Essential Questions DO Graduates Should Ask for Addiction Medicine Residency

As a DO graduate interested in Addiction Medicine, the questions you ask programs can significantly shape how you are perceived—and just as importantly, how you perceive them. Thoughtful, targeted questions show you understand the field, have clear goals, and are evaluating fit, not just chasing a position.

This guide is written specifically for the DO graduate residency and fellowship applicant focused on Addiction Medicine. Whether you’re applying directly to an addiction medicine fellowship, exploring substance abuse training opportunities during residency, or preparing osteopathic residency match interviews with future fellowship in mind, you’ll find concrete, high‑yield questions to ask programs and program directors.

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Understanding Your Goals Before You Ask Questions

Before compiling questions to ask residency or fellowship programs, clarify what you want from your training. For Addiction Medicine–focused DO graduates, think in three domains:

1. Clinical Training Goals

   • Breadth of exposure (inpatient, outpatient, consults, detox, rehab, community work)
   • Specific populations (pregnant patients, adolescents, justice-involved, homeless, dual diagnosis)
   • Modalities (MAT, harm reduction, psychotherapy, integrated primary care)

2. Professional Identity Goals

   • How you want to use your osteopathic background
   • Career direction: academic, community, policy, integrated primary care, pain/addiction, telehealth
   • Desire for leadership, teaching, advocacy, or research roles

3. Personal and Lifestyle Goals

   • Call schedule and flexibility
   • Support for wellness and boundaries
   • Geographic and family considerations

Once you know your priorities, you can select the right interview questions for them and avoid generic, forgettable conversations.

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Questions to Ask About Clinical Training & Patient Care

These questions help you understand what your day‑to‑day will look like and whether the program will make you a confident, independent Addiction Medicine physician.

1. Scope and Volume of Addiction Medicine Experience

Core questions:

• “Can you describe the typical clinical settings where fellows/residents see patients with substance use disorders—such as inpatient consults, outpatient clinics, opioid treatment programs, and residential facilities?”
• “What is the approximate patient volume per clinic day and per inpatient rotation for patients with substance use disorders?”
• “How much direct responsibility do trainees have in managing MAT (e.g., buprenorphine, methadone, naltrexone) and coordinating care with counseling and recovery services?”

Follow-up / clarifying questions:

• “What proportion of your patients have co‑occurring psychiatric disorders, and how is integrated care structured with psychiatry?”
• “Are there dedicated pain–addiction clinics, or opportunities to manage patients with chronic pain and opioid use disorder together?”

These questions signal that you’re thinking about comprehensive, real‑world addiction practice rather than a narrow, detox‑only view.

2. Subspecialty Populations and Unique Experiences

Addiction Medicine can be very different depending on the populations served. To assess alignment with your goals, ask:

• “What opportunities exist to work with special populations, such as:
  • pregnant and postpartum patients,
  • adolescents and young adults,
  • people experiencing homelessness,
  • justice-involved individuals, or
  • patients with complex medical comorbidities like HIV or hepatitis C?”
• “Are there rotations or electives in correctional facilities, syringe service programs, low-threshold buprenorphine clinics, or street medicine teams?”
• “How much exposure is there to alcohol use disorder compared with opioid, stimulant, and polysubstance use disorders?”

If you have a specific interest, name it:

• “I’m particularly interested in pregnancy and substance use. How often do fellows work with OB/GYN or maternal-fetal medicine on these cases?”

3. Multidisciplinary Team and Integrated Care

Addiction Medicine thrives on team-based care. You want to know who you’ll be learning from:

• “Who are the key members of the multidisciplinary team in your Addiction Medicine settings—for example, social workers, recovery coaches, psychologists, peer support specialists, pharmacists?”
• “How often do trainees participate in team huddles, case conferences, or interdisciplinary rounds?”
• “What is the level of exposure to integrated models, such as primary care–addiction clinics or co‑located mental health and addiction services?”

These questions show you value collaborative care, which is core to the specialty.

4. Level of Supervision and Autonomy

To grow, you need both supervision and autonomy:

• “How is supervision structured in the first few months, and how does trainee autonomy evolve over the course of the year?”
• “By the end of training, what kind of independent decision-making is expected regarding MAT initiation, detox planning, and complex polysubstance cases?”
• “How comfortable are your graduates in independently managing complicated patients in community or academic settings?”

Ask current fellows or residents:

• “Can you share an example of a complex case you managed where you felt you made the key treatment decisions?”

Their stories will reveal far more than numbers alone.

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Questions to Ask About Curriculum, Teaching, and Substance Abuse Training

As a DO graduate, you bring a holistic, biopsychosocial perspective—this can be an asset in a field like Addiction Medicine. Your goal is to identify programs that will expand your clinical reasoning and not just teach you protocols.

1. Structure and Content of the Curriculum

Core questions about substance abuse training:

• “Can you walk me through the formal didactic curriculum for Addiction Medicine—how often are lectures, case conferences, journal clubs, and workshops?”
• “What topics receive the most emphasis—for example:
  • pharmacology of MOUD,
  • motivational interviewing,
  • contingency management,
  • harm reduction,
  • co‑occurring psychiatric disorders,
  • pain management in patients with substance use disorders?”
• “Are there required rotations in toxicology, psychiatry, pain management, infectious disease (HIV/HCV), or emergency medicine with an addiction focus?”

Programs that can answer these questions clearly often have a stronger educational framework.

2. Procedural and Practical Skills

Practical, hands-on skills matter:

• “What procedural or technical skills are emphasized—for example:
  • managing withdrawal protocols,
  • interpreting urine drug screens,
  • performing brief interventions and motivational interviewing,
  • managing overdose prevention and naloxone distribution?”
• “Do trainees get experience in quality improvement or system-level interventions, such as implementing screening protocols (SBIRT) in primary care or ED settings?”

You can also ask:

• “At graduation, what concrete skills do you expect your trainees to confidently perform that they probably couldn’t do on day one?”

3. Osteopathic Principles and DO-Specific Opportunities

For a DO graduate residency or fellowship applicant, you want to understand how your osteopathic identity is supported:

• “How have DO graduates integrated osteopathic principles into their Addiction Medicine training here?”
• “Are there opportunities to teach or demonstrate OMT for pain management, withdrawal-related discomfort, or comorbid musculoskeletal conditions as part of comprehensive care?”
• “How many of your current or recent trainees have been DO graduates, and how have they done in terms of board performance and career placement?”

You might also ask other DOs in the program:

• “Have you felt fully supported in using your osteopathic training, and have faculty been receptive to that perspective?”

4. Teaching Culture and Feedback

Strong programs invest in teaching and formative feedback:

• “How often do faculty observe clinical encounters and provide direct feedback on interviewing, counseling, and treatment planning?”
• “Are there structured evaluations with specific Addiction Medicine competencies (e.g., motivational interviewing, risk assessment for diversion, managing difficult conversations around relapse)?”
• “What opportunities exist for trainees to teach medical students, residents from other specialties, or interprofessional learners about Addiction Medicine?”

These interview questions for them demonstrate that you’re serious about growth and academic culture—not just checking a box.

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Questions to Ask Program Directors About Culture, Support, and Wellness

“What to ask program director?” is one of the most common anxieties among applicants. With Addiction Medicine—where burnout, vicarious trauma, and boundary issues can be significant—your questions about wellness and culture are essential.

1. Program Culture and Values

Core questions:

• “How would you describe the culture of this program in a few words?”
• “What personal qualities do you think make trainees particularly successful in Addiction Medicine here?”
• “How does the program respond when trainees struggle—whether clinically, emotionally, or personally?”

If you want a deeper sense of alignment:

• “What do you see as the mission of this Addiction Medicine program, and how does that show up in day-to-day training?”

This invites the program director to articulate what they truly care about.

2. Support for Emotional Burden and Burnout Prevention

Addiction Medicine exposes clinicians to trauma, relapse, loss, and stigma. Ask:

• “What formal and informal supports are available to help trainees manage the emotional aspects of working with patients with substance use disorders?”
• “Are there debriefing sessions, Balint groups, wellness curricula, or dedicated mentorship for processing challenging cases like overdose deaths or treatment failures?”
• “How does the program address burnout and compassion fatigue among fellows and faculty?”

You can clarify:

• “Can you give an example of a time when a trainee was struggling, and how the program supported them?”

3. Workload, Call, and Work–Life Integration

You need honest, concrete information:

• “What does a typical week look like in terms of clinical hours, call responsibilities, and administrative tasks for trainees?”
• “How often are nights or weekends worked, and what type of issues typically arise on call in your Addiction Medicine service?”
• “Has the program made any recent changes to duty hours or workflow in response to trainee feedback?”

Ask residents or fellows separately:

• “Does your schedule feel sustainable? What are the stress points, and how does the program help mitigate them?”

If the answers from leadership and trainees are mismatched, pay attention.

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Questions to Ask About Career Outcomes, Research, and Fellowship Pathways

If you’re targeting an addiction medicine fellowship or planning to incorporate substance abuse training into a broader career, your interview questions should address long‑term outcomes.

1. Graduate Outcomes and Career Paths

Ask specifically:

• “Where have your recent graduates gone after completion—academic positions, community practice, integrated primary care, correctional health, pain clinics, telehealth, or further training?”
• “Do you have a sense of what percentage of graduates stay in Addiction Medicine full‑time versus incorporating it into another specialty practice?”
• “For DO graduates specifically, what career trajectories have they pursued, and have there been any differences in opportunities or experiences compared with MD graduates?”

You can ask for examples:

• “Could you share a few examples of recent graduates’ current roles that you’re particularly proud of?”

2. Addiction Medicine Fellowship and Subspecialty Opportunities

If you’re currently applying to residency and planning ahead for an addiction medicine fellowship, or if you’re directly interviewing for fellowship:

• “How many graduates match into an Addiction Medicine fellowship each year, and where?”
• “For residents interested in Addiction Medicine, what structured pathways or tracks exist—such as addiction-focused rotations, scholarly projects, or mentorship?”
• “How does the program support fellowship applicants—for example, with mentorship, letters, dedicated time for interviews, or guidance in selecting programs?”

These questions are especially important for a DO graduate residency applicant because some may wonder about competitiveness:

• “Do DO graduates from your program have similar success in matching into competitive Addiction Medicine fellowships as your MD graduates?”

3. Research, Quality Improvement, and Scholarship

If you’re interested in academic medicine, leadership, or policy:

• “What research or quality improvement opportunities in Addiction Medicine are available to trainees?”
• “Are there ongoing projects in areas like:
  • implementation of MAT in primary care or EDs,
  • harm reduction programs,
  • overdose prevention,
  • stigma reduction initiatives,
  • care of justice-involved individuals?”
• “Is there protected time for scholarship, and what support is available for presenting at conferences or publishing?”

Ask trainees:

• “Were you able to complete at least one scholarly project during your training?”
• “How accessible are research mentors, and do they have time for regular meetings?”

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Practical Interview Strategies for DO Graduates in Addiction Medicine

You may have an excellent list of questions to ask residency or fellowship programs, but how you use them matters. This section focuses on strategy and delivery.

1. Prioritize and Personalize Your Questions

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

• Identify 3–5 must-ask questions tied to your top priorities (e.g., special populations, DO support, work–life integration).
• Tailor a few questions to the specific program:
  • “I noticed your program partners with a syringe service program. Could you share how trainees are involved in that work?”
  • “I saw that several faculty here focus on pregnancy and substance use—are there dedicated rotations for that population?”

This shows you did your homework and see yourself specifically in their program.

2. Use Open-Ended, Reflective Questions With Program Directors

When deciding what to ask a program director, choose questions that invite them to reflect and reveal their values:

• “What changes have you made to the program in response to trainee feedback in the last few years?”
• “If you had additional resources, what aspects of the Addiction Medicine training would you most want to expand?”
• “What do you think makes this program particularly strong, and what areas are you actively working to improve?”

These probe both strengths and limitations respectfully—and show you understand that no program is perfect.

3. Distinguish Questions for Faculty vs. Fellows/Residents

Some topics are best asked of faculty; others are better asked of trainees:

Good questions for faculty / program leadership:

• Structure of curriculum and rotations
• Long-term vision of the program
• Policies about wellness, leave, and remediation
• Strategic priorities in Addiction Medicine (e.g., expanding harm reduction, telehealth)

Good questions for current trainees:

• “What surprised you most about this program after you started?”
• “What are the strongest and weakest parts of your week?”
• “How does the program respond when a trainee is overwhelmed or makes a mistake?”
• “Would you choose this program again, knowing what you know now?”

This division helps you get both official and lived perspectives.

4. Avoid Common Pitfalls in Interview Questions

Some types of questions can hurt your impression:

• Overly basic questions that are clearly answered on the website (“How long is the fellowship?”).
• Questions focused only on time off or moonlighting without context (better: “How does the program think about work–life boundaries and moonlighting in the context of burnout prevention?”).
• Yes/no questions that don’t open discussion (“Do you have research?” rather than “What research roles do trainees typically take on?”).

Instead, demonstrate insight. For example, instead of:

• “Is there wellness support?”
  Use:
• “Working in Addiction Medicine can be emotionally demanding. How does your program build in wellness and debriefing opportunities to address vicarious trauma and burnout?”

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Frequently Asked Questions (FAQ)

1. As a DO graduate, should I bring up my osteopathic background during Addiction Medicine interviews?

Yes. Your osteopathic background is an asset, particularly in Addiction Medicine, where holistic, biopsychosocial care is central. Briefly highlight:

• How osteopathic training shaped your approach to whole‑person care.
• Any experience using OMT in pain management, anxiety, or withdrawal-associated discomfort.
• Interest in teaching OMT or integrating osteopathic perspectives into multidisciplinary care.

Then follow with targeted questions, such as:
“How have prior DO graduates incorporated osteopathic principles or OMT into their Addiction Medicine training here?”

2. What are the most important questions to ask programs if I know I want an addiction medicine fellowship later?

If you’re still in residency application phase but already planning an addiction medicine fellowship, prioritize:

• “What structured pathways exist for residents interested in Addiction Medicine (rotations, electives, mentorship)?”
• “How many graduates have matched into Addiction Medicine fellowships in recent years, and where?”
• “What opportunities are there for addiction-related research, QI, or leadership during residency?”
• “How early do residents typically connect with addiction-trained mentors, and how formal is that process?”

These will help you judge how well the residency can position you for a future addiction medicine fellowship.

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

Quality matters more than quantity. In a typical 20–30 minute interview:

• Aim for 3–5 well-chosen questions, allowing time for discussion.
• Prioritize questions that:
  • Can’t be answered online.
  • Directly relate to your priorities (clinical exposure, culture, support for DOs, fellowship pathways).
  • Show thoughtful engagement with Addiction Medicine as a field.

Have a longer list prepared, but be flexible—some may be answered organically in conversation.

4. Can I ask about weaknesses or limitations of a program without sounding negative?

Yes, if you frame the question constructively and respectfully. For example:

• “Every program has areas it’s working to improve. What aspects of your Addiction Medicine training are you actively trying to strengthen over the next few years?”
• “What feedback have you received from recent graduates, and how are you using that to evolve the program?”

This demonstrates maturity, insight, and a realistic understanding of training environments—qualities that Addiction Medicine program directors appreciate.

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Thoughtful, focused questions to ask programs do more than gather information—they also communicate your clinical insight, self-awareness, and genuine commitment to Addiction Medicine. As a DO graduate, leveraging your holistic training while exploring substance abuse training opportunities will help you identify programs where you can thrive clinically, academically, and personally. Use this guide as a framework, adapt it to your interests, and enter each interview ready to have a real conversation—not just an evaluation.