Essential Questions for Non-US Citizen IMGs in Med-Peds Residency Interviews

Understanding Your Goals as a Non‑US Citizen IMG in Med-Peds

As a non-US citizen IMG interested in Medicine-Pediatrics (Med-Peds), the residency interview is not just about programs evaluating you—it’s your best opportunity to evaluate them. The questions you ask programs will shape:

• How well you understand their training environment
• How you assess whether they truly support foreign national medical graduates
• How clearly you communicate your priorities as a future Med-Peds physician

Because you’re navigating immigration, licensing, and often cultural transitions, the questions you ask in interviews matter even more than they might for US graduates. Thoughtful, targeted questions signal maturity, preparation, and genuine interest in the medicine pediatrics match.

This guide will help you:

• Prioritize high-yield questions to ask residency programs
• Tailor questions specifically for Med-Peds training
• Focus on critical areas for non-US citizens (visa, support, board prep, careers)
• Differentiate what to ask program directors, faculty, and residents

You won’t be able to ask everything in every interview, so think of this as a question bank you can choose from and personalize.

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Core Strategy: How to Use Questions Effectively

Before getting into specific questions, clarify your strategy. The best questions are:

• Specific (not answerable by the website)
• Open-ended (invite explanation, not yes/no)
• Relevant to your situation as a non-US citizen IMG
• Program-focused, not self-focused (avoid questions that sound like “what can you do for me?” without context)

A good structure for each interview:

1. Program Director / APD meeting
   • Big-picture training, visa policy, outcomes, academic opportunities
2. Resident Q&A
   • Culture, workload, wellness, reality of training, informal insights
3. Faculty / Clinic leadership
   • Teaching quality, Med-Peds identity, mentorship, patient mix

Bring a written list (or notes in your interview folder) but avoid reading them robotically. Choose 3–5 priority questions for each type of person you’ll meet.

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Questions to Ask the Program Director (PD) and Leadership

This is where you focus on training structure, visa sponsorship, outcomes, and institutional commitment to Med-Peds and IMGs. These are some of the most important interview questions for them.

1. Visa Support and IMG Experience

For a foreign national medical graduate, visa and immigration support are non-negotiable. Never assume.

Questions to ask program director:

• “Can you tell me about your current visa sponsorship policies for residents? Do you typically sponsor J-1, H-1B, or both?”
• “In the last 3–5 years, approximately how many residents in your program have been non-US citizen IMGs?”
• “How experienced is your GME office with issues specific to foreign national medical graduates—such as visa renewals, travel needs, or transitions after residency?”
• “Do IMG residents here ever have difficulty securing H-1B or jobs/fellowships after graduation due to visa issues, and how does the program support them?”

What you’re listening for:

• Clear, confident answers (not vague or hesitant)
• Evidence that IMGs are part of the program’s culture, not an exception
• Whether they understand visa timelines and post-residency transitions

If the program has never had a non-US citizen IMG, proceed carefully; you may be the one navigating new ground.

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2. Med-Peds Identity, Structure, and Support

Med-Peds is a combined specialty; you want a program where the Med-Peds identity is strong and respected.

Key questions to ask:

• “How would you describe the Med-Peds identity within your institution? Are Med-Peds residents integrated well into both departments?”
• “What is the relationship like between the Med-Peds program and the categorical Internal Medicine and Pediatrics programs?”
• “Are there Med-Peds faculty in leadership roles (e.g., chiefs, program leadership, department committees)?”
• “How do you protect the Med-Peds training experience so that residents don’t feel like ‘extra help’ for either department?”

Why this matters for non-US citizen IMGs:

A strong Med-Peds identity usually correlates with:

• Better mentoring
• Clearer rotation structure
• Less confusion or exploitation
• More support navigating career paths (especially complex ones like combined hospitalist, primary care, or fellowship)

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3. Clinical Training, Autonomy, and Patient Population

You want to know whether the program will truly prepare you for independent practice in both adult and pediatric medicine, especially if your prior clinical exposure was outside the US.

Questions to ask:

• “Can you describe the balance between inpatient and outpatient training across the four years for Med-Peds residents?”
• “How does resident autonomy progress from PGY-1 to PGY-4 in both Medicine and Pediatrics settings?”
• “What types of patients do Med-Peds residents typically care for? Are there particular populations that are a strength of your program (e.g., complex chronic disease, medically fragile children, underserved populations, transition care)?”
• “How are Med-Peds continuity clinics structured—do residents have separate adult and pediatric clinics throughout training?”

As a non-US citizen IMG, listen for:

• Opportunities to gain broad US-style clinical experience
• Supportive supervision early on, with clear progression to autonomy
• Diverse and complex patient populations (helpful for boards and future jobs)

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4. Academic Support, Board Preparation, and Remediation

For any non-US citizen IMG, success on the ABIM and ABP board exams is essential—not just to graduate but to be competitive for jobs and fellowships.

High-yield questions:

• “How does the program support residents in preparing for both Internal Medicine and Pediatrics boards?”
• “What has been your ABIM and ABP board pass rate for Med-Peds graduates over the last 3–5 years?”
• “If a resident is struggling academically or clinically, what kind of remediation or support systems are in place?”
• “Do residents have protected time or resources (question banks, board review courses) supported by the program?”

Red flags:

• Leadership is defensive or vague about board pass rates
• No formal support structures for struggling residents
• No clear plan tailored to Med-Peds (only categorical-focused resources)

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5. Career Outcomes, Fellowship, and Visa-Sensitive Planning

You need to understand how the program prepares residents for life after training, especially given your immigration constraints.

Questions to ask program director:

• “What have your recent Med-Peds graduates gone on to do—fellowships, hospitalist work, primary care, academic positions?”
• “Do you track and support outcomes specifically for non-US citizen IMG graduates?”
• “Can you give examples of fellows or attendings who were foreign national medical graduates and how the program helped them transition to their next step?”
• “Are there particular fellowships or job networks that commonly recruit from your program, especially for residents on visas?”

What to look for:

• Evidence that IMG graduates placed into reputable fellowships or jobs
• Understanding of how visa type (J-1 vs H-1B) impacts job/fellowship options
• Career counseling or mentoring systems that start early (PGY-2 or even PGY-1)

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Questions to Ask Residents: Culture, Reality, and Support

Residents will usually give you the most honest and practical view of daily life. Frame your questions in a way that invites openness and specifics.

1. Program Culture and How IMGs Fit In

You need to know whether IMGs—and non-US citizen IMGs in particular—feel supported and included.

Resident-focused questions:

• “How would you describe the culture of the program among residents—more collaborative or more independent and competitive?”
• “Are there current residents who are non-US citizen IMGs? How well are they supported here?”
• “Do you feel there is any difference in expectations, evaluation, or treatment between IMGs and US grads?”
• “Can you tell me about how approachable the program leadership is when residents have personal or academic challenges?”

Listen for:

• Clear examples, not just “It’s great here”
• Whether IMGs are in chief or leadership roles (a good sign of inclusion)
• Whether residents feel psychologically safe to speak up and ask for help

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2. Workload, Schedule, and Rotations

You need realistic expectations to decide if the program’s workload is sustainable for you, especially if you’ll be navigating a new country, health system, and often separation from family.

Questions to ask residents:

• “What does a typical week look like on a busy inpatient rotation for a Med-Peds resident? How many patients are you usually responsible for?”
• “How well does the program adhere to duty-hour regulations in practice?”
• “Are rotations balanced between Medicine and Pediatrics, or is there a tendency to be pulled more heavily to one side?”
• “How manageable is the call schedule, and how does it compare between PGY-1 and PGY-4?”

Pay attention to:

• Whether residents seem burned out or generally satisfied
• Whether residents mention “being pulled to cover” services frequently (a warning sign)
• How often you hear the words “flexible,” “supportive,” or “overwhelming”

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3. Support Systems, Mentorship, and Well-Being

Adjustment as a non-US citizen IMG is not only academic but also social and emotional.

Good questions include:

• “How easy was it for you to adjust when you first arrived? Did the program or co-residents help you with housing, transportation, or basic logistics?”
• “Are there formal mentorship systems for Med-Peds residents, and do IMG residents have mentors who understand their unique challenges?”
• “How does the program handle time off for illness, family reasons, or emergencies?”
• “What wellness resources are actually used by residents (not just advertised)?”

If you are moving without family or support, you might also ask:

• “How easy is it to build a social life here outside of work, especially if you’re new to the country or the area?”

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4. Practical Life Issues Specific to Non-US Citizens

Sometimes the most important information is about life outside the hospital, particularly if you’re a non-US citizen IMG navigating finances and logistics.

Targeted questions:

• “For residents on visas, have there been any challenges with things like credit history, renting apartments, or getting a driver’s license, and did anyone guide you through that?”
• “Is the salary sufficient for the local cost of living, especially if you’re supporting family abroad or bringing family with you?”
• “Do any residents have experience with sending money home, childcare, or managing long-distance families while in training?”

You don’t need to share all your personal circumstances, but you can frame questions generally while still getting useful information.

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Med-Peds–Specific Questions to Show Insight and Commitment

Beyond immigration and IMG issues, you want to show that you understand what makes Med-Peds unique, and that you’re committed to this combined pathway.

1. Transitions of Care and Combined Clinics

One of the strengths of Med-Peds is caring for patients moving from pediatric to adult systems.

Questions to ask:

• “What opportunities do Med-Peds residents have to participate in or lead transition-of-care clinics for adolescents with chronic conditions?”
• “Are there Med-Peds–run clinics or services where you see both adult and pediatric patients in the same setting?”
• “Do Med-Peds residents have a cohesive ‘home clinic’ identity, or do they feel split between Medicine and Pediatrics clinics?”

These questions show thoughtful understanding of what makes Med-Peds special.

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2. Teaching Opportunities and Leadership

If you’re interested in academic medicine, these questions help you gauge your future opportunities.

High-yield questions:

• “What opportunities are there for Med-Peds residents to teach medical students or junior residents on wards and in clinics?”
• “Do Med-Peds residents hold leadership roles such as chief residents, quality improvement leaders, or committee membership?”
• “Are there any Med-Peds–specific conferences, journal clubs, or core curriculum sessions?”

Programs that invest in resident leadership and teaching often have more robust support and mentorship—important for career advancement, especially as a foreign national medical graduate.

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3. Research, QI, and Scholarly Work

Scholarly activity can be crucial for fellowship and visa-friendly academic opportunities.

Questions to ask:

• “What types of scholarly projects have recent Med-Peds residents completed—research, QI, education, advocacy?”
• “Is there protected time or structural support (mentors, statisticians, IRB guidance) for residents who want to pursue research?”
• “How early in residency can you get involved in projects, and are there mentors who particularly enjoy working with IMGs or Med-Peds residents?”

Ask for specific examples of projects and publications from recent graduates to gauge how real these opportunities are.

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How to Personalize and Prioritize Your Questions

You won’t have time to ask everything. Use this framework to choose what to ask in each encounter.

Step 1: Identify Your Top 3–4 Priorities

Common priorities for a non-US citizen IMG in Med-Peds:

• Strong visa support and history with foreign national medical graduates
• Solid board preparation and academic support
• A welcoming, inclusive culture for IMGs
• Clear outcomes (jobs, fellowships, J-1 waiver or H-1B–friendly pathways)
• Geographic location and cost of living

Rank your own list, then select questions that directly address your top concerns.

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Step 2: Avoid Low-Yield or Easily Googleable Questions

Don’t waste time on things clearly stated on the website or in the program brochure, such as:

• “How many residents are in your program?”
• “What are your required rotations?”

Instead, build on that information:

• “I saw that your program has an X-month rotation in [subspecialty]. How do Med-Peds residents typically use that experience in shaping their future careers?”

This shows preparation and sophistication.

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Step 3: Ask Questions that Invite Stories, Not Slogans

The best interview questions for them are those that prompt real examples:

• “Can you share a recent example of how the program supported a resident going through a difficult time?”
• “Could you tell me about a recent Med-Peds graduate whose path you’re especially proud of, and what the program did to help them?”

Stories reveal true culture in a way that general adjectives (“supportive,” “friendly”) do not.

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Step 4: Close with A Reflective Question

Near the end of the conversation, you can ask:

• “Based on what you know about my background as a non-US citizen IMG interested in Med-Peds, is there anything you think I should particularly consider about training here?”

This can yield candid insight and signals maturity and self-awareness.

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Sample Question Sets You Can Use Directly

To make this more practical, here are sample sets you can adapt for different people.

For Program Director / Associate Program Director

1. “How experienced is your program and institution with supporting non-US citizen IMG residents, particularly in terms of visas and career planning after residency?”
2. “How would you describe the Med-Peds identity here, and what makes your Med-Peds training distinct from doing separate Medicine and Pediatrics residencies?”
3. “What systems are in place to support residents academically—especially those who might need more time to adjust to the US clinical environment?”
4. “What have Med-Peds graduates from your program done in the last few years, and are there examples of foreign national medical graduates who have successfully secured fellowships or jobs?”

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For Current Residents (especially IMGs)

1. “What has your experience been like as an IMG or working with IMG co-residents in this program?”
2. “How manageable is the workload realistically, and do you feel you have enough time for studying, rest, and personal life?”
3. “Did you feel supported in your first few months as you learned the hospital system, EMR, and cultural expectations?”
4. “If you had to decide again, would you still choose this Med-Peds program, and why or why not?”

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For Faculty / Clinic Directors

1. “How do you see the role of Med-Peds residents in your clinic or service? What do they bring that’s unique?”
2. “What teaching and mentorship opportunities do you typically offer Med-Peds residents, especially those interested in academic careers?”
3. “Are there any ongoing Med-Peds–oriented projects or QI initiatives that residents can join early in training?”

Use these as starting points, then modify the wording to match your own voice.

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FAQ: Common Questions from Non‑US Citizen IMGs About Interview Questions

1. Is it okay to ask directly about visas and sponsorship in the interview?

Yes. For a non-US citizen IMG, visa sponsorship is fundamental. It is entirely appropriate and necessary to clarify:

• What visa types they sponsor
• Their history of sponsoring non-US citizen IMGs
• Any known constraints for H-1B or J-1 waiver positions

Frame it professionally:
“Because I will require visa sponsorship, may I ask about your recent experience supporting IMG residents on J-1 or H-1B visas and how the institution handles these processes?”

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2. How many questions should I ask in each interview?

Aim for:

• 2–3 focused questions with each faculty member
• 3–5 questions in a group resident session

Quality matters more than quantity. Prioritize depth over breadth—better to explore two questions meaningfully than to rush through five.

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3. What if the program already answered my prepared question in their presentation?

Acknowledge that and build on it. For example:

“I appreciated your overview of the Med-Peds continuity clinic structure. Could you share how residents feel about balancing their adult and pediatric panels over the four years, and whether they’d change anything about that structure?”

This shows you were listening and can think critically.

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4. Are there any questions I should avoid?

Yes. Avoid:

• Questions about salary and benefits in faculty interviews (these are usually standard and on the website; ask residents informally if needed).
• Questions that could imply you’re not committed to Med-Peds (“If I match here, can I later switch to categorical?”).
• Questions that sound like demands (“How will you guarantee I get a fellowship in X?”).

Focus instead on how the program supports residents broadly and what typical pathways look like.

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As a non-US citizen IMG pursuing Med-Peds, your questions are one of your most powerful tools. Thoughtful, well-chosen questions will help you find programs that are not only strong clinically, but also truly equipped to support you through the challenges—and opportunities—of building a career in combined Internal Medicine and Pediatrics in the United States.