Essential Questions for MD Graduates Pursuing Peds-Psych Residency

Understanding Your Goals Before You Start Asking Questions

Before you think about specific questions to ask residency programs, you need clarity on what you want from a Pediatrics-Psychiatry (Peds-Psych) or Triple Board residency. As an MD graduate from an allopathic medical school, you likely already understand the basics of the allopathic medical school match, but combined programs add unique layers you must explore deliberately.

Clarify Your Training and Career Vision

Ask yourself:

• Do you want to practice primarily as a child & adolescent psychiatrist? A general pediatrician with strong behavioral health skills? Or a blended role in integrated care or systems-level work?
• Are you planning on:
  • Working in academic medicine (teaching, research, leadership)?
  • Primarily clinical outpatient work?
  • Hospital- or system-level leadership in integrated behavioral health?
• How important are:
  • Location and geographic ties?
  • Research opportunities?
  • Work–life balance?
  • Flexibility for fellowships (e.g., Child & Adolescent Psychiatry, Developmental-Behavioral Pediatrics)?

Having this clarity will help you prioritize which interview questions for them (program leadership, faculty, and residents) matter most.

What Makes Peds-Psych and Triple Board Unique

Pediatrics-Psychiatry-Child & Adolescent Psychiatry (“Triple Board”) and other combined training pathways have distinctive structures and cultures:

• Three board-eligible disciplines in five years (for Triple Board)
• Switching between services (Peds ↔ Adult Psych ↔ Child Psych)
• Complex rotation schedules and program coordination
• Unique identity formation—are you “peds,” “psych,” both, or something else?

Your questions should specifically probe how well programs handle:

• Integration across departments
• Resident support during transitions
• Long-term career mentorship for combined training graduates

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Core Questions About Program Structure and Curriculum

Most MD graduate residency applicants focus on lifestyle and reputation; as a Peds-Psych or Triple Board applicant, you must also dig into structure and integration. These questions help you understand what daily life and long-term training really look like.

A. Big-Picture Structure of the Program

Key questions to ask program director or chief residents:

1. “Can you walk me through how the five years (or full program duration) are structured, year by year, across Pediatrics, Adult Psychiatry, and Child & Adolescent Psychiatry?”

   • Listen for: clear structure, logical progression, balanced exposure.
   • Red flag: vague or conflicting descriptions between faculty and residents.

2. “How are rotations scheduled—do we alternate blocks frequently, or are they clustered by specialty?”

   • Insight: Frequent switching can be exciting but cognitively and emotionally taxing; clustered blocks may support deeper learning but may delay integrated experiences.

3. “How is call organized for combined residents, particularly when we’re on pediatric vs psychiatry services?”

   • Clarify:
     • Frequency and intensity of pediatric inpatient call
     • Night float vs 24-hour call
     • Whether call differs significantly from categorical residents

4. “How are ACGME and board requirements for all three disciplines (where applicable) ensured and tracked over time?”

   • You want evidence of:
     • Meticulous tracking
     • Clear understanding of requirements
     • A track record of successful board eligibility

B. Integration Across Disciplines

Combined residents are at risk of feeling like “guests” in multiple departments and fully at home in none. You want to understand how a program supports integrated identity.

Questions to ask during faculty or resident sessions:

1. “How do the Pediatrics and Psychiatry departments collaborate specifically around the combined program?”
   Follow-up:

   • Joint conferences?
   • Shared leadership meetings?
   • Cross-department mentorship?

2. “Are there dedicated didactics or case conferences focused on integrated Peds-Psych or Triple Board topics?”
   Look for:

   • Regular, protected educational sessions
   • Participation from both pediatric and psychiatric faculty

3. “How are combined residents viewed by pediatric and psychiatry faculty—more as ‘peds people,’ ‘psych people,’ or truly dual-trained colleagues in progress?”
   Resident responses here matter more than official program statements.

4. “Do combined residents have roles that uniquely leverage their dual training, such as integrated clinics or liaison roles?”
   Examples:

   • Behavioral health consults on pediatric wards
   • Co-located clinics with pediatricians and psychiatrists

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Questions About Culture, Support, and Resident Experience

The best curriculum can be undermined by a poor culture. As a combined Peds-Psych resident, your experience can be more complex than that of categorical colleagues. Your questions should probe how the program lives its values day-to-day.

A. Resident Support and Wellness

Working across two or three specialties can be exciting but demanding. Burnout risk is real.

Questions to ask current residents:

1. “How does the program support combined residents during transitions between pediatric and psychiatry rotations?”
   Look for:

   • Transitional orientation sessions
   • Extra supervision during early rotations
   • Acknowledgment that switches are challenging

2. “When residents are struggling—academically, personally, or emotionally—what does help actually look like here?”
   Pay attention to:

   • Specific mechanisms (coaching, altered schedules, wellness resources)
   • Actual stories showing follow-through

3. “Do combined residents feel that their unique workload and identity are understood, or are wellness resources more geared toward categorical residents?”

4. “What is the culture around taking vacation, sick days, or leave as a combined resident?”

   • Important for:
     • Parental leave
     • Illness
     • Life events across a 5-year program

B. Program Culture and Psychological Safety

Culture is often best assessed through informal interactions and resident-to-resident conversations.

Questions to ask residents and fellows:

1. “If you had to decide again, would you choose this program?”

   • Follow-up: “Why or why not?”

2. “Can you tell me about a time when a resident raised a concern or gave critical feedback? How did leadership respond?”
   Specific stories reveal far more than generic praises.

3. “Do you feel safe asking questions on rounds or in supervision, or is there pressure to always look ‘on top of it’?”

4. “How do categorical pediatrics and psychiatry residents view the combined residents? As part of the team, or more as outsiders?”

5. “What’s the general tone between faculty and residents—formal and distant, or approachable and supportive?”

C. Identity, Belonging, and Mentorship

A recurring theme in Peds-Psych and Triple Board training is professional identity. You want to know whether you’ll be supported in defining your path.

Questions to ask program leadership and senior residents:

1. “How do you help residents think about and shape their combined-career identity over the five years?”

2. “Are there faculty who are themselves dual- or triple-boarded, and how accessible are they?”

3. “Are there mentorship pairings specifically for combined residents, or do we select mentors across departments?”

4. “What proportion of recent graduates are practicing in roles that actually use all parts of their training?”
   This speaks volumes about how well the program prepares you for the real world.

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Clinical Training, Research, and Career Outcomes: Questions That Reveal the Program’s Strengths

A thoughtful MD graduate residency candidate will go beyond lifestyle and ask concrete questions about training quality and outcomes—especially in a niche pathway like Peds-Psych or Triple Board.

A. Clinical Exposure and Breadth

You’re training to care for complex kids and teens at the intersection of medicine and mental health. You want robust, diverse exposure.

Questions to ask faculty and residents:

1. “What types of pediatric populations do residents see most often—urban underserved, suburban, rural, medically complex, neurodevelopmental, etc.?”

2. “On the psychiatry side, what is the balance among inpatient, outpatient, consult, emergency, and subspecialty child/adolescent experiences?”

3. “Do residents get meaningful exposure to integrated behavioral health models, such as co-located or collaborative care in pediatric clinics?”

4. “How are residents trained to manage medically complex children with overlapping developmental, neurologic, and psychiatric needs?”
   Example: kids with autism and epilepsy, medically complex PICU survivors with PTSD, etc.

5. “Are there formal experiences with school systems, child welfare, or juvenile justice, given their impact on pediatric mental health?”

B. Teaching, Supervision, and Feedback

Questions to ask program director or core faculty:

1. “How is supervision structured on each type of rotation? How available are attendings for real-time coaching?”

2. “How often do residents receive formal feedback, and is it integrated across pediatric and psychiatric evaluations?”

3. “Do combined residents receive targeted teaching on topics unique to our role—for example, psychotropic prescribing in medically complex children?”

4. “How much autonomy do senior residents have, especially in integrated or consultation roles?”

C. Research, Scholarship, and Academic Development

If you foresee an academic or leadership pathway, this section is critical.

Questions to ask research mentors, faculty, or PD:

1. “What are some common scholarly or QI projects that combined residents have completed recently?”
   Ask for examples specifically by combined residents, not just categorical.

2. “Are there protected research blocks or elective time that can be used for academic work?”

3. “How easy is it to find a research or QI mentor who understands the integrative aspects of Peds-Psych or Triple Board?”

4. “What support exists for presenting at national meetings (AACAP, APA, PAS, etc.)—funding, time, coaching?”

D. Board Performance and Career Paths

For a combined MD graduate residency, the stakes are higher: you’re aiming for up to three boards.

Essential questions to ask program leadership:

1. “What has been your board pass rate over the last 5–10 years in Pediatrics, Psychiatry, and Child/Adolescent Psychiatry for combined residents?”

2. “Where have your recent graduates gone—what types of positions and settings?”
   Look for:

   • Integrated clinics
   • Academic child psychiatry
   • Pediatric primary care with behavioral focus
   • Leadership or systems work

3. “If a resident decides midway to pivot—e.g., not to sit for all three boards—how flexible is the program in supporting that transition?”
   Programs should be honest about pathways and constraints.

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Logistical, Lifestyle, and Hidden-Curriculum Questions

Even the most intellectually appealing program may not be a good fit if the day-to-day realities don’t work for you. These are some of the most practical, high-yield questions to ask residency programs that applicants often overlook.

A. Schedule, Workload, and Flexibility

Questions to ask senior residents:

1. “What does a typical week look like on a busy pediatric inpatient month versus a psychiatry outpatient month?”
   Ask for:

   • Start/end times
   • Number of clinic sessions
   • Documentation load
   • Call frequency

2. “How often do you feel you have time to read or study during rotations?”
   This is a good proxy for workload and efficiency.

3. “How are duty hours monitored and enforced, especially when you’re balancing expectations from two departments?”

4. “Are there opportunities for schedule flexibility—e.g., for parental leave, illness, or academic travel—and how often are such requests accommodated?”

B. Financial and Geographic Considerations

Especially in a 5-year training path, finances and location matter more.

Questions to ask program coordinator or GME office:

1. “What are the salary and benefits, and do they change over the 5 years?”

2. “Are there additional financial supports for combined residents, such as conference travel, board preparation resources, or exam fees?”

3. “Are there any relocation stipends, childcare resources, or housing assistance programs for residents?”

4. “What is the cost of living like in this area, and where do most residents choose to live?”

C. Program Stability and Vision

For a long, integrated training path, program stability and leadership vision are critical.

Questions to ask program director or associate program director:

1. “How long has the combined Peds-Psych or Triple Board program been established, and how has it evolved over time?”

2. “What changes or innovations are you hoping to implement over the next 3–5 years?”

3. “How stable is the leadership team, and how involved are they in day-to-day resident education?”

4. “Can you share an example of resident feedback that led to a concrete program change in the last couple of years?”

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How to Ask Questions Strategically on Interview Day

Knowing what to ask residency programs is only half the equation; how you ask matters as well. Thoughtful, well-targeted questions signal maturity, insight, and genuine interest—especially in a nuanced field like combined Peds-Psych training.

Tailoring Questions to the Audience

• Program Director / Associate Program Director

  • Focus on: curriculum, vision, board outcomes, program culture at a high level.
  • Example:
    • “What do you see as the unique strengths of your Peds-Psych pathway compared with other Triple Board programs nationally?”
    • “If you could change one thing about the program but can’t yet due to resources or system constraints, what would it be?”

• Faculty Interviewers

  • Focus on: clinical teaching, supervision style, research or niche interests.
  • Example:
    • “How do you approach teaching combined residents differently from categorical residents?”
    • “What kinds of projects have you mentored combined residents on?”

• Current Residents

  • Focus on: day-to-day reality, culture, support, hidden curriculum.
  • Example:
    • “What surprised you most about the program after you started?”
    • “What has been your most challenging rotation so far, and how did the program support you?”

• Program Coordinator

  • Focus on: logistics, onboarding, schedules, licensure, exam planning.

Framing Your Questions Effectively

• Lead with curiosity, not critique.
  Instead of:

  • “Why are the call schedules so demanding?”
    Try:
  • “Can you help me understand how the call schedules are designed and how residents experience them?”

• Use your goals as context.

  • “I’m very interested in integrated outpatient care long-term. How does your program help residents build that skillset and those connections?”

• Prioritize open-ended questions that invite stories rather than yes/no answers.

  • “Can you tell me about…”
  • “How do residents typically handle…”
  • “What happens when…”

Pre-Interview Prep: Your Personal Question Bank

To avoid feeling overwhelmed, create a short, prioritized list you can adapt on the fly:

• 3–4 must-ask questions for program leadership
• 3–4 for current residents
• 2–3 specifically about combined training logistics
• 1–2 about your unique interests (e.g., research, advocacy, global health)

Rotate through questions across interview days so you can compare responses between programs without sounding scripted or repetitive.

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FAQs: Questions to Ask Programs for MD Graduate in Pediatrics-Psychiatry

1. As an MD graduate from an allopathic medical school, should I ask different questions than DO or IMG applicants?
Your core questions about curriculum, culture, and integration are similar, regardless of background. However, as an MD graduate residency applicant from an allopathic medical school, you may be especially attuned to:

• How the program’s graduates perform in the allopathic medical school match for subsequent fellowships (if applicable)
• Academic expectations and research infrastructure
  Focus less on your degree type and more on your specific interests in Peds-Psych and Triple Board training.

2. What are the most high-yield “must-ask” questions if time is limited?
If you only have time for a few, consider:

• “How are the years structured across Pediatrics, Psychiatry, and Child & Adolescent Psychiatry, and how does that shape resident identity?”
• “How do combined residents fit into the culture of both departments, and how are they supported during rotations switches?”
• “What do your recent graduates typically do, and how are they using their combined training?”
• “Can you give an example of resident feedback that led to a meaningful program change recently?”

3. How can I tell if a Peds-Psych or Triple Board program is truly supportive versus just sounding good on paper?
Look for:

• Consistency between what leadership and residents say
• Specific stories that show follow-through on resident concerns
• Transparent discussion of challenges (e.g., workload, identity confusion) paired with concrete support strategies
• Clear, trackable outcomes: board pass rates, jobs that genuinely use combined training

4. What should I avoid asking on interview day?
Avoid:

• Questions whose answers are clearly available on the website (e.g., “How many residents per year?”).
• Overly aggressive or adversarial questions (“Why are your board scores lower than other programs?”).
  Instead, frame such concerns constructively:
• “I noticed some variability in board outcomes nationally for combined programs—how do you support residents with exam preparation across three disciplines?”
  Also avoid detailed salary or vacation questions in your very first faculty interview; those are usually better for coordinator or resident chats later in the day.

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Thoughtfully chosen questions will not only help you compare programs; they will also signal to interviewers that you understand the complexity and potential of Pediatrics-Psychiatry and Triple Board training. Center your own goals, listen for concrete examples, and look for alignment between what’s promised and what residents actually experience. That alignment is where you’ll find the program that truly fits you.