Essential Questions to Ask for EM-IM Combined Residency Interviews

Why Your Questions Matter in EM-IM Residency Interviews

Emergency Medicine-Internal Medicine (EM IM combined) residencies attract applicants who want broad clinical skills, versatility, and long-term flexibility in their careers. Programs know this, and how you use your interview day tells them a lot about your preparation, insight, and fit.

Thoughtful, specific questions to ask residency programs do three things:

1. Show you understand the combined nature of emergency medicine internal medicine training
2. Help you compare programs in a meaningful, structured way
3. Signal to faculty and current residents that you’re serious, reflective, and team-oriented

This guide walks you through high-yield, practical questions to ask residency programs, how to tailor them for EM-IM combined training, and what red flags or green flags to listen for in the answers.

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Core Strategy: How to Approach Questions on Interview Day

Before diving into lists, it helps to have a framework for how to ask and when to ask.

1. Types of People You’ll Talk To

You’ll usually have chances to speak with:

• Program Director (PD) / Associate PD
• Core EM-IM combined faculty
• Current EM-IM residents
• EM-only and IM-only residents or faculty
• Department leadership (EM chair, IM chair, etc.)
• Program coordinator

You should not ask everyone the same questions. The most effective applicants tailor their “interview questions for them” by role.

2. Categories of Questions to Cover

For EM IM combined programs, you’ll want at least a few questions in each of these domains:

• Curriculum & combined training structure
• Clinical exposure and autonomy
• Culture, wellness, and support
• Career outcomes & fellowship opportunities
• Program logistics & schedule realities
• Mentorship, evaluation, and feedback
• Location, lifestyle, and overall fit

Think of it as building a data set about each program so you can compare them realistically when you create your rank list.

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High-Yield Questions for the Program Director and Leadership

You’ll often get a chance to ask the PD or APD a few questions. These should be big-picture, thoughtful, and specific to EM-IM.

A. Questions About Program Vision and Structure

1. “How does the EM-IM combined program integrate with the categorical EM and IM programs?”

Why it matters: You want to know whether you’re seen as a “fifth wheel” or a fully integrated member of both departments.

Listen for:

• Shared conferences, call schedules, and rotations
• “We consider our EM-IM residents central to both departments” vs. “They mostly follow a separate track”

2. “What is your long-term vision for the EM-IM program over the next 5–10 years?”

Why it matters: Signals program stability, growth potential, and leadership engagement.

Green flags:

• Clear plans for curriculum evolution, fellowship pipelines, or combined roles
• Mention of tracking outcomes and adjusting curriculum

Red flags:

• Vague answers like “We’ll see” or “We’re still figuring things out” in long-established programs

3. “How are EM-IM specific needs accounted for when curricular or policy decisions are made?”

Why it matters: You want to know if someone in leadership actively advocates for combined residents.

Good signs:

• “We have an EM-IM program director or dedicated faculty champion”
• EM-IM residents represented on key committees

B. Questions About Curriculum and Scheduling

4. “Can you walk me through how the five years are structured—particularly how you balance EM and IM months each year?”

Why it matters: Programs differ widely in how they mix EM and IM rotations. You want clarity.

Clarify:

• Distribution of EM vs IM months each year
• ICU exposure, wards, electives, and off-service rotations
• Continuity clinic schedule and ED shifts

5. “How often do EM-IM residents switch between EM and IM rotations, and how do you support those transitions?”

Why it matters: Combined residents can feel like they’re always “changing teams.” Good programs plan for this.

Look for:

• Structured orientation each time you re-enter a department
• Support for switching mindsets (e.g., from inpatient wards to high-acuity ED)

6. “Do EM-IM residents meet all EM and IM board requirements without difficulty? How do you track that?”

Why it matters: Certification is non-negotiable.

Expect:

• A confident, detailed answer
• A clear tracking system for ACGME/ABIM/ABEM requirements

C. Questions About Culture and Support

7. “What do you think distinguishes your EM-IM combined program culturally from other residency programs here?”

Why it matters: Reveals how leadership perceives the combined residents and what “identity” they expect.

8. “How do you support residents who are struggling academically, clinically, or personally?”

Why it matters: Every resident struggles at some point. The structure of support is key.

Good answers mention:

• Proactive check-ins, mentorship, wellness resources
• A non-punitive approach to remediation

9. “What’s your approach to resident wellness, especially given the intensity of combined EM-IM training?”

Why it matters: EM-IM can be demanding; structured wellness is a big plus.

Examples of strong answers:

• Formal wellness curriculum
• Protected time, debriefing after critical events
• Access to mental health services tailored to residents

D. Questions About Outcomes and Careers

10. “What have recent EM-IM graduates gone on to do, and how does the program support different career paths?”

Why it matters: EM-IM graduates are diverse—hospitalists, ED attendings, intensivists, administrators, academic leaders, global health.

Look for:

• Specific examples of graduates and their roles
• Openness to non-traditional paths (e.g., administrative leadership, rural hybrid roles)

11. “How does the program help EM-IM residents position themselves competitively for fellowships, if they choose that route?”

Why it matters: Many EM-IM grads pursue critical care, cardiology, hospital medicine, ultrasound, or administration.

Strong signs:

• Track record of fellowship matches
• Research, mentorship, and dedicated time for CV-building

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Key Questions for Current EM-IM Residents

Your conversations with current residents are the most honest and high-yield part of the day. This is where you learn what the program really feels like.

A. Daily Life and Workload

12. “What does a typical week look like for you on an EM block? On an IM block?”

Why it matters: You want concrete, not vague, descriptions.

Ask for:

• Actual shift times and numbers on EM
• Call schedules and day/night distribution on IM
• Average total hours per week

13. “Do you feel the workload is sustainable for five years?”

Why it matters: EM-IM is long; burnout risk is real.

Green flags:

• Honest recognition that it’s busy, plus examples of how people cope and thrive
• Residents remain engaged and upbeat

Red flags:

• Residents look exhausted or cynical
• Frequent references to people “barely hanging on”

B. Integration and Identity

14. “Do you feel like you belong equally in both EM and IM communities here?”

Why it matters: Combined residents can feel like outsiders if programs are poorly integrated.

Follow-up:

• “Are there any areas where you’ve felt ‘in the middle’ or left out?”
• “How do faculty and categorical residents view EM-IM residents?”

15. “What are the best and hardest parts of being EM-IM at this institution?”

Why it matters: This usually yields honest reflections about identity, workload, and long-term benefits.

C. Education and Autonomy

16. “Do you feel you get enough hands-on procedures and critical care exposure in both ED and inpatient settings?”

Why it matters: EM-IM should make you very comfortable with sick patients in any setting.

Clarify:

• Central lines, intubations, chest tubes, complex resuscitations
• ICU rotations and trauma exposure

17. “At what level of training do you start functioning like the senior decision-maker—both in the ED and on the wards?”

Why it matters: Autonomy is key for growth.

Strong signs:

• Gradual, supervised progression to senior roles
• Clear expectations by PGY year

D. Support, Mentorship, and Morale

18. “Who do you go to when you’re having a tough rotation or personal problem?”

Why it matters: Reveals real mentorship culture.

Look for:

• Multiple names: PD, faculty mentors, chief residents, peers
• Evidence that these people are approachable and effective

19. “Have any residents left the EM-IM program early in the past few years? If so, why?”

Why it matters: Turnover is a meaningful data point.

A healthy answer:

• Honest acknowledgement if someone left
• Clear, understandable reasons (e.g., family move, change in specialty)
• No defensiveness or secrecy

20. “If you had to choose again, would you pick this EM-IM program?”

Why it matters: One of the most revealing questions.

Pay attention to:

• Tone, not just content
• Whether there’s hesitation or nuanced caveats

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Targeted Questions for EM and IM Faculty (and Chairs)

Since you’re dual-trained, you should engage thoughtfully with leaders from both departments.

A. For EM Leadership / ED Faculty

21. “How do EM faculty view the EM-IM residents compared with categorical EM residents?”

Why it matters: You want to ensure you won’t be “second tier” in the ED.

Listen for:

• “We treat them exactly like our EM residents, with additional IM strengths”
• “They’re leaders on our sickest patients”

22. “What unique contributions do EM-IM residents bring to the ED team?”

Why it matters: Programs that value EM-IM can articulate meaningful advantages (e.g., complex medical decision-making, nuanced inpatient planning).

23. “How are EM-IM residents incorporated into ED leadership roles, quality projects, or administration?”

Why it matters: EM-IM residents are well-positioned to lead systems-improvement across ED and inpatient care.

B. For IM Leadership / Ward Faculty

24. “How do you leverage the emergency medicine skill set of EM-IM residents on the inpatient side?”

Why it matters: Good programs recognize and use your EM strengths in rapid response, codes, and triage.

Examples:

• Leading rapid response teams
• Teaching code leadership
• Early involvement in decompensating patients

25. “How does the program ensure EM-IM residents are competitive for IM-based fellowships if they’re interested?”

Why it matters: You’ll need strong letters, research, and leadership roles despite split time.

Look for:

• Established EM-IM alum fellowship matches
• Protected research or scholarly time
• Faculty with experience mentoring combined residents into fellowships

C. Cross-Departmental Collaboration

26. “How do the EM and IM departments collaborate for EM-IM-specific education (e.g., conferences, retreats, or joint simulation)?”

Why it matters: Dedicated EM-IM educational time is a strong sign of commitment to the combined program.

27. “Can you give an example of a patient care or quality improvement project led by an EM-IM resident that impacted both departments?”

Why it matters: Real-world examples show you how residents can operate in that EM–IM “bridge” role.

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Practical Logistics: Schedule, Call, Benefits, and Location

These may not feel glamorous, but they heavily influence your day-to-day happiness and sustainability.

A. Schedule and Call Structure

28. “How is night coverage structured for EM-IM residents across EM and IM rotations?”

Why it matters: Nights and call can be very different in EM vs. IM.

Clarify:

• Night float vs. 24-hour call on IM
• ED overnight shift expectations
• Distribution of nights over the five years

29. “How are vacation and personal time scheduled for EM-IM residents, given they rotate through two departments?”

Why it matters: You need flexibility, but also fairness compared with categorical residents.

Good signs:

• Clear, transparent vacation policies
• Ability to group weeks for longer trips (within reason)
• No last-minute cancellations of approved time except for true emergencies

B. Benefits and Practical Support

30. “Are there differences in salary, benefits, or moonlighting options for EM-IM residents compared with others?”

Why it matters: Combined residents sometimes have different eligibility for moonlighting or bonuses.

Ask specifically:

• When moonlighting is allowed
• Whether EM-IM residents frequently moonlight (and where)
• Any restrictions unique to combined residents

31. “What resources are available for board preparation—for both EM and IM?”

Why it matters: Dual boards = dual prep.

Look for:

• Paid question banks, review courses, protected study time
• EM-IM-specific board review strategies

C. Location, Commute, and Lifestyle

32. “Where do most residents live, and what does your commute look like?”

Why it matters: Real-life time and cost of living.

Good info includes:

• Safety, affordability of neighborhoods
• Parking or public transit options, especially for night shifts

33. “What do you enjoy doing outside of work in this city/region?”

Why it matters: Residents’ real lives tell you more than brochures.

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Smart Questions to Ask During Pre-Interview Socials

The pre-interview dinner or virtual social is relaxed and often more candid. This is a great time for some of your more personal or “sensitive” questions.

A. Culture and Hidden Curriculum

34. “What unwritten expectations or ‘hidden curriculum’ should incoming EM-IM interns know about?”

Why it matters: You want to know how things really work.

Examples might include:

• “Certain attendings really value detailed presentations”
• “Don’t be afraid to ask for help early here; it’s expected”

35. “How approachable are attendings in both departments? Do you feel comfortable calling them at 3 AM?”

Why it matters: Safety and education depend on your ability to ask for help.

B. Wellness and Burnout

36. “When residents struggle or feel burned out, what actually happens here?”

Why it matters: This is a more direct version of your wellness question.

Red flags:

• Dismissive attitudes (“It’s residency, what do you expect?”)
• Stories of punitive responses to struggling residents

C. Choosing the Program (Reverse-Engineering Fit)

37. “What made you choose this EM-IM program over others when you were applying?”

Why it matters: Helps you identify the program’s strengths for different personalities.

Follow up:

• “Did it live up to your expectations?”
• “What surprised you—good or bad—after you started?”

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How to Use These Questions Strategically

You’ll never have time to ask all of these questions to ask residency programs, and you shouldn’t try. Instead:

1. Build a Personalized Shortlist

Before interviews, pick:

• 3–4 questions for the PD
• 4–6 questions for current EM-IM residents
• 2–3 questions for EM faculty
• 2–3 questions for IM faculty
• 1–2 logistical questions for the coordinator

Tailor based on what’s unclear from the website and what matters most to you (e.g., critical care exposure, research, wellness, location).

2. Avoid Redundant or Easily Searchable Questions

Examples of questions to skip asking live (unless you need clarification):

• “How many residents do you take each year?” (usually online)
• “Do you have a didactic curriculum?” (every ACGME program does)

Instead, ask:

• “How are didactics structured specifically for EM-IM residents?”
• “What does attendance and participation look like in practice?”

3. Watch How People Answer, Not Just What They Say

Important cues:

• Do they seem rushed, annoyed, or genuinely interested?
• Are they transparent and specific or vague and defensive?
• Do multiple people give consistent answers about culture, workload, and support?

4. Take Notes Immediately After Interviews

Right after each interview day, jot down:

• Specific quotes or impressions
• Pros and cons in each domain (education, culture, wellness, location)
• Anything that feels like a red flag or strong positive

This will be invaluable when you build your rank list weeks later and programs blur together.

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Common Mistakes to Avoid When Asking Questions

Even strong applicants make avoidable missteps. Watch out for:

1. Asking “What can I do to match here?”

   • Can sound anxious or transactional. Better: “What qualities do you think help residents thrive specifically in your EM-IM program?”

2. Asking questions clearly answered on the website

   • Suggests lack of preparation. Skim the site and program brochure first.

3. Over-focusing on one department

   • If you only ask about emergency medicine or only about internal medicine, it may signal you’re not committed to the combined path.

4. Asking about salary or vacation as your first or only questions

   • Important topics, but should be part of a balanced set of questions that also address education and culture.

5. Using yes/no questions

   • You’ll get shallow answers. Reframe as open-ended:
   • Instead of “Do residents get good ICU exposure?” → “How is ICU exposure structured over the five years for EM-IM residents?”

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Frequently Asked Questions (FAQ)

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

Aim for 2–3 thoughtful questions per interview with faculty or leadership, and 3–5 in group sessions with residents. Quality matters more than quantity. Prioritize questions that help you compare programs and understand whether you’ll thrive there.

2. What are the best “interview questions for them” that show I understand EM-IM combined training?

Examples that resonate strongly with EM-IM programs include:

• “How do you help residents maintain and integrate both EM and IM identities over five years?”
• “What unique opportunities exist here that specifically leverage the dual EM-IM skill set?”
• “How do your EM-IM graduates feel their training has shaped their careers compared to EM-only or IM-only paths?”

These demonstrate insight into the nuances of emergency medicine internal medicine training.

3. Is it okay to ask about fellowship during interviews for EM-IM programs?

Yes—absolutely. Many EM-IM residents pursue fellowships. It’s appropriate to ask:

• “What proportion of your EM-IM graduates pursue fellowship?”
• “How does the program support residents aiming for [critical care/cardiology/ultrasound/etc.]?”

Just balance these questions with others about general training, culture, and support.

4. What should I ask if I’m not yet sure whether I’ll practice more EM, more IM, or a mix?

You can be honest about this uncertainty. Try:

• “How does your program support residents who are still deciding what blend of EM and IM they want in their future careers?”
• “Do you have examples of graduates who chose very different career mixes, and how did the program help them get there?”

Programs know many EM-IM applicants are still exploring. Framing your uncertainty as thoughtful exploration is a strength, not a weakness.

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By preparing strong, targeted questions to ask programs, you’ll not only impress interviewers—you’ll also gather the nuanced information you need to choose the right Emergency Medicine-Internal Medicine combined residency for your goals, personality, and future career.