Malignant Programs

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Greensheen

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Since this topic has not been touched upon in quite some time I thought I would open a new thread.
Programs that are known to be malignant, have a low resident retention rate, residencies being sued by former residents or any other problematic residency. Let's start a recent list.
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Greensheen said:
Since this topic has not been touched upon in quite some time I thought I would open a new thread.
Programs that are known to be malignant, have a low resident retention rate, residencies being sued by former residents or any other problematic residency. Let's start a recent list.

I heard Miami is having some issues with their PD
I know that Long Island lost at least 1 resident last year
Hawaii lost at least 1 resident last year
I think Georgia lost a resident
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When you say lost a resident, what do you mean? Quit the program, committed suicide, died, or got lost on the way home?
It's always good to keep up to date when choosing a program, though. My former residency had some problems a couple of years before I got there with a couple of residents and a director before I matched, but by the time I arrived there everything had improved a lot and overall it was great. I had no idea they even had ever had any problems until I was part of the team for a while.
 
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wolfvgang22 said:
When you say lost a resident, what do you mean? Quit the program, committed suicide, died, or got lost on the way home?
It's always good to keep up to date when choosing a program, though. My former residency had some problems a couple of years before I got there with a couple of residents and a director before I matched, but by the time I arrived there everything had improved a lot and overall it was great. I had no idea they even had ever had any problems until I was part of the team for a while.
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When I say "lost a resident" I mean that 1 or more residents did not return for the next year. Frequently, residencies will not say why someone left they will just never come back
 
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Someone leaving a program as a data point can go both ways. The only thing worse than a program letting a resident go un-graduated, is not letting a resident go who shouldn't graduate. Sometimes people leave for family reasons, sometimes things just don't work out. Even when someone leaves mad and feeling mistreated, often there are a few dozen other residents who are staying and don't feel that way. I agree, a mass exodus is bad, but just listing programs where "someone left" doesn't say anything about the nature or quality of the program.
 
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MacDonaldTriad said:
Someone leaving a program as a data point can go both ways. The only thing worse than a program letting a resident go un-graduated, is not letting a resident go who shouldn't graduate. Sometimes people leave for family reasons, sometimes things just don't work out. Even when someone leaves mad and feeling mistreated, often there are a few dozen other residents who are staying and don't feel that way. I agree, a mass exodus is bad, but just listing programs where "someone left" doesn't say anything about the nature or quality of the program.
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Just looking for a list not a philosophical debate
 
Sometimes I wonder if I shouldn't have chosen a different specialty. If after my first year I switch to EM or Anesthesia does that make my program malignant or does it just say that the immersive experience helped awake a realization in me? It happens, it happens at "top programs" every year in every specialty. And as MacDonaldTriad said, losing one resident in 2 to 3 years isn't a poor retention rate or indicative of anything except "this didn't work out for me."
 
Creighton might be considered "malignant." It was the only program I interviewed at where the residents blatantly told me that they are unhappy and wish they had gone somewhere else. I also heard similar stories from other people who interviewed there.
It pains me to say it because I love Omaha and I did my undergrad at Creighton, but it's got to be pretty bad when the residents aren't even pretending to be happy... They do have a new PD, though, so hopefully things will change.
 
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Greensheen said:
Since this topic has not been touched upon in quite some time I thought I would open a new thread.
Programs that are known to be malignant, have a low resident retention rate, residencies being sued by former residents or any other problematic residency. Let's start a recent list.

I heard Miami is having some issues with their PD
I know that Long Island lost at least 1 resident last year
Hawaii lost at least 1 resident last year
I think Georgia lost a resident
Click to expand...

I think you are doing more than quoting fact here.
 
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Greensheen said:
Quoting fact is not slander. If a person left that is a fact. One may do as they please with the information
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What are the statistical odds of this occurring, and it mean NOTHING about the program and SOMETHING about the resident?
 
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erg923 said:
What are the statistical odds of this occurring, and it mean NOTHING about the program and SOMETHING about the resident?
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p<0.05

Even if a program is malignant, it is rare for a resident to leave--there are precious few openings with greener grass on the other side, and it's significantly difficult to negotiate and navigate a transfer even for good reasons, with all parties willing.
 
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Greensheen said:
Quoting fact is not slander. If a person left that is a fact. One may do as they please with the information
Click to expand...
UCSF lost 4 residents.


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Mind you, they fast tracked into child. But Greensheen isn't asking for context here...


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Keep in mind that some residents want to transfer elsewhere for personal reasons (family member falls ill, long distance relationship, etc.). The programs that were supportive and helped make that transfer happen would land on this list as malignant. That's more than a philosophical point.
 
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I think the only way to tell if a program is "malignant" is to talk to people you trust that you know are there. If you can't do that, the next best thing you can do is visit for an interview and try to establish a rapport with the senior residents there to get the down-low. I know when I was a PGY3 and above I didn't mind telling anybody exactly what I thought about my program in person, because I was on my way out, and I knew for sure I would be moving on. I would tell people the good, the bad, and the ugly. It was mostly good, which is true of most psychiatry programs I know about. Psychiatry residencies in general are not "malignant."

What you want to do on this forum is ask about a specific program or programs. Chances are you'll find somebody who has been there and you can get some good info via PM about a program if there is anything really bad about it. The rank list threads around here are usually pretty good.
 
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When you say malignant, do you mean the "occasional-mad-attending-or-the-stressful-q5-call-schedule" type, or do you mean the "rounding-on-30-patients-at-5am-before-8hrs-of-brain-surgery-and-working-q2-call-working-85-hrs-a-week-practically-never-going-home-with-an-attending-who-yells-at-you-while-you-are-half-asleep" type of malignant?
 
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Bluejay87 said:
Creighton might be considered "malignant." It was the only program I interviewed at where the residents blatantly told me that they are unhappy and wish they had gone somewhere else. I also heard similar stories from other people who interviewed there.
It pains me to say it because I love Omaha and I did my undergrad at Creighton, but it's got to be pretty bad when the residents aren't even pretending to be happy... They do have a new PD, though, so hopefully things will change.
Click to expand...

I'm a first-year resident at Creighton-UNMC and pleased to report that I have not experienced the program as the least bit malignant in either of the senses Leo Aquarius described. I am very happy here and recommend the program unreservedly based on my experience so far.

I can't speak first-hand about what the program was like before our new program director took over this year, but my general sense from talking to upper level residents is that there were some valid concerns about the program that were brought up by residents year after year without ever being adequately addressed. I believe the previous program director was sympathetic to residents' concerns but for whatever reason was not effective at implementing changes in the program to address them satisfactorily. In the past year there have been major changes in the program for the better, and I feel I know my fell0w PGY-1's well enough to say that the least enthused among us is neutral about the program. The PGY-2 class seems pretty happy, by and large, but they have borne the brunt of the growing pains of our program so if there is some lingering resentment I wouldn't totally blame them. Namely, the primary call burden shifted from PGY-1's to PGY-2's this year which really sucked for them, though it was a necessary change.

The problem from a recruiting standpoint is that there are a few upper-level residents, whom I'm afraid you may have encountered on your interview day, Bluejay87, who are bitter about their experiences here in their first couple of years and are not open to changing their minds about the program now. Maybe I'd feel the same way if I were in their shoes, and I don't begrudge them their right to tell applicants how they really feel about the program, but I do wish they would limit their negative comments about the program to its current weaknesses rather than badmouthing it to interviewees based on information that no longer applies.

Again, I'm not at all overworked at Creighton--UNMC and overall I am quite content here. I suppose our new PD deserves a lot of the credit for that--she wasted no time in making changes that have improved both the quality of training and the quality of life for residents here. I'm open for questions about the program via PM (or in-thread, but I don't want to thread-jack).
 
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With an IM month and C&L time at sloan ketterring, as well as a joint psychosomatic/psycho-oncology fellowship with MSKCC, Cornell gives great exposure to malignancy...
 
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Bashir, thanks so much for the insight! I did get the impression that things have improved recently, and I actually still ranked the program fairly high because of that. :)
 
I agree that losing residents is a bad metric. Really good programs also might try very hard to retain a resident who is knowingly bad because they need someone to do clinical work. And that is only 1 small piece of the reason why people leave. Someone in my program, for instance, left because she wanted to focus on being a mother. That shouldn't go against the program.

N would have to be quite large for me to pay attention to the data without context.
 
Bluejay87 said:
Creighton might be considered "malignant." It was the only program I interviewed at where the residents blatantly told me that they are unhappy and wish they had gone somewhere else. I also heard similar stories from other people who interviewed there.
It pains me to say it because I love Omaha and I did my undergrad at Creighton, but it's got to be pretty bad when the residents aren't even pretending to be happy... They do have a new PD, though, so hopefully things will change.
Click to expand...
We have 1 or 2 people that have the personalities where they could be on a unicorn flying towards a pot of gold at the end of a rainbow and they would figure out a way to be bitter about it. Probably bitch about the size of the rainbow or the color of their unicorn.

I guess malignant means working 50 to 60 hours a week with light call, most faculty that cares about residents and a new PD that is more than happy to go to bat for her residents.

We do not send only our bright and cheery residents to our interview dinners. Try and remember one persons opinion doesn't make a program malignant. I understand your hesitancy with your interactions as I had a similar interaction at another residency interview I had last year; but please stop jumping to conclusions about a whole program based on an interview dinner where you appeared to interact with one resident the whole time.


Tldr: what Bashir said, just a lot less P.C.

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It sucks that apparently just one or two particular residents have given applicants such a negative impression of the Creighton program.
It's totally not just me - every time I asked other applicants what they thought of the program prior to interviewing there myself, they told me that they got the impression that the residents were unhappy. I also got that impression. But you are right that, looking back at it, it was actually only one person who specifically told me "none of the senior residents are happy and I wish I had gone somewhere else."
For me, I can honestly say that my ROL would not be different even if I had not had that experience. I'll always be a Creighton fan (note the screen name.) But it's too bad that some people probably ranked the program lower than they otherwise would have because of one or two bitter people.
 
Bluejay87 said:
Creighton might be considered "malignant." It was the only program I interviewed at where the residents blatantly told me that they are unhappy and wish they had gone somewhere else. I also heard similar stories from other people who interviewed there.
It pains me to say it because I love Omaha and I did my undergrad at Creighton, but it's got to be pretty bad when the residents aren't even pretending to be happy... They do have a new PD, though, so hopefully things will change.
Click to expand...
I actually heard something similar
 
If we made a list of all programs in which anyone heard a resident say something negative about their program, it would be called the ACGME list of accredited programs in the United States of America. I wish there was a better way to give applicants a broader view of the elephant, but they only touch a few teachers and students in one day. Efforts to produce mass media profiles and descriptions come off as very biased and self serving. I know doing away rotations is a mixed bag and limited to only one of two at most, but it is an effective way to see a program and programs want applicants to make the right decision just as much as applicants want to end up in the right place.
 
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MacDonaldTriad said:
If we made a list of all programs in which anyone heard a resident say something negative about their program, it would be called the ACGME list of accredited programs in the United States of America. I wish there was a better way to give applicants a broader view of the elephant, but they only touch a few teachers and students in one day. Efforts to produce mass media profiles and descriptions come off as very biased and self serving. I know doing away rotations is a mixed bag and limited to only one of two at most, but it is an effective way to see a program and programs want applicants to make the right decision just as much as applicants want to end up in the right place.
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Although I would say that going to the applicant dinner and saying lots of bad stuff about your program is pretty atypical. Most disgruntled residents opt for avoiding applicants rather than going out of their way to find them and tell them bad things about the program. Of course that might speak more to the resident than to how malignant the program actually is.

Also I'm thinking this op has some specific concern with University of Miami, which might be the reason for he/she starting this thread.
 
Bluejay87 said:
It sucks that apparently just one or two particular residents have given applicants such a negative impression of the Creighton program.
It's totally not just me - every time I asked other applicants what they thought of the program prior to interviewing there myself, they told me that they got the impression that the residents were unhappy. I also got that impression. But you are right that, looking back at it, it was actually only one person who specifically told me "none of the senior residents are happy and I wish I had gone somewhere else."
For me, I can honestly say that my ROL would not be different even if I had not had that experience. I'll always be a Creighton fan (note the screen name.) But it's too bad that some people probably ranked the program lower than they otherwise would have because of one or two bitter people.
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I had some correspondence with an applicant over email about the same issue so I know you're not the only one.

I'm also willing to bet said resident gave you no substantial evidence as to why he felt that way.

The fact our residency let's him voice his grievances in forums during didactic times, as well as still allowing him to interact with potential applicants (though this appears to be a mistake), as opposed to reprimanding him and keep him in a cage during interviews would be another reason I'd find our program nonmalignant.

Again, I'm guessing many residencies have someone like this at one point or another and it's just what they do with them as to whether interviewers see this or not.

Ironically I'm not from Omaha, this residency was supposed to be my throw away interview prior to a fancier named residency interview, but I felt a real collegial friendly attitude from the residents and ranked it in front of the program I was preparing for, partially because of this.

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LSU Shreveport can be considered malignant, but it is still better to match and end up with a spot then end up with nothing at all. So a malignant program is better than nothing.
 
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marsh20 said:
If you want to know malignancy and brutality at its finest, look no further than Louisiana State University Shreveport. Faculty is extremely scarce and non-existent (it's laughable how little supervision you get). The new chair and PD are extremely controlling and the training environment is very hostile whether it be the lazy support staff, nurses or the faculty, EVERYONE is out to get you in this program. The workload is also ridiculously high and the resident burnout is tremendous. But no one dares to say anything for fear of retaliation/termination. Residents are asked to repeat years of training and held back for minor reasons. There is no back up for resident emergencies and 2nd year is the absolute worst in this program as you have to handle the Psychiatry Crisis Unit all on your own (which can get INSANELY busy). A lot of inappropriate admits and Alcohol, Substance abuse at this place and potential for dangerous clinical situations. Your notes are scrutinized to the core and every action you take is monitored. When I left there were 10 residents, it was hard enough, now there are 8 because they lost the VA site, I can't even imagine how much worse it has gotten with fewer residents to pull the weight. I've heard that they even have residents traveling back and forth from Monroe to Shreveport on a regular basis for service obligations on the weekends.

What adds to the malignancy is the fact that the state of Louisiana is completely dry when it comes to resources for healthcare and on top of that mental health/substance abuse facilities are not able to sustain themselves anymore. The salary for both faculty and residents is almost nil (I think it's somewhere like $45,000 with no benefits) and you work in very remote areas without attending supervision. The whole northwest region of the state is in ruins as well and is literally sinking if you watch the recent news.

I don't think you can get a more harsh and unstable training environment even if you try. Don't go here if you can avoid it. The institution in general has been cited from ACGME many times and the GME office knows clever ways on how to avoid persecution to keep the programs running, but believe me when I tell you it is absolutely miserable working here. STAY AWAY from this program if you can afford to.
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Dude, you have 21 posts, and all of them are about LSU Shreveport.

We get it, you have a giant hard-on for the program. Move on, maybe?
 
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Psychotic said:
Dude, you have 21 posts, and all of them are about LSU Shreveport.

We get it, you have a giant hard-on for the program. Move on, maybe?
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Now that I'm done with residency, I can finally have my say without feeling any fear that anyone is going to retaliate against me.

I'm just trying to watch out for future applicants who might be thinking about applying to this dump and Shreveport really is the armpit of America. Facts don't lie.

http://www.ktbs.com/story/25461935/shreveport-ranks-8-on-most-miserable-cities-list
 
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MLT2MT2DO said:
We have 1 or 2 people that have the personalities where they could be on a unicorn flying towards a pot of gold at the end of a rainbow and they would figure out a way to be bitter about it. Probably bitch about the size of the rainbow or the color of their unicorn.

I guess malignant means working 50 to 60 hours a week with light call, most faculty that cares about residents and a new PD that is more than happy to go to bat for her residents.

We do not send only our bright and cheery residents to our interview dinners. Try and remember one persons opinion doesn't make a program malignant. I understand your hesitancy with your interactions as I had a similar interaction at another residency interview I had last year; but please stop jumping to conclusions about a whole program based on an interview dinner where you appeared to interact with one resident the whole time.


Tldr: what Bashir said, just a lot less P.C.

Sent from my SM-G900V using SDN mobile
Click to expand...

Completely agree. I have zero legitimate complaints about my program, but if you were to talk with some of my classmates you might come to the conclusion that this is the worst program ever. I doubt they would say these things to applicants, but they have complaints about things which have absolutely nothing to do with the training or even the program directly. Not to mention that their complaints have questionable veracity anyway. Unsurprisingly, it seems to be the small number of people that always have something to complain about...
 
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A malignant program is still better than no program at all. It's just 4 years of misery at its worst.
 
WisNeuro said:
I heard that the Baylor College of Medicine eats steak with ketchup. Add it to the list. If that's not malignant, I don't know what it
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I heard those Baylor psych residents do car commercials. In Japan.
 
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MacDonaldTriad said:
Someone leaving a program as a data point can go both ways. The only thing worse than a program letting a resident go un-graduated, is not letting a resident go who shouldn't graduate. Sometimes people leave for family reasons, sometimes things just don't work out. Even when someone leaves mad and feeling mistreated, often there are a few dozen other residents who are staying and don't feel that way. I agree, a mass exodus is bad, but just listing programs where "someone left" doesn't say anything about the nature or quality of the program.
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Why is it bad to let a resident graduate who shouldn't? What happens to you, as the PD, in that case? You gotta know that there are plenty of bad doctors out there already, every program graduates some of them from time to time, and it's sheer narcissism for you to think you'll never graduate someone bad. Right?
 
lockian said:
I heard those Baylor psych residents do car commercials. In Japan.
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I don't think Baylor can afford international electives. I wonder if they ever managed to finish construction on their bankrupt hospital that sat empty for several years. Does anyone know?
 
nancysinatra said:
Why is it bad to let a resident graduate who shouldn't? What happens to you, as the PD, in that case? You gotta know that there are plenty of bad doctors out there already, every program graduates some of them from time to time, and it's sheer narcissism for you to think you'll never graduate someone bad. Right?
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I'm not a PD, but I imagine there are 2 reasons to care:
1) You feel bad for patients for seeing this totally incompetent doctor that you let out there. It doesn't directly affect you, but empathy is a real thing.

2) Every resident you graduate becomes a living advertisement for your program. If patients and other hospital systems start to associate your program with incompetent doctors, then that damaged reputation may affect your other graduates from getting good jobs, and this bad reputation may trickle down to future applicants to your program.
 
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I reckon half the gripes people on SDN have about the field of psychiatry are problems mostly attributable to people who have no business being doctors/psychiatrists being passed along and allowed to practice as doctors/psychiatrists.

I tire of the "participation trophy" mentality. Just because you feel you deserve to be a doctor doesn't mean you have some right to. If you can't demonstrate competency, you shouldn't be out there practicing.

Don't mean to sound harsh, and god knows enforcing this justly is challenging and problematic, but to not even bother try and give anyone who scramble their way into any medical school a gold sticker to practice medicine because the alternate is just so bad doesn't cut it.
 
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nancysinatra said:
Why is it bad to let a resident graduate who shouldn't? What happens to you, as the PD, in that case? You gotta know that there are plenty of bad doctors out there already, every program graduates some of them from time to time, and it's sheer narcissism for you to think you'll never graduate someone bad. Right?
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Maybe it's just me, but...Professional Ethics?
My name is on the letter that says "this person is competent to practice psychiatry", so maybe it's just narcissism and self-protection, but it matters.
 
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nancysinatra said:
Why is it bad to let a resident graduate who shouldn't? What happens to you, as the PD, in that case? You gotta know that there are plenty of bad doctors out there already, every program graduates some of them from time to time, and it's sheer narcissism for you to think you'll never graduate someone bad. Right?
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We are the last point of quality control. If medical schools graduate problems, and we graduate problems, no one has to board certify to practice. Shouldn't there be a certain % who are not fit intellectually or emotionally to practice competently? There isn't a specialty out there that hasn't had to flunk a trainee at some time. It isn't just psychiatry. If there is a specialty where everyone match graduates, someone isn't doing their job. It would be nice if everyone developed smoothly into competent physicians, but that just isn't the reality.
 
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