MD Anderson surgpath and subspecialty

[Korzh]

Hi guys. Does anybody have any info re how good general surg path train is at MDA? I know there's "some" scutwork that comes with it but I am more interested how decent the training is. Any input is highly appreciated!

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[Unty]

I dont think you will have problems finding a job doing surgpath there, thats for sure.

 

[Korzh]

Thank you, Unty. Do you know what's the chance of securing subspecialty after completion surg path there?

 

[Ishie1013]

I have not heard good things.

 

[Korzh]

I have not heard good things.

what about bad things?

 

[Ishie]

It's hearsay, but yes.

 

[maji]

Okay. As someone who has done the fellowship I can speak a bit about things there. First of all, as far as subspec goes it really depends on what you want. Things like DP are set up quite in advance, while on the other hand, the GU fellowship wont pick a fellow until you are already doing SP there, putting them a year off the other cycles. To the comment that MDA will get you a job, I am not sure that is the case. Certainly having the experience is beneficial, and the material is pretty great, but there are few attendings there who seem to actively advocate to find their fellows work. In my year, there were fellows who were unemployed until late April/May. I think a lot of the faculty there are pretty insulated to the world outside. I think on your CV it will give you a leg up on someone without that, but otherwise I am not so convinced. Out of my class, only 1 person did just that fellowship and got a good job. There was a sudden opening for the next year DP spot, which that person wanted, but instead of offering him an interview and a position, they re-interviewed/offered a candidate they had interviewed the year prior... a non MDACC fellow. Everyone else either had done a previous fellowship or were doing another including (cyto, GI, derm, GU etc).

The fellowship itself is an intense one. Grossing has been reduced, and I am not sure how the schedule is now, but really the reduction in grossing doesn't change the lifestyle. On average I got there around 6:30 am and left at 7pm. Certain rotations required more than that. Many faculty expect you to come in weekends to previous cases that get dumped in your box the friday preceding. If you are on one rotation, and the following week you are another, even if you dont finish signout until 5pm, they will expect you to have written up the stack of cases before signout monday. The sarcoma fellow would routinely come in at 7:00, go home at 6 for dinner, and come back at 7 and work until 10-11 every day.

The book fund is 250 dollars. The MDACC institution won't honor the public service loan forgiveness program, will not sign the paperwork, and do not consider their fellows "employees".

 

[jupiterianvibe]

Okay. As someone who has done the fellowship I can speak a bit about things there. First of all, as far as subspec goes it really depends on what you want. Things like DP are set up quite in advance, while on the other hand, the GU fellowship wont pick a fellow until you are already doing SP there, putting them a year off the other cycles. To the comment that MDA will get you a job, I am not sure that is the case. Certainly having the experience is beneficial, and the material is pretty great, but there are few attendings there who seem to actively advocate to find their fellows work. In my year, there were fellows who were unemployed until late April/May. I think a lot of the faculty there are pretty insulated to the world outside. I think on your CV it will give you a leg up on someone without that, but otherwise I am not so convinced. Out of my class, only 1 person did just that fellowship and got a good job. There was a sudden opening for the next year DP spot, which that person wanted, but instead of offering him an interview and a position, they re-interviewed/offered a candidate they had interviewed the year prior... a non MDACC fellow. Everyone else either had done a previous fellowship or were doing another including (cyto, GI, derm, GU etc).

The fellowship itself is an intense one. Grossing has been reduced, and I am not sure how the schedule is now, but really the reduction in grossing doesn't change the lifestyle. On average I got there around 6:30 am and left at 7pm. Certain rotations required more than that. Many faculty expect you to come in weekends to previous cases that get dumped in your box the friday preceding. If you are on one rotation, and the following week you are another, even if you dont finish signout until 5pm, they will expect you to have written up the stack of cases before signout monday. The sarcoma fellow would routinely come in at 7:00, go home at 6 for dinner, and come back at 7 and work until 10-11 every day.

I feel if you want to do a SP fellowship, then you should go do it at a place like MDACC, MSK, JH etc. The morning didactic which is fellow level is very good. The primary focus of the fellowship really is efficiency and speed in my opinion. You really don't have the luxury of cracking open books to study about an interesting case because you just have too much work. Some faculty are more flexible, but you work with so many. Often you are double scoping every benign prostate biopsy you saw, etc. There is little independence. Ordering immunos without asking is usually a no go. Covering the FS service you are never really alone, although some attds will not look at the slide until you call it in, then look and call back immediately if they disagree.

For the "bad" things. Here are just some of the things we were told during orientation. "I don't believe in lunch, I think this fellowship is a good time to lose weight". At the orientation there was some free food, and the PD at the time said "enjoy the food, this is the last time there will be free food" (not true exactly). On the whole, most faculty are nice on a 1 on 1 basis, but the intradepartmental politics aren't really hard to experience. I think the faculty work extremely hard, and the stress shows. They are often there as early and stay as late as the fellows. Some faculty kept their fellows till 10 pm. Some faculty are there until 2 am...

Overall I don't think the faculty are particularly invested in training the fellow. You are there to push glass, gross, and write up a reasonable report so they can key it out. There is NOTHING wrong with that, but it isn't exactly academic. You are pushed to do research in order to get your certificate, but are given very little time to work on it. I wrote a paper with references and everything, and have given up on publishing it after the faculty on the paper would not read it or give any feedback on it. Other faculty are good to publish with, and I can tell you in a PM if you decide to go there.

The book fund is a laughable 250 dollars. They wouldn't let me present my poster at CAP using an academic day because the poster wasnt from MDACC (I understand not using their travel funds). They pressure you at USCAP to present and come right back. The MDACC institution won't honor the public service loan forgiveness program, will not sign the paperwork, and do not consider their fellows "employees". I have friends who were given grief about going for job interviews, told they did too much research and not enough clinical, and then told the opposite.

That sounds like a crappy experience.

 

[pathslides]

Wow. Sounds like a horribly malignant program. Why would anyone ever want to go there after reading that post?

 

[Thrombus]

What a nightmare! I think I would rather run the gauntlet in the Dark Ages.

 

[Ishie]

I was wondering if you'd come by and confirm, but didn't want to speak for you.

 

[maji]

It was certainly a stressful experience. It was made alright by the great group of fellows we had. Most everyone there was thoughtful, considerate, and willing to help. We had regular social get togethers outside of work every few weeks as well. Again... most faculty one a 1-1 basis are very good. You often have to solicit the teaching, but that is stylistic. Some people teach at you the whole time, some grill you, others just quietly agree or disagree with you. I see no problem in those things. Again, learning high volume efficiency as well as seeing complex gross cases (face resections, hemipelvectomies, pelvic exenterations etc) it is very very good. Keep in mind it is an ONC center, so you will see mostly cancer. Derm is mostly cutaneous lymphoma, dysplastic nevi, and melanoma.

On the flip side of things, the cytology program there is great and everyone is super happy!