Essential Questions for US Citizen IMGs in PM&R Residency Interviews

Why Your Questions Matter as a US Citizen IMG in PM&R

As an American studying abroad or a US citizen IMG, you already know: getting an interview is hard-won. Once you’re in the (virtual or in‑person) room, how you use your time matters just as much as how you answered “Tell me about yourself.”

Thoughtful, targeted questions to ask residency programs are one of your most powerful tools to:

• Demonstrate genuine interest in Physical Medicine & Rehabilitation (PM&R)
• Show that you understand the realities of being a US citizen IMG
• Clarify whether a program can truly support your goals, learning style, and visa/career needs
• Stand out from other applicants by sounding like a future colleague, not a passive observer

This guide focuses specifically on questions to ask PM&R residency programs as a US citizen IMG / American studying abroad, and how to use them strategically throughout interview season. You’ll get:

• Themed question banks for faculty, program directors, residents, and coordinators
• IMG‑specific questions that are professional (not defensive or apologetic)
• Examples of what to listen for in responses
• Guidance on virtual vs in‑person interviews
• A quick‑hit FAQ at the end

Use this as a customizable toolkit, not a script. The best questions are the ones that align with your own priorities in physiatry.

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Core Strategy: How to Choose the Right Questions

Before jumping into specific questions, it helps to understand why certain questions land better than others—especially in PM&R and especially as a US citizen IMG.

1. Show you understand PM&R as a specialty

Physiatry is misunderstood by many applicants. Strong questions:

• Reflect awareness of functional outcomes, interdisciplinary care, and longitudinal rehab
• Acknowledge the breadth of practice: inpatient rehab, outpatient musculoskeletal, interventional pain, neurorehab, EMG, sports, spine

Weak questions:

• Could apply to any specialty (“How many ICU months do we do?” at a rehab‑heavy program with minimal ICU exposure)
• Make it sound like you don’t understand what physiatrists actually do day‑to‑day

2. Highlight your identity as a US citizen IMG—without centering your “deficit”

Programs already know you’re an IMG. Your questions should:

• Emphasize your strengths (adaptability, cross‑cultural experience, maturity)
• Clarify whether they support IMGs, including Americans studying abroad
• Avoid sounding defensive (“Will I be treated differently because I’m an IMG?”) and instead be curious and solution‑oriented

3. Tie questions to your long‑term goals

You’ll stand out more if you show you’re thinking past residency:

• Fellowship (sports, pain, SCI, TBI, pediatrics, EMG)
• Academic vs community practice
• Desire to work in the US long-term (even though you’re a citizen, you may still be seen as an “outside” trainee initially)

This turns generic interview questions for them into career‑focused discussions, which programs really appreciate.

4. Plan questions by audience

Have different sets of questions ready for:

• Program Director (PD) / Associate PD – big‑picture vision, outcomes, support
• Faculty – teaching, feedback, clinical practice style
• Residents – culture, workload, real‑world experience
• Program Coordinator – logistics, benefits, practical details

Then adjust based on what’s already been answered during the day.

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High‑Impact Questions for Program Directors and Faculty

The program director is the person whose vision shapes everything—from curriculum to how IMGs are perceived. This is where you should focus your most strategic questions.

A. Questions About Training Quality and Scope (PM&R‑Specific)

These show you understand the breadth of physiatry and care about your future competence.

1. Inpatient vs Outpatient Balance

• “How would you describe the balance between inpatient rehab and outpatient experiences over the four years?”
• “By graduation, what kind of patient mix do most residents feel most comfortable managing—neurorehab, musculoskeletal, interventional pain, EMG?”

What to listen for:
Clear structure, not vague answers. Strong programs can describe specific rotations and how they produce well‑rounded physiatrists.

2. Exposure to Core PM&R Domains

• “What opportunities are there for advanced exposure to subspecialty areas such as spinal cord injury, TBI, pediatrics, and sports or interventional spine?”
• “If a resident is interested in building a strong foundation in EMG or ultrasound‑guided procedures, how do you help them achieve that?”

3. Longitudinal and Interdisciplinary Care

• “In what ways do residents participate in longitudinal care—following patients from acute care through inpatient rehab to outpatient follow‑up?”
• “How integrated are residents with PT/OT/speech and other members of the rehab team in daily practice?”

What to listen for:
Examples of interdisciplinary rounds, family conferences, and consistent follow‑up clinics.

B. Questions About Educational Culture and Feedback

These questions help you evaluate whether the environment is supportive—particularly important for a US citizen IMG adjusting to a new system.

4. Feedback and Remediation

• “How is feedback delivered to residents here—formally and informally? How often do residents get direct feedback about their performance?”
• “If a resident is struggling in a particular area—for example, documentation or efficiency—what kind of support or remediation process is available?”

5. Teaching and Supervision Style

• “Could you describe the culture of supervision here—how do you balance resident autonomy with attending support, especially in busy inpatient or procedural settings?”
• “How do you ensure that junior residents get enough hands‑on experience, particularly with procedures, in a way that feels safe for patients and learners?”

6. Curriculum Adaptability

• “How has the curriculum changed in the last 3–5 years, and what changes do you anticipate in the next few years?”
• “How do resident evaluations or suggestions actually shape program changes?”

Programs that welcome resident feedback and can cite recent changes (e.g., adding MSK ultrasound workshops, protected didactic time) are often healthier learning environments.

C. US Citizen IMG–Focused Questions (Subtle but Direct)

You want to learn how IMGs are supported, but frame it in a way that reflects your professional goals.

7. Experience with US Citizen IMG Trainees

• “I’m a US citizen who completed medical school abroad. How has the program supported US citizen IMG residents in the past in terms of orientation to the US system, documentation expectations, and academic success?”
• “Have previous residents with non‑US medical school backgrounds had any specific challenges, and how has the program helped them overcome those?”

8. Integration and Perception

• “How does the program help all residents—regardless of background—integrate into the team culture early in PGY‑2 and PGY‑3 years?”
• “Are there any particular resources or check‑ins that help new residents adjust to your documentation and EMR expectations?”

What to listen for:
Concrete examples (“We pair new residents with senior mentors,” “We have an EMR boot camp,” “We’ve had several successful US citizen IMGs who went on to strong fellowships”), not vague reassurances.

D. Questions About Outcomes and the Physiatry Match

9. Fellowship and Job Placement

• “Where have your residents gone after graduation over the last few years—both in terms of fellowships and first jobs?”
• “For residents who want to pursue competitive fellowships, such as sports, interventional spine, or SCI, how does the program help them be strong candidates?”

10. Research and Academic Development

• “What types of research or scholarly projects are most accessible for residents here—clinical, QI, education, basic science?”
• “How do you support residents who are starting with little research exposure, especially those like me who did medical school abroad and may not be as familiar with US research infrastructure?”

Your goal is to see if graduating from this program will open doors in the wider PM&R world and how they practically help you get there.

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Resident‑Level Questions: Getting the Real Story

Current residents will give you the most authentic view of how the program functions day‑to‑day. For a US citizen IMG, this is where you can ask more practical and culture‑focused questions.

A. Questions About Culture and Support

1. How Residents Actually Treat Each Other

• “How would you describe the relationship between residents across different years—collaborative, independent, competitive?”
• “Can you tell me about a time when a resident was having a hard rotation or personal challenge, and how the program or co‑residents supported them?”

2. Wellness and Burnout

• “What are the most challenging aspects of this program, and what helps you get through those periods?”
• “Do you feel like you can actually use your days off, or is there a culture of working on days off to catch up?”

3. IMG Experience from the Resident Perspective

Even if there are no current US citizen IMGs, there may be other IMGs whose experience overlaps with yours.

• “Have there been residents from non‑US medical schools? How have they integrated into the team and academic environment?”
• “From your perspective, are there any unspoken expectations or norms that were harder for IMG colleagues to learn, and how did they figure those out?”

B. Questions About Workload, Autonomy, and Learning

4. A Typical Day and Week

• “What does a typical day look like for you on inpatient rehab? What about on busy outpatient rotations?”
• “How many patients do you usually carry on the busiest inpatient services? Does that feel manageable for learning?”

5. Autonomy vs Oversight

• “On call or on busy services, do you usually feel well‑supervised, or are there times where you feel like you’re functioning above your comfort level?”
• “When you have a clinical question, how easy is it to reach an attending or senior resident?”

6. Procedural and EMG Experience

• “By the end of residency, how comfortable do most of you feel with common procedures—joint injections, trigger point injections, EMG, ultrasound‑guided interventions?”
• “Do residents feel they have to compete for procedures, or is there enough volume for everyone?”

C. Questions About Life Outside the Hospital

As a US citizen IMG, you may be relocating back to the US after years abroad. Understanding the city and lifestyle is key.

• “How livable is the area on a resident salary—housing, commuting, cost of living?”
• “Do most residents have time and ability to pursue hobbies or family life outside of work?”
• “If someone is moving back to the US after several years abroad, what do you think would be most helpful for them to know about living here and working in this system?”

These are subtly IMG‑aware questions—they acknowledge your unique transition without overemphasizing it.

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Program Logistics, IMG Nuances, and What to Ask the Coordinator

Program coordinators and administrative staff are often underutilized sources of crucial information—especially for American studying abroad applicants navigating re‑entry into the US system.

A. Practical and Schedule‑Related Questions

• “How are call schedules typically built, and how much say do residents have in their schedules?”
• “Are there options for vacation timing flexibility—for example, for residents with family obligations abroad?”

Even though you’re a US citizen, if you have family outside the US, this can be important.

B. Orientation and Onboarding Support

• “What does orientation look like for incoming residents, especially those who may be less familiar with your EMR or hospital system?”
• “Are there any pre‑start resources (policies, documentation examples, order sets) that PGY‑2s find especially helpful to review?”

C. Administrative Support for US Citizen IMGs

While you don’t need visa sponsorship, there are still logistic nuances for Americans who studied abroad.

• “Have you had recent residents who completed medical school abroad? Are there any additional steps or timelines they should be aware of regarding onboarding, credentialing, or documentation?”
• “Do you recommend anything specific for applicants who trained internationally to help their transition go more smoothly—either before starting or in the first few weeks?”

You’re looking for awareness and experience, not perfection. Programs that already have systems for non‑traditional residents tend to be more flexible and supportive.

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Tailoring Questions to Highlight Your Strengths as a US Citizen IMG

You can use questions strategically to subtly market your strengths while still genuinely seeking information.

1. Frame questions around your interest in physiatry and patient populations

If you’re drawn to neurorehab, for instance:

• “I’m particularly interested in working with patients after stroke or TBI. How early in residency do we get meaningful exposure to these populations, and are there opportunities to follow them longitudinally?”

This both communicates your focus and prompts specific program details.

2. Use your international background as an asset

• “Having trained abroad, I’ve worked with very diverse patient populations and different healthcare systems. How do residents here engage with culturally and linguistically diverse patients, and are there community outreach or advocacy opportunities?”

This reframes “IMG” from a risk factor into a resource.

3. Ask about mentorship in a way that shows initiative

• “What does mentorship look like here? For example, if I know I’m interested in outpatient MSK and interventional spine, how early could I be paired with mentors in that area?”
• “Are there any faculty who have a special interest in supporting non‑traditional or IMG trainees?”

Programs like to see that you’re already thinking about how to build your path proactively.

4. When (and how) to ask about board performance

Board pass rates matter, especially if you had to adapt to different exam styles abroad.

• “How does the program support residents in preparing for the PM&R board exam—for example, structured board review, question banks, or protected study time?”
• “If residents have struggled with in‑training exams, what additional support is made available?”

You don’t need to ask, “What’s your pass rate?” directly unless it isn’t published, but you can. If you do, frame it professionally:

• “I didn’t see board pass rates listed on the website—would you be open to sharing how residents have done on boards over the last several years?”

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Putting It All Together: Interview Day Strategy and Question Etiquette

A. How Many Questions Should You Ask?

Aim for:

• 2–3 thoughtful questions for the PD
• 1–2 questions per faculty interviewer
• 3–5 questions for resident Q&A sessions
• 1–2 practical questions for the coordinator (often via email if time is short)

Quality matters much more than quantity. It’s okay to say, “You’ve already answered many of my planned questions; I have one more that hasn’t been covered…”

B. Adapting on the Fly

Avoid asking something that was clearly covered in the program overview talk. Instead:

• “Earlier you mentioned that residents have significant EMG exposure in PGY‑3. Could you elaborate on how that’s structured and how comfortable graduates feel interpreting EMGs independently?”

This shows active listening and critical thinking.

C. Questions You Should Generally Avoid

• Anything that sounds like you haven’t read the website
  (“What’s your call schedule?” when it’s in a big slide or brochure)
• Overly confrontational IMG questions
  (“Why do you take so few IMGs?” – can be rephrased more constructively)
• Overly personal questions about interviewers (family status, etc.)

If you want to explore IMG friendliness more diplomatically, try:

• “I noticed the current resident list doesn’t show many graduates from international medical schools. How do you see applicants with non‑US medical school backgrounds fitting into your program?”

D. Virtual vs In‑Person Considerations

For virtual interviews:

• Ask a specific question about how they’ve adapted educationally:
  “How has the program maintained a sense of resident community and teaching quality in the context of increased virtual meetings or telehealth?”

For in‑person interviews:

• Use visual context:
  “I noticed the rehab gym is very busy. How involved are residents in direct collaboration with PT/OT during sessions like these?”

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FAQ: Common Questions About What to Ask PM&R Programs as a US Citizen IMG

1. As a US citizen IMG, should I directly ask programs about how they view IMGs?

You can, but focus on support and success stories, not “Do you like IMGs?” Better versions include:

• “How have residents from non‑US medical schools done here—academically, clinically, and in terms of fellowships or jobs?”
• “Are there any specific resources or orientation elements for residents new to the US training environment?”

These yield more useful information and sound more professional.

2. What are good “interview questions for them” that work at almost any PM&R program?

A few universally strong questions:

• “If you could change one thing about the program right now, what would it be, and what steps are being taken in that direction?”
• “What characteristics do your most successful residents tend to share?”
• “When graduates look back a few years out, what do they say they appreciated most about training here—and what do they wish had been different?”

These questions show big‑picture thinking and often yield candid, program‑specific insights.

3. What should I ask if I’m especially interested in a PM&R fellowship (e.g., sports, pain, SCI)?

Target questions toward fellowship preparation and opportunities:

• “How does this program position residents for competitive fellowships, such as sports or interventional spine?”
• “Are there home fellowships, and how do residents here tend to match into them?”
• “What kind of case volume and mentorship would I get to build a strong application in [fellowship area]?”

Listen for real outcomes (match lists, faculty advocacy) rather than just enthusiasm.

4. Is it okay to ask what to ask the program director specifically?

You generally don’t ask them what to ask; you use the PD for big‑picture, future‑facing questions, such as:

• “Where do you see the program in 5 years, and how do you see incoming residents contributing to that vision?”
• “What personal qualities are you most looking for in residents who will thrive here?”

These signal maturity and help you gauge fit.

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Thoughtful, well‑targeted questions are not just a formality; they’re a powerful signal of who you’ll be as a colleague and learner. As a US citizen IMG in PM&R, you bring unique experiences and perspectives—use your questions to highlight that, to evaluate programs honestly, and to choose a training environment where you can become the physiatrist you envision.