Questions to Ask Residency Program Directors Before Ranking

The questions

Open any question to see why it works.

1. 1

   How would you describe the kind of resident who does well here?

   Their description is a self-portrait of the program. If the answer amounts to someone who never complains and always stays late, you are hearing about staffing needs rather than training.

2. 2

   What does a typical week look like for an intern on your busiest rotation?

   Ask about the busiest rotation specifically, because an average week hides it. A program director who cannot narrate an intern's day hour by hour is not close to the wards.

3. 3

   What is the call structure, and how often is someone on nights?

   Night float, 24-hour call, and home call produce very different lives outside the hospital. A schedule that is currently being reworked usually means the coverage math does not close.

4. 4

   Which hospitals and clinics will I actually rotate through, and how far apart are they?

   Multi-site programs can add an hour of driving to each end of the day. Count the sites, then ask who pays for parking at each one.

5. 5

   What is the case mix like, and is there anything residents finish here without seeing much of?

   Every program has a gap: a service with thin volume, a population it rarely treats. A director who names one candidly is giving you a real answer, and one who says the program sees everything is not.

6. 6

   How many residents have left, transferred, or extended in the past five years?

   Attrition is the hardest number to spin. Extensions and transfers matter as much as departures, and a program that has never counted them is telling you something too.

7. 7

   Have you had any accreditation citations recently, and what changed as a result?

   Accreditation status is a matter of record, so this tests candor more than compliance. What you want is a specific fix with a date attached, not a reassurance that nothing significant happened.

8. 8

   What is your board pass rate over the last few years, and what happens for residents who struggle?

   A high pass rate can also describe a program that moves weak residents out before the exam. The useful half of the answer is the support offered to someone who fails a practice test.

9. 9

   How is a resident in academic difficulty handled here, from first concern to remediation?

   Every program has residents who struggle. The difference is whether remediation is a written plan with a timeline or a quiet reputation, so ask who is told and what goes in your file.

10. 10

    How much protected time do residents get for teaching, and does clinical work usually interrupt it?

    Protected time only counts if the pager is covered. Otherwise it shows up as sitting in conference answering calls, which is how programs report didactic hours they do not really provide.

11. 11

    What procedures will I be doing myself by the end of intern year, and how does sign-off work?

    Procedure numbers vary widely between programs with identical accreditation. How competency is signed off tells you whether logging happens in real time or is reconstructed later.

12. 12

    How much room do senior residents have when they disagree with an attending's plan?

    This is graded responsibility, which is easy to feel and hard to advertise. Programs where seniors never push back tend to graduate cautious decision-makers who need supervision longer.

13. 13

    Where have your last two or three graduating classes ended up?

    Placement is concrete and checkable against public directories. If outcomes can only be described in general terms, the program may not be following its own graduates.

14. 14

    If I want a competitive fellowship, what does the program actually do to help?

    Some programs have standing relationships with fellowships and some leave residents to cold-email. The answer also shows whether help means mentorship and phone calls or just a letter.

15. 15

    What research support exists, and how many residents used it last year?

    Statistician access, funding, and protected time are what separate output from intentions. Ask for the number of residents who published rather than whether opportunities exist.

16. 16

    How do residents raise a complaint about a rotation or a supervisor, and what happened the last time someone did?

    The written policy is always fine. What matters is the most recent real case: what was raised, what changed, and whether the resident who raised it was protected afterwards.

17. 17

    What mental health care can a resident get without program leadership knowing about it?

    Confidentiality is the whole question. Care that routes through the program, or that uses faculty who also evaluate you, is care residents quietly decline to use.

18. 18

    How does parental leave work here in practice, and who covers the schedule?

    Leave is where stated values meet the call calendar. If coverage falls on co-residents with no backfill, taking leave costs you relationships as well as time.

19. 19

    What is the pay, and what do residents typically spend on parking, housing, and food on shift?

    Salary is published; the costs around it are not. Parking fees, call meals, and rent near the hospital can differ by thousands between two programs you are ranking side by side.

20. 20

    What are you actively trying to fix about the program right now?

    A director who names a genuine weakness is easier to trust than one who cannot. It also tells you whether the fix is likely to land while you are still a resident there.