Questions to Ask

What's the relationship like between residents and attendings?

Do residents actually get along or is it competitive?

How supportive is the program when residents struggle?

If a resident runs into real academic or professional trouble, what does remediation actually look like — a fair, clear process, or do people quietly get pushed out?

Can you actually get time with program leadership, or is the PD hard to reach?

Is there real mentorship here, or do you find it on your own?

How diverse is the program, and does it actually feel welcoming?

What's the volume and variety like — case numbers, and the range of pathology you actually see?

What's the patient population and payer mix — county/safety-net, VA, private, or a blend — and how does that shape the pathology and acuity you see?

Do residents feel ready for independent practice by graduation, or do most feel they need a fellowship to get there?

How much autonomy do you get as a PGY-1 versus a senior — and by your final years, how much do you genuinely do unsupervised?

Are attendings actively teaching, or just supervising and signing off?

Is the patient load a learning load or a service load — how much is scut versus medicine you'll actually use?

What ancillary support exists — phlebotomy, IV team, transport, social work — or does it fall on residents?

How do NPs and PAs fit into the team day to day — does their role affect what residents get to do and learn?

How much of training happens at outside or community sites, and how much time is spent away from the main hospital?

How are the didactics — structured and useful, or just a formality — and is conference time actually protected?

Is there simulation or hands-on skills training, and is it actually used?

How heavy is the documentation and EMR burden day to day?

How much elective time is there, and can you tailor your training toward your goals?

How have recent classes done on their board and in-training exams?

Is research required or just encouraged — and is there protected time for it?

What research mentorship, funding, and statistical support actually exist?

Do residents regularly present at national meetings and publish? What's the track record?

If you want an academic career, does this program set you up for it?

What fellowships have recent graduates matched into, and how competitive were they?

Of the residents who apply for fellowship, how many get their first choice?

Does the program actively support fellowship applications — protected time, research, and letters?

Do graduates feel the program's name and letters carry real weight in the specialties and regions they applied to?

For residents who went straight into practice, did they land jobs where they wanted?

Where do graduates tend to end up — academic or community, employed or private, and in what regions?

Does the alumni network actually help with fellowships and jobs, or is it just a list?

Does the program sponsor visas — and specifically which? (Many sponsor J-1 only, not H-1B.)

How many international graduates are in recent classes — is it genuinely IMG-friendly, or just on paper?

Are there year-of-graduation or US clinical experience requirements I should know about?

Who actually pays the visa filing and legal fees — the institution or the resident?

Do IMGs get equal access to competitive electives, research, and chief-resident roles?

For J-1 residents, does the program support waiver pathways (Conrad 30, etc.) for after training?

For residents who'll need it, has the institution sponsored permanent residency (a green card) before?

How does the program support dependents — J-2 work authorization, spousal employment, schooling?

What administrative and legal support does the GME office provide with visas, ECFMG certification, and state licensing?

Does the program have a track record of keeping IMGs on as fellows or faculty?

Have IMG graduates matched into the fellowships and landed the jobs they wanted?

What's the call schedule really like — traditional call, night float, or a mix, and how does it change by year?

How many hours per week are you actually working?

How is vacation time handled — do you actually get to use it?

When a resident is out sick or on leave, who covers — do co-residents get buried?

What's parental and family leave actually like for residents who've used it?

Is there real, confidential mental-health support — and do residents actually use it?

How does the program handle burnout — is it acknowledged, or brushed off?

Are duty hours respected in practice, or do they sometimes get stretched?

Would you rank here again knowing what you know now?

What's the one thing you wish you knew before matching here?

Have any residents left or transferred out? Why?

Does the program fill in the Match every year, or has it had unfilled spots recently — and if so, what happened?

What's the worst part of this program nobody talks about?

What does the program NOT do well?

Has the program had any ACGME citations or accreditation concerns?

Has there been recent turnover in the PD, chair, or core faculty — and why?

Is the hospital system financially stable — any mergers, closures, or hiring freezes that could affect training?

What's the biggest change the program has made recently — and why?

How is the pay and are there any moonlighting opportunities?

Beyond salary, what's the benefits package — insurance, meal stipends, education funds?

Is there a relocation or sign-on stipend, and what does it cover?

What's the housing situation like — is it affordable nearby?

Does the salary actually stretch to the cost of living here?

Be honest — do you actually like living here?

How's the city for a partner's career, or for family life during residency?

Is there a residents' union or collective bargaining here, and has it changed pay or working conditions?

How does the program handle board prep time?