Are AOA programs less malignant than ACGME programs?

[serimeri]

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Hey guys,

I matched into an ACGME Psychiatry program and am glad I matched because I should not have been going through the ACGME match to begin with. I recently found out the program was on probation and a lot of residents had been let go (IDK why). Needless to say, the program was never my top choice because they tried to minimize the time we got to spend with residents on interview day. I knew it was heavy populated with people from India and Bangladesh who needed help with their Visas, so I thought maybe that was the issue that put them on probation.

It's probably a minor point, and I'm just happy I will have a job to pay back the darn high loans I have. But I did interview at some AOA programs and they seemed to be more transparent (even the malignant ones). In general, is malignancy and expectations a little more lax in AOA programs? I know the hospitals are usually smaller community ones, but is that the case? The main reason I didn't rank AOA programs was because I was getting so many ACGME interviews at big name places.

I'll be the first non-FMG in this program in 3 years. A lot of my colleagues where professors of Psychiatry in their home countries. I'm feeling a bit insecure in my ability to work with them, I am afraid that they may think that I don't know anything and I feel inadequate about my ability to work at their level. I am just afraid that they program director may not kick me out for not knowing enough. I don't think I would have had this issue at a place that was AOA since we'd all relatively be at the same level (recent MS4 graduates etc.).

Any thoughts? Im probably just being paranoid.

 

[Kevin Baker]

I can't speak for everyone and specifically can only speak for one AOA psych program but having rotated at an extremely malignant non psych AOA program, one bad AOA psych program, and Larkin, I'd be happy with having avoided the AOA. I haven't heard of MD psych residencies closing down midway and stranding students which has happened in the AOA psych world and who knows what will survive the merger. Not to imply ACGME > AOA or most AOA residencies are bad. There are bad apples in each bunch but more regulations and protections on the ACGME side

 

[serimeri]

I can't speak for everyone and specifically can only speak for one AOA psych program but having rotated at an extremely malignant non psych AOA program, one bad AOA psych program, and Larkin, I'd be happy with having avoided the AOA. I haven't heard of MD psych residencies closing down midway and stranding students which has happened in the AOA psych world and who knows what will survive the merger. Not to imply ACGME > AOA or most AOA residencies are bad. There are bad apples in each bunch but more regulations and protections on the ACGME side

Thats definitely something I didn't account for. Luckily the merger is a few years away.

 

[serimeri]

At least being in a DO program though, you know that you're amongst your own, so you have that sense of loyalty or something in common. We attend expensive schools, have loans to pay, I'm in a bit of a predicament right now as most of the people I will be working with have secure jobs in their home countries, had rich backgrounds, have savings, for them money is not so tight. I understand that the fees in those countries are sometimes minimal if at all (India and Pakistan) based on merit. So for them its not a big deal to spend outside of their means as they aren't $250K in debt like me.

Still, I agree with your point about more pathology and security (though ACGME programs can shut down if a hospital can't keep its doors open).

 

[WhendoIstartfirstaid?]

Lol don't feel insecure comparing yourself to Fmgs. I've interacted with fmgs, and as bright as they were, the things they were taught were mindblowinglly wrong. And given that they've had the bad habits hardwired in, they'll struggle more.

And a program being full of IMG/FMG is a sure sign that it's bad.

On average, in terms of malignancy/education quality:
Average Acgme>Average AOA>Acgme full of IMGs>AOA where you're stuck in private outpatient clinic and never see a complex case (a ton of these exist and will absolutely close. It's impossible for them to survive even if they want to.)

 

[psych72]

I don't know about all, but where I did my medicine core, a DO hospital, was a pretty crappy place to work, forget the lack of pathology. The way the residents were treated didn't seem very professional.

I also don't trust COCA and its ability to take issues seriously. I saw some of these new AOA programs and they have pretty crappy call schedules. I don't know if AOA regulates same way as ACGME in terms of work hour violations and such.

From what I've concluded though your training is what you make of it. A crappy place can still be a great learning experience if you put in the effort and look for opportunities.

 

[D4C]

Having seen a few cases of malignant AOAs, I'd say you should be worried about the low fellowship metastases rate.

 

[hallowmann]

Each program is different. They have very different characteristics and different pros and cons. That's true whether it's an AOA program or an ACGME one. Some are malignant, some are hostile, some have limited camaraderie, etc. It really just depends on the place and people involved.

It's never a good sign for a program to fire a bunch of its residents, and what's worse, the FMGs aren't going to complain to anyone about problems & violations for risk of losing their sponsorship/jobs.

That said, I wouldn't be too worried at this point. It's possible all those residents were fired for a good reason. If I were you, I'd go in expecting it to be a perfectly fine and good experience. Going in worried that you won't get along with anyone, have nothing in common with everyone, or scared that you'll get fired at any second will probably turn into a self-fulfilling prophecy. Go in excited to start this journey.

 

[serimeri]

Thanks guys Im super stoked to start! I miss my home and my family, but itll be super fun.

 

[serimeri]

Lol don't feel insecure comparing yourself to Fmgs. I've interacted with fmgs, and as bright as they were, the things they were taught were mindblowinglly wrong. And given that they've had the bad habits hardwired in, they'll struggle more.

And a program being full of IMG/FMG is a sure sign that it's bad.

On average, in terms of malignancy/education quality:
Average Acgme>Average AOA>Acgme full of IMGs>AOA where you're stuck in private outpatient clinic and never see a complex case (a ton of these exist and will absolutely close. It's impossible for them to survive even if they want to.)

One thing that I wonder though. Is the abundant amount of free time and support they have. A lot of the ones I' ve encountered tend to suck up too much in my opinion compared to people from DO schools, AMGs and even Carribean school.

 

[NurWollen]

One thing that I wonder though. Is the abundant amount of free time and support they have. A lot of the ones I' ve encountered tend to suck up too much in my opinion compared to people from DO schools, AMGs and even Carribean school.

I'm not sure exactly what you're trying to say... I'm genuinely interested... but you used too many pronouns. Who us the 'they' that have abundant support and free time? Who are the "ones who suck up too much compared to people from DO scholls, AMGs, etc?"

Again, I'm not trying to be rude or be a grammar nazi or anything, I'm genuinely curious as to what you have to say. A DO surgical subspecialist once told me he thought his AOA residency was very humane, that they pushed him very hard but also treated him like a human, respected any family needs he had, etc. He said that stood out compared to some of the stories he'd heard from colleagues who did ACGME surgical residencies.

 

[serimeri]

I'm not sure exactly what you're trying to say... I'm genuinely interested... but you used too many pronouns. Who us the 'they' that have abundant support and free time? Who are the "ones who suck up too much compared to people from DO scholls, AMGs, etc?"

Again, I'm not trying to be rude or be a grammar nazi or anything, I'm genuinely curious as to what you have to say. A DO surgical subspecialist once told me he thought his AOA residency was very humane, that they pushed him very hard but also treated him like a human, respected any family needs he had, etc. He said that stood out compared to some of the stories he'd heard from colleagues who did ACGME surgical residencies.

What I'm saying is that a lot of FMG's were practicing attendings in their home countries, made a good living, have had opportunities to start families, do more research, etc.

I shouldnt generalize, but in general, I've seen them try and go the extra mile to kiss up.

Whereas, if you're just coming out of med school, it's just residency...no time for anything in between.

 

[serimeri]

Lol don't feel insecure comparing yourself to Fmgs. I've interacted with fmgs, and as bright as they were, the things they were taught were mindblowinglly wrong. And given that they've had the bad habits hardwired in, they'll struggle more.

And a program being full of IMG/FMG is a sure sign that it's bad.

On average, in terms of malignancy/education quality:
Average Acgme>Average AOA>Acgme full of IMGs>AOA where you're stuck in private outpatient clinic and never see a complex case (a ton of these exist and will absolutely close. It's impossible for them to survive even if they want to.)

By the way, hate to revive this thread, but you were right about some of the bad habits. I had dinner with some of them and some of the conversations they have had in front of the PD & PC were just totally inappropriate for the moment.