Duke surgery, still malignant?

surge0n said:

Anybody here with first hand information about Duke General Surgery Residency Program? I know it has a reputation of being mlignant, but have things changed after Danny Jacobs took over as the Chair? Would highly appreciate any info from current med students, residents or anybody who have reliable information. Would also appreciate other information such as case volumes, overall surgical training, camradarie among residents and with staff. I know it arguably doesn't get any better than Duke as far as research and academic reputation are concerned but do you have to keep up with 7 years of hell in order to earn the Duke tag? Thanks.

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I've never been there, and I have no first hand information at all. Still, I'd be willing to bet any money I have that it's still malignant.

Things don't change that fast......

You still get to wear white pants and a short white coat. Perhaps not malignant, but certainly not a pretty sight.

dc

A friend and former Chief resident of mine who did Plastics there says its still pretty bad.

Being from NC but not living there now I always strike up chit chat with the traveling OR staff about where they've been recently. Many of the old school ways at Duke still seem to persist, at least from what I hear. I have a few friends who went to med school there who have less than flattering things to say about the place.


Best advice is to check it out for yourself and see what you think. Durham itself is pretty dumpy but the surrounding areas are great and as you note the training at Duke is the best of the best.

Ina strange sort of way it is refreshing to see that surgical traditions still carry on in some places.

- although now that I personally know what an old school malignant program is like, I wouldnt want to go through it again.

The only good thing about a malignant big name program is finishing it- kinda like the marine corps.

I have a friend who went through the Duke program. His stories are pretty awful. He's been gone for a couple of years now, but it was super cut-throat when he was there. He says that it was worth it, but I remember at the time he didn't think he wanted to continue.

surge0n said:

Thank you all for sharing your impression of Duke. If any med students or residents from Duke are lurking around, please let us know your thoughts too if you can.

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Perfect example of someone who will convince themselves of something, then complain next year when the environment sucks.

The input given so far may not be directly from Duke's PD, but where there's smoke, there's fire......

I wasn't GSx at Duke, but rotated on 2 surgical services when I was a resident there. They had just gone to the 12 hour shifts (after doing so nominally the year prior, and getting busted for not adhering), and that seemed to take a lot of pressure off (there were still 24 hour calls for interns, and home call for seniors). I didn't pick up on the malignancy, as the people there were superstars, so they were happy with their jobs. The seniors, if they were bugged, certainly didn't show it - and they didn't keep much back. There was only one really raging *******, and the others ascribed that to the "Johns Hopkins Mentality" (<-- verbatim).

But, then again, my surgical experience is compared to Mt. Sinai and SUNY-Brooklyn, so YMMV. I felt Duke was malignant across the board, but the house staff was up to it, so maybe I had some Stockholm Syndrome.

surge0n said:

Anybody here with first hand information about Duke General Surgery Residency Program? I know it has a reputation of being mlignant, but have things changed after Danny Jacobs took over as the Chair? Would highly appreciate any info from current med students, residents or anybody who have reliable information. Would also appreciate other information such as case volumes, overall surgical training, camradarie among residents and with staff. I know it arguably doesn't get any better than Duke as far as research and academic reputation are concerned but do you have to keep up with 7 years of hell in order to earn the Duke tag? Thanks.

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Duke Surgery is a hard-core surgery training program, but from the stories I have heard from my attendings, it is much less malignant than it was in the era of Sabiston. I don't think it is any worse in terms of malignancy than any of the other top-tier programs out there. I also think that it depends on your definition of malignancy. It is definitely not all kittens and puppies (but then again I don't think many surgery programs are). You are expected to work hard and be on top of things. Those who do not are less respected. There is a good camaraderie between the residents.

It is a traditional program that is relatively top heavy. Interns run the floor. 2nd years have 4 months of ICU and 7 months that are more operative. That being said, I still managed to log about 150 cases as an intern, many of them as Surgeon Junior. Most of my categorical classmates similarly logged between 100-200 cases. Many cases were smaller (breast, lumps and bumps, small hernias, PEGs), but I did get some larger bowel cases. I think that the stats place the chiefs with finishing with around 900-1000 cases. You can check with the surgery office for the exact details. Seniors seem to have a decent amount of autonomy, and there is a good variety of the bread and butter stuff and the rare big-whack cases that you can't see many other places.

There were a lot of rumors on the interview trail when I was interviewing which I found to be false. For example, we do not have a 110% divorce rate. I think there are 1-2 residents who have gotten divorced or are separated, but there are a great many more who have gotten married or have started families. Also, the day in which the program was "a decade with Dave" have passed. I don't know of any residents who have been held back to repeat a year.

Adherence to the 80 hour work week is relatively good with the exception of a few rotations. Also, you ability to finish on time and check out improves as you become more efficient during your intern year. Overall, I average 80 hours or less with 24h off a week. As an intern, most of your work is under the night float system. For most rotations you only have one 24h call per week (at most), and that only occurs 1-2 times each month. You usually have one entire weekend off each month. The exception is SICU which is q3.

Danny Jacobs is a great chair. He has done a lot to recruit additional and more diverse attendings. He is very approachable and genuinely interested in resident well-being, but he is a little removed from the daily activities of the residents which are managed by our program direct Dr. Bryan Clary.

The interns and JARs (PGY-2) do wear white pants and short white coats. All residents are expected to dress for morning rounds and conferences, but scrubs are accepted on the floor if you are in the OR or between cases.

While there are still parts of Durham that are ghetto (this is good for your trauma experience), there are many very nice areas to live and some great places to go out, shop, and eat in Durham proper. Plus, you are only ~15-30 min from Raleigh depending on where you live. The cost of living is not bad, and many of the residents buy houses or condos.

Research is done for 2 years between your second and third clinical years. As you mentioned, research is top-notch and you have many world-class researchers (and surgeon-scientists) to chose from at Duke. Your research years are not limited to just investigators in the department of surgery. You can go outside the department. Your salary is guaranteed at Duke through training grants. They will also support you (although not fund you) if you chose to go outside of Duke for your research. Also, I know at least 1 person doing and MPH for her research years. Most people really enjoy the free-time (and extra money made moon-lighting) during their research years.

I hope that I answered your questions and dispelled some of the rumors that seem to be circulating second- or third- hand. I apologize for the overly long reply. Please PM me if you want any more info.