New UCSF/San Francisco General program?

[Gr42]

Does anyone have any info about this new UCSF/SGH residency program? There is not much information on FREIDA

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[bulgethetwine]

Does anyone have any info about this new UCSF/SGH residency program? There is not much information on FREIDA

Great program director.

She's a F&*%ing bulldog, but she'll get sh*% done.

 

[Gr42]

On FREIDA it says that the program director is Michael Callahan, is that a She? Sounds like a male name to me

 

[bulgethetwine]

On FREIDA it says that the program director is Michael Callahan, is that a She? Sounds like a male name to me

I thought the new program director at UCSF was Susan Promes. She started one of the North Carolina programs (Duke).

Maybe I heard misinfo, though, I don't know who Callahan is.

Promes is, like I said, as advertised: She'll get stuff done, but I wouldn't want to work for her. But if she was leading the way for a new residency and fighting all the initial battles, you couldn't have a better Napoleon. Or Napoleonette.

 

[Hard24Get]

Dr. Promes is the PD, Dr. Callaham is the Division Chief . They have a nice new website, complete with fancy buttons:
http://www.ucsf.edu/emergmed/

 

[EctopicFetus]

fancy buttons are cool

 

[igcgnerd]

fancy buttons are annoying

 

[jigga_what]

I thought living in santa monica would be expensive on the U-C salary, but the bay area is even worse. 43K to live in SF? Preposterous... would barely support lving in a storage unit....

 

[TxMed]

I thought living in santa monica would be expensive on the U-C salary, but the bay area is even worse. 43K to live in SF? Preposterous... would barely support lving in a storage unit....

Salary
Residents will be paid according to the University of California salary scales:
PGY level Monthly salary Annual Salary
1 $3,614.67 $43,376.00
2 $3,732.42 $44,789.00
3 $3,879.08 $46,549.00
4 $4,027.67 $48.332.00

Additional incentives
• All PGY-1 interns will be funded to attend the national SAEM meeting in the month of May.
• $500 monthly housing allowance to help off-set the higher cost of living in San Francisco
• $2,400 relocation stipend for new, incoming residents
• Partial reimbursement of new and renewed medical license
• Partial reimbursement of USMLE Step 3 examination fees

 

[rina33]

Anyone actually worked with her? I'm curious what your experience was... and any more info (other than above) about what she might be like as program director.

 

[Chulito]

Anyone actually worked with her? I'm curious what your experience was... and any more info (other than above) about what she might be like as program director.

Didn't Apollyon do his residency at Duke? I'll PM him and ask him to come here and comment on her if he knows her.

 

[Apollyon]

Dr. Promes gets results - period. If she's in favor of something, it's 100%. In one word? Driven. She's not the warmest person at all times, but she will support you 100%, and get you any help she can.

If you want a hands-off PD that will let you slack, Dr. Promes isn't that person. However, with the tight ship she keeps, and being in SF, you'd be hard-pressed to get better training.

She also knows essentially everybody who is anybody in EM.

 

[TommyGunn04]

Having worked with her on several occasions, although not extensively, my impression is that Dr. Promes is VERY opinionated, aggressive, forceful, and inflexible, often to the point of absurdity. If she gets her mind set on something, watch out. As was said above, this surely makes her a good advocate for residents. On the other hand, if also means that if she doesn't agree with you then you're pretty much out of luck. I found her to be very unpleasant to work with, and at times rather unreasonable. I also was not particularly impressed with her clinical knowledge or skills.

She did a rather poor job running a medical school course at Duke Med for the 2 years that she was in charge of it. She always tried to present herself as being caring and responsive to feedback, when in reality she was quite cold and inflexible. Actions speak louder than words, and her actions were definitely reflective of the aggressive and inflexible attitude I described above.

Personally, I would not want to work in a program run by her. This is not to say that she couldn't build a great program, I just don't like her personal approach to patients and residents, and wouldn't want to have to deal with her on a routine basis. She looks great on paper, but from what I've heard from EM residents and countless students, she was not very well-liked at Duke.

 

[Apollyon]

Having worked with her on several occasions, although not extensively, my impression is that Dr. Promes is VERY opinionated, aggressive, forceful, and inflexible, often to the point of absurdity. If she gets her mind set on something, watch out. As was said above, this surely makes her a good advocate for residents. On the other hand, if also means that if she doesn't agree with you then you're pretty much out of luck. I found her to be very unpleasant to work with, and at times rather unreasonable. I also was not particularly impressed with her clinical knowledge or skills.

She did a rather poor job running a medical school course at Duke Med for the 2 years that she was in charge of it. She always tried to present herself as being caring and responsive to feedback, when in reality she was quite cold and inflexible. Actions speak louder than words, and her actions were definitely reflective of the aggressive and inflexible attitude I described above.

Personally, I would not want to work in a program run by her. This is not to say that she couldn't build a great program, I just don't like her personal approach to patients and residents, and wouldn't want to have to deal with her on a routine basis. She looks great on paper, but from what I've heard from EM residents and countless students, she was not very well-liked at Duke.

Having worked with her almost daily for 3 years, and having been older and more experienced in EM than most students or residents (from my EMS years), I can tell you that there are several-to-many PDs that are 1. crazier 2. less intelligent 3. less efficient 4. less invested in their residents and 5. less liked.

Also, a general viewpoint that I accrued in my 3 years at Duke: internal medicine colors heavily many med students opinions, and I grew tired of student after student - who had no cachet or standing - MFing EM residents and the ED in general. I'm just saying that a Duke med student that is now an IM resident has some bias. I mean, you may have gotten nothing out of the capstone course, but she was chosen by administration to run it. Likewise, she was chosen as the new PD at UCSF, and did receive several teaching awards, including one from Duke.

I mean, what if I said that Dr. McNeill was a strident advocate for IM residents, at the expense of other residents? Or that the MICU rotation was cliqueish and insulting (as I was accused - as "the ER resident" - of taking the answer sheet for a test that one of the Pulmonary/CC fellows had for a research project, when it was indeed and in fact an IM resident that took it), and there were few real MICU patients, and that it was more like a Duke IM floor than anything else (chasing lab values all day, and IM residents afraid of procedures)? That was my take, but it does not sound very positive, does it?

Your post is almost verbatim a repetition of what you said in another post. Your point is taken. I just wanted to qualify it a bit.

 

[TommyGunn04]

Hey Apollyon, thanks for your reply. It's always good to get an insiders' opinion, and to hear the other side of the story. I'm really surprised to hear you speak so highly of Dr. Promes though. Over the past several years I've talked and/or worked with many EM residents and faculty, and have literally never heard any of them say something positive about her. On the other hand, I've heard countless residents and faculty make negative or derogatory comments about her and the way she does things.

I agree that there's definitely a bias against the EM program and the faculty/housestaff at Duke, which certainly colors the opinions of many students and residents, but it's hardly fair to discount my opinion based on this assumption. In fact, there's good reason to think differently about Duke EM vs. Duke Medicine. Indeed, the prestige of the Duke EM program pales in comparison to that of most other residency programs at Duke, mostly because it's still a very young program, so it makes sense to expect there to be differences in the overall average quality of faculty and residents. Having seen countless cases of poor patient management by EM residents and attendings, there's a reason why Duke medicine residents often carry a bit of resentment about the EM folks. I think it's improved quite a bit over the past few years though, as the quality of the residents and faculty have improved immensely with the hiring of people like Josh Broder. There are many fantastic EM attendings and residents, but we all have our "horror stories." (similarly, we all have horror stories about IM colleagues too!)

Everyone is entitled to their own opinion, and each person has their own unique background that colors their experience. There's no "correct view," just opinion, so there's no use arguing about it. I'm just presenting my own experience and an opposing yet valid viewpoint, in the hopes of helping people make their decisions about the program. No offense meant, but of all the people I've polled about Dr. Promes, I've have to argue that your opinion is very much in the minority.

 

[Apollyon]

Having seen countless cases of poor patient management by EM residents and attendings, there's a reason why Duke medicine residents often carry a bit of resentment about the EM folks.

I think that that says it all. However, let me tell you of an opposing perspective from "up above", despite your claims (which I take as absolutely true) of faculty being unprofessional enough to defame another faculty member to junior people (including students), which is professionally inexcusable and unacceptable. We were told that, per Andrew Muir and Diana McNeill, the EM residents should not complete every workup, as there was nothing being left for IM residents to do, save for data mining and following up lab results. As you may be unwilling to believe this, ask Kathy Clem. Xavier Preud'homme said the same thing - that he has been at Duke from well before there was true "EM" until after the program had been moving along, and it was leaps and bounds from before until after.

Finally, Duke IM residents, generally, have not distinguished themselves in the ED (showing up late, seeing less than 1 patient per hour, blatantly avoiding procedures, and then complaining about what they DO have to do), and, adding that to the disdain they show, it's a positive-feedback loop, and it's reiterated among highly impressionable second-year med students rotating through. There were a few that did indeed stand out, and did a fine job, but they were certainly in the minority.

Now, I'm making buckets of cash, and am easily following the standard of care, and that is due to the training I had at Duke. That in itself is directly a result of Susan Promes and her management of the program. You don't have to like her (as you evidently don't, but, in case you're not clear on it yet, one doesn't need to be liked to be effective), but, de jure and de facto, what she does works. And the faculty that would deride her don't have standing, or the guts to stand up for their principles, as she did, as I said, receive a teaching award from Duke.

UCSF is not a low-profile place, and they had many to choose from, and they chose her. Honestly, I think that the collective minds of UCSF, SFGH, and University Hospital have a bit more evolved perspective than a relatively young, newly-graduated doctor. What I'm saying is that it isn't a free pass with her, but you get your chops - guaranteed. Because people are rubbed the wrong way because it's not the typical coddling style amongst the "in crowd" (of which we were decidedly not invited into), that has little bearing on the results - even if it is that "I don't want to be like that", that's enough. I can tell you, whether people liked her or not (including all of the "EM residents" you know - whom I guarantee, for most at least, I know better than you), we all got what we needed. No one has yet to have flunked their board certification exams, among other benchmarks.

 

[aliraja]

To offer a little different perspective (and come back from the Duke IM vs. EM war being waged here)

I went to Duke Med but, for various reasons, decided to leave for residency. I did, however, watch and work with Susan Promes for 2 years while I was there. BTW, I'm not looking for a job in SF, nor do I plan to in the future...

She is exactly what a new EM program at a big-time academic institution needs in order to gain ground quickly. If you've ever heard Ron Walls talk about the early years of his program at BWH and the fights he both fought and avoided with the various departments there, you know the kinds of hurdles that Promes faced at Duke and will no doubt face at UCSF. She has to be hard-nosed and a little stubborn... anything less and the already-powerful IM and Surgery Depts will have their way with a fledgeling EM Department. Don't think for a second that Duke's EM program would be as up and coming as it is today if Promes hadn't fought a bunch of fights early on and stuck to her guns to get what she felt her program deserved.

 

[rina33]

Thanks for your replies... this has been a very interesting discussion. I wonder if there's anyone else on this forum who has worked with her. Anyone know if she likes/is supportive of residents with families?

 

[chumbojumbo]

yea...and does she like us IMGs?

 

[bcrosspac]

I could never even come close to the eloquent posts by Apollyon. I have to agree with him wholeheartedly as well. As a member of her last graduating class at Duke, I can only offer her praise as well. She can be hard nosed at times but it is always with the best interest of the resident and program at heart. She takes her role very seriously and I feel lucky to have had her as our PD. I am now working at a very busy community ED along with another Duke graduate and we both feel like our training has been more than adequate to perform well here. I think any prospective resident should consider that Dr. Promes will put together an outstanding program and would be lucky to be accepted there.

Also, to the IM resident who posted earlier about the quality of the EM workups, I am not sure who you are but I am apalled that you would make such a comment on this public forum. EM and IM residents work alongside each other on many rotations and both departments have worked hard to develop a collegial relationship. Those types of comments do nothing but undermine that relationship.

 

[hyperbaric]

FWIW, I meet Dr Promes recently and had the opportunity to speak with her one-on-one for about 5 minutes. In this short time, I was impressed with her enthusiasm and candor. And, I would have to agree (again based on my brief encounter) that she would be a great person to fight the inter-departmental turf war faced by a new program.

 

[TraumaCheers]

I could never even come close to the eloquent posts by Apollyon. I have to agree with him wholeheartedly as well. As a member of her last graduating class at Duke, I can only offer her praise as well. She can be hard nosed at times but it is always with the best interest of the resident and program at heart. She takes her role very seriously and I feel lucky to have had her as our PD. I am now working at a very busy community ED along with another Duke graduate and we both feel like our training has been more than adequate to perform well here. I think any prospective resident should consider that Dr. Promes will put together an outstanding program and would be lucky to be accepted there.

Also, to the IM resident who posted earlier about the quality of the EM workups, I am not sure who you are but I am apalled that you would make such a comment on this public forum. EM and IM residents work alongside each other on many rotations and both departments have worked hard to develop a collegial relationship. Those types of comments do nothing but undermine that relationship.

covered above afterall.

 

[TommyGunn04]

Also, to the IM resident who posted earlier about the quality of the EM workups, I am not sure who you are but I am apalled that you would make such a comment on this public forum. EM and IM residents work alongside each other on many rotations and both departments have worked hard to develop a collegial relationship. Those types of comments do nothing but undermine that relationship.

In all fairness, my comments need to be taken in their full context. I didn't say that all EM workups at Duke are bad, as you claim, nor did I make any attempt to generally undermine the residents or attendings. I even said that I've seen several of my own colleagues make poor decisions. Indeed, I'm sure I've made several of my own throughout the training process. But it's a fact that patients sometimes come to the floor not having had essential components of their workup performed, which can dictate whether they should go to the MICU instead of the general floor (NG lavage is a prime example). This is a fact. But as I said several times, I've been very impressed with many of the EM residents and attendings I've worked with, and I even mentioned a few specific names here. It's not fair or equitable to take a few random snippets from my posts and then make it look like I'm somehow trashing the whole EM program and all of its residents. To do so would be very unprofessional and inappropriate. But as to your comments about the "collegial relationship," I must say that the current state of relations between IM and EM leaves much to be desired. I hope it improves, and I have worked a great deal to try to foster a good rapport, but there's still a long way to go.

Let's not make this personal, as it seems to be getting. I'm not saying you're a bad doctor because you trained in EM at Duke, and I'm not claiming to be an expert. I'm simply presenting my own observations and experience, as it's always helpful to get two sides of the story. Honestly, I find it very peculiar and intriguing that Dr. Promes gets such praise on this board when she seems so universally disliked by everyone I've asked at Duke. Yes, it's mostly students who took capstone who have disliked her, but many residents and attendings have said so as well. I just wanted to make sure that people were aware of this "other side of the story." Just because your experience has been different doesn't somehow invalidate my own, nor does that fact that you're a couple years older, or claim to know these residents better than I happen to. Apparently you're unable to tolerate viewpoints other than your own, so I'll stop talking about it. I've made my points and you've made yours; hopefully reading this will make people stop and think a bit more during the application and interview process.

By the way, I wholeheartedly agree that the EM workups are MUCH better than they were 4-5 years ago. I never said they weren't. I've also heard those comments made about "data mining" on the floors, with so many diagnoses being made now in the ED, but I don't think it contradicts anything I've said (I also disagree that it's a problem for the IM residency; it's more of a problem for the hospital and the ED, since patients stay down there forever and a day waiting for scans and labs). In fact, I said many times that EM is a young and ever-improving program at Duke. I simply qualified this by saying that it's not on the same level reputation-wise as other Duke residency programs. But this doesn't mean I'm somehow calling you a bad doctor. Don't take my posts as some sort of personal attack against the quality of your training or your expertise. I think we're in agreement about much more than you realize. As I said at the very beginning, I agree that Dr. Promes would be a great advocate for her residents. I was simply trying to make the point that she rubs some people the wrong way, and that some people feel she can be difficult to work with. But this hardly takes anything away from her teaching award or her being chosen to lead this new program. These things speak for themselves.

 

[Apollyon]

The essence is that you're IM on an EM forum. Most prospective residents viewing this forum are prospective EM residents, not IM, and your words (just as mine are) are seen by many, many people. What I wholeheartedly don't want is a misrepresented view - that is all. It's not apples and oranges, but more like red delicious and Granny Smith.

The point is that EM residents that worked under her give (in my opinion) the most accurate impression, since we were/are of the EM mindset (which is, at times, markedly different from virtually all other specialties), and that the lurkers would not be misdirected due to an "outsider" viewpoint. I certainly do not disclaim your statements - just that IM faculty, IM residents, and med students in capstone courses are not the right (or, at least, best) sample space to evaluate the program director for EM.

 

[TommyGunn04]

Well put. I agree.

 

[bulgethetwine]

The essence is that you're IM on an EM forum. Most prospective residents viewing this forum are prospective EM residents, not IM, and your words (just as mine are) are seen by many, many people. What I wholeheartedly don't want is a misrepresented view - that is all. It's not apples and oranges, but more like red delicious and Granny Smith.

The point is that EM residents that worked under her give (in my opinion) the most accurate impression, since we were/are of the EM mindset (which is, at times, markedly different from virtually all other specialties), and that the lurkers would not be misdirected due to an "outsider" viewpoint. I certainly do not disclaim your statements - just that IM faculty, IM residents, and med students in capstone courses are not the right (or, at least, best) sample space to evaluate the program director for EM.

With all due respect to Apol and bcrospac, both of whom I have always respected on this board, I feel that one should not dismiss TommyGunn's opinion because he is IM.

Although I agree with Apol's assessment that EM folks are better poised to comment, I am EM and while I didn't do three years of residency under Promes like they did, I do have extensive knowledge of her based on personal interaction and the fact that I do personally know (and well) several Duke residents. When allowed to comment wholly anonymously (which I'm afraid Apol and bcross aren't here) they speak of her closer to the way TG describes.