Essential Questions to Ask During Your Internal Medicine Residency Interviews

Why Your Questions Matter in Internal Medicine Residency Interviews

During internal medicine residency interviews, you are not just being evaluated—you are evaluating programs just as carefully. The questions you ask programs shape how you are perceived and, more importantly, determine whether the program truly fits your goals, values, and learning style.

Thoughtful, specific questions to ask residency programs can:

• Demonstrate genuine interest and preparation
• Show you understand internal medicine residency training structure
• Help you compare programs more accurately for your rank list
• Reveal red flags that may not appear on websites or brochures

This guide focuses on what to ask program directors, residents, faculty, and coordinators in Internal Medicine (IM), with emphasis on:

• Key domains to explore
• Sample questions you can adapt
• How to interpret answers
• Common pitfalls to avoid

Use this as a starting point, then customize questions to each program’s strengths and your own career goals (hospitalist, subspecialty fellowship, primary care, academic medicine, etc.).

---

Strategy First: How to Approach Asking Questions

Before diving into specific interview questions for them, it’s worth outlining an overall strategy.

Clarify Your Priorities

Internal medicine residency programs can all look similar on paper. To make your questions meaningful, first list your top 4–6 priorities. For example:

• Fellowship opportunities and match track record
• Teaching culture and supervision
• Procedural and ICU experience
• Work–life balance and call structure
• Diversity, equity, and inclusion
• Geographic needs (partner, family, visa, etc.)

Your priorities guide which questions you must get answered before rank list time.

Ask the Right Questions to the Right People

Different stakeholders are better suited to answer certain topics:

• Program Director (PD)/Associate PD (APD)
  Curriculum, vision, evaluation, remediation, career development, program culture at the leadership level, response to challenges (like COVID, duty hour changes).

• Chief Residents / Senior Residents
  Day-to-day workflow, call and night float, teaching quality, workload, wellness, how the program’s promises play out in real life.

• Current Interns
  Transition to residency, how supported they feel, actual work hours, how approachable attendings and seniors are.

• Fellows / Subspecialty Faculty
  Fellowship preparation, research opportunities, letters of recommendation, mentorship in IM subspecialties.

• Program Coordinators / Admin Staff
  Logistics, schedule, contract details, relocation support, visa issues, onboarding experience.

Principles for Strong Questions

• Be specific, not generic.
  Weak: “How is your program?”
  Strong: “How has your program changed the inpatient schedule in the last few years based on resident feedback?”

• Ask open-ended questions.
  Avoid yes/no when possible: “Can you describe…?” “How do you…?” “What happens when…?”

• Avoid questions you can easily answer from the website.
  You can reference the website, then go deeper: “I saw on your website that interns rotate in the MICU twice. How does autonomy evolve between the first and second ICU rotations?”

• Ask follow-up questions.
  This shows you’re listening and often reveals the most important information.

---

Questions to Ask Program Directors and Leadership

When you think about what to ask program director and leadership, focus on vision, training philosophy, and support systems. These shape your entire residency experience and your future IM match prospects for fellowship or jobs.

1. Program Vision, Culture, and Leadership Style

These questions help you understand what the program stands for and where it’s headed.

Sample questions:

• “How would you describe the culture of your internal medicine residency in a few words, and what are you doing intentionally to maintain or change that culture?”
• “What distinguishes your program from other internal medicine residency programs in this region?”
• “Can you share a recent change you made in response to resident feedback, and how it impacted the residents’ experience?”
• “How do you see this program evolving over the next 3–5 years? Are there any major curricular or structural changes planned?”
• “How do you support residents who want to innovate—whether that’s in QI, medical education, or curriculum design?”

Things to listen for:

• Concrete examples vs vague platitudes
• Evidence that leadership is responsive and transparent
• Attention to resident input and adaptability

2. Curriculum, Autonomy, and Supervision

You want a program that balances supervision with graduated responsibility.

Sample questions:

• “How is autonomy cultivated across PGY-1 to PGY-3? Can you give examples of what a typical intern versus senior resident is expected to handle independently?”
• “How does supervision work on busy inpatient services and in the ICU? Are attendings generally in-house or home call?”
• “What changes have you made to reduce scut work or non-educational tasks for residents?”
• “How do you ensure residents get enough exposure to both bread-and-butter internal medicine and complex tertiary-care cases?”
• “Are there specific tracks (hospitalist, primary care, research, global health) within the internal medicine residency, and how flexible is it to switch tracks?”

Things to listen for:

• Clarity on expectations at each PGY level
• Protection of educational time (morning report, noon conference)
• Concrete mechanisms to support learning, not just service

3. Evaluations, Feedback, and Remediation

Understanding how you’ll be evaluated and supported is critical.

Sample questions:

• “How are residents evaluated, and how often do they receive formal feedback?”
• “What attributes do your most successful residents tend to share?”
• “If a resident is struggling clinically or academically, what does remediation look like here?”
• “How transparent are milestone evaluations and how are they used to guide growth?”
• “Do residents receive feedback on their teaching skills when they supervise students or interns?”

Things to listen for:

• A structured evaluation system (e.g., milestones, 360 evaluations)
• Non-punitive, supportive approach to remediation
• Culture of feedback (both giving and receiving)

4. Fellowship and Career Outcomes (IM Match Success)

If you’re considering fellowship, you want data and details, not just reassurance.

Sample questions:

• “Where have your recent graduates matched for fellowship, especially in competitive subspecialties like cardiology, GI, and heme/onc?”
• “How does the program support residents aiming for academic vs community careers?”
• “Are there formal mentorship programs for residents interested in specific careers (e.g., hospitalist, primary care, clinician educator, research)?”

Things to listen for:

• Specific fellowship match lists or examples
• Structured mentorship and letter-writing support
• Support for residents who choose primary care or hospitalist roles as well as subspecialties

---

Questions to Ask Residents: The Reality Check

Current residents can answer many of the most important questions to ask residency programs. Their answers reveal what life is actually like beyond the slide deck.

1. Day-to-Day Life, Workload, and Call

These questions uncover daily realities, which strongly impact your wellness and learning.

Sample questions:

• “What does a typical day look like for you on a busy ward month? What time do you usually leave?”
• “How often are duty hours approached or exceeded, and how does leadership respond when that happens?”
• “Can you describe the night float or call system? How manageable are the nights?”
• “How many patients do interns and seniors typically carry on ward and ICU services?”
• “What are the most challenging rotations here, and why?”

Things to listen for:

• Whether reported hours are realistically within ACGME duty limits
• How often residents feel overwhelmed vs appropriately challenged
• Whether there is a “punishing” rotation everyone dreads—and why

2. Education, Teaching, and Learning Culture

Internal medicine is highly cognitive and educationally dense. You want robust, protected teaching.

Sample questions:

• “Are conferences and didactics truly protected time, or are you frequently paged or pulled away?”
• “How is morning report run, and who typically participates (residents, faculty, students)?”
• “Do you feel that attendings at this program are invested in teaching? Can you give examples?”
• “How much exposure do you get to bedside teaching versus lecture-style learning?”
• “How comfortable do you feel asking questions or admitting when you don’t know something?”

Things to listen for:

• Attendance patterns at conferences
• Faculty engagement and enthusiasm for teaching
• Psychological safety and humility within the learning environment

3. Culture, Support, and Wellness

Resident wellness and culture can be decisive in your IM match decision.

Sample questions:

• “How would you describe the resident culture here? Do residents mostly socialize outside of work?”
• “Have there been residents who struggled significantly with workload or personal issues? How did the program respond?”
• “What formal wellness initiatives actually make a difference (not just pizza)? For example, mental health access, coverage for medical appointments, parental leave?”
• “Do you feel comfortable approaching leadership or chiefs when you’re burned out or overwhelmed?”
• “Have you ever considered leaving the program, and what made you stay?”

Things to listen for:

• Honesty about burnout and how it’s handled
• Whether residents seem genuinely supportive of each other
• How approachable leadership truly is

4. Resident Autonomy and Responsibility

Autonomy is crucial in internal medicine training—but it must be paired with safety and support.

Sample questions:

• “Do you feel you have appropriate autonomy on wards and in clinic? Can you share an example where you felt your judgment was trusted?”
• “How are decisions balanced between residents, fellows (if present), and attendings?”
• “Do interns get to do procedures like paracentesis, thoracentesis, central lines? How is this tracked?”

Things to listen for:

• Intern involvement vs just observing
• Whether fellows overshadow residents or enhance their learning
• Concrete systems for logging and ensuring procedural competency

---

Key Domains and Sample Questions for Every Internal Medicine Program

Below is a structured checklist of questions to ask programs in internal medicine, organized by domain. Adapt or select based on what matters most to you.

1. Inpatient and ICU Training

• “How are patients distributed between residents, hospitalists, and advanced practice providers? Does this affect resident case volume or complexity?”
• “What percentage of rotations are inpatient versus outpatient over three years?”
• “How many months of ICU do residents complete, and how is the experience different for interns versus seniors?”
• “Do residents place their own lines, perform intubations, or manage ventilators? Is there a procedure service?”

Red flags:

• Very limited ICU exposure or heavy reliance on non-resident providers for core IM care
• Residents rarely doing standard IM procedures in a categorical IM program

2. Outpatient Continuity Clinic

Internal medicine residency must prepare you for both inpatient and outpatient care, regardless of your fellowship ambitions.

• “Where is continuity clinic located (on campus vs community site), and how often do you go (e.g., 1+4, x+y schedule)?”
• “How many patients do interns and seniors typically see per half-day in clinic?”
• “How supportive is clinic staff with refills, forms, and follow-up calls?”
• “Is there opportunity to experience different clinic settings (VA, community health center, subspecialty clinics)?”

Things to listen for:

• Reasonable clinic patient volumes for learners
• Consistency of preceptors and clear feedback in clinic

3. Research, QI, and Scholarly Activity

If fellowship is a priority, you should dig deep into scholarly opportunities.

• “What proportion of residents are involved in research or QI projects each year?”
• “Is there protected time for research, or is it mostly done on your own time?”
• “Do you have dedicated research mentors or a research director within the department of internal medicine?”
• “Can you share examples of recent resident posters, presentations, or publications?”
• “Is there funding or support to attend conferences (ACP, subspecialty societies) if we present?”

Red flags:

• Vague assurances of research “opportunities” with no structure
• No recent examples of resident scholarship, especially if you seek a competitive fellowship

4. Diversity, Equity, Inclusion, and Patient Population

The diversity of your training environment significantly shapes your competence as an internist.

• “How diverse is your resident and faculty group in terms of background, identity, and experience?”
• “What efforts are in place to recruit and support residents from underrepresented backgrounds?”
• “What is the typical patient population like—urban vs rural, insured vs uninsured, language and cultural diversity?”
• “Are there structured opportunities in health equity, community outreach, or global health for internal medicine residents?”

Things to listen for:

• Specific initiatives (DEI committees, mentorship, affinity groups)
• Thoughtful reflection on caring for underserved populations

5. Logistics, Contracts, and Practical Considerations

Don’t overlook practical questions; they matter to your life outside the hospital.

• “How are schedules made? How much flexibility do residents have for switching or requesting specific vacation times?”
• “How often do schedules change after being posted?”
• “What is parking, commuting, or housing like for residents?”
• “What benefits are included (health insurance, meal stipends, educational funds, exam fees, parental leave policies)?”
• “For IMGs: How does your program handle visas (J-1, H-1B), and has this changed recently?”

Red flags:

• Frequent last-minute schedule changes
• Unclear or inconsistent responses about visas or contracts

---

How to Use These Questions Strategically on Interview Day

Having excellent questions to ask residency programs is only half the battle; how you deploy them matters.

Prioritize 3–5 Must-Ask Questions Per Session

You will not have time to ask everything. For each program:

• Identify 3–5 highest-priority questions for:
  • Program director / leadership
  • Residents (group or 1-on-1)
  • Possibly a coordinator or faculty member

Have extra “backup” questions in case some are already answered during the presentation.

Tailor Questions to Each Program

Use what you know about the program to customize:

• “I read about your hospitalist track. How does participation in that track influence senior year rotations and fellowship or job opportunities?”
• “I noticed your program expanded from 24 to 36 categorical residents in recent years. How has that affected case volume, supervision, and teaching?”

Personalized questions stand out and show you did your homework.

Avoid These Common Question Pitfalls

• Overly self-serving questions too early
  e.g., “How many vacation weeks?” as your first question to the PD. These are important, but better for residents or coordinators.

• Questions easily answered online
  e.g., “Do you have a MICU rotation?” if it’s clearly listed on the website.

• Aggressive or confrontational framing
  Ask about challenges, but with curiosity and professionalism:
  “I’ve heard workload can be intense in many internal medicine residency programs. How does your program monitor and address resident burnout?”

• Asking about salary only to leadership
  Salary questions are reasonable but often better posed to residents or coordinators, unless leadership brings it up first.

Take Notes in a Structured Way

Right after the interview:

• Jot down key impressions: culture, strengths, concerns
• Record specific answers about call, ICU, fellowship outcomes
• Rank your “gut feel” while it’s fresh

These notes are invaluable when building your rank list and comparing programs weeks later.

---

Frequently Asked Questions (FAQ)

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

Aim for:

• Program director/leadership session: 2–4 focused, high-level questions
• Resident-only session: 3–6 questions about daily life, culture, and support
• Faculty or small-group interviews: 1–3 tailored questions each

Be mindful of time and group dynamics. You don’t need to ask a question in every session, but make sure your top priorities are answered by the end of the day.

2. Is it okay to ask directly about fellowship match and board pass rates?

Yes—these are central outcomes of any internal medicine residency. You can phrase them professionally:

• “Would you be willing to share your recent board pass rates and trends?”
• “Could you tell me about your recent fellowship match results and how the program supports residents through the IM match process for subspecialties?”

Look for honest, specific answers and whether the program has strategies in place for improvement if there were challenges.

3. What if my most important question feels ‘negative,’ like about burnout or problem residents?

It’s appropriate and wise to ask about challenges. Focus on how the program responds, not on blaming:

• “How does your program identify and manage resident burnout?”
• “Can you give an example of how leadership has supported a resident going through personal or academic difficulty?”

Programs that answer these questions transparently often have healthier cultures than those that deflect or minimize.

4. Should I ask the same questions at every program, or change them?

Use a core set of comparable questions (e.g., about call structure, ICU time, fellowship outcomes) to allow fair comparison between programs. But also:

• Customize at least a few questions to each program’s unique features
• Adjust based on what’s already been answered in presentations

A mix of standardized and tailored questions helps both your decision-making and your impression on interviewers.

---

Thoughtful, well-placed questions can transform your internal medicine residency interviews from one-way evaluations into true conversations. Use this guide to clarify your priorities, craft specific and meaningful questions to ask programs, and gather the information you need to build a rank list that aligns with your goals, values, and future in internal medicine.