Residency Advisor
Essential Questions DO Graduates Should Ask in Med-Peds Residency Interviews
Understanding Your Leverage as a DO Graduate in Med-Peds
As a DO graduate entering the Medicine-Pediatrics (Med-Peds) residency match, you bring a unique background to a competitive and highly versatile specialty. In the osteopathic residency match era and now in the unified ACGME system, Med-Peds programs have become increasingly DO-friendly, but they still vary widely in culture, structure, and support for osteopathic physicians.
Knowing the right questions to ask residency programs—especially as a DO—can dramatically change how well you assess fit, support, and long-term opportunity. This is not just about avoiding awkward silences at the end of the interview; it’s about gathering crucial information to decide where you will thrive for four intense years.
This guide will walk you through:
- Key domains you should explore during Med-Peds interviews
- Tailored interview questions for them (residents, faculty, program directors)
- Specific questions that matter for DO graduates (board exams, osteopathic identity, fellowship prospects)
- How to prioritize and customize what to ask program directors vs. residents
- Concrete examples of strong and weak answers to look out for
Throughout, the focus is on the medicine pediatrics match from a DO perspective, helping you strategically evaluate each program.
Core Strategy: How to Approach Questions on Interview Day
Before diving into specific questions, you need a strategy. Most candidates underutilize the “Do you have any questions for us?” moment. You can stand out by having thoughtful, structured questions that show you understand Med-Peds and your own goals.
Principles to Guide Your Question Strategy
Prepare by category, not by script
Think in themes: curriculum, culture, DO support, mentorship, wellness, career outcomes, and logistics. Have 2–3 go-to questions ready in each category, then choose what fits the specific interviewer’s role.Aim for depth, not quantity
Three to five well-chosen questions per interview is enough. Long laundry lists tend to feel rushed and superficial.Direct questions to the right person
- Program Director (PD): Big-picture structure, philosophy, vision, policies, and outcomes.
- Associate/Assistant PD or Core Faculty: Teaching style, evaluation, research opportunities.
- Residents: Culture, workload, call, how policies actually play out, real-life support for DOs.
- Chair or Department Leadership: Departmental resources, future directions, institutional support.
Ask questions that reveal behavior, not just policy
Policies sound good on paper. You want to know, “What actually happens?” Focus on concrete examples.As a DO, always clarify how the program supports your pathway
Ask explicitly about:- COMLEX vs. USMLE and board pass support
- DO presence in the program
- Osteopathic recognition or OMT opportunities, if important to you
- Fellowship placement of DO grads
High-Yield Questions to Ask the Program Director (PD)
The PD sets the tone, vision, and expectations of the Med-Peds residency. Your questions to ask residency leadership should target how well the program aligns with your values and long-term goals.
1. Program Philosophy, Culture, and Vision
Questions to ask program director:
“How would you describe the identity of your Med-Peds program within the institution? What makes it distinct from the categorical IM and Pediatrics programs?”
- Why this matters: Med-Peds can either be strongly unified and respected, or an “in-between” hybrid with a weaker voice. You want programs where Med-Peds has a clear role, leadership presence, and advocacy.
“What are you most proud of about this Med-Peds program?”
- Listen for: Specific examples (resident initiatives, strong fellowship match, scholarly achievements, QI projects, innovative curricula) rather than vague statements like “our residents are great.”
“Where do you see the program evolving over the next 5 years?”
- Look for: Clear plans for growth—more Med-Peds leadership, new tracks (global health, primary care, hospital medicine), or improved scholarly opportunities. Lack of vision is a red flag.
2. Training Structure and Balance of Medicine vs. Pediatrics
Med-Peds structure can vary—how your rotations are integrated affects how competent and confident you feel in both fields.
Key questions:
“How is time balanced and integrated between medicine and pediatrics across the four years? Are there any unique Med-Peds-specific rotations?”
- Good signs: Thoughtful scheduling to prevent long gaps between adult and pediatric experiences, dedicated Med-Peds clinics or transitions-of-care rotations.
“How are Med-Peds residents integrated on categorical IM and Peds rotations? Do you feel they are treated equivalently in training opportunities and leadership roles?”
- Listen for: Not just “yes,” but examples of Med-Peds residents serving as chiefs, leading committees, teaching medical students, or receiving awards.
3. Support and Outcomes for DO Graduates
For a DO graduate, your osteopathic background should be clearly valued, not just tolerated.
DO-specific questions:
“How many DO residents are currently in the program, and how have DO graduates historically done here in terms of board pass rates and fellowship or job placement?”
- Strong response: PD knows the numbers, speaks positively about DO residents, and can name DO alumni in competitive fellowships or leadership positions.
“How do you support residents who have COMLEX only, or who may have different board preparation needs as DO graduates?”
- Look for: Structured board review, attending mentorship, dedicated study time. Beware of programs that seem unfamiliar with COMLEX or dismissive of DO exams.
“Are there any osteopathic-focused opportunities here, such as OMT clinics, teaching roles for DO students, or faculty development in osteopathic principles?” (if important to you)
- This may be less relevant if your personal priority is fellowship rather than OMT, but it’s still valuable to gauge how your DO identity is viewed.
4. Evaluation, Feedback, and Resident Support
You need a program that will coach you, not just judge you.
Questions to ask:
“How are residents evaluated, and how do feedback and remediation work if someone is struggling?”
- Good programs: Have clear milestones, semiannual reviews, and specific support (coaching, extra supervision, wellness resources).
- Red flag: Vague or punitive-sounding answers.
“Can you give an example of a time a resident struggled academically or personally, and how the program supported them?”
- You’re looking for: A concrete story showing compassion, confidentiality, and effective problem-solving.
5. Career Outcomes and Fellowship Opportunities
Med-Peds graduates go in many directions; the program’s track record is crucial.
Targeted questions:
- “What have your recent graduates gone on to do—both DO and MD? How many pursue fellowship versus primary care or hospital medicine?”
- Ask for a recent 3–5-year snapshot, not just a one-off success story.
- “How does the program support residents interested in fellowship—especially those who may be DOs applying to competitive subspecialties?”
- Look for: Dedicated mentorship, mock interviews, letter-writing support, and connections at other institutions.
- “For residents interested in Med-Peds hospitalist work, complex care, or academic primary care, what specific training or mentoring opportunities exist?”
- Med-Peds has unique roles; you want a program that understands and supports these.
Key Questions to Ask Current Residents
Residents will give you the clearest sense of “real life” in the program. This is where you confirm whether the polished picture from leadership matches the day-to-day experience. Many of the strongest interview questions for them are open-ended and behavior-based.
1. Culture, Camaraderie, and Support
High-yield questions:
“What surprised you most about the program once you started?”
- Good answers: Honest reflections that show both positives and areas for growth.
“On a tough rotation, who actually notices and steps in to help?”
- Listen for: Concrete examples of co-residents, chiefs, PD, or coordinators actively helping—covering shifts, checking in, arranging coverage.
“How do Med-Peds residents fit socially and academically with categorical IM and Peds residents?”
- You want to hear: Inclusion, collaboration, shared leadership roles, not isolation or constant identity confusion.
“What’s communication like with leadership when residents bring up concerns?”
- Pay attention to tone. Do they describe leadership as genuine listeners or only “open door” in theory?
2. Workload, Schedule, and Wellness
These are some of the most practical questions to ask residency members, and residents’ answers will be the most honest.
“What does a typical week look like for an intern on wards here—hours, number of patients, call schedule?”
- Compare across programs to gauge relative intensity.
“How often do you feel you’re working at or beyond your limit?”
- No program is stress-free, but chronic overwhelm is a warning sign.
“What specific things does the program do that actually help with wellness (not just on paper)?”
- Strong programs: Protected time, schedule transparency, mental health access, financial or food support during heavy rotations.
“Have you ever considered leaving or regretted ranking this program? Why or why not?”
- This question can feel risky, but you’ll often get the most honest “fit” information from it.
3. Education and Clinical Confidence
As a DO graduate, you want to emerge clinically strong in both medicine and pediatrics.
“Do you feel adequately prepared when you rotate between adult and pediatric services, or does the transition feel jarring?”
- Look for: Residents describing good integration, frequent switching, and solid orientation.
“How well supported did you feel during your first few months as an intern?”
- You want to hear about structured on-boarding, accessible seniors, and non-punitive teaching.
- “What kinds of teaching do you get on rounds—are they rushed, or is there protected time for learning?”
- Beware of programs where everything is service-driven with minimal teaching.
4. DO Identity and Board Support
Fellow DO residents (or MD residents who work with them) can tell you how DOs really fare in this program.
- “As a DO (or working with DO co-residents), do you feel there is any difference in how DOs are treated, evaluated, or advised?”
- You want: “No difference at all,” plus examples of DOs in leadership roles or matching into top fellowships.
- “How does the program support board preparation for both IM and Pediatrics? Were there any unique challenges as a DO?”
- Strong programs: Provide review resources, in-training exam feedback, and protected study time before boards.
- “If you could change one thing about the program for incoming DO Med-Peds residents, what would it be?”
- This can surface hidden issues—like implicit bias, uncertainty about COMLEX vs USMLE, or advising gaps.
Focused Questions for DO Graduates in the Osteopathic Residency Match Era
The unified ACGME system has changed how DOs approach the osteopathic residency match, especially for combined specialties like Med-Peds. Programs that previously were MD-dominant may now be much more welcoming, but you cannot assume all programs are equally DO-friendly.
1. COMLEX vs. USMLE and Credentialing Issues
If you took COMLEX only, or if your COMLEX and USMLE profiles differ, clarity is essential.
Targeted questions:
“Does your institution or any of its affiliated hospitals require USMLE for credentialing, or is COMLEX accepted without issue?”
- This can affect moonlighting, future job options, and even fellowship applications.
“How do your faculty and advisors handle board preparation for residents who have taken different exam pathways (COMLEX-only vs dual COMLEX/USMLE)?”
- Look for understanding of exam differences, not confusion or dismissiveness.
“Have any recent DO residents encountered obstacles with fellowship programs related to COMLEX vs USMLE, and how did the program help them navigate that?”
- Gauge how proactive the program is in advocating for DO graduates.
2. Osteopathic-Specific Opportunities (If Important to You)
If your osteopathic identity and OMT are central to your practice goals, ask:
- “Are there any opportunities to incorporate OMT into clinical care—either in continuity clinic or elective rotations?”
- “Do you have DO faculty in Med-Peds or affiliated departments who serve as mentors for osteopathic practice or academic careers?”
- “Are there DO-focused teaching opportunities with COM students or osteopathic interest groups?”
These questions help identify programs where your training will be recognized as a strength rather than a side note.
3. Fellowship and Career Outcomes for DO Med-Peds Graduates
For many DOs, an important measure of a program is what doors it opens.
Questions to ask program director or chiefs:
- “Can you share specific examples of DO Med-Peds graduates from this program and what they are doing now?”
- “Have DO graduates from this program matched into competitive fellowships (e.g., cardiology, heme/onc, critical care, allergy-immunology, endocrinology, palliative care, ID) and at what types of institutions?”
- “How do you advocate for DO residents who are applying to historically MD-heavy fellowships or academic positions?”
Listen not only to outcomes, but to how confidently and proudly they talk about DO grads.
Specialty-Specific Questions for Med-Peds (Beyond Generic Interview Lists)
Med-Peds sits at the intersection of internal medicine and pediatrics, and your questions should reflect that nuance. Generic lists of “what to ask program director” miss some critically Med-Peds-specific issues.
1. Med-Peds Identity and Leadership
Questions:
- “Who are the Med-Peds leaders here (PD, APDs, chiefs), and how do they advocate for Med-Peds at the departmental and institutional levels?”
- “Do Med-Peds residents have any Med-Peds-specific conferences, retreats, or teaching sessions?”
- “Are there Med-Peds-focused clinics such as transition clinics, complex care clinics, or combined adult/child continuity clinics?”
These questions help you see if Med-Peds is structurally and culturally supported.
2. Transitions of Care and Unique Clinical Experiences
Med-Peds uniquely positions you to care for patients through adolescence into adulthood.
- “What opportunities exist to care for patients who are transitioning from pediatric to adult care—especially those with chronic or complex conditions?”
- “Are there specialized rotations for Med-Peds residents in areas like cystic fibrosis, sickle cell disease, congenital heart disease, or complex care clinics?”
Programs that invest in these experiences will better prepare you for classic Med-Peds careers.
3. Primary Care vs. Subspecialty Preparation
Med-Peds training is flexible; ask how well each track is supported.
- “How does your program support residents who plan to go into primary care Med-Peds versus those who are strongly fellowship-bound?”
- “What proportion of Med-Peds graduates stay in combined practice versus single-boarded practice (only IM or only Peds)?”
- “For residents interested in academic careers or clinician-educator roles, what mentorship and scholarly opportunities are available?”
This helps you determine if the program fits your vision—whether that’s complex primary care, hospital medicine, global health, or subspecialty.
Putting It All Together: How to Use the Answers You Get
Knowing what to ask is only half the task; the other half is knowing what to do with those answers.
1. Pay Attention to Alignment, Not Perfection
No program will be perfect. Instead, ask yourself:
- Does this program’s strengths match my top 2–3 priorities (e.g., fellowship, primary care, geographic location, Med-Peds identity, DO support)?
- Do the weaknesses they admit to feel manageable for me, or like deal-breakers?
2. Watch for Consistency Between PD and Residents
Compare how leaders and residents answer similar questions:
- If the PD emphasizes wellness and a supportive culture, do residents agree?
- If the PD cites strong Med-Peds identity, do residents describe feeling respected and central?
Major discrepancies are more concerning than modest shortcomings.
3. Take Structured Notes
Immediately after each interview day, write down:
- Key points from your questions to ask residency faculty and residents
- Green flags (e.g., DO in leadership, excellent board support, enthusiastic Med-Peds culture)
- Yellow/red flags (e.g., vague answers about DOs, minimal Med-Peds presence, poor communication)
- Your gut feeling: “Could I see myself thriving here for four years?”
These notes will be invaluable when you create your rank list for the medicine pediatrics match.
4. Follow Up Thoughtfully if Needed
If you forgot something or want clarification, it’s acceptable to email the PD or coordinator with a short, focused question after interview season, such as:
- “Could you share a recent list of Med-Peds graduates’ fellowship placements?”
- “Can you clarify whether COMLEX alone is sufficient for hospital credentialing at your main sites?”
Keep follow-ups concise and professional.
FAQs: Questions to Ask Programs for DO Graduate in Medicine-Pediatrics
1. As a DO, should I specifically ask whether the program is DO-friendly, or is that too direct?
You don’t need to ask, “Are you DO-friendly?” directly. Instead, ask concrete questions:
- “How many DOs are currently in your Med-Peds program?”
- “How have DO grads historically done in fellowship placement?”
- “Are there any DO faculty in Med-Peds or leadership roles?”
Their answers will clearly show how genuinely DO-inclusive the program is.
2. What are the most important questions to ask if I only have time for two or three during an interview?
If time is short, prioritize:
- To PD: “How would you describe what makes your Med-Peds program unique, and where do you see it in 5 years?”
- To residents: “What do you like most and least about training here, and would you choose this program again?”
- As a DO: “How have DO graduates from this program done in terms of board performance and post-residency outcomes?”
These give you culture, trajectory, and DO-specific outcomes in a compact set.
3. Is it okay to ask about duty hours, call, and workload, or does that look like I’m not hardworking?
It’s absolutely appropriate—and smart—to ask. Frame questions neutrally and professionally:
- “Can you walk me through a typical week on wards as an intern here?”
- “How does the program monitor and respond to duty hour concerns?”
Programs expect you to care about sustainability and wellness. Thoughtful questions show maturity, not laziness.
4. Should I ask every program the exact same questions to compare them?
Have a core set of questions (especially about Med-Peds identity, DO support, board prep, and outcomes) that you ask almost everywhere, so you can compare programs directly. But also customize 1–2 questions per program based on:
- Their unique tracks (global health, advocacy, research)
- Geographic or patient population differences
- What you’ve learned from their website or pre-interview materials
This balance lets you make meaningful comparisons while also showing genuine interest in each individual program.
By approaching interviews with intentional, well-crafted questions—and listening closely to what’s said and unsaid—you will be far better equipped to choose a Med-Peds residency where you, as a DO graduate, can grow, succeed, and build the career you envision.
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