Essential Questions DO Graduates Should Ask in Preliminary Surgery Residency Interviews

As a DO graduate pursuing a preliminary surgery residency, your interviews and program interactions are critical opportunities—not just for programs to evaluate you, but for you to evaluate them. The questions you ask will help you understand whether a program can meet your goals, especially if you plan to:

• Transition into a categorical general surgery position
• Use the preliminary surgery year as a stepping-stone to another specialty (e.g., anesthesia, radiology, EM)
• Strengthen your application after a prior unfilled or SOAP experience

This guide focuses on what to ask programs—especially tailored for a DO graduate in preliminary surgery—so you can leave each interview day with clarity, not confusion.

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Understanding Your Goals as a DO Applicant in a Prelim Surgery Track

Before you decide on questions to ask residency programs, you need clarity on your own priorities. The best questions are the ones that help you decide: Is this program the right fit for me?

Clarify your primary goal for a preliminary surgery year

Common goals for DO graduates entering a prelim surgery residency include:

• Pathway to categorical general surgery
  • Aim: Prove yourself clinically and academically, then transition to a categorical spot—either at the same institution or elsewhere.
• Required surgical year for another specialty
  • Aim: Fulfill PGY-1 requirements for fields like anesthesia, radiology, PM&R, or urology.
• Strengthen your file for reapplication
  • Aim: Improve your letters, evaluations, and experience if you previously went unmatched or had a non-traditional path.

Each of these paths requires different information from programs. That’s why your interview questions for them should be intentional and focused.

Consider DO-specific concerns

As a DO graduate, you should pay particular attention to:

• Program’s history of taking and supporting DO residents
• How faculty and leadership view COMLEX vs USMLE
• Opportunities for osteopathic recognition or OMT (if that matters to you)
• The program’s track record in advancing DOs from prelim to categorical status or into other specialties

Knowing your DO-specific priorities will shape what to ask program director and residents.

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Core Priority: Conversion from Prelim to Categorical

For many DO graduates, the central question is: Will this preliminary surgery year realistically help me secure a categorical position?

This should be one of the major themes in your questions to ask programs.

High-yield questions about prelim-to-categorical transition

Use these questions to get concrete information, not vague reassurance:

1. Historical conversion data

   • “In the last 3–5 years, how many preliminary surgery residents have transitioned into categorical general surgery positions here?”
   • “Of your prelims over the last few years, how many have matched into categorical positions at other programs?”

2. Pathways and expectations

   • “Is there a formal pathway or mechanism by which a preliminary surgery resident can be considered for a categorical spot if one opens?”
   • “What qualities or metrics do you look for when considering a prelim resident for categorical conversion?”

3. Realistic availability of categorical spots

   • “On average, how often do categorical positions open during or at the end of the year (e.g., from attrition, expansion, or new funding)?”
   • “Do you ever promote prelims internally if a categorical resident leaves mid-year?”

4. Support for future applications

   • “How does the program support preliminary residents who are reapplying to general surgery or another specialty? For example, help with letters, advocacy calls, or scheduling interviews?”
   • “Would faculty be comfortable making advocacy phone calls on behalf of strong prelims?”

5. Differentiation between DO and MD prelims

   • “Have previous DO preliminary residents successfully moved into categorical positions here or at other programs? Could you share any examples of their paths?”

These questions are critical for a DO graduate residency candidate, because the historical record of success for DO prelims can be a strong predictor of your own opportunities.

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Questions About Training Environment, Workload, and Support

The quality of your preliminary surgery year will depend heavily on the day-to-day environment. As a DO graduate, you want to make sure you’ll have enough operative exposure, teaching, and support to grow and shine.

Clinical and operative experience

1. Case volume and operative autonomy

   • “What is the typical operative exposure for preliminary residents? How does it compare to categorical interns?”
   • “Are prelims ever first assist or primary surgeon on basic cases, or do they mostly function in a floor/consult role?”
   • “Are there any rotations where prelims historically get more OR time?”

2. Rotation structure

   • “How are the rotations divided between OR time, floor work, ICU, and off-service rotations?”
   • “Are prelim residents included on higher-yield rotations like trauma, vascular, or surgical oncology?”
   • “Do prelims and categoricals share the same call schedule and rotation assignments, or are there differences?”

3. Education and conferences

   • “Are preliminary surgery residents fully integrated into didactics, M&M, and skills labs with categorical residents?”
   • “Do prelims receive protected time for academic half-days, conferences, and simulation sessions?”

Work hours, workload, and culture

1. Workload realism

   • “How often do interns approach or hit the 80-hour limit, and how does the program monitor this?”
   • “What are the expectations for pre-rounding, notes, and sign-out for prelims compared to categoricals?”

2. Culture and respect

   • Ask residents:
     • “Do you feel preliminary residents are treated as full members of the team?”
     • “Have you seen any differences in how DOs or prelims are perceived compared to MD categoricals?”
   • “If a prelim is performing at a very high level, how is that acknowledged or rewarded?”

3. Supervision and feedback

   • “How often do interns receive formal feedback, and is that feedback documented in evaluations that could support future applications?”
   • “Is there a formal mentorship structure, and do prelims get assigned faculty mentors?”

These questions help you assess whether the prelim surgery residency year will allow you to both grow and stand out.

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DO-Specific and Professional Development Questions

As a DO graduate, your question list should explicitly address how the program supports osteopathic physicians and helps them advance into desired fields.

Program’s approach to DO residents

1. Track record with DOs

   • “How many DO residents are currently in the program (prelim or categorical)?”
   • “Have DO residents from your program successfully matched into competitive specialties or categorical surgery here or elsewhere?”

2. COMLEX and USMLE considerations

   • “How do you view COMLEX relative to USMLE scores when assessing performance or future potential?”
   • “Are there any disadvantages for DO residents in internal competitive selections (for fellowships, chief roles, or special rotations)?”

3. Osteopathic identity

   • “Is there any osteopathic recognition, OMT clinic exposure, or flexibility if I want to maintain my osteopathic skills during residency?”

While these may feel sensitive, thoughtfully worded, they show maturity and self-advocacy.

Career development & letters of recommendation

For DO applicants, letters and advocacy can be critical for the osteopathic residency match or reapplication process.

Ask:

1. Letters and mentoring

   • “How do faculty typically handle letters of recommendation for prelims? Are there opportunities to work closely with particular attendings who often write strong letters?”
   • “Does the program help identify mentors early in the year so that letters can be meaningful and specific?”

2. Research and scholarly work

   • “Are there opportunities for prelim residents to participate in research or quality improvement projects?”
   • “Is there any protected time or flexibility to pursue research relevant to my long-term specialty goals?”

3. Application timing and logistics

   • “If I am planning to reapply during my prelim year, how does the program help with scheduling interviews and providing days off or coverage swaps?”

For a DO graduate trying to strengthen their CV and reputation, these questions directly affect your long-term trajectory.

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What to Ask Program Director vs. What to Ask Residents

Your interview questions for them should be targeted to the role of each audience: the program director (PD), faculty interviewers, and residents. Each group offers different types of insight.

What to Ask the Program Director

When considering what to ask program director, focus on program strategy, policy, and long-term outcomes.

1. Program philosophy and prelim role

   • “How do you see the role of preliminary residents in your program?”
   • “What do you think differentiates a successful prelim resident who moves into a categorical spot or a strong next-step fellowship/residency?”

2. Advocacy and support

   • “How do you advocate for strong prelims when they apply for categorical positions or other specialties?”
   • “Are there formal evaluation milestones or checkpoints where you review a prelim’s progress and career planning?”

3. Transition opportunities

   • “If a categorical spot becomes available, how do you decide whether a prelim is a good fit for that role?”
   • “Have you ever proactively helped a prelim secure a categorical position at another institution?”

4. Program direction and stability

   • “Where do you see the program going in the next 3–5 years in terms of growth, case volume, and accreditation status?”
   • “Have there been any recent changes in leadership or structure that a new prelim should be aware of?”

These questions show that you think strategically and understand the residency match and applications landscape.

What to Ask Current Residents

Current residents will give you the most honest perspective on daily life.

1. Real culture and treatment of prelims

   • “Do prelims feel supported here, or more like backup labor?”
   • “How are prelims integrated into social events, resident retreats, and wellness initiatives?”
   • “Have you seen DO preliminary residents succeed coming out of this program?”

2. Workload and reality check

   • “What does a typical day look like for a prelim on your busiest rotation?”
   • “Are there rotations where the work crosses the line from challenging to unsafe or unmanageable?”

3. Outcomes and success stories

   • “Do you know where previous prelims have gone after this program—either into categorical surgery or other specialties?”
   • “If you had to do it again, would you still choose this program for a prelim surgery year?”

The answers you get from residents should heavily influence your rank list.

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Practical Question Lists You Can Use on Interview Day

To make this immediately usable, here are consolidated lists you can adapt and bring to your interviews. You don’t need to ask every question in each category; pick the ones most relevant to your goals.

Top 10 High-Yield Questions for a DO Graduate in Preliminary Surgery

1. “In the last 3–5 years, how many preliminary surgery residents have transitioned into categorical positions here or at other institutions?”
2. “How are preliminary residents integrated into OR cases, and how does their operative exposure compare to categorical interns?”
3. “How are DO residents represented in your program, and have DO prelims historically been successful in moving on to categorical positions or other specialties?”
4. “What specific qualities do you look for when considering a prelim for a categorical spot if one becomes available?”
5. “How does the program support prelim residents applying or reapplying during the year (letters, advocacy, interview days, mentorship)?”
6. “Do prelims participate fully in didactics, simulations, and M&M, or are there differences in expectations?”
7. “Can you share examples of where your recent prelims ended up and how the program helped them get there?”
8. “What is the typical call schedule and average workweek hours for prelim interns on your busiest rotations?”
9. “If a DO prelim performs at a high level, are there any barriers to their consideration for internal promotions or opportunities?”
10. “If you were advising your own family member who is a DO pursuing a preliminary surgery year, what would you tell them to look for in a program like this?”

Questions to Prioritize if You Want Categorical General Surgery

• “Is there a formal or informal track for prelims who are strongly interested in categorical general surgery here?”
• “How often do categorical spots open, and what is the realistic likelihood of internal promotion?”
• “Who should I work especially closely with during the year if I want strong surgery letters and mentorship?”

Questions to Prioritize if You’re Using Prelim Year for Another Specialty

• “Have recent prelims matched into anesthesia, radiology, EM, or other fields after this program?”
• “Are there any rotations or attendings especially supportive of non-surgery career goals?”
• “How flexible is the schedule for interviews in other specialties during the year?”

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Strategies for Asking Smart, Professional Questions

It’s not just what you ask, but how you ask it.

Be specific, not generic

Programs hear “What are your strengths and weaknesses?” dozens of times per season. Instead:

• Bad: “So, what’s your program like?”
• Better: “How would you describe the balance between service and education for your interns, particularly prelim residents?”

Showing that you’ve done your homework (e.g., referencing their website, case volume, or current DO residents) makes your questions more impactful.

Avoid sounding transactional

You absolutely need to know if a prelim year will convert to a categorical spot—but you also want to show you care about being a good resident.

Consider framing:

• Instead of: “What are my chances of getting a categorical spot?”
• Say: “For prelims who hope to be considered for categorical positions, what behaviors and performance markers differentiate those who are successful here?”

This signals you are focused on earning opportunities, not just acquiring them.

Tailor questions to each interviewer

• Program Director: Outcomes, policies, long-term vision, promotion pathways
• Faculty: Mentorship, letters, operative autonomy, teaching style
• Residents: Lifestyle, culture, schedule, “real talk” about how DOs and prelims are treated

Prepare a mix of questions and flex them based on the flow of the conversation.

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Red Flags to Watch for in Responses

As you listen to the answers to your questions to ask residency programs, pay attention not just to content but to tone and consistency.

Potential red flags:

1. No clear data on prelim outcomes

   • “I’m not really sure where our prelims end up.”
   • “We don’t really track that.”

2. Prelims described mainly as service

   • “Prelims mostly help with floor work; they don’t get much OR time.”
   • “We value our categorials more because they’re here long term.”

3. Minimizing or dismissive attitude toward DOs

   • “We’ve had a few DOs, but we mostly prefer MDs.”
   • “DOs usually have to work harder to prove themselves.”

4. Lack of support for reapplication

   • “We can’t guarantee help with letters or time off for interviews.”
   • “Prelims are on their own when it comes to future applications.”

If several of these appear, consider how that aligns with your career goals and values.

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FAQs: Questions to Ask Programs for DO Graduates in Preliminary Surgery

1. As a DO, should I directly ask about DO vs MD treatment in the program?

Yes—respectfully. You might say,
“I’m a DO graduate and want to be sure I train in a supportive environment. How have DO residents fared in your program, and have there been any differences in opportunities or outcomes compared to MD residents?”

This allows the program to demonstrate its track record and philosophy without putting anyone on the defensive.

2. How many questions should I ask during an interview?

Aim for 2–4 thoughtful questions per interview depending on time. It’s better to ask fewer, well-crafted questions than rush through a long list. You can always clarify additional details later via email to the coordinator or on a second-look visit.

3. Is it appropriate to ask directly about my chances of converting to a categorical position?

It’s appropriate to ask, but frame it around process and expectations, not personal odds. For example:
“For prelims who hope to be considered for categorical positions, what has that process looked like historically, and what performance level is usually needed?”

This gives you realistic information without forcing an awkward prediction about your individual chances.

4. Should I ask different questions at osteopathic-focused vs ACGME-only programs?

You can keep a similar core list, but at programs with a strong osteopathic presence you might lean into questions about osteopathic recognition, OMT opportunities, and DO leadership roles. At more traditionally allopathic institutions, emphasize DO representation, past DO successes, and how COMLEX is interpreted. The underlying goal is the same: gauge how well they will support you as a DO graduate in residency.

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By preparing and using these targeted interview questions for them, you’ll walk into each preliminary surgery interview as a DO graduate who is informed, strategic, and focused on long-term success. Your questions are not just for information—they are one of the most powerful tools you have to shape your career path and choose a program that will truly invest in your future.