malignant program?

[HotFratBoy]

what is mean by a program being "malignant?"

Thank you!

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[turkleton]

I don't know you but that screenname just screams tool.

Malignant program typically means hours intensive- possibly in violation of 80 hrs, and a general unfriendly environment which may not be conducive to learning: berating attendings, unreceptive administration, mean spirited house staff, terrible ancillary staff, poor didactics, and just overall hell. It takes on different meanings for different people, but overall just a toxic place to spend your formative training years at.

 

[mmed]

what is mean by a program being "malignant?"

Thank you!

Any program could be malignant for somebody not to other. If you like spending more than 80h at work so 40h program may be malignant. If you have unfriendly character, so friendly program is usually malignant. If you don’t like seminars, lectures so a program with excellent didactics for sure will be malignant.

 

[Winged Scapula]

Like a malignant tumor, the unpleasantness of a malignant program tends to spread. It starts at the top/center (which is usually faculty and administration) and spreads to allied health care workers, other residents and eventually to your life outside of the hospital. Once it has spread, there is little you can do to stop the malignancy, even getting rid of the source (ie, the primary tumor/chair or faculty) may not make a program less malignant until the culture changes - which may take years: to get new residents and faculty, as well as administration and allied health care workers who are kinder and gentler. Malignant programs are often more about service than education and think little about providing a pleasant and educational work environment for their residents. Sometimes you don't even know you're in a malignant environment until you experience something else.

I think few would define a program which has a friendly demeanor or good hours as malignant; that would simply be "undesirable" for the few who prefer a less friendly or more hour intensive program. Thus, turkelton's definition would be the most commonly used for malignancy.

 

[Amgen1]

I think a lack of job security (ie residents regularly fired) is one good defining characteristic of malignancy . . . .

 

[McDoctor]

Like a malignant tumor, the unpleasantness of a malignant program tends to spread. It starts at the top/center (which is usually faculty and administration) and spreads to allied health care workers, other residents and eventually to your life outside of the hospital. Once it has spread, there is little you can do to stop the malignancy, even getting rid of the source (ie, the primary tumor/chair or faculty) may not make a program less malignant until the culture changes - which may take years: to get new residents and faculty, as well as administration and allied health care workers who are kinder and gentler. Malignant programs are often more about service than education and think little about providing a pleasant and educational work environment for their residents. Sometimes you don't even know you're in a malignant environment until you experience something else.

This is probably the best description of "malignant program" I have seen.

There is a certain carelessness to patient care that exists in a malignant program which also semms to spread along with the overall unpleasantness. A sort of "The attendings seemingly don't care, and the nurses don't care, and the ER docs don't care, and the lab techs don't care, So why should I care?" approach to patients which you will see in malignant programs. The appearance of good care may be there, on the customer service end so to speak, but actual thorough medical decision making will be lacking.