Are these really WORKHORSE programs?

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Hey everyone,

I have heard a lot of rumors of the following programs being so called workhorse programs where the residents are pretty much being worked to death +80 hrs a week or very close to it on a regular basis. I found it hard to gauge from asking residents on the interview trail as I wasn't sure if they were being dishonest and/or if their answers were reflective of the avg resident's.

Can anyone please give me some input ?
Rush
MCW
Penn State
CCF
Boston University
UT Houston

 

[amyl]

i don't know about the other programs but I can tell you about CCF. read my old posts if you want, the clinical training here is awesome, its a big program (you decide if thats a plus or minus for your personality), the movement here is toward smaller and more focus on education, etc. we don't work 80+ hour weeks. There are weeks here and there depending on how the call schedule works out that I have worked in the 70s... and there are weeks I have had thursday call and worked in the 40s. they say on average we work 60-65h per week.... but gosh, sometimes it seems like more! ;-)

there are definitely easier places that CCF to do your residency. you have to decide what is more important to you.

 

[Trajan]

Fair or not, Boston University has an absolutely horrible reputation for having the issues that you raised.

 

[Coastie]

Fair or not, Boston University has an absolutely horrible reputation for having the issues that you raised.

👍

 

[loveumms]

Penn State is far from a work horse program. I work around 65 hours a week. Never get near 80 during my OR month.

I don't know how we got lumped in with that reputation. I think there are a few unhappy residents that have tainted our reputation. Insteading of speaking up and trying to make positive changes, they talk about the program and write things on anonymous websites. They think that CRNAs should be getting us out of the OR at 3pm and we should never work weekends. I would say a majority of the residents are happy at my program and I think we have a very solid program. Ask some of the graduates that have left (there are quite a few here on SD).

Bottom line - if you want a program where you are getting out of the OR every day at 3pm, we are not your program and please don't rank us if that is what you want. Personally, I think it's crazy for anyone to think this is a good thing. Anesthesia is like surgery, being in the OR is where you learn. Reading is important but, a large part of my training/knowledge has come from doing cases.

My average day is 6:15am - 5pm. There are many days where I'm done by 4 and some that I'm there until 8 (we have a late resident system so at least I know when I'm going to get stuck late). I have plenty of time to read/study at least an hour a day and still plenty of time left over to spend with my family.

Whats important is I will graduate and be able to take care of pretty much anything that comes my way. There are only three to four years to be able to learn as much as possible. I will be a consultant anesthesiologist and I will be competent. In my eyes, that is what residency is all about.

I'm a pretty honest person so if you have any questions, please PM me and I will answer them.

 

[BeddingfieldMD]

I'm currently an intern at MCW, so I can't speak from first-hand experience about the CA-x years, but from my observation I'd say MCW is similar to CCF described above. By no means will you be getting out of the OR at 3:00 every afternoon M-F here--and I don't really know that that's such a great benefit either. But none of the residents I know are routinely breaking hour rules or anything like that. Seems like typically things are more in the 65-70 range for weekly hours, which is definitely doable.

I can speak from personal experience regarding our intern program (for the categorical program, of which about 85+% of our match spots are) that it's VERY good. You get a nice mix of medicine, ICU, surgery, ER, plus a month each of OR anesthesia, pre-op clinic, and pain clinic. The latter three months are all M-F with normal hours. I'd say counting all months, I've averaged about 65 hours per week on my intern year, which ain't bad at all. That's including pretty heavy months for medicine wards, cardiology wards, and CT surgery.

I asked the same question about MCW being a workhorse program here on SDN prior to ranking it, and it's hard to get good answers because people will sometime exaggerate, post especially negatively or positively for ulterior motives, and because programs change. I can't say for sure, but I think there's some of the latter at MCW. I know there's been a push in the administration over the last several years to reduce grunt work, keep everyone in check with hours, have more didactics (which I've been pleased with so far), and save more time for reading. I think possibly with the softening CRNA market, they recently hired some more CRNAs to help with overnight call to help with hours, and supposedly this has made some positive differences.

I do still hear from residents that your months at Children's Hospital (of which most get a few throughout the three anesthesia years) are the hardest, and you will hit the work-hour limits there. But I'm sure just about every program has their few rotations here and there that are tougher than others.

Anyhow, I would just take everything you read about programs with a grain of salt and try to go by what the current residents say--because programs really do change every few years depending on leadership, trends in the field, etc. I will try to post again after next year once I have some first-hand experience, but as of now, I have no evidence based on discussions with residents and observation that MCW is what I'd call a "workhorse" program.

It's DEFINITELY not the easiest program in terms of hours, but you're not going to be violating work hours, routinely working 'til midinight, or performing tons of scut work either. Think somewhere in the middle as far as anesthesia programs go. And the intern year isn't too bad either.

 

[Gimlet]

It's DEFINITELY not the easiest program in terms of hours, but you're not going to be violating work hours, routinely working 'til midinight, or performing tons of scut work either. Think somewhere in the middle as far as anesthesia programs go. And the intern year isn't too bad either.

CA-1 at MCW here. I can verify everything jackdaniels said in his post above, especially the last paragrah. I can 100% guarantee I've never broken 80 hours in a week. I probably have only cracked 70 in a week once or twice. You work hard while you're at the hospital, but they're good about getting you out early when it's your turn to be (pre or post-call).

If this is a workhorse program I can't even fathom how the cushy ones are run.

 

[imfrankie]

You want a lifestyle residency, mayo florida. Nothing like the traditional hardworking programs. No value judgement, just the facts.

 

[FutrrENT]

Hey everyone,

I have heard a lot of rumors of the following programs being so called workhorse programs where the residents are pretty much being worked to death +80 hrs a week or very close to it on a regular basis. I found it hard to gauge from asking residents on the interview trail as I wasn't sure if they were being dishonest and/or if their answers were reflective of the avg resident's.

Can anyone please give me some input ?
Rush
MCW
Penn State
CCF
Boston University
UT Houston

Correct me if I’m wrong, but residency is supposed to be hard as hell. You’re supposed to work long hours. You do that so that you can see a lot, learn a lot, and become competent anesthesiologists (or ENTs, or neurosurgeons, or whatever else it is you’re training in). My ENT program is brutal, and I am grateful for it. I’ll be a kick-ass otolaryngologist when it’s over.

If you want your anesthesia training to be easy, then become a CRNA.

 

[deleted126335]

correct me if i’m wrong, but residency is supposed to be hard as hell. You’re supposed to work long hours. You do that so that you can see a lot, learn a lot, and become competent anesthesiologists (or ents, or neurosurgeons, or whatever else it is you’re training in). My ent program is brutal, and i am grateful for it. I’ll be a kick-ass otolaryngologist when it’s over.

If you want your anesthesia training to be easy, then become a crna.

+1

 

[flyingdutchman]

Correct me if I’m wrong, but residency is supposed to be hard as hell. You’re supposed to work long hours. You do that so that you can see a lot, learn a lot, and become competent anesthesiologists (or ENTs, or neurosurgeons, or whatever else it is you’re training in). My ENT program is brutal, and I am grateful for it. I’ll be a kick-ass otolaryngologist when it’s over.

If you want your anesthesia training to be easy, then become a CRNA.

I agree...to a point. The key word is "balance". Sure there's a positive correlation between hours worked/experience and your abilities as a future doctor, but this reaches a breaking point at which fatigue and quality of life start to suck enough to negatively impact your training. Some people have a low threshold...they do FM or Psych, others have a high threshold, ie. the surgeons (this is obviously not generalizable completely, just trying to make a point). That being said, personally I lean toward the hard-working side of things, and I hope any doctor that takes care of me or my family in the future does as well.

 

[12th man]

Residency has its months. The 80 rule is averaged over a month. Some weeks may be busier than other (mulitple calls, SICU months...) vs pain clinic months. The truth is, it's not going to be easy, it shouldn't be. Not as time consuming as surgery, but just as intensive study. To be a good doctor, devote a lot of time to study. Know everything, b/c it is your job. Take advantage of the lighter weeks and read, read, read, but keep your life balanced. Do something for your family/self everyday. 👍

 

[Depakote]

My contention with the "workhorse" mentality us that volume does not necessarily equate to quality education.

Sure, you might be staying to 7pm while the guys at some other program got out at 3, but if you both did a pheo that day and they went home and read while you sent the CRNA home and finished her lap chole room, who is really getting the better experience?

I'm more than willing to work, but I'm in this for my education... Let the crnas do the scut cases.

 

[kazuma]

My contention with the "workhorse" mentality us that volume does not necessarily equate to quality education.

Sure, you might be staying to 7pm while the guys at some other program got out at 3, but if you both did a pheo that day and they went home and read while you sent the CRNA home and finished her lap chole room, who is really getting the better experience?

I'm more than willing to work, but I'm in this for my education... Let the crnas do the scut cases.

I agree with this. You need to have time to read and reinforce what cases you did during the day. I doubt that rotting in a room at night while doing low yield cases is going to result in higher ITE or board scores or make you more competent.

 

[Consigliere]

RUSH - definitely a "workhorse" program. When you finish though, you'll be a great anesthesiologist like me.

 

[deleted126335]

My contention with the "workhorse" mentality us that volume does not necessarily equate to quality education.

Sure, you might be staying to 7pm while the guys at some other program got out at 3, but if you both did a pheo that day and they went home and read while you sent the CRNA home and finished her lap chole room, who is really getting the better experience?

I'm more than willing to work, but I'm in this for my education... Let the crnas do the scut cases.

You only do one residency. You are still climbing the learning curve for experience and judgement after 3 years. I think it is a given that a resident who had three years of anesthesia training @ 70 hrs/week will be more qualified on graduation day than one who had three years of anesthesia @ 50 hrs/week. The difference won't be linear, but it will be noticeable. SOme of my most important learning experiences were on bread and butter cases gone bad. Do more bread and butter cases, more likely to have the near miss with a key learning experience.

 

[FutrrENT]

You only do one residency. You are still climbing the learning curve for experience and judgement after 3 years. I think it is a given that a resident who had three years of anesthesia training @ 70 hrs/week will be more qualified on graduation day than one who had three years of anesthesia @ 50 hrs/week. The difference won't be linear, but it will be noticeable. SOme of my most important learning experiences were on bread and butter cases gone bad. Do more bread and butter cases, more likely to have the near miss with a key learning experience.

You took the words right out of my mouth.

While I may be a budding ENT, I think I can say with confidence that anesthesiology is one of the few fields of medicine where nothing is guaranteed to be routine. Taking out tonsils is pretty-much guaranteed to be routine -- and after doing 10 cases of them, an ENT resident doesn’t learn anything from them.

But bringing someone to near-clinical death is never routine. There’s a hell of a lot that could go wrong at any time. Every anesthesia patient is a potential ticking time-bomb who can die on you. Not likely, but certainly possible. Even if you’re not worrying about the patient dying, anesthesiologists are also worried about the patient waking up uninjured, calmly, and comfortably and not thrashing around or waking up with emergence delirium or whatever other kinds of post-anesthesia problems patients can have (I’m an ENT, so I don’t really know much about that). Every anesthesia patient is going to be a bit different and will react differently to anesthesia. Those are the more subtle variations you’ll encounter from case to case, and you certainly need to be very well-versed on those too. I don’t simply consider anesthesiologists to be superior to CRNAs because of their more extensive medical knowledge or their ability to manage the super-complex patient, I also consider you guys to be superiior to CRNAs because you know the subtleties of anesthesia better as well. So, I would imagine that you guys, more than any other type of resident, would benefit from seeing case after case after case -- even the ones you consider to be “routine”.

 

[Code Brown]

CA-1 at MCW here. I can verify everything jackdaniels said in his post above, especially the last paragrah. I can 100% guarantee I've never broken 80 hours in a week. I probably have only cracked 70 in a week once or twice. You work hard while you're at the hospital, but they're good about getting you out early when it's your turn to be (pre or post-call).

If this is a workhorse program I can't even fathom how the cushy ones are run.

Hopkins workload:

Pain/Preop clinic - 40-45 hrs/wk, OR/OB - 50-55 hrs/wk, ICU - 65-70 hrs/wk (but the Q3 is a pain)

Usually do 3-5 calls per month, and every other Thursday we have off for educational day (no clinical responsibilites what-so-ever).

So yes, comparing to MCW, you guys would be a workhorse program...

 

[Stank811]

MCW you probably will average 55-60hrs a week on your normal OR months...so I guess that extra 5 hrs a week on average classifies us as a workhorse program. Just out of curiosity who covers the OR when you have off every other Thursday?

 

[cfdavid]

My contention with the "workhorse" mentality us that volume does not necessarily equate to quality education.

Sure, you might be staying to 7pm while the guys at some other program got out at 3, but if you both did a pheo that day and they went home and read while you sent the CRNA home and finished her lap chole room, who is really getting the better experience?

I'm more than willing to work, but I'm in this for my education... Let the crnas do the scut cases.

This has always been my philosophy, and it was instrumental in ranking my list. It has nothing to do with work ethic. Residency is for training. Some of that is "work" and other parts need to be academic. A good balance is what I'd advise med students to seek.

I think that there are diminishing returns to hours worked during training, and I've seen it in other specialties, mostly, but also in anesthesiology residencies. Those that aren't SO fried when they get home to read for 1 hour have the leg up IMHO.

 

[Stank811]

What it really comes down to is knowing your own learning style. If you will have a hard time working from 6:30am to 5:30pm and then having to go home to read a little than I would agree a "workhorse" program is not in your best interest. But if that is not a problem for you then don't count out the programs that have been given the label "workhorse" because you might be missing out on a program that fits your style

 

[Code Brown]

MCW you probably will average 55-60hrs a week on your normal OR months...so I guess that extra 5 hrs a week on average classifies us as a workhorse program. Just out of curiosity who covers the OR when you have off every other Thursday?

Attendings, CRNA's, and fellows. Thursday is usually a lighter OR day anyway with the various surgical departments having their conferences and grand rounds on that day, so it works out. That said, it was apparently quite the effor to make this happen.