I am (another) one of the 5 residents who have left Duke's program between January and May 2005.... I am now a PGY2 in another Family Medicine program and would like to make it very clear that transferring was the best decision I ever made!
As with all Family Med residencies it is difficult to summarize a typical day, because they vary considerably from one rotation to another. Prior to my departure from Duke there was no Morning Report or Grand Rounds for the Family Medicine department. I reported every morning to whatever rotation I was on that month. Interns have there own clinic one half day a week, which increases to two half days as a second year. On certain rotations, I was expected to attend Family Med Noon Conferences which were very repetitive and covered a narrow (outpatient only) topic range or didn't occur at all due to staff administrative meetings. There was only one noon conference a month (out of twenty or more potential conferences) that was dedicated to inpatient medicine issues (despite most of the Intern & Resident's time being dedicated to inpatient medicine). One afternoon a month was dedicated to Community Medicine education- which meant that the Interns/ Residents sat in a classroom and listened to lectures.
The teaching in the clinic left quite a bit to be desired. There was little education on how to work up a problem. The gut reaction of the attendings was to refer everything to specialist without doing even a basic work-up. Unfortunately, the cutting edge education that Residents received on various rotations such as Cardiology, Pediatrics, OB etc, was not encouraged to be implemented within the Family Medicine realm due to Attendings own lack of knowledge of Evidence Based Medicine and new therapeutic approaches.
Duke tended to boast about their great Practice Management education for their residents. Now that I am in another Residency I find that I am woefully unprepared for Practice Management when compared to my current classmates or even the current Interns in my new program... I am now a second year and on the steep learning curve that the residents in my current program were on as Interns.
I also felt that Duke misrepresented itself in terms of the Community medicine curriculum. I was under the impression after interviewing there that I would be actively participating in providing medical care to underserved communities. However, since the satellite clinics that were boasted about at my interview are staffed only by PAs, residents don't work in them, other then under special circumstances.
Education & Research at Duke University overall is superior- my rotations outside of the FM dept (eg Internal Medicine, OB, Peds) were outstanding. There have been difficulties on some rotations (eg Surgery) in which the FM residents were not treated as equals, and there are quite a few rotations which consist almost completely of observation (eg ENT), with very little hands-on-experience.
Camaraderie is very dependent on which residents are involved. Some of the residents are great people and become very close friends... others shouldn't be trusted under ANY circumstances due to the culture set forth by the administrators. Out side of work, the "Triangle" is very beautiful, but can produce difficulties with finding things to do and people to do it with. It tends to be an older settled down area, so the night life is very subdued.
Overall, I would not recommend this program. I am very happy with my decision to leave. The major pros to the Duke program are the rotations outside of the department which provide a great education in their respective specialties. The downside of the Duke program is the Family Medicine department- its negative atmosphere and poor quality of teaching are enough to earn this program a strong warning label... proceed with caution!!!