Essential Questions for US Citizen IMGs in Med-Peds Residency Interviews

As a US citizen IMG and an American studying abroad, you bring a unique profile to the Medicine-Pediatrics (Med-Peds) match. You’ve worked hard on USMLEs, clinical rotations, and your ERAS application—but what you ask programs during interviews and open houses can strongly influence both how you are perceived and how well you choose a program.

This guide focuses entirely on questions to ask programs—questions tailored to US citizen IMGs interested in Med-Peds residency. You’ll find structured, practical suggestions, along with context on why each question matters and how to adapt them to your specific situation.

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Why Your Questions Matter as a US Citizen IMG in Med-Peds

Programs evaluate you not only by how you answer their questions, but also by the quality, insight, and maturity of the questions you ask. Thoughtful questions signal:

• You understand the unique nature of Med-Peds (not just “half medicine, half peds”).
• You’ve reflected on how being a US citizen IMG shapes your training needs.
• You are genuinely interested in their program, not just “any spot.”

For you, strong questions help you determine:

• Will this program support my IMG background and transition into US training?
• Does the culture feel collegial, supportive, and resident-focused?
• Will I graduate prepared for my career goals (hospitalist, primary care, fellowship, global health, etc.)?

Think of each question as doing double duty:

1. Signaling to the program who you are and what you value.
2. Gathering data you’ll need when building your rank list.

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Strategic Framework: Who to Ask and When

Before diving into specific examples, it helps to organize your questions by audience and purpose.

Audiences to Target

1. Program Director (PD) / Associate PD
   • Big-picture philosophy, curriculum, outcomes, support for IMGs, career development.
2. Residents (especially Med-Peds residents)
   • Real culture, workload, wellness, hidden strengths/weaknesses.
3. Faculty / Core Med-Peds Faculty
   • Mentorship, research, Med-Peds identity, education quality.
4. Program Coordinator / Administrative Staff
   • Logistics, visa issues for non-citizen peers (helps you gauge IMG-friendliness), onboarding, schedules.

Timing Across the Interview Season

• Before the interview: Use websites, social media, and open houses to generate program-specific questions.
• During formal interview: Higher-level and strategic questions for PDs and faculty.
• Resident meet-and-greets / social events: Honest, detailed “day-in-the-life” questions.
• Post-interview communication: Clarifications and specific follow-up that helps you distinguish similar programs.

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High-Yield Questions to Ask the Program Director and Leadership

When you think about what to ask the program director, aim for questions that show insight into Med-Peds training and your IMG-specific perspective. You can’t ask everything; pick 3–5 that matter most to you.

1. Questions About Program Philosophy and Med-Peds Identity

Use these to show you understand Med-Peds as a distinct specialty:

• “How would you describe the identity and role of Med-Peds physicians within your institution?”
  Why it matters: Reveals whether Med-Peds is truly integrated or treated as an afterthought among categorical IM and pediatrics programs.

• “What distinguishes your Med-Peds program from your categorical Internal Medicine and Pediatrics programs?”
  Signals you understand that synergy and integration are core to Med-Peds.

• “How do Med-Peds graduates from your program typically practice—more in adult medicine, pediatrics, a mix, or subspecialty care?”
  This helps ensure your career goals (primary care vs hospitalist vs fellowship) align with their training outcomes.

2. Questions About Curriculum Structure and Flexibility

Highlight that you’re thinking about your long-term development:

• “How is the switching between medicine and pediatrics structured, and how do you support residents through those transitions?”
  As a US citizen IMG, adapting to two systems can be intense; look for formal orientation or buddy systems.

• “Are there opportunities to tailor the curriculum—for example, additional rotations in med-peds continuity care, global health, or combined subspecialty experiences?”
  Shows initiative and interest in shaping your training.

• “How does your program incorporate transitions of care for adolescents and young adults who move between pediatric and adult services?”
  This tests whether the program is truly focused on the unique strengths of Med-Peds.

3. Questions About Support for US Citizen IMGs and Onboarding

Because you’re an American studying abroad, you want to know how they handle the transition:

• “How have you supported US citizen IMGs or non-traditional graduates adjusting to your training environment?”
  Look for specific examples—orientation, extra supervision early on, mentorship, feedback.

• “Are there any structured resources for residents who trained abroad, such as additional EMR training, simulation, or guidance on documentation and billing?”
  This question shows self-awareness and signals that you want to be proactive in addressing potential gaps.

Even though you don’t need a visa, how they treat IMGs overall is revealing:

• “What has been your experience training IMGs in your program, and what strengths do you think they bring?”
  Their answer will tell you a lot about program culture and bias (or lack thereof).

4. Questions About Evaluations, Feedback, and Remediation

As an IMG, clear expectations and early feedback are crucial:

• “How do residents receive feedback, and how early would a struggling resident be identified and supported?”
  You’re probing for a learning culture vs a punitive culture.

• “Can you describe your approach to remediation or extra support if a resident is having difficulty on a rotation or with exams?”
  You want a program that sees remediation as educational, not stigmatizing.

5. Questions on Career Outcomes, Fellowship, and Job Placement

Because Med-Peds graduates have many paths:

• “What have your recent Med-Peds graduates gone on to do, and how does the program support different career paths—primary care, hospitalist roles, combined fellowships, or academic careers?”

• “How do you advise residents interested in fellowships, especially combined or less common fellowships for Med-Peds graduates?”

• “Do your graduates have any difficulty marketing themselves as Med-Peds physicians to employers, and how do you support that transition?”

These questions help you judge whether the program truly prepares you for the real world as a dual-trained physician.

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Questions to Ask Current Residents: Day-to-Day Reality and Culture

Residents will often give you the most honest, practical information. Ask questions that get beyond the brochure.

1. Workload, Schedule, and Balance Between Medicine and Pediatrics

• “How does the call schedule and workload compare between your medicine and pediatrics rotations?”
  Listen for whether one side is chronically heavier or more stressful.

• “Are there particular rotations that Med-Peds residents find especially challenging, and how does the program help you get through them?”

• “How manageable is it to maintain life outside the hospital here—family, hobbies, wellness?”
  You want specifics: “I can usually do X on post-call days,” not vague “We value wellness.”

2. Program Culture, Support, and IMG Friendliness

As a US citizen IMG, you want to know how it feels to be here:

• “How integrated do you feel between the medicine and pediatrics sides? Do you feel truly part of both departments?”

• “How supportive have attendings and seniors been when you’re learning the system or EMR—especially early in intern year?”

• “Have there been other US citizen IMGs or IMGs in general in the program? How have they adjusted?”
  Ask for examples: “Our PGY-3 did med school in the Caribbean and…” gives you real insight.

• “If you had to start intern year again, what do you wish you had known about this program or city?”

3. Education, Teaching, and Autonomy

• “How consistent is the teaching on the wards and in clinic? Do attendings make time for bedside teaching?”

• “Do you feel you have the right balance between supervision and autonomy—especially when switching between medicine and pediatrics rotations?”

• “How is your continuity clinic structured on both the adult and pediatric sides, and do you feel you’re graduating confident in outpatient care?”

This is essential in Med-Peds, where you need strong skills in both inpatient and outpatient across the age spectrum.

4. Well-Being, Burnout, and Resident Voice

• “What does the program actually do—beyond words—to address wellness and burnout?”
  Look for tangible examples: protected wellness time, mental health access, schedule changes based on feedback.

• “Do residents feel comfortable giving honest feedback to leadership? Can you recall a time when resident feedback led to a real change?”

Those specific examples reveal whether residents’ voices are truly heard.

5. City, Cost of Living, and Community

Especially relevant if you’re returning to the US after several years abroad:

• “How has it been adjusting to living in this city, especially on a resident salary?”

• “Do residents tend to live near the hospital? Is commuting a big part of daily life?”

• “How would you describe the relationship between Med-Peds residents and the local community or patient population?”

For many US citizen IMGs, the interview season is also a chance to re-assess where you’d like to live long-term.

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Med-Peds–Specific Topics You Shouldn’t Forget to Ask About

As someone focused on a Med-Peds residency, you want questions that go beyond generic internal medicine or pediatrics issues.

1. Combined Identity and Clinical Opportunities

• “How do you ensure that Med-Peds residents see truly combined patient populations, such as complex adolescents transitioning to adult care?”

• “Are there dedicated Med-Peds clinics or transition clinics, and what’s the Med-Peds presence in subspecialty services?”

• “How do faculty model the unique role of Med-Peds physicians for residents and other services?”

These questions highlight that you aren’t just seeking “two residencies” but a cohesive combined training.

2. Rotation Structure and Switching Frequency

Med-Peds programs vary in how often you switch between medicine and pediatrics:

• “How often do residents switch between medicine and pediatrics blocks, and how does that impact continuity, learning, and personal life?”

• “Do you group certain rotations (e.g., ICU, wards) to minimize disruption, or are switches frequent throughout the year?”

If you think frequent transitions will be hard as you adjust to US training, you might favor programs with longer blocks.

3. Mentorship and Role Models in Med-Peds

• “What does mentorship look like for Med-Peds residents—formal mentors, informal mentoring, or both?”

• “How many core Med-Peds faculty are there, and are they visible in leadership roles within the hospital?”

• “If I were interested in [insert your interest: global health, hospital medicine, fellowship, underserved care], which faculty would you connect me with?”

Asking for names or concrete connections shows you’re already envisioning yourself in the program.

4. Research, Scholarship, and QI Opportunities

Even if you’re not aiming for fellowship yet, having options matters:

• “What kinds of research or quality improvement projects have recent Med-Peds residents been involved in?”

• “Is there protected time or structured support for scholarly work, especially for residents pursuing the Medicine Pediatrics match who may want to keep fellowship options open?”

• “How do you support residents with less research experience, including US citizen IMGs who may not have had many opportunities abroad?”

Programs that can articulate a clear pathway for you to build a portfolio are a plus.

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Practical Tips: How to Use These Questions Effectively

Having a long list of questions is only helpful if you can deploy them strategically.

1. Prioritize 3–5 Core Themes for Each Program

Examples of core themes you might choose:

• Support for US citizen IMGs and onboarding.
• Strength of Med-Peds identity and integration.
• Workload and wellness.
• Career outcomes and fellowship options.
• Location and lifestyle.

Select 1–2 key questions under each theme so you don’t overwhelm the interviewer.

2. Make Your Questions Program-Specific

Generic:

• “Do you have research opportunities?”

Program-specific:

• “I saw on your website that your Med-Peds residents are involved in a transition-of-care QI project. How do residents typically get involved in projects like that, especially early in residency?”

Program-specific questions show genuine interest and preparation—especially important for an American studying abroad who may not have had as many chances for in-person networking.

3. Turn Questions into Conversations, Not Checklists

If an interviewer answers broadly, follow-up with:

• “Can you give an example of…?”
• “How did residents respond when…?”
• “What changed after that feedback?”

The best interview questions for them create a back-and-forth dialogue, not a rigid Q&A.

4. Avoid Questions with Obvious Website Answers

Don’t waste valuable PD time asking:

• “How many residents are in your program?”
• “What’s your board pass rate?” (if clearly listed)

Instead, build on what you already know:

• “I noticed your board pass rate has been strong. What specific strategies do you think contribute most to that success?”

5. Keep Notes Immediately After Each Interview

After each interview day, jot down:

• Specific strengths that stood out.
• Any concerns raised by residents’ answers.
• Your overall gut feeling.

Use your notes to compare programs later, especially when multiple Medicine-Pediatrics programs start to blend together in your memory.

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Sample Question Sets You Can Adapt

Here are a few ready-made bundles of questions tailored to different situations. You can customize them with your own details.

A. If You’re a US Citizen IMG Interested in Primary Care Med-Peds

Ask the PD/faculty:

• “How does your program prepare Med-Peds residents for a primary care–focused career that spans both adults and children?”
• “What is the structure of your continuity clinics, and how much exposure do residents have to complex chronic care and underserved populations?”
• “Do you have any graduates currently practicing as combined Med-Peds primary care physicians in this area, and what has their experience been?”

Ask residents:

• “Do you feel confident managing bread-and-butter outpatient issues for both children and adults when you graduate?”
• “How easy is it to see the long-term follow-up of your own continuity patients across both age groups?”

B. If You’re Considering Fellowship After Med-Peds

Ask the PD/faculty:

• “What proportion of your recent Med-Peds graduates pursued fellowship, and which specialties were most common?”
• “How does the program support residents in obtaining strong letters and research experiences—particularly for those who may not have extensive research backgrounds from medical school abroad?”
• “Have any graduates from your program pursued combined fellowships or unique training pathways as Med-Peds graduates?”

Ask residents:

• “For residents here planning on fellowship, how early do they typically start planning, and what support did they receive?”
• “Have you felt any tension between pursuing a combined Med-Peds identity and fellowship requirements, or does the program support both equally?”

C. If You’re Unsure About Long-Term Career Plans

Ask the PD/faculty:

• “How does your program expose residents to the different career paths in Med-Peds—hospitalist, primary care, academic medicine, global health, etc.?”
• “What kind of career counseling or mentorship do residents receive as they figure out their path?”

Ask residents:

• “Did your career goals change during residency, and did you feel supported in that process?”
• “Do you feel the program leaves doors open for multiple career directions by the time you graduate?”

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Frequently Asked Questions (FAQ)

1. As a US citizen IMG, should I mention my IMG status when asking questions?

Yes, selectively and thoughtfully. You don’t need to repeat “as an IMG” constantly, but it can be helpful to frame certain questions:

• “Having done med school abroad, I’m particularly mindful of learning EMR and US documentation. What support do you offer for residents who are new to the US system?”

This shows self-awareness and a proactive mindset, rather than insecurity.

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

Aim for 2–3 meaningful questions per interviewer, and a few more for resident sessions. Depth beats quantity. It’s better to have one question that leads to a rich 5-minute conversation than five rapid-fire questions that get superficial answers.

3. Are there any questions I should avoid?

Avoid:

• Questions that sound like you haven’t read their website at all.
• Overly aggressive or negative questions (“Why is your board pass rate lower than others?”). Instead, phrase them neutrally: “I saw that your board pass rates vary across years; how do you support residents who may struggle with exams?”
• Questions that focus excessively on vacation, salary, or moonlighting with leadership—those are better for coordinators or residents.

4. How can I use my questions to stand out in the Medicine Pediatrics match?

Use questions that:

• Show specific knowledge of Med-Peds (transitions of care, complex chronic patients, dual-board training).
• Reflect your background as a US citizen IMG (awareness of transitions, eagerness to adapt).
• Connect directly to your interests and experiences (“In my clinical rotations in the Caribbean, I saw X; how does your program handle Y in that context?”).

This helps programs remember you as a thoughtful, intentional applicant who knows why Med-Peds—and why their program in particular—fits your goals.

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By approaching the interview day with targeted, thoughtful questions, you transform the experience from a one-sided evaluation into a true conversation. As a US citizen IMG pursuing a Med-Peds residency, these questions will not only help programs see your maturity and insight—they’ll also give you the clarity you need to build a rank list that matches who you are and the physician you aim to become.