I was wondering if you guys could let me know some of the malignant general surgery programs out there. I realize "malignant" may mean different things to different people, but generally speaking I mean those programs that are know to have low resident morale and comradrarie (sp?) due to abrasive faculty, uncaring administration, poor nursing support, etc. I'd like to hear about any program (community as well as university).

I'm a graduating 4th year medical student at the university of washington. I can tell you that the UW here in seattle is an extremely malignant program. Not only to medical students, but also to residents. There a lot of egos floating around and you can expect to be the recipient of much maligned attitudes. This is not just me, you can ask any other student here and you will undoubtedly find out the same thing. You can expect to get yelled at for moving your head to stretch your neck because it distracts the surgeon, for talking about anything non-surgical during an OR case, even if the resident brings it up and the attending does not approve, and there have been cases of medical students being told off for simply asking if they may ask a question (and this did not occur at an inappropriate time, i.e. acute hemorrhage, etc). The residents here look extremely worked over, and morale is not very good. My advice to any who are interested in surgery would be to steer clear of this program. Yes, you may get into the best fellowships following training, and you will certainly be 'prepared', but i think the route they put you through is unnecessary and unwarranted. Also, as i'm contemplating gsurg, many of the residents here have told me that they would not come here if they could help it. I hope this helps.

Hey Dr. Strangelove,
I must say that I was pretty disappointed to read your negative comments about U.of Washington. I am seriously considering it for a general surgery residency. Do you see any improvements coming in the near future? Are they going to try to comply with the RRC 80hr/wk requirements? I have only heard good things about Dr. Pelligrini and can't imagine that he would run a malignant program. I certainly hope changes are on the way.

I hope it does change, but I do not see that happening in the near future. The prevailing thought is that they are a high-caliber program and do not need to change.

80 hour weeks? Not here. I'm not sure when the next review will be or was, but I don't know how they are going to pass. The bottom line is that the residents are overworked and not happy. It's a powerful statement when residents say they wouldn't come here if they could go back and redo it. The ones that are would gladly just live at the hospital and would be happy anywhere no matter what. This isn't just coming from my experience, but those of my classmates and friends who have graduated within the last couple years and have gone on to surgery programs elsewhere. I encourage you to not take my word for it but contact other medical students here if you don't truly believe me, I believe you will hear similar stories.

You will know surgery when you leave here. However, if you have a wife, family, or any other interests then you may want to think about it. It's hard to work you butt off and still get disrespected.

Dr. Strangelove,
Unfortunately, I believe you. We have a couple of surgery interns at my school who interviewed at UW and said basically the same thing you did. I guess that's why they are here and not there.
I wish it weren't the case because I think living in Seattle would be great. Thanks for the reply.
By the way, I would prefer to have a husband over a wife:)

oops, sorry about the wife/husband thing. I should have been more universal. I apologize about that!

Although I didn't attend UW, while I was on the interview trail last year, not a single one of the UW students I met was applying to their own program.

Other programs with "reputations"--although I will freely admit I have absolutely ZERO data to base these statements on other than reports from people who have interviewed or attended school/residency at these places:

University of Colorado
Mass General
Brigham and Women's
UAB
U. of Louisville (sorry, RIO)
Hopkins
MUSC

I'm sure I've heard of others, but those were the ones that came to mind immediately.

Originally posted by LaCirujana
Although I didn't attend UW, while I was on the interview trail last year, not a single one of the UW students I met was applying to their own program.



That's probably the most telling statement of all. Though I'm sorry to hear it. I come from a very malignant program in my own profession, and you couldn't pay me to go back there.

It wasn't too many years ago either that the UW surg program didn't even take their own students from Seattle. Although, as Kim pointed out, most UW students don't want to apply to the program anyhow (and the ones who do and go, are ones who would go through any abuse to be a surgeon).

I wonder what was the rationale for not taking their own students?

LaCirujana,

I too had heard stories about Louisville before I came. It used to be that when you heard the interview buzz on where malignant programs were, you routinely heard UofL, UAB, & Cinncinnatti mentioned. All 3 are fantastic programs to me, and tended to get their rep. due to their chairman's personalities. Honestly, I was just so impressed with how professional the interview process was here & a number of the very prominent people here that I was sold (as was another of my classmates who also ranked it #1 & ended up here - in context we were both top 10 with high in our class with high board scores & had plenty of options on where to look at).

I think that the feedback you get from students applying for surgery from somewhere can really give you some good insight. If there's problems they know about it & tell everyone they meet when they interview. Last year we ended up with 7 students from here (all great) that wanted to stay here as their #1 choice - I thought that said a lot about how they viewed both their med school training in surgery here as well as the atmosphere in the program. We also had a few other students who were great that really wanted to look elsewhere (usually for geographic preferences). I wish we had so many good ones like that every year & that we could redshirt them:)

UAB has had a soaring buzz as far as I can tell since Dr. Kirby Bland took over 2 years back in a program that had about the lowest morale of anywhere a few years ago. We have had 3 students match there in the past 2 years.

As far as the work-week hours go, we made dramatic changes this past July to come into compliance with the pending 2003 ACGME regulations. It has allowed us some time to see what works to get it tweaked by next year & has been HUGELY popular with the junior-housestaff (they get home @ ridiculously early times post call or else. It has made my work as a chief a little harder especially being short handed @ clinic, but rarely do I approach 80 hrs/week in the hospital these days. There will be some real growing pains at other places as they also make some of these changes & it will hurt the smallest programs the most I think.