MGH - still crazy after all these years?

[howareyou]

All I found were prehistoric stories on Scutwork, and some banter here and there on this Forum, so...
Is Neuro at MGH still the crazy experience it used to be, or have things changed since the 80 hrs cap?

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[chagall]

Well, a resident there during one of my interviews described the first year as "brutal"...one of the several things that caused me to rank it much lower than expected. (I think I put it as #5!).

 

[howareyou]

Well, a resident there during one of my interviews described the first year as "brutal"...one of the several things that caused me to rank it much lower than expected. (I think I put it as #5!).

Was this the prelim year (PGY-1) or the first year of the Neuro program (PGY-2)?

 

[chagall]

Was this the prelim year (PGY-1) or the first year of the Neuro program (PGY-2)?

PGY-2 (I think).

 

[typhoonegator]

First off, the residency at MGH is combined with BWH, and is called Partners. There is no "MGH neurology residency".

Programs like Partners pride themselves on having a rigorous academic training program in which you see a ton of patients and carry a lot of responsibility. You can't really cover MGH and BWH and not end up taking care of a lot of sick people. As a result, it isn't easy, particularly during that PGY-2 year.

There are many ways to become well-trained in neurology. As you explore different programs, you will find many different approaches and philosophies. The most important thing for you as an applicant is to select a program that fits your style. It would be an outright lie for anyone at Columbia or Partners or Mayo to say that their way is the best and only way to train smart neurologists. However, they believe in what they do, and their track records speak for themselves.

There are certainly easier programs than Partners out there where you can train and become a fully-functional board-certified neurologist. The people at Partners happen to think that there are advantages to the way they train. You certainly shouldn't be blinded by the big names -- see for yourself and decide based on your own personality and goals.

 

[howareyou]

However, they believe in what they do, and their track records speak for themselves.

There are certainly easier programs than Partners out there where you can train and become a fully-functional board-certified neurologist.

So, if everyone agrees that there are many ways to become a well-trained neurologist, but if Partners residents say their first years are "brutal", how come Partners still "believe in what they do". Wouldn't it be a logical step for them to become less-brutal and still provide excellent training (as other programs do)? I know it won't happen, but I'm just saying.

 

[typhoonegator]

Well, some people happen to like the intensity and additional responsibilities that come with training at a program like Partners. Certain types of people thrive in that kind of environment. There are also academic and research opportunities available via these programs that make the environment worth it for them. If that isn't your bag, fine, don't go there.

And let's be clear, Partners isn't the only program to have a challenging junior year. In fact, they are probably unfairly singled out due to preformed conceptions.

 

[chagall]

Well, some people happen to like the intensity and additional responsibilities that come with training at a program like Partners. Certain types of people thrive in that kind of environment. There are also academic and research opportunities available via these programs that make the environment worth it for them. If that isn't your bag, fine, don't go there.

And let's be clear, Partners isn't the only program to have a challenging junior year. In fact, they are probably unfairly singled out due to preformed conceptions.

I agree...to be fair, the same person who called the program "brutal" also said he wouldn't have chosen to go anywhere else and that this type of program had its upsides. It just wasn't for me.

 

[DarthNeurology]

Well, some people happen to like the intensity and additional responsibilities that come with training at a program like Partners. Certain types of people thrive in that kind of environment. There are also academic and research opportunities available via these programs that make the environment worth it for them. If that isn't your bag, fine, don't go there.

And let's be clear, Partners isn't the only program to have a challenging junior year. In fact, they are probably unfairly singled out due to preformed conceptions.

When people use terms like "intense" and "challening" I tend to think they mean either one of two things:

A. A large number of patients, longer work hours, or regular patient load but added on clinical lectures.

B. A significant percentage of faculty feel the need to make the residency or rotation "intense" through artificial means such as constantly pointing out how little subordinates know and how incompetent they are, basically treating residents pretty poorly so they forget their sense of humanity.

I think anyone can thrive in environment "A" listed above and do well, i.e. if a group of attendings are as sweat as a peach then it is fun to go to hospital/clinic and you do a good job and you learn more. The only people who thrive in environment "B" are those who are so concerned with their careers that they are willing to ignore sub-par working conditions and delude themselves into believing that they are receiving superior medical training in what is essentially a prison boot camp, and subconciously hope to be the warden someday. When finished with said residency they further torture themselves and their colleagues and students with comments about how crappy medicine is and what a pain the paperwork is because the part of their brain that knew how to be happy atrophied during residency and like the son of the devil only know how to work in a place that is like hell.

The unthinkable combination of A and B in a residency is a place to avoid like the plague.

I find it curious that MGH renamed itself, i.e. is now "Partners!" . . . everybody knows McDonalds, it is like they renamed themselves Ronald's or something . . .

 

[typhoonegator]

At the risk of de-anonymizing myself, I can tell you unequivocally that option B is not in play at Partners.

Regarding the naming thing, it is all just big business. When the administration of BWH and MGH came together to form one organization, they called it "Partners", for whatever reason -- probably some focus group or something. This was done so the two hospitals could jointly negotiate with the insurance companies, who were playing the two hospitals against eachother. A few of the departments really did merge together as well, but for the most part, the faculties remained independent, and only connected on an administrative level. Hence, while the residents are Partners residents, the faculty are either part of MGH or BWH.

 

[DarthNeurology]

At the risk of de-anonymizing myself, I can tell you unequivocally that option B is not in play at Partners.

Regarding the naming thing, it is all just big business. When the administration of BWH and MGH came together to form one organization.

I guess kinda of how Taco Bell and Pizza Hut are owned by the same corporation so sometimes you in a single franchise a Taco Bell/Pizza Hut and you order both Pizzas and Tacos in the same restaurant. So if a patient at MGH wants a second opinion from someone at the BWH then do you have to disclose that Taco Bell owns Pizza Hut as it were? What does MGH want to be known as to the outside world? I guess they are still MGH in terms of describing a single phsician who is in the media, not "A leading neurologist at Partners today discovered . . . blah blah blah"

 

[CarefreeCFC]

I guess kinda of how Taco Bell and Pizza Hut are owned by the same corporation so sometimes you in a single franchise a Taco Bell/Pizza Hut and you order both Pizzas and Tacos in the same restaurant. So if a patient at MGH wants a second opinion from someone at the BWH then do you have to disclose that Taco Bell owns Pizza Hut as it were? What does MGH want to be known as to the outside world? I guess they are still MGH in terms of describing a single phsician who is in the media, not "A leading neurologist at Partners today discovered . . . blah blah blah"

Darth--I'm not sure I'd make anything significant or sinister about the "Partners" moniker, or the fast-food analogy either, to be honest. I do think your point about residency programs that systematically break down the morale and confidence of their Residents is an extremely good one though. I'm not in a position to say anything about the "Partners" program specifically--but suffice it to say that, on the whole, the 'Top Tier' programs practice more than their fair share of this compared with other residency programs.

Sadly, everyone knows what an "East Coast mentality" is on the interview trail, and it's become code for an authoritarian, top-down, soul sucking residency, and the only programs who can regularly get away with it and still fill their slots are the gleaming Mecca's of Academia. Luckily for myself I'm not in such a program, although I do fear that for a lot of aspiring (academic) Neurologists, they are willing to place their 'Career' and publications ahead of their own well-being. I honestly don't think that anyone at a "top" program believes they're getting better training than at any one of the 50 or so schools ranked "below" them--or at least I hope not. Because let's be clear: you're attending one of these programs in exchange for a career in Academia. By focusing on that and the publications that come with it, you will by definition be less able to focus on becoming an outstanding "Clinical" Neurologist.

This is all probably common knowledge to most on this board, but for any promising applicant with the credentials otherwise to match at a "top tier" program who doesn't want an Academic career with every fiber of their being, you're probably better served looking elsewhere. You can save yourself a lot of angst, time and frustration by finding a program with a reputation for training excellent Clinical Neurologists, with high Resident morale and camraderie, collegial Staff-Resident interactions, and whose program structure is at least partly controlled by the Residents. If only the interviewees next year would discuss some of these aspects of the Residency Programs where they interview on this board, instead of creating yet another mind-numbing 1 to 100 ranked list of the country's Neuro residencies... Sadly, I'm sure that's exactly what will happen...

 

[DarthNeurology]

Darth----but suffice it to say that, on the whole, the 'Top Tier' programs practice more than their fair share of this compared with other residency programs.

Sadly, everyone knows what an "East Coast mentality" is on the interview trail, and it's become code for an authoritarian, top-down, soul sucking residency,

I have seen a lot Neurologists who are very academic, i.e. multiple research projects, teaching etc. . . who most certainly did not go to the Top 10 Neurology programs. Conversely, there are probably a lot of Neurology residency graduates from the Top 10 who do not go into academics, but do mostly private practice. . . I think clinical training is what you make out of it, and you can make it much more out of it if you are at a place that treats residents decently. Also, I think academics is becoming much less competitive than it was some 20 years ago, . . . today's neurologist in general wants a balanced life, not to have the constant pressure of academic world, which they can get with private practice or just doing clinical stuff at an academic hospital. I think is why a lot of northeast neurology programs go unfilled, and a fair number of them did this year as well, they simply aren't seen as desirable. A big ten neurology program doesn't make you a great academic, just a lot academic types apply and rank highly northeastern neuro programs, when probably they could have gone to any university program with decent academic base and done similarly successfully. . .

 

[Woatalk]

I think is why a lot of northeast neurology programs go unfilled, and a fair number of them did this year as well, they simply aren't seen as desirable. A big ten neurology program doesn't make you a great academic, just a lot academic types apply and rank highly northeastern neuro programs, when probably they could have gone to any university program with decent academic base and done similarly successfully. . .

Dude, What are you talking about! There where more unfilled spots in other parts of the US, when compared to the Northeast. I have the #s to prove it

Secondly, the Big Ten Neurology programs are designated so for a reason. They weren't just placed there overnight! A lot of the best and strongest work in the field have come from these institutions...thats why they are heavily funded year after year by the NIH. Hence, this it not some type of theory concocted by SDNers; rather, it is solely the present concensus in the WORLD of academia.

Also, going to one of these programs would more so increase your probability of going to the fellowship of your choice-- as a whole lot of inbreeding occurs, (as been discussed on numerous other threads)....remember it is who u know!

SO the moral of the story is: Choose wisely.

 

[buckley]

It's hard to have a discussion like this going without it turning into a my-residency-is-better-than-yours debate. Indeed, choose wisely, and oh yeah, KNOW THY SELF

I agree the academe is opening up, and I think there are actually lesser people with an inclination towards it. Would it be possible to go into the academe from a non-top-tier program? I've met a couple in the interview trail. Would it be easier to go into the academe from a top-tiered program? I think that would make sense now, right? At the end of the day though, or should I say come job hunting season, sure--prestige is a factor, and it's a big plus. But it can only give you a foot-in-the-door and the work does speak for itself. It's not where you go but what you make out of it. That being said, I am a fan of the Partners curriculum, and no, I am not affiliated with them.

 

[DarthNeurology]

Dude, What are you talking about! There where more unfilled spots in other parts of the US, when compared to the Northeast. I have the #s to prove it
quote]

From the other thread the NorthEast programs that went unfilled (NOT highly ranked obviously were):

Einstein/Montefiore Med Ctr-NY 9 7 2
Mt Sinai Hospital-NY 6 3 3
Boston Univ Med Ctr-MA 5 4 1
New England Med Ctr-MA 6 4 2
Temple Univ Hosp-PA 4 1 3
UMDNJ-R W Johnson-Camden 2 0 2

While there are the traditionally "Hotties" i.e. Partners, which are very good to excellent in the Northeast, these are some of the "Notties"

i.e. 6 out 20 were Northeastern programs that went unmatched, and many were midwestern. . . the further out west you go the few unmatched, i.e. see any in California that went unmatched? And considerin that Duke is an eastern program, "highly" regarded after this years match less so in some quarters . . . most University Neurology programs I know of have great NIH funding and they are not in the Northeast, I think the golden days of the Northeast being a leader in Neurology are over as many not obvious "Big Ten" neurology programs are doing ground breaking research and producing future excellent neurologists, California alone balances out Northeastern programs in terms of having a brand name and getting to know people in the field, I honestly believe that 70% of the best programs are NOT in the Northeast and will produce the majority of the leading neurologists in years to come.

 

[DarthNeurology]

It's hard to have a discussion like this going without it turning into a my-residency-is-better-than-yours debate. Indeed, choose wisely, and oh yeah, KNOW THY SELF

I agree the academe is opening up, and I think there are actually lesser people with an inclination towards it. Would it be possible to go into the academe from a non-top-tier program? I've met a couple in the interview trail. Would it be easier to go into the academe from a top-tiered program? I think that would make sense now, right? At the end of the day though, or should I say come job hunting season, sure--prestige is a factor, and it's a big plus. But it can only give you a foot-in-the-door and the work does speak for itself. It's not where you go but what you make out of it. That being said, I am a fan of the Partners curriculum, and no, I am not affiliated with them.

Totally possible to do academia without "Big Ten Neurology", most academic neurologists didn't go to the big ten snooty Northeastern programs. I think if you work hard you will do very well, i.e. work hard to publish, in the past these people self selected to the Northeast, but not so much any more