so how malignant is U dubb

any info about how malignant univ. of washington is???

I was speaking w/ someone about it on the interview trail regarding that program's possible "malignant" attitude and their recent probationary status (most likely b/c of work hour violations). After mulling it over during the before dinner interview wine, we had 2 hypotheses (sp):

#1) Going to a program "on probation" is probably not going to ding the rep. much- I bet if you were going to take a secret straw poll amongst the educators/PD's/Fellow Directors, most are probably against the 80 hr. work week in some degree (some vehemently, some with some minor alterations). I doubt there would be very many that would frown upon your res. program come fellowship time if it was in violation 2 years ago (the caveat is of course that they fixed the problem...). Take JHU for example- they were on probation a few years ago- does anyone truly think they were crippled by it?

#2) .... it may make intern year a bit easier! Being post-probation, my guess is that the ACGME/RRC are paying close attention to improvements. Ward attendings will make sure you're not going over your hours (for better or worse). By no means I am applying that intern year at Udubb will become a breeze, but it will probably closely approximate the 80 hr. rule for a while.

Anyone out there from U Washington? Thoughts?

coogmed said:

I was speaking w/ someone about it on the interview trail regarding that program's possible "malignant" attitude and their recent probationary status (most likely b/c of work hour violations). After mulling it over during the before dinner interview wine, we had 2 hypotheses (sp):

#1) Going to a program "on probation" is probably not going to ding the rep. much- I bet if you were going to take a secret straw poll amongst the educators/PD's/Fellow Directors, most are probably against the 80 hr. work week in some degree (some vehemently, some with some minor alterations). I doubt there would be very many that would frown upon your res. program come fellowship time if it was in violation 2 years ago (the caveat is of course that they fixed the problem...). Take JHU for example- they were on probation a few years ago- does anyone truly think they were crippled by it?

#2) .... it may make intern year a bit easier! Being post-probation, my guess is that the ACGME/RRC are paying close attention to improvements. Ward attendings will make sure you're not going over your hours (for better or worse). By no means I am applying that intern year at Udubb will become a breeze, but it will probably closely approximate the 80 hr. rule for a while.

Anyone out there from U Washington? Thoughts?

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So how was the uw interview ? How many faculties interviewed you, was it laid back?

Sorry about that... we were actually discussing probation in relation to programs at a DIFFERENT interview dinner (Hopkins) and brought up the similarities to U Washington in passing. Washington is my last one (1/27) Sorry about that and good luck!

coogmed said:

#1) Going to a program "on probation" is probably not going to ding the rep. much- I bet if you were going to take a secret straw poll amongst the educators/PD's/Fellow Directors, most are probably against the 80 hr. work week in some degree (some vehemently, some with some minor alterations). I doubt there would be very many that would frown upon your res. program come fellowship time if it was in violation 2 years ago (the caveat is of course that they fixed the problem...). Take JHU for example- they were on probation a few years ago- does anyone truly think they were crippled by it?

Click to expand...

I think the top 10 programs compete for the same pool of excellent medicine applicants. For some applicants they would be happy at any of the top programs in the Northeast and hints of probation/mistreatment of residents/loss of faculty can swing some applicants from one program to another (for ex. BWH vs MGH vs U Penn vs JHU). In the end these programs still maintain their strong academic reputation, but ACGME probations may bias the top applicants away from some institutions towards comparable programs. However for U Washington, there is less perceived geographic competition in the Pacific Northwest and I would expect the violations to not affect their applicant pool.

I spent a month at UW this fall, and I did not get a malignant vibe. They work hard, but from what I've heard during interviews, I think the interns at UW are as happy or more so as those at other programs of a similar caliber. To me, malignancy is being treated poorly by your upper levels and attendings, spending most of your time doing scut without any educational value, and receiving little to no teaching from attendings. None of these things were true at UW. The faculty loved to teach, were very approachable, and the housestaff were also supportive of one another.

While I was there, they were gearing up for their visit from the ACGME on Nov 17, and a concerted effort was being made to ensure that they would have the probation removed. The chief residents were constantly working to adjust schedules and workloads. Frankly, it seemed to me that the primary issue was to change the mindset of the housestaff themselves, most of whom felt a strong sense of ownership for their patients and hated to leave until all their work was complete. Some felt working longer hours was justified in order to finish taking care of their patients for the day. The chiefs had to encourage them to ask for help and hand things off towards the end of their shifts. I met with the assoc PD while I was there and was impressed. She didn't make excuses and stressed how important it was to them that their residents leave after 30 hours, with no exceptions. When I left, they had only 1-2 rotations that were running over, and that was by a small margin - under 1hr. (BTW, work hours were not the only violation, but they were the main issue.) One housestaff member did point out that it was unfortunate that it took being put on probation for UW to take the work hours seriously. Although this person was very happy with the decision to go to UW, I suppose that does give some sense of the overall climate there.

At any rate, they should hear in January about the decision by the ACGME, so we should have this info before making rank lists.

BigBadBix said:

When I left, they had only 1-2 rotations that were running over, and that was by a small margin - under 1hr. (BTW, work hours were not the only violation, but they were the main issue.)

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What were the other ones?

bigtuna said:

What were the other ones?

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Here are a few other things I remember:

-Not enough female outpt visits among those doing more clinic time at the VA.
-Those who are doing the Boise Primary Care track spend their intern & R3 years in Seattle and their R2 year in Boise. The idea is to train rural primary care docs, but in order to do this they lose the required 3-year continuity clinic experience.
-According to the ACGME, faculty are supposed to go over a list of written learning objectives/expectations at the beginning of rotations and to give formal evaluations at the end. The residents surveyed at UW said these meetings took place 75% of the time, but the standard is 80%.

But please take with a grain of salt as I may have remembered something incorrectly or misunderstood the issues. The best thing to do would be to ask for more info when you are at your interviews. I'm sure they would be happy to discuss with you at length, as they know this is very important to applicants.

Had my interivew at UW this past week and I left with some mixed feelings. Before going to the interview, I had them ranked as one of my top 3 programs. After the interview, I'm not so sure.

First of all the interview day is scheduled horribly. I did not step foot inside the University Hospital. Me and around 8 other people in my group were bussed to the VA and spent our whole day there. You spend 1-2 months at the VA during your intern year. According to all the other applicants, he people who interviewed you at the VA had no idea how the rest of the program was set up. You get to tour the VA. If someone can find me a VA that looks any different from the rest, please message me and let me know. This was a HUGE waste of time.

The work hour violations seem to be taken care of. I doubt many people break the 30 hour limit anymore. However, there were several other violations that the ACGME cited them for. These other violations were deemed inconsequential by everyone that you talked with at the interview but make sure you pick up the list of violations and UW's response to these citations which is handed out during the last hour of the interview day. When you look through this list, I think you'll realize that there is much more going on there than just work hour violations.

While all these violations might be minor, I think that the administration's inability to take care of these problems sooner says a lot about their level of competency/respect for residents.

One other observation: It seemed to me that in a hurry to get the work hour situation resolved, the program has made didactic teaching less of a priority. Several residents admitted to not having time to attend grand rounds and being late to lectures scheduled before their continuity clinics because they had to finish work to meet work hour requirements.

All of this being said, the residents seemed very smart and the faculty that I interacted with seemed very smart and taught very well. The fellowship match is great. The city is fantastic. The diversity of patients is great. You do have to drive to different parts of the city and work in 4 different hospitals which could end up being a drag or could be a bonus since you get out of the hospital and get some sun (in seattle?).

In conclusion, I left Seattle with no clue how I am going to rank this program. I know I will get great training there but will I be happy? I'm not so sure. Seattle is a great city. I will say that if this same program was anywhere other than Seattle, then I would have a very easy time not even ranking them.

DBD - thanks for sharing your experience. My pre-interview rank list had U of W in the top two...if I get the same vibe out there next month, it will fall significantly. Very disappointing as I also thought I'd enjoy living in Seattle.

Good luck with the rest of your interviews...