More malignancy at Yale

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As many of you know, a diatribe against the Yale EM program was recently posted by one the residents. It caused quite a stir here. For a good week or so after it was posted, it was the hottest topic of conversation. Speculation and accusations were flying around constantly. Some thought it was this resident, others thought it was that resident. Some even speculated that it was a disgruntled faculty member who posted it. Well, as unbelievable as it sounds, what was a malignant department to begin with has become even more malignant since that post appeared.

A couple of weeks ago, it was announced that two of our interns are leaving the program. Not surprising. The illustrious program director has continued his dictatorial rule over his program. While no one knows for sure why those two chose to leave, I would not be surprised if his crafty manipulations were behind their decisions to some extent. Rumors are now circulating that others in other years will be announcing their departure soon as well.


Then, he announced his choices for chief residents for the coming year. He chose three residents. I am not going to say anything bad about who he did choose, but there was one resident who was NOT chosen who seems to be an absolutely egregious omission. He was the top choice by residents and faculty alike. There are rumors flying all over the place about improprieties in the chief selection process. I do not know what is truth and what is speculation, but I do know that SOMETHING is not right. What is also clear is that the decision was made entirely by one person. Faculty input was completely ignored. It is unclear what the chairman herself wanted. That's how we roll here- we never know what she wants. She never seems to make any real decisions.


Another scandal seems to be brewing as well. One particularly lame resident seems to have combed through the schedules from the last year and identified what he thinks are abuses among the current chiefs in scheduling their own shifts. He posits that the chiefs have systematically given themselves fewer clinical shifts at the expense of other residents. It is unclear whether he is right or not. He may very well be. One thing is clear however, morale here is non-existent and his "investigation" has only made the problem worse.


It seems to me that one person is at the route of most of the problems here. Before this man came to power there were problems, but they were problems that could be fixed. Now, it is his way or else. From conversations I have had with faculty, particularly younger, less well established faculty, he rules with an iron fist and threatens them with their jobs and their livelihoods if they don't fall in line. This really has to stop. This is no way to run a department or a residency. I will be graduating soon and as much as it pains me to malign my own program, I do not really have any other venue to express my concerns.


I am sure now there shall be all sorts of posts from current residents and faulty disputing what I have said, but the we all know the real truth here. Unlike the previous poster, I am not posting this as a warning to prospective residents. I am posting this for the benefit of my own colleagues. It really is a shame that SDN has become the only place that we can discuss these matters without fear of reprisals.

Sounds like President Snow and now...
"May the odds be ever in your favor"

Do residents do battle in an outdoor arena and only the survivor becomes chief resident?

I personally disagree - I don't think SDN is the appropriate place to publicly slander your residency. Just as you assert unprofessional conduct, so is posting this type of thing online.

"It really is a shame that SDN has become the only place that we can discuss these matters without fear of reprisals."

Originally Posted by YaleResident2

As many of you know, a diatribe against the Yale EM program was recently posted by one the residents. It caused quite a stir here. For a good week or so after it was posted, it was the hottest topic of conversation. Speculation and accusations were flying around constantly. Some thought it was this resident, others thought it was that resident. Some even speculated that it was a disgruntled faculty member who posted it. Well, as unbelievable as it sounds, what was a malignant department to begin with has become even more malignant since that post appeared.

A couple of weeks ago, it was announced that two of our interns are leaving the program. Not surprising. The illustrious program director has continued his dictatorial rule over his program. While no one knows for sure why those two chose to leave, I would not be surprised if his crafty manipulations were behind their decisions to some extent. Rumors are now circulating that others in other years will be announcing their departure soon as well.


Then, he announced his choices for chief residents for the coming year. He chose three residents. I am not going to say anything bad about who he did choose, but there was one resident who was NOT chosen who seems to be an absolutely egregious omission. He was the top choice by residents and faculty alike. There are rumors flying all over the place about improprieties in the chief selection process. I do not know what is truth and what is speculation, but I do know that SOMETHING is not right. What is also clear is that the decision was made entirely by one person. Faculty input was completely ignored. It is unclear what the chairman herself wanted. That's how we roll here- we never know what she wants. She never seems to make any real decisions.


Another scandal seems to be brewing as well. One particularly lame resident seems to have combed through the schedules from the last year and identified what he thinks are abuses among the current chiefs in scheduling their own shifts. He posits that the chiefs have systematically given themselves fewer clinical shifts at the expense of other residents. It is unclear whether he is right or not. He may very well be. One thing is clear however, morale here is non-existent and his "investigation" has only made the problem worse.


It seems to me that one person is at the route of most of the problems here. Before this man came to power there were problems, but they were problems that could be fixed. Now, it is his way or else. From conversations I have had with faculty, particularly younger, less well established faculty, he rules with an iron fist and threatens them with their jobs and their livelihoods if they don't fall in line. This really has to stop. This is no way to run a department or a residency. I will be graduating soon and as much as it pains me to malign my own program, I do not really have any other venue to express my concerns.


I am sure now there shall be all sorts of posts from current residents and faulty disputing what I have said, but the we all know the real truth here. Unlike the previous poster, I am not posting this as a warning to prospective residents. I am posting this for the benefit of my own colleagues. It really is a shame that SDN has become the only place that we can discuss these matters without fear of reprisals.

Wow. Here we go again...

Originally Posted by dotcb

I personally disagree - I don't think SDN is the appropriate place to publicly slander your residency. Just as you assert unprofessional conduct, so is posting this type of thing online.

"It really is a shame that SDN has become the only place that we can discuss these matters without fear of reprisals."

Just as fine as any other place

i feel bad for the class of 2016--they are coming into this with so much public chaos! they certainly don't deserve to have the amount of anxiety that i'm sure this kind of public discourse generates for them, without the ability to (yet) speak with their peers and colleagues about what is true and what isn't, as they won't start for several months. ugh. bad situation all around.

Round 2.... (or is it 3?)

Oh my god, I am ****ing sick of these Yale posts. We get it already! ok? we get it! You think Yale's a malignant program. Now shut up already. We don't need to hear you rail against Yale in yet another anonymous post. The first 2 or 3 times were enough.

Pick one account and use it already.

To round out the picture, as a Yale EM resident I will say that this and the two previous anti-Yale posts are widely believed to be published by a single disgruntled resident who is frankly incompetent and the acceptance of whom was probably a mistake for the program. One intern is leaving to pursue a different field this year - after already having changed specialties once - and one is leaving to go to another top-notch program (Denver - does anyone honestly believe Yale to be a more malignant program?) to be closer to family. I don't believe either of these decisions reflect poorly on our program. Although I am a bit surprised there was an open spot at such an excellent program for this intern to transfer into. As for our chair, as compared to many departments where the chair is concerned only with academic matters and views residents as cheap labor, ours is a vocal proponent of resident education and has put the
department's money where her mouth is. The only controversial decision I am aware of our program director having made was in reducing the number of electives (historically higher at Yale than anywhere else). There is a small but vocal minority opposed to this - most of whom are able to express their opinions in a more civil, intelligent, and dignified manner with an actual productive goal. The overwhelming majority of us are happy to have come here and feel well-supported by our leadership. I would encourage any applicants to speak with many people at all programs and found their opinions on real research about the program rather than the diatribe of one resident who admits themself to be disgruntled.

As a prior chief (NOT at Yale), I am rather certain it is customary for a Chief to work less shifts.... Just as its typically for a medical director, program director, research director, etc to work less shifts in exchange for the adminstrative 'stuff' that has to be done...

Our chiefs worked probably 2-4 less shifts each month; however, we went to multiple meetings, made schedules, dealt with daily resident issues, etc.... even just phone calls from residents about issues added up...

I assure you if you added my actual time as chief dealing and thinking about the residency program, it was many more hours than the 48-72 hours less pure shift work...

In regard to the issues with the number of shifts worked by the Chief, I agree with EM_Rebuilder. At my program, the Chiefs spend much more time dealing with issues and ultimately work more hours than everyone else when that time is included.

Whether there is one or multiple disgruntled residents at Yale, it is good information for future applicants to be extra cautious when interviewing there. It is rare for anyone to have the guts to publicly raise red flags on their program. My own program has serious issues such that myself and several other residents skipped all interview season activities as we did not want to lie to applicants. If we had participated and been honest, other residents with agendas (in the fight to become Chiefs) would have reported back to the PD. I do feel sorry for the incoming class that matched under false pretenses.

At every residency that has a competitive chief selection process very commonly someone is outraged that someone didn't get selected. This in no way distinguishes Yale.

Yale backwards is e-lay. Not sure why that amuses me so much but it does.

The Denver opening was someone who switched fields, to general surgery I believe. Had nothing to do with their program, just someone who has 50/50 when they ranked and got the wrong side of the coin. Just another case to argue that people leaving/changing programs very often does not reflect on the program itself, but revolves around other issues. (Would still argue that repeat attrition may indicate otherwise, however)

.

Where there's smoke, there's fire.

Each individual post may not be entirely accurate. However, when you step back and realize that there have been multiple such posts you have to believe that there is something very wrong with Yale EM program.

LIke the previous post said, if one comes out against their own program they only hurt themselves. Therefore the mere fact that so many residents are bashing their own program at the expense of their own reputation only further proves that there are serious problems with the program.

I feel terrible for the incoming PGY-1s.

All you have to do is search for "Yale malignant" and you get hits almost 10 years back.

Originally Posted by Jewgar

Where there's smoke, there's fire.

Each individual post may not be entirely accurate. However, when you step back and realize that there have been multiple such posts you have to believe that there is something very wrong with Yale EM program.

LIke the previous post said, if one comes out against their own program they only hurt themselves. Therefore the mere fact that so many residents are bashing their own program at the expense of their own reputation only further proves that there are serious problems with the program.

I feel terrible for the incoming PGY-1s.

Maybe, all these posters have one post and just joined this month. Whos to say if they are multiple residents or the same disgruntled person making separate accounts?

Originally Posted by sylvanthus

Maybe, all these posters have one post and just joined this month. Whos to say if they are multiple residents or the same disgruntled person making separate accounts?

Usually the mods can figure out if it's multiple accounts/same guy.

Originally Posted by Jewgar

I feel terrible for the incoming PGY-1s.

I'd only feel bad for them if they ranked Yale low and end up matching there. Otherwise people get what they asked for. I'm not going be the naive one and think that people didn't rank Yale high because of the Yale name, or it could be because of the location, or it could be because they really believe Yale had superior training. Whatever their reason is for ranking Yale high, they asked for it.

How often do we cringe when we hear a medical student say things like "I want more Trauma!" or " I think the training there is so worth that extra 4th year!" or "I love that place because it's like a war zone and I have to do everything myself, draw labs and push patients around!" .....etc and we all know whatever we say is not going to change a mind like that. Some people do try, so you can't say that nobody told the medical students. People just have their reasons, to prefer whatever they prefer. So I don't feel bad at all when people get what they asked for.

Originally Posted by nycqqe

I'd only feel bad for them if they ranked Yale low and end up matching there. Otherwise people get what they asked for. I'm not going be the naive one and think that people didn't rank Yale high because of the Yale name, or it could be because of the location, or it could be because they really believe Yale had superior training. Whatever their reason is for ranking Yale high, they asked for it.

How often do we cringe when we hear a medical student say things like "I want more Trauma!" or " I think the training there is so worth that extra 4th year!" or "I love that place because it's like a war zone and I have to do everything myself, draw labs and push patients around!" .....etc and we all know whatever we say is not going to change a mind like that. Some people do try, so you can't say that nobody told the medical students. People just have their reasons, to prefer whatever they prefer. So I don't feel bad at all when people get what they asked for.

Harsh!

Originally Posted by Rendar5

Oh my god, I am ****ing sick of these Yale posts. We get it already! ok? we get it! You think Yale's a malignant program. Now shut up already. We don't need to hear you rail against Yale in yet another anonymous post. The first 2 or 3 times were enough.

Pick one account and use it already.

+1 to this.

Zzzzzzzzz...

Originally Posted by Rendar5

Oh my god, I am ****ing sick of these Yale posts. We get it already! ok? we get it! You think Yale's a malignant program. Now shut up already. We don't need to hear you rail against Yale in yet another anonymous post. The first 2 or 3 times were enough.

Pick one account and use it already.

I agree. I don't like my program either (not Yale), but that doesn't make it a malignant program. It's just not a great program for me, to the point that I was considering leaving EM as a specialty. But some other people like it a lot, and I'm sure the same thing is true for the Yale program.

There are options for residents like me and the OP who don't like our programs. You can switch to another program or specialty, or you can get involved at your program to try to change the things you don't like, or you can make up your mind to shut up, suck it up and get through, which is what I decided to do.

Seriously, OP, stop it already with this whole spectacle. If you have problems with your colleagues, go talk it out with them like an adult instead of using SDN as your personal soapbox.

I believe this disgruntled resident will be posting here in a few years about how malignant life as an attending is. Someone is just not happy with life.

I've already written numerous times how I do not think the program is malignant and how I'm extremely happy with my training there.

I have a very simple solution for those of you who despise these types of threads: Don't read them. No one is forcing you to read these posts, let alone post responses of your own.

For example, I find the "Best EM program" posts to be extremely annoying. Therefore, I stopped reading those threads. I suggest you do the same.

Originally Posted by southerndoc

I believe this disgruntled resident will be posting here in a few years about how malignant life as an attending is. Someone is just not happy with life.

I've already written numerous times how I do not think the program is malignant and how I'm extremely happy with my training there.

However, aren't you also working at a place where the average is 2.7 patients per hour? The pay is good, which motivates the docs, but, still. My point is, what others find "malignant", you found not to be - the same stuff.

Still, as I said above, you can go back almost 10 years with the malignancy stuff on SDN.

Originally Posted by Apollyon

However, aren't you also working at a place where the average is 2.7 patients per hour? The pay is good, which motivates the docs, but, still. My point is, what others find "malignant", you found not to be - the same stuff.

Still, as I said above, you can go back almost 10 years with the malignancy stuff on SDN.

I average that, but our facility average is 2.3 per hour I believe.

Originally Posted by Jewgar

I have a very simple solution for those of you who despise these types of threads: Don't read them. No one is forcing you to read these posts, let alone post responses of your own.

For example, I find the "Best EM program" posts to be extremely annoying. Therefore, I stopped reading those threads. I suggest you do the same.

Spoken like a true neurotic medical student struggling with the uncertainty that is pre-residency match life.

When did Obama become a program director?

Originally Posted by bulgethetwine

Spoken like a true neurotic medical student struggling with the uncertainty that is pre-residency match life.

How does your reply make any sense? And what does being a medical student post-match have anything to do with it?

As a current Yale resident, everytime I read one of these posts, i cringe a little. I honestly don't think that this is the best way to heir griecvances with our program. That being said, the reality is that most of what is said in these posts is true. Yale IS a malignant program. There's no denying it. Fact is that almost every resident in this program regrets his/her decision to come here. Why is it malignant? The answer, in my opinion, is alarming but reassuring at the same time. Surprise surprise, it IS Dr. Bernstein. The man is a force. I, as well as most of the residents here, believe that he is almost entirely responsible for the malignant atmosphere that has been created here. I heard that prior to coming to Yale, he had never had a job for more than a year or two because he kept getting fired. I also heard that he was fired because no one could stand him at his previous jobs - both residents and faculty.

So why, if I am against these posts, and if I cringe when I read them, am I posting this? The answer is that I firmly believe that Dr. Bernstein will not be here for much longer. EVENTUALLY, the powers that be will realize what he is doing and they will put a stop to it. I'm not saying that it will happen tomorrow, but it will happen. It has to. The program will continue to spiral our of control, attract poorer and poorer quality applicants and lose current good residents as long as he is at the helm, and eventually SOMEONE will notice.

So even though I am unhappy here, and even though I think the place is malignant and I wouldn't recommend it to anyone, I really do think that eventually it will turn around and become a great place to train. The fact is that we have a core of fantastic faculty who do really are about resident education. Once Dr. Bernstein is gone, I am hopeful that everything else will fall into place and this place will shine. Just don't apply here until that happens!

Originally Posted by anotheryaleres

As a current Yale resident, everytime I read one of these posts, i cringe a little. I honestly don't think that this is the best way to heir griecvances with our program. That being said, the reality is that most of what is said in these posts is true. Yale IS a malignant program. There's no denying it. Fact is that almost every resident in this program regrets his/her decision to come here. Why is it malignant? The answer, in my opinion, is alarming but reassuring at the same time. Surprise surprise, it IS Dr. Bernstein. The man is a force. I, as well as most of the residents here, believe that he is almost entirely responsible for the malignant atmosphere that has been created here. I heard that prior to coming to Yale, he had never had a job for more than a year or two because he kept getting fired. I also heard that he was fired because no one could stand him at his previous jobs - both residents and faculty.

So why, if I am against these posts, and if I cringe when I read them, am I posting this? The answer is that I firmly believe that Dr. Bernstein will not be here for much longer. EVENTUALLY, the powers that be will realize what he is doing and they will put a stop to it. I'm not saying that it will happen tomorrow, but it will happen. It has to. The program will continue to spiral our of control, attract poorer and poorer quality applicants and lose current good residents as long as he is at the helm, and eventually SOMEONE will notice.

So even though I am unhappy here, and even though I think the place is malignant and I wouldn't recommend it to anyone, I really do think that eventually it will turn around and become a great place to train. The fact is that we have a core of fantastic faculty who do really are about resident education. Once Dr. Bernstein is gone, I am hopeful that everything else will fall into place and this place will shine. Just don't apply here until that happens!

Inquiring minds want to know if all of this negative attention has affected the Incoming residency class this year. Obviously the program filled since there were no open spots this year but were they filled with "less desirable applicants"?

i happen to know several of the incoming applicants--and know for a fact that they're badasses.

Originally Posted by EMlvr

Inquiring minds want to know if all of this negative attention has affected the Incoming residency class this year. Obviously the program filled since there were no open spots this year but were they filled with "less desirable applicants"?

4 Caribbean grads, 3 DOs, 1 Naturopathic grad, then to fill up the spots, a dental grad, 2 undergrads that just seemed really interested in EM and a korean kid who doesn't speak any English but is a whiz with orthoglass. I think that might help.

If "anotheryaleres" is truly a current Yale resident, wouldn't he/she know that Dr. Bernstein is only the interim PD and that Dr. Dave Della-Giustina will be the new PD? This was made abundantly clear to the applicants. Why wouldn't a supposed Yale resident be aware of this?

Originally Posted by MissyMD

If "anotheryaleres" is truly a current Yale resident, wouldn't he/she know that Dr. Bernstein is only the interim PD and that Dr. Dave Della-Giustina will be the new PD? This was made abundantly clear to the applicants. Why wouldn't a supposed Yale resident be aware of this?

I am well aware that Dr Bernstein is the interim PD. However, even after Dr Della-Giustina arrives, Dr Bernstein will remain vice chair of education and thus he will still be able to exert his influence make every one else' life miserable.

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I have to chime in and disagree with previous poster stating the PD being the root of all things going bad. He is likely going to be at Yale for awhile and this should NOT deter applicants from applying. He will be stepping down as PD but will still be on the administrative staff, and I honestly think him remaining part of the EM faculty is a great thing. He has put his heart into trying to revamp the program to make it a better place to learn and gain diverse exposures. What does he have to gain by taking on the role of interim director? Absolutely nothing. If anything, it hinders his research and other primary responsibilities. He has taken on the role to try and make Yale a top tier program. He has not acted malicious in any way and has been straightforward with his proposals and has sought the opinions and feedback of the house staff and faculty. There may be some areas for improvement in the program, but many were around long before he took on his current position. To future applicants, the program is going to be changing drastically over the next few years. New leadership, new facilities, new EMR. There is top-notch faculty here that loves teaching and are invested in the residents education. It has all the right ingredients for an amazing education.

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I could care less about Yale or the gripes of supposedly overworked residents in the era of ever expanding ACGME regulations complaining about chief selection.

That being said this thread has devolved into an anonymus character assassination of an emergency physician who has no ability to defend himself against the nebulous and unspecified claims by multiple nameless posters. I find this sort of nonsense to be unprofessional and borderline libelous.

Doesn't the malignancy of a program have to do with the faculty and to a lesser extent the residents, being nasty? It seems like everyone's beef is with a few individuals, not the residency as a whole.

More importantly, the malignancy has nothing to do with the quality of training at a program. I spent 3 years as a neurosurg resident before switching to EM at a program that was truly malignant--the faculty and my co-residents were arrogant turds. However, the program turned out outstanding physicians--they were all cocksmokers, but magnificent surgeons. My point is, the people at Yale EM may not all be peaches, but the training there could still be phenomenal.

Just my $0.02

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Originally Posted by odoreater

I could care less about Yale or the gripes of supposedly overworked residents in the era of ever expanding ACGME regulations complaining about chief selection.

That being said this thread has devolved into an anonymus character assassination of an emergency physician who has no ability to defend himself against the nebulous and unspecified claims by multiple nameless posters. I find this sort of nonsense to be unprofessional and borderline libelous.

I agree. I don't think bad blood regarding Chief resident selection is at all uncommon - probably happens at every residency at some point. I really think the direction these threads have taken though is progressively more and more unprofessional. If you have a bone to pick with your program or PD, man up and tell it to them without hiding behind an anonymous user name. Have these threads done anything to make your program a better place to train or have they just created a lot of departmental drama and mistrust? I'd really hate being a resident at a program where some anonymous person(s) are stirring up drama online and causing the faculty to scrutinize every resident as though they might be one of these posters

Just graduated the Yale EM program last year.

I wanted to add a note of support for Dr. Bernstein. So many of the changes he made when he came into the interim PD position were over-due. He wasn't satisfied with tinkering around the edges, incremental steps - he saw where we were, and where we should be, and started pushing the clinical and educational structure in that direction immediately.

That can be a polarizing approach, but he made essential changes that immediately made the program stronger and more effective. He doesn't just "care about resident education," he is a driven man. We need more guys/girls like this in EM.

I've never been a "rah-rah" kind of guy about any organization I've belonged to, and Yale EM is no different. But the creepy OP, who uses trite imagery and language ("illustrious," "dictatorial,"his craft manipulations") is just revealing him/herself to be petty and adolescent in their view of the world.