University of Texas Health Science Center - San Antonio (UTHSCSA)
1. Communication was good. My interview date was scheduled within a week and the admins were helpful with finding accomodations.
2. None provided. Dinner the night before was sparsely attended. Residents appeared tired and some discussed a recent internal investigation lowering morale when their concerns were dismissed. That's when the red flags started.
3/4. Most of the day went as planned on the schedule. This is a joint civilian and military program, so I interviewed with men and women in uniform as well. There are sites at the military medical center, county hospital, VA, university mental health, and likely more I've forgotten. Some residents complained about the bureaucracies at each site and inefficiencies. More senior residents praised the range of experiences.
The interviews were generally conversational, and spanned 2 hours with 4 faculty. During the lunch with more residents, I asked about the internal investigation but didn't get a straight answer from anyone.
When I asked about calls, I got the sense that residents and faculty were evasive about the question. From what I can piece together, residents take overnight calls in years 2-4, somewhere between 20-25 times per year. Depending on the site, calls can range from slow to busy.
According to the program, at least 2 residents were dismissed for reasons that couldn't be disclosed.
5. Faculty seemed very nice during the interview day. In my post-interview communications, I got a totally different view from at least 4 people. Words such as "ineffective", "passive aggressive", "uninterested in teaching", "hierarchical", "vengeful", "waste of my supervision time" were used to describe faculty. I spent over 3 hours after the interview day talking with residents of all years to get a full picture of the faculty. The impressions I got during and after the interview day were polar opposites.
6. Having spent some time living in San Antonio, I think "big city with small town feel" is a good description. The Riverwalk and Alamo are draws for tourists, and should be visited at least once. Traffic isn't bad at all compared to other large cities, but there is considerable new expansion of highways. Residents did describe the city as more "family friendly" and I agree.
7. Salary and benefits seemed typical compared to other programs in Texas. Female residents mentioned difficulty in getting leave for pregnancy, which I thought was federally mandated. The military ID can get you some discounts on entertainment.
8/9/additional feedback:
After some more digging, I found a few people willing to discuss the investigation last year. This was the gist I took away:
- Faculty backup not available after hours and sometimes during the work day, leaving residents to provide patient care without supervision.
- Lack of teaching by faculty. Working at the expense of education. Residents missing didactics due to excessive work and didactics aren't protected.
- Residents violating duty hour rules.
- After residents logged duty hours, staff were known to have changed work hour logs to comply with requirements (residents reports discrepancies with logged and finalized hours). When this was brought up to leadership, the concern was dismissed.
- Faculty members retaliate against residents who attempt to learn and ask questions.
- Faculty asking residents to write discharge summaries on patients the residents have not evaluated upon discharge.
- Leadership failing to address issues, and dismissed investigation.
I stopped taking notes after this. I really wanted to like the program because I like the city and have some family in the area, but don't think I'll be ranking them.
