ACGME SURVEY - Are all program like this?

[tyrionlannister00]

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[backrow]

I was never "coached" on how to reply; however, the program would provide some clarification on some of the questions. This clarification was nice as some of the questions were poorly worded or worded in some way to be nebulous. For example: working in multidisciplinary teams. Some residents would mark no, forgetting they worked with nurses, techs, etc on a daily basis.

If they are telling you "answer this way" then that is wrong.


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[AlmostAnMD]

Our program director doesn't tell us what to put on it

He did, however, explain each question to us in painful detail as though we were all illiterate

 

[backrow]

Forgot to answer your second question: yes, there are programs out there where residents are happy and rate their programs accordingly.


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[Raryn]

Our program director never asked us to lie on anything.

That said, we did have the various terms explained to us in detail. For example, night float does NOT count as "being on call more often than every third night."

 

[ProfMD]

Clarifications seem legit, but coaching you to answer certain ways - that's shady.

 

[LucidSplash]

Agreed with the above. Our program routinely points out the following before the survey: everyone can see their file anytime they want and everyone is given an electronic file with the handbook at the beginning of every year which contains the specific goals and objectives for each year level for each rotation. Apparently for a few years running everyone would forget that by February and mark the wrong thing. But we don't get coached on "right answers" like you are talking about. The PD just makes a point to make everyone understand that their answers matter and to take it seriously.

 

[Jaydid]

Do the PD's ever find out who said what?


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[IMPD]

Do the PD's ever find out who said what?


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Yes, and the NRMP also allows us to manipulate the Match based on cash payments to them in small, unmarked bills.

 

[mvenus929]

Our program has a time set aside every year where we go through the definitions that the ACGME uses (our night shifts are not night float because we only cover one team, etc) to ensure that people aren't saying things that aren't true about the program, but our PD emphasizes that we should be honest. She has a pretty open door policy and is happy to make changes if that's what people want, so we've scored pretty well (better than the national average) on most things over the past few years.

 

[Crayola227]

Do the PD's ever find out who said what?


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My understanding is that in small programs depending on what comments are made, they can sometimes put 2 and 2 together....

 

[Raryn]

Do the PD's ever find out who said what?


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In a large program, no way. There's IM programs with 50+ residents a year, so unless someone has a very unique writing style, there's no way to tell who wrote what comment amongst the 150.

OTOH, a fellowship program with a total of 2-4 fellows will get the same survey.

If your program has 4 fellows in it and your score on a measure averages 4.75/5, it's pretty clear there's three fives and a four. Also, comments are probably more easy to identify amongst a small group. But there's no way to obfuscate that short of grouping multiple years worth of data, and that makes it harder to see trends.

 

[mvenus929]

A friend of mine's program does that, but also literally makes them sit there and complete the survey at the same time. Like they give the presentation in a computer lab while everyone fills it out. Seems awfully coercive to me

Yeah, ours is usually 10 minutes at the end of the resident meeting, then we are free and get lots of emails asking us to complete it by the deadline.

 

[J ROD]

Yeah, we are "educated" on what to say. And things are explained to us so we understand what we should say.

 

[jthedestroyr]

Yeah, we are "educated" on what to say. And things are explained to us so we understand what we should say.

Same, although this just started this year
We were told many programs do this, but ours never did.

The multiple dis team question came up as an example why.

 

[J ROD]

yeah, anybody feel like they are in kindergarten? haha

 

[NotAProgDirector]

For small fellowships/programs, the survey is aggregated over several years.

 

[Apollyon]

For small fellowships/programs, the survey is aggregated over several years.

To explain more clearly, so that individuals cannot (theoretically) be identified.

 

[URHere]

Our program makes us fill out a mini version of their own each year...we then have a group meeting to go over the results and the program director points out any things that are concerning (people reporting more duty hour violations than they do on our duty hour reports, etc). Our PD also defines "rarely", "sometimes", and "often" for us because that has apparently been an issue before.

We're encouraged to tell the truth, but our PD very much wants to know what we are going to say before we say it.

 

[caffeinemia]

Yeah. It's a fine line and we are definitely given an "explanation" beforehand --- but the questions are definitely confusing or vague especially when you're tired and careless after a long day of surgery or something... for example ... nightfloat versus call versus home call are all drastically different but can easily be confused.

 

[Gfliptastic]

Yeah, we are "educated" on what to say. And things are explained to us so we understand what we should say.

Same for us.

Interesting enough, we had an ACGME audit recently and the auditor actually told those of us selected to participate which survey number choices trigger more careful scrutiny by the ACGME. Which is education, not necessarily coaching...indirectly. But if you weigh that input on the upcoming survey, it's a bit like saying: "As long as you like this aspect of your program do NOT pick anything less than this."

I recall one of the questions we fared only adequate in responding was about supervision. So when the program discussed our survey results, they clarified that supervision isn't necessarily, "in the same room, same floor" but more like, are there adequate attendings available to you. And you could see a few people have sheepish mea culpa looks on their faces afterwards.

 

[mimelim]

For small fellowships/programs, the survey is aggregated over several years.

From a practical standpoint it doesn't matter. Programs/GME usually can figure out who said what. I know, I've sat in several GME meetings where they openly discussed who said what. Residents, like medical students and pre-meds are not as subtle as they think they are. It is just a matter of putting two and two together.

Personally, I wish that the ACGME survey was better equipped to improve programs, because lord knows that residents are a vulnerable group. But, from a practical perspective, for an individual resident, there is no reason to not put perfect marks for your program. Future residents may benefit from you trashing your own program, but you will not.

 

[chicagochildpsych]

We were coached, and when residents were honest anyway....we were asked by our PD in an email "are you guys smoking crack?". Oddly enough, most of our program grads avoided academia.


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[axiomofchoice]

The irony is.... negative responses only hurt yourself.

 

[siliso]

Only one that is mentioned is the one like "do service obligations detract from your education" and the Acgme definition of "service" is like rolling patients to radiology or doing blood draws, which we basically never do. Easy to confuse with my "service" of taking care of 15 sick patients kept me from going to grand rounds. Seems fair enough to explicate to me.

 

[Ismet]

Only one that is mentioned is the one like "do service obligations detract from your education" and the Acgme definition of "service" is like rolling patients to radiology or doing blood draws, which we basically never do. Easy to confuse with my "service" of taking care of 15 sick patients kept me from going to grand rounds. Seems fair enough to explicate to me.

That's one of the questions that was explained to us and I honestly appreciated it. My program did not "coach" us one bit, but did explain what they meant by 3-4 of their more confusingly-worded questions. I've had to miss didactics on several occasions due to busy services and I would have interpreted it that way, rather than the way they meant it as doing scut work on the floor.

 

[ThoracicGuy]

As someone else mentioned, the problem is you really only hurt yourself by answering negatively. That's why the whole ACGME survey thing is such a joke. If I destroy my program on the survey, the ACGME investigates. If they find bad stuff they put the program on probation. So great, now I'm at a program on probation, that's going to be great for my CV. And then if the program keeps breaking the rules they lose their accreditation. Which means I lose my ability to finish the program and am hosed.

A program being on probation is not going to affect your cv. Losing accreditation could, but only because you'd be moving to another program.

 

[Light at end of tunnel]

So what's the best way to let the ACGME you or your colleagues are being coached?

I would think that that this would be a big red flag for a program, because in essence one can infer that only programs with something to hide would have incentive to coach residents.

On the surveys, are you asked if you felt like you were coached???

 

[Light at end of tunnel]

A program being on probation is not going to affect your cv. Losing accreditation could, but only because you'd be moving to another program.

Probation can have implications for your program beyond simply affecting your CV. The information is public information these days; certainly any applicant is going to be aware of a program probationary status and stay away from that program.

Additionally, since gossip spreads like wildfire, if your current program becomes under probation, then your "Reputation" is also affected. After all, no body wants to be a product of a program in probation, and nobody wants to accept the product or a publicly deficient institution.

Doesn't being on probation also affect funding for a program? I thought it did, which means people's pockets start to hurt, and heads start rolling.

 

[NotAProgDirector]

It doesn't affect funding.

Concerns on the Resident Survey don't automatically lead to probation. Only if there are severe problems, or a track record of unaddressed problems, or worsening issues, will the ACGME act. The GME office could work with the program to improve.

But I agree it's a conflicted situation.

 

[Light at end of tunnel]

This is both depressing and concerning.

How would a resident go about alerting the ACGME that residents are being coached into manipulating the survey?

Being coached (and allowing that manipulation to occur) defeats the purpose of the ACGME surveys, I really hope there is a way to alert folks to that type of situation.

🙁🙁🙁

 

[Kissmyabjj]

Nothing to see here. Please move along.

 

[bannie22]

I'm sure there are different levels of coaching. From clarification of some vague questions to strongly "suggesting" the appropriate responses.

 

[Light at end of tunnel]

How do you let the acgme know?

Do you need proof?

 

[kjamess]

Only one that is mentioned is the one like "do service obligations detract from your education" and the Acgme definition of "service" is like rolling patients to radiology or doing blood draws, which we basically never do. Easy to confuse with my "service" of taking care of 15 sick patients kept me from going to grand rounds. Seems fair enough to explicate to me.

cough NYC programs cough

 

[KnuxNole]

Just do what I do, answer the "best" choice down the line so you can finish that pathetic crap in 5 minutes....I hate surveys...