ultimate career direction?”

Triple board programs expect evolving interests; they’re not looking for a perfectly formed 10-year plan, but they are looking for residents who think about long-term fit.

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

• Are easily answered on the website (“How many residents do you take?”) unless you’re clarifying something not clear.
• Sound like you’re only focused on how little you can work (“How much can I get out of call?” vs “How is call structured and supported?”).
• Put programs on the defensive (“Why don’t you have X that other programs have?”). A better framing: “Are there any areas you’re hoping to grow or develop, especially for triple board training?”

Instead, center your questions around fit, growth, and support—and how the program will help you become a strong, sustainable triple board physician.

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By thoughtfully planning questions to ask residency programs—especially tailored interview questions for them in the unique context of a peds psych residency—you give yourself the best chance of finding a triple board program where you’re not only trained well, but also seen, supported, and set up for a meaningful career.