Essential Questions for Non-US Citizen IMGs in Medicine-Psychiatry Residency

Why Your Questions Matter as a Non‑US Citizen IMG in Medicine-Psychiatry

As a non-US citizen IMG interested in med psych residency (Medicine-Psychiatry combined training), the questions you ask programs are almost as important as the answers you give. You’re not only trying to match; you’re trying to match into a place that:

• Understands visa sponsorship and international trainee needs
• Truly supports dual-board training in Internal Medicine and Psychiatry
• Has a track record of successfully training foreign national medical graduates
• Offers realistic pathways for a career and potential long-term stay in the US

This guide focuses on questions to ask residency programs, specifically tailored for a non-US citizen IMG applying to Medicine-Psychiatry combined programs. You can use these questions during:

• Virtual or in-person interviews
• Resident and faculty meet-and-greets
• Pre-interview socials
• Follow-up emails to program directors or coordinators

You do not need to ask every question; instead, select the ones that best address your situation and priorities.

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Strategy First: How to Use Your Questions Effectively

Before diving into specific questions, structure your approach so you sound thoughtful and strategic, not interrogative or anxious.

Clarify Your Priorities as a Non-US Citizen IMG

Common priority areas for foreign national medical graduates include:

• Visa sponsorship & long-term immigration planning
• Clinical exposure in both Medicine and Psychiatry
• Supportive culture for IMGs and diverse backgrounds
• Career outcomes: fellowship, hospitalist, outpatient, academic, research
• Financial and logistical realities (moonlighting, relocation, housing)

Make a short personal list (3–5 top priorities) and select questions that align directly with them.

General Tips for Asking Questions

• Be specific, not generic. Instead of “What’s your program culture like?”, try “How does the program support residents navigating two departments (Medicine and Psychiatry) while maintaining wellness?”
• Aim your question at the right person:
  • Visa, contract, and policies → Program Director (PD), Program Coordinator (PC), or GME office
  • Day-to-day life, call, rotations → Residents
  • Research, mentorship → Faculty and PD
• Avoid questions whose answers are clearly on the website unless you’re asking for clarification or an update.
• Ask follow-up questions based on their answer; this shows genuine engagement.
• Be polite but direct about visa and IMG-related issues. Programs expect you to ask.

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Essential Questions About Visa, Immigration, and IMG Support

For a non-US citizen IMG, these are not side topics—they are mission critical. It is reasonable and professional to raise them.

Questions to Ask About Visas and Sponsorship

These are best directed to the Program Director or Program Coordinator (or the GME office if the program directs you there).

1. Visa Types and Policies

   • “As a non-US citizen IMG, I’d like to understand your visa policies. Which visa types do you currently sponsor for categorical residents in Medicine-Psychiatry (for example, J-1 vs H-1B)?”
   • “For the last few incoming classes, how many residents have been on J-1 vs H-1B visas?”

2. Consistency and Future Stability

   • “Has your approach to visa sponsorship changed in recent years? Do you anticipate any changes in the near future?”
   • “Is H-1B sponsorship dependent on specific exam scores or funding availability, or is it standard for all eligible residents?”

3. Exam and Licensing Requirements Related to Visa

   • “For residents on H-1B visas, do you require that all USMLE Steps, including Step 3, be completed before the rank list deadline or before starting residency?”
   • “Is there institutional support or guidance for taking Step 3 early if it impacts visa eligibility?”

4. Transition to Fellowship or Employment

   • “Do you have graduates on visas who successfully matched into fellowships (in Psychiatry, Internal Medicine subspecialties, or combined fields)? How did the program support them?”
   • “Are there affiliated hospitals or networks that commonly hire your graduates who are on J-1 or H-1B visas?”

Questions That Reveal How IMG-Friendly the Program Really Is

Go beyond “Do you accept IMGs?” and probe the depth of support.

1. Track Record With IMGs

   • “Approximately what percentage of your current residents in the Medicine-Psychiatry combined program are international medical graduates?”
   • “Have you trained many foreign national medical graduates who later pursued academic or leadership roles in the US?”

2. Support Systems for Non-US Citizens

   • “What kind of institutional support is available for non-US citizen residents—such as visa-related guidance, legal resources, or assistance with licensing paperwork?”
   • “Is there an IMG mentorship group or faculty/resident who serves as a point person for international trainees?”

3. Adaptation and Integration

   • “How does the program help new international graduates adapt to the US healthcare system, especially given the dual demands of Medicine and Psychiatry rotations?”
   • “Are there any formal orientation sessions or boot camps specifically addressing documentation, EMR use, and communicating in US clinical settings?”

Use these questions to see if they have processes and examples, not just abstract reassurance.

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Program Structure and Training: Medicine-Psychiatry Specific Questions

As a med psych residency applicant, you need to understand both how the combined training is structured and whether they are genuinely committed to the combined identity, not just running two parallel tracks.

Questions About Curriculum and Rotation Structure

Direct these to the PD and chief residents if possible.

1. Balance Between Medicine and Psychiatry

   • “How is time divided between Medicine and Psychiatry over the five years? Is there flexibility to adjust this balance for individual interests?”
   • “Do rotations alternate frequently between Medicine and Psychiatry, or are there longer blocks in each specialty? How does that impact continuity and learning?”

2. Integrated Experiences

   • “What specific rotations or experiences integrate both Medicine and Psychiatry skills—for example, consult-liaison psychiatry, integrated primary care, or behavioral health in medical clinics?”
   • “Are there opportunities to follow medically and psychiatrically complex patients longitudinally across settings?”

3. Board Eligibility and Exam Preparation

   • “How does the program help residents prepare for both Internal Medicine and Psychiatry board exams? Are there structured board review programs or in-training exam preparation?”
   • “Have all recent graduates been able to successfully sit for and pass both boards? If not, what were the common challenges?”

4. Electives and Customization

   • “How many elective months are available during the combined training, and can they be used to deepen experience in one field more than the other?”
   • “Are there electives in areas particularly relevant to Medicine-Psychiatry, such as addiction medicine, psychosomatic medicine, neuropsychiatry, or primary care psychiatry?”

Questions on Supervision and Mentorship Across Two Departments

1. Coordinated Mentorship

   • “Is there a dedicated Medicine-Psychiatry faculty advisor for each resident, or do we have separate mentors in Medicine and Psychiatry?”
   • “How do the Internal Medicine and Psychiatry departments coordinate feedback and evaluations for combined residents?”

2. Identity as a Combined Resident

   • “In clinical practice and call schedules, are Medicine-Psychiatry residents integrated with categorical residents, or do they maintain a distinct identity?”
   • “Do faculty understand the combined training pathway well, or do residents often need to explain their role and schedule?”

3. Academic and Research Opportunities

   • “Are there faculty who focus on research at the Medicine-Psychiatry interface—for example, chronic disease and mental health, integrated care models, or psychopharmacology in medically complex patients?”
   • “How often do residents participate in scholarly projects, and are there recent examples of Med-Psych residents presenting at national conferences?”

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Daily Life, Call, Wellness, and Financial Realities

Programs often describe themselves as “supportive” and “balanced.” Your job is to turn those labels into specific, measurable realities—especially important when you may not have a strong local support network.

Questions for Residents About Day-to-Day Life

Residents will give you the clearest picture of the real culture.

1. Workload and Culture

   • “On Medicine and Psychiatry rotations, what does a typical day look like for a Medicine-Psychiatry resident?”
   • “How does workload compare to categorical residents on the same services?”
   • “When conflicts arise between Medicine and Psychiatry obligations (for example, changing rotations or scheduling clinics), how are they usually handled?”

2. Wellness and Support

   • “What specific wellness resources do residents actually use (not just those listed on paper)?”
   • “When someone is struggling—personally, academically, or with burnout—how does the program typically respond?”
   • “As an IMG or international graduate, have you felt included and supported socially and professionally?”

3. Community and Belonging

   • “How is the relationship between Medicine-Psychiatry residents and categorical Internal Medicine and Psychiatry residents?”
   • “Do residents socialize outside work? Are there cultural or religious communities nearby that might be supportive for someone moving from abroad?”

Questions About Call, Schedules, and Flexibility

1. Call Structure

   • “How are call responsibilities divided between Medicine and Psychiatry rotations for combined residents?”
   • “Are there night float systems, and how often do Medicine-Psychiatry residents do nights compared to categorical residents?”

2. Scheduling Across Two Departments

   • “How far in advance are schedules released, and how much input do residents have into scheduling preferences—especially considering dual department requirements?”
   • “If a personal or visa-related issue comes up, how flexible has the program been in adjusting schedules?”

3. Moonlighting Opportunities (especially relevant to financial stability)

   • “Are Medicine-Psychiatry residents allowed to moonlight once eligible, and are there institutional or departmental restrictions?”
   • “Do current residents actually find time to moonlight, or is the workload too heavy to make it practical?”
   • “Do visa restrictions impact moonlighting opportunities for non-US citizens?”

Questions About Cost of Living and Practical Logistics

For a foreign national medical graduate moving to the US, practical life questions are essential, not superficial.

• “What is the typical range of rent for residents living near the hospital?”
• “Do residents usually have roommates? Do they live in the city or surrounding suburbs?”
• “Are there any relocation stipends, housing assistance, or parking benefits for residents?”
• “How accessible is public transportation, especially for residents who may not have a car initially?”

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Career Development, Fellowship, and Long-Term Planning for Non-US Citizens

Non-US citizen IMGs often have additional constraints and questions about long-term planning. You should probe how realistic the program’s promises are.

Questions on Fellowship and Job Placement

Ask these to PDs and senior residents:

1. Fellowship Outcomes

   • “What proportion of recent Medicine-Psychiatry graduates pursued fellowships versus going directly into practice?”
   • “Which fellowships have recent graduates entered—for example, addiction psychiatry, consult-liaison, cardiology, hospital medicine, primary care, etc.?”
   • “Have non-US citizen IMG graduates had any particular challenges in securing fellowships? How did the program support them?”

2. Mentoring for Career Planning

   • “When during residency do career planning discussions typically start, especially for those considering dual-board careers or specific fellowship paths?”
   • “Do residents have protected time or structured advising sessions for planning jobs and fellowships?”

3. Academic vs Community Career Paths

   • “Are there examples of graduates working in integrated systems (like VA, academic medical centers, or community mental health centers) where both their Medicine and Psychiatry skills are used?”
   • “Does the program encourage residents to develop a niche at the Medicine-Psychiatry interface, and if so, how?”

Immigration, J-1 Waivers, and Long-Term Stay

Some of these are sensitive questions, but they are appropriate when asked professionally.

• “Do you have former residents on J-1 visas who have successfully obtained J-1 waiver positions after graduation? Are these typically in primary care internal medicine, psychiatry, or mixed roles?”
• “Are there institutional or regional connections that help graduates find waiver or sponsored positions after training?”
• “How familiar is your GME office with supporting residents who are exploring long-term immigration options after residency?”

You may not always get detailed answers, but you’ll see which programs recognize and respect the complexities of your situation.

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How to Phrase Questions to Program Directors and Residents

The way you ask questions matters. You want to show maturity, insight into the Medicine-Psychiatry pathway, and awareness of your identity as a non-US citizen IMG without sounding fearful or transactional.

Examples of Well-Phrased Questions for the Program Director

These integrate multiple SEO-related concepts like what to ask program director, questions to ask residency, and interview questions for them in a natural way:

• “As a non-US citizen IMG strongly interested in a long-term career in integrated medical and psychiatric care, what do you think makes your Medicine-Psychiatry program particularly supportive for foreign national medical graduates?”
• “If you imagine a resident who thrives here, especially in the med psych residency track, what qualities or habits do they tend to have?”
• “Are there any unique challenges that Medicine-Psychiatry residents face in your institution, and how has the program adapted to support them?”
• “From your perspective as Program Director, what professional opportunities do you see opening up for combined-trained physicians over the next 5–10 years?”

These show that you are thinking beyond just matching—about identity, career, and contribution.

Examples of Well-Phrased Questions for Residents

• “Looking back, what surprised you most about training in a Medicine-Psychiatry combined program compared to what you expected during interview season?”
• “As an IMG or someone from a diverse background, did you feel the faculty and residents respected your perspective and experiences?”
• “If you had to make the decision again, would you still choose this Medicine-Psychiatry program, and why or why not?”
• “What do you wish you had asked during your own residency interviews that you only figured out after starting here?”

These questions encourage honest reflections and often yield the most useful information for your rank list.

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Putting It All Together: A Sample Question Plan for Interview Day

To avoid sounding repetitive or taking too much time, plan a short, prioritized list for each major person/group you’ll meet.

For the Program Director (3–5 key questions)

Example set:

1. “Which visa categories do you currently sponsor for Medicine-Psychiatry residents, and has that policy been stable over recent years?”
2. “How does your curriculum ensure true integration between Medicine and Psychiatry, rather than just alternating between two separate programs?”
3. “What have been the most common challenges for Medicine-Psychiatry residents here, and how does the program help them navigate those challenges?”
4. “How have recent graduates—especially non-US citizen IMGs—fared in terms of fellowships or jobs?”

For Current Residents (5–7 key questions spread across several residents)

Example set:

1. “What does a typical week look like on a combined or integrated rotation?”
2. “Do you feel the program listens and responds when residents raise concerns?”
3. “How manageable is the workload, and does it still allow you to have a life outside the hospital?”
4. “As an IMG or as someone working with IMGs, how would you describe the culture—welcoming, neutral, or challenging?”
5. “Have you had any issues with visas, licensing, or administrative tasks, and how did the program help?”

For the Program Coordinator or GME Office (2–3 targeted questions)

Example set:

1. “Could you clarify the typical timeline and process for visa paperwork for incoming residents?”
2. “How does the institution support residents in managing licensing paperwork, Step 3 scheduling, and other administrative requirements?”
3. “Are there institutional orientation sessions that help international graduates learn about the hospital system, EMR, and local resources?”

By distributing different interview questions for them across PD, residents, and coordinators, you get a multidimensional picture without repeating yourself.

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FAQs: Questions Non‑US Citizen IMGs Commonly Ask About Med-Psych Interviews

1. Is it okay to ask detailed visa questions during residency interviews?

Yes. For a non-US citizen IMG or foreign national medical graduate, visa sponsorship is fundamental, not optional. The key is professional phrasing, for example:

• “As a non-US citizen applicant, I’d like to understand your visa sponsorship policies better. Could you share which visa types you currently sponsor and whether you anticipate any changes?”

Programs are used to these questions and will not view them negatively if asked respectfully and succinctly.

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

Aim for 3–5 focused questions for the Program Director and 5–7 spread among residents, plus 1–3 for the coordinator or faculty. Quality matters more than quantity. Avoid long, multi-part questions that are hard to follow. Your goal is to leave with clarity on:

• Visa and IMG support
• Curriculum and integrated training
• Culture and workload
• Career outcomes

3. What if the program’s website already lists some answers?

You can still ask for clarification or updates:

• “I saw on your website that you offer both J-1 and H-1B sponsorship. Has that remained the same for your most recent classes?”
• “Your website mentions integrated primary care-psychiatry clinics. Could you describe how Medicine-Psychiatry residents participate in those clinics?”

This shows you did your homework and are using the time to deepen understanding.

4. Are there any questions I should avoid asking during residency interviews?

Avoid:

• Questions clearly answered and unchanged on the website (“What are your duty hours?” when posted verbatim)
• Questions that sound like you are only interested in money (“How much can I moonlight?” as your first question)
• Overly aggressive or confrontational questions about past problems

Instead, frame concerns constructively:

• “How does the program ensure duty hour compliance and protect resident wellness, especially during intense Medicine or Psychiatry rotations?”

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By preparing thoughtful questions to ask residency programs, tailored to your unique position as a non-US citizen IMG pursuing Medicine-Psychiatry combined training, you not only gather vital information but also present yourself as a mature, insightful applicant. Use this guide to build your personal question list, adapt it to each program, and walk into interviews with a clear plan for what to ask—and how to listen.