Essential Questions for Non-US Citizen IMGs in PM&R Residency Interviews

Why Your Questions Matter as a Non‑US Citizen IMG in PM&R

For a non-US citizen IMG or foreign national medical graduate, the Physical Medicine & Rehabilitation (PM&R) residency interview is not just about impressing the program—it’s your best chance to evaluate whether the program can truly support your visa, your training goals, and your long‑term career.

Thoughtful, specific questions to ask residency programs—especially targeted to your situation as a non-US citizen—can:

• Reveal how experienced they are with sponsoring visas and supporting IMGs
• Clarify whether their training environment actually prepares you for physiatry practice in the US
• Help you compare programs beyond just location and reputation
• Demonstrate your maturity, insight, and genuine interest in PM&R

This guide focuses on what to ask program directors, faculty, residents, and coordinators in PM&R programs as a non-US citizen IMG, with example phrases you can adapt into your own style.

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Strategy: How to Approach “Questions to Ask” During PM&R Interviews

Before diving into specific topics, it helps to have a strategy for how to use your questions.

1. Prepare a Structured Question List

As a non-US citizen IMG applying for PM&R residency, divide your questions into key buckets:

• Visa & institutional policies
• Clinical training & patient mix
• Education, mentorship, and board prep
• Fellowship and job outcomes for IMGs
• Program culture & support systems
• Practical life issues (housing, transportation, community)

Create a 1-page “cheat sheet” (printed or on your laptop/tablet) and mark which questions are must‑ask (critical to your decision) versus nice‑to‑ask (helpful but optional).

2. Direct Your Questions to the Right Person

You’ll maximize value if you match questions to the person who can answer best:

• Program Director / Associate PD
  • Vision, curriculum, evaluation, fellowships, career pathways, policies
• Residents (especially IMGs or foreign nationals)
  • Real culture, call schedule, practical life issues, unfiltered experience
• Program Coordinator / GME office
  • Visa procedures, onboarding logistics, licensure requirements
• Faculty (especially physiatrists in subspecialties you like)
  • Mentorship, research, specialty training, day-to-day PM&R practice

3. Prioritize During Limited Time

You might only have 5–10 minutes for questions in some interviews. Prioritize:

1. Deal-breakers (visa type, experience with foreign national medical graduates)
2. Training quality (exposure to core PM&R areas, board prep)
3. Culture and support (especially for non-US citizen residents)

Keep backup questions for resident socials or virtual meet-and-greets, where you may have more informal time.

4. Phrase Questions Professionally

Avoid yes/no questions. Use open-ended, specific, and respectful phrasing. For example:

• Instead of: “Do you sponsor visas?”
• Ask: “Can you walk me through your recent experience sponsoring visas for non-US citizen IMG residents, and which visa types you typically support?”

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Visa & Policy: Essential Questions Every Non‑US Citizen IMG Must Ask

For a non-US citizen IMG or foreign national medical graduate, visa status is foundational. You cannot assume all programs handle this equally.

A. Questions to Ask Program Director or Coordinator About Visa Sponsorship

Key goals: Confirm visa type, stability, and the program’s track record.

Core questions:

1. “What visa types do you currently sponsor for residents in PM&R?”

   • Follow-up: “Have your policies changed in the last few years?”

2. “How many current residents in the program are on visas, and which types?”

   • This shows whether the program has a real track record with non-US citizen IMGs.

3. “For foreign national medical graduates, is visa sponsorship handled mainly at the program level or by the institution/GME office?”

   • Helps you understand where decisions are made and how fixed the policies are.

4. “Have any residents, particularly non-US citizen IMGs, had issues with visa renewals, transitions, or delays in the last 3–5 years?”

   • You’re trying to uncover red flags without sounding confrontational.

5. “If I match here, what is the timeline and process for filing visa paperwork before residency starts?”

   • Clarifies logistics and whether they are organized and proactive.

B. Questions About Long‑Term Planning (H-1B, Waivers, Future Work)

For many foreign national medical graduates, long-term planning is critical.

Consider asking:

1. “For residents interested in staying in the US long-term, how do you advise them regarding H-1B options, waivers, or future work visas?”

2. “Do past non-US citizen IMG graduates from your PM&R program typically secure fellowships and jobs within the US? Are there specific states or practice types where they’ve been most successful?”

3. “Does the institution have any restrictions on H-1B sponsorship for residents or fellows?”

   • Many PM&R residencies are J-1 only; better to know clearly.

C. Subtle but Important Visa-Related Signals

Ask residents (particularly IMGs) questions such as:

• “How supportive was the program during your visa process? Did you feel you had to manage it yourself, or was there clear guidance?”
• “Have any residents had to delay their start date or training because of visa issues?”

Their tone and specific examples will tell you more than official policy statements.

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Training & Clinical Experience: Questions to Judge the Quality of a PM&R Program

Visa sponsorship is necessary but not sufficient—you also need strong, well-rounded PM&R training to pass boards and be employable.

A. Questions About Breadth of Physiatry Training

Ask the program director or faculty:

1. “How is clinical exposure balanced between inpatient rehabilitation, consults, and outpatient PM&R across the three or four years of residency?”

2. “What are the core strengths of your PM&R residency—such as spinal cord injury, brain injury, musculoskeletal medicine, or pain?”

   • Follow-up: “How are residents integrated into those services?”

3. “For a non-US citizen IMG who may not have extensive US clinical experience, how do you help them adapt to your PM&R practice environment?”

4. “How early do residents get hands-on experience with electrodiagnostics (EMG/NCS), injections, and spasticity management (e.g., botulinum toxin, intrathecal baclofen)?”

5. “Could you walk me through a typical week on your busiest inpatient rehabilitation rotation—and a typical outpatient-heavy week?”

   • This gives you a realistic view of workload and experiential depth.

B. Questions to Ask Residents About Day‑to‑Day PM&R Life

During the social events or breakout sessions, ask current residents:

1. “Do you feel confident managing core PM&R conditions—like stroke rehab, spinal cord injury, TBI, prosthetics/orthotics—by the time you reach your PGY-4 year?”

2. “Are procedures and EMG fairly distributed among residents? How do you ensure everyone meets procedural milestones?”

3. “How manageable is call, and how does it impact your learning and well-being?”

4. “Are there any rotations or sites that are particularly challenging for a non-US citizen IMG starting out—such as documentation, communication, or system navigation?”

Specific stories from residents often reveal much more than schedules on a website.

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Education, Mentorship & Board Prep: Smart Interview Questions for PM&R Success

As a non-US citizen IMG, you may be particularly focused on ABPMR board pass rates, structured teaching, and mentorship, especially if your prior training system is different.

A. Questions About Educational Structure

Ask the program leadership:

1. “How is formal didactic time protected, and what percentage of sessions are specifically focused on preparation for the PM&R boards?”

2. “Do you use any structured board review resources or in-service exam preparation as a program requirement?”

3. “How have your graduates, including IMGs, performed on the ABPMR written and oral boards over the last several years?”

4. “Are there faculty or chief residents assigned as mentors to incoming residents, especially those who are IMGs?”

5. “How do you support residents who may start off behind in areas like US medical documentation or systems-based practice?”

B. Questions on Research, Leadership, and Career Development

For a strong long-term career as a physiatrist, especially if you’re a foreign national medical graduate, opportunities for research and leadership are valuable.

You might ask:

1. “What types of research projects are residents commonly involved in—clinical outcomes, quality improvement, basic science, or education?”

2. “Are there any active projects or mentors in areas I’m particularly interested in, such as sports medicine, pain, brain injury, or prosthetics?”

3. “Do residents present at national PM&R meetings (e.g., AAPM&R, AAP), and does the program provide funding or protected time for that?”

4. “Have non-US citizen IMG residents held leadership roles here—such as chief resident, committee membership, or national organizations?”

Questions like these show you’re thinking beyond just matching—you’re thinking about growing.

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Fellowship, Jobs & Long-Term Outcomes: Questions to Assess Your Future as an IMG Physiatrist

PM&R is increasingly fellowship-driven, and as a non-US citizen IMG you must understand how your status impacts opportunities.

A. Questions to Ask Program Director About Fellowship Outcomes

Be direct but professional:

1. “Where have your recent graduates matched for fellowship, particularly those who were non-US citizen IMGs?”

2. “Are there any fellowship programs within your institution (such as pain, sports, TBI, SCI) that give preference to internal candidates from your PM&R residency?”

3. “How does the program advise residents who are uncertain between fellowship and going directly into general physiatry practice?”

4. “Have visa-related issues ever limited fellowship opportunities for your foreign national medical graduate residents?”

The answers will help you identify if this program truly supports your long-term growth, rather than just getting you through four years.

B. Questions to Ask Residents About Career Mentorship

Talking with current IMGs or international residents is especially valuable:

1. “What kind of career guidance have you received about practicing PM&R in the US—contract negotiation, job search, understanding the market?”

2. “Do faculty actively connect residents with former graduates, including IMGs, who are now practicing physiatrists?”

3. “Have any foreign national medical graduate residents here had difficulty finding jobs or fellowships because of their visa status?”

If residents describe specific support systems, that’s a strong sign. If they seem uncertain or vague, the program may not be very hands-on with career planning.

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Culture, Support & Daily Life: The Most Revealing “Interview Questions for Them”

Many applicants focus only on academic questions to ask residency programs, but program culture and support—especially for non-US citizen IMGs—often matter just as much for your happiness and performance.

A. What to Ask Program Director About Culture and Wellness

You can phrase culture-related questions in a way that’s honest but not confrontational:

1. “How would you describe the culture of your PM&R residency, especially in terms of collaboration, feedback, and resident independence?”

2. “Have you made any recent changes based on resident feedback—such as workload adjustments, didactic format, or wellness initiatives?”

3. “How do you support residents who may be far from family or adjusting to a new country and healthcare system?”

   • This is directly relevant to non-US citizens but applies to everyone.

4. “Are there formal mechanisms for residents to raise concerns or suggestions safely?”

B. What to Ask Current Residents (Especially IMGs and Foreign Nationals)

These are some of the most important questions to ask residents on interview day:

1. “As a non-US citizen or IMG, how was your transition into this program? Did you feel welcomed and supported?”

2. “Have you ever felt treated differently—positively or negatively—because you’re an IMG or on a visa?”

3. “How approachable are faculty and program leadership when residents have personal, academic, or visa-related issues?”

4. “How is the work-life balance here? What do you typically do on a post-call day or a free weekend?”

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

The honesty and detail of their answers will tell you more than any brochure.

C. Practical Questions About Living and Working There

Residency is your life for several years. Ask:

• “Is a car necessary here, or can residents manage with public transportation?”
• “Where do most residents live, and what is typical rent?”
• “How easy is it to access international grocery stores, cultural communities, or places of worship?”

For a non-US citizen IMG, feeling connected to a community can significantly affect your well-being and performance.

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Tailoring Your Questions: Examples for Different Interview Settings

Below are sample “scripts” for different people you’ll meet, integrating the required topics like what to ask program director and interview questions for them.

A. To the Program Director (Formal Session)

“As a non-US citizen IMG interested in a long-term career in physiatry in the US, I’m trying to understand how different programs support both visa needs and professional development.
Could you share your experience with sponsoring visas for foreign national medical graduates, and how your program has helped those residents successfully pursue fellowships or jobs after graduation?”

“Looking at your curriculum, I see strong exposure to inpatient rehabilitation. How does your program ensure balanced outpatient and procedural training—especially EMG and injections—so that graduates are competitive for both general physiatry and subspecialty practice?”

B. To Current Residents (Informal Social or Breakout Room)

“I’m a non-US citizen IMG, so I’m especially curious about your transition into this system. When you started here, what kind of orientation and day-to-day support did you get, for both clinical work and navigating life in this city?”

“When you were making your rank list, what were your top deciding factors for this PM&R program—and have those turned out to be accurate? Anything that surprised you, good or bad?”

C. To the Program Coordinator or GME Office

“Could you walk me through the typical timeline and steps for visa processing for incoming foreign national medical graduate residents? Are there specific documents or milestones I should be aware of early?”

“Have there been any major institutional changes recently related to visas, licensure requirements, or onboarding that might affect future non-US citizen IMG residents?”

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Putting It All Together: Making Sense of the Answers

As you interview around, you’ll hear different responses to similar questions. To use them effectively:

1. Track everything immediately.
   After each interview, spend 10–15 minutes writing down what you heard about:

   • Visa sponsorship and policies
   • Clinical strengths/weaknesses
   • Culture and IMG support
   • Fellowship and job placement

2. Look for consistency.

   • Do the PD and residents tell the same story about work hours, culture, and support?
   • Are visa answers clear and confident, or vague and uncomfortable?

3. Identify deal-breakers vs. trade-offs.
   Possible deal-breakers for a non-US citizen IMG might include:

   • No clear visa sponsorship pathway
   • No current or recent IMG residents
   • Poor support or concerning resident morale

4. Rank programs based on your priorities.
   For PM&R, your priorities might be:

   • Visa and institutional experience with IMGs
   • Strong, balanced PM&R training
   • Supportive culture and mentorship
   • Clear fellowship and job outcomes

Use your questions not just to impress the program, but to protect your future.

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FAQ: Common Questions from Non-US Citizen IMGs About PM&R Interviews

1. How many questions should I ask each program during the interview?

Aim for 2–3 high‑quality questions per formal interview (PD/faculty) and several more during resident sessions. It’s better to ask fewer, thoughtful, program-specific questions than many generic ones. Always be ready with at least one question about training, one about support/culture, and one about visa or long‑term planning as a non-US citizen IMG.

2. Is it okay to ask directly about visa sponsorship during interviews?

Yes. For a non-US citizen IMG or foreign national medical graduate, visa status is fundamental. Phrase it professionally and contextually, such as:
“As a non-US citizen IMG, understanding visa sponsorship is critical for me. Could you share the types of visas your PM&R residents are currently on and how the institution supports that process?”
Programs are used to this question; you will not be penalized for asking it respectfully.

3. What if the program’s answers about IMGs or visas are vague?

Vagueness can be a red flag. If the program director is uncertain, ask if the program coordinator or GME office can clarify details. Also ask current residents—especially IMGs—about their real experiences. If, after all this, you still don’t have clear information, consider whether you want to risk ranking that program highly.

4. Should I send follow-up questions after the interview day?

Yes, if you have important, unanswered questions that affect your rank decisions—especially about visa processes, rotation details, or fellowship outcomes. Email the program coordinator or, if appropriate, the assistant/associate program director. Keep it concise, appreciative, and focused. Thoughtful follow-up reflects professionalism, not desperation.

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As a non-US citizen IMG pursuing PM&R, your questions are your most powerful tool for evaluating programs—and for showing you understand what it truly takes to build a successful career in physiatry in the US. Use them intentionally, listen carefully, and build a rank list that reflects both your goals and your reality.