SDN Members don't see this ad. (About Ads) I keep hearing about "malignant" residency programs. My two questions: 1) What schools are considered to be malignant for IM? 2) What exactly do people mean by this term? My understanding is it applies to programs who do not abide by duty hour restrictions, overwork the residents, or have little to no elective or ED time (all ICU/wards intern year). Some schools I have heard that are "malignant" include Mass General, Duke, UMichigan, UT Houston, and UAB. Would be interested in residents from these programs to comment whether they feel this is true, why/why not?