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Does anyone know why Cedars in Los Angeles is on probation? They were put on probation as of Jan 18 per the ACGME website. No idea why, though!
Cedars-Sinai on probation
- Thread starter CA115
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ooh, good catch! looks like they are on probation until 2009, isn't probation normally one year? i was just there too but didn't know to ask. maybe it's the 12 weeks of night float!!! 
just kidding. if anyone knows, please share.
just kidding. if anyone knows, please share.Well shoot, I liked Cedars alot ... this is a huge surprise and may cause me to rethink my list a bit (just when I was starting to feel comfortable with it). It looks like the probation just went into effect on January 18, so I wonder if they even knew about it during the interviews. I'll just second the call for anyone to please share any information that they might have.
... this is a huge surprise and may cause me to rethink my list a bit (just when I was starting to feel comfortable with it). It looks like the probation just went into effect on January 18, so I wonder if they even knew about it during the interviews. I'll just second the call for anyone to please share any information that they might have.- Joined
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Oh no!! My rank list is hard enough to make with LAC+USC on probation too! I did get a phone call from Cedars recently but I haven't gotten back in touch with them. I might have to reconsider my list now
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Has anyone heard any news about this? It's still listed as probation...
Hi there
I am a resident at Cedars and I can verify that we were very recently informed of the probation status. This was likely a result of decreased gyn and primary care stats which were secondary to poor record keeping by previous classes. We are now diligently recording our stats to prove otherwise. We are actually very busy on gyn and even have rotating residents to cover the abundance of cases!
I would be more than happy to answer any questions
I would be more than happy to answer any questions
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Hey califob - thanks for making yourself available for questions! Here are a few: 1. When was the computer record-keeping system introduced, 2. Is there a reason gyn and primary care stand out (i.e., ob#s are recorded okay)? 3. When are they expecting the letter from ACGME documenting the actual citations? 4. On a personal note, around this time of the year when you applied, did you also get a phone call from Cedars?
Thanks again, I appreciate how responsive and transparent Cedars has been
Thanks again, I appreciate how responsive and transparent Cedars has been
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Interesting- that is the same excuse cited by USC and other programs on probation.
One aspect about the ACGME web based reporting started a few years back
is programs are now required to submit actual cases of specific patients (eg each Hyst case is linked to a specific resident, and patient Med Record number). In years past it was self reported by a simple tally- more of a guesstimate- and there was no realistic way to confirm.
So current reporting is more accurate and accountable than in the past.
Seems that "poor recording keeping" means either
1, these programs failed to educate current residents on the importance of accurately documenting cases on the web based system. . . .
2, or their prior numbers were inflated (perhaps inadvertently) and now the more accurate numbers are calling attention to the drop off in cases reported.
Probation itself not likely to be an issue with a good program like CS, but casts doubt on their self reports of surgery volume.
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hi califob! thank you for addressing our concerns.
Could you also clarify the citation regarding a deficiency in continuity? i heard residents don't typically work up the patient (and often don't even meet the patient) before hand but then shows up for cases; and similarly, if a patient in your "continuity clinic" needs surgery, is it difficult to schedule the pt so that you can be in the case? in other words, is it rare to be able to follow a pt from pre-op to post-op?
i'm guessing Cedars is not a resident-run program? Do you feel that attendings run the show (ie, the "primary provider") and the residents are more like assistants? i apologize in advance if you take offense to this comment but it's just what i've been told by some. thanks again for your input!
Could you also clarify the citation regarding a deficiency in continuity? i heard residents don't typically work up the patient (and often don't even meet the patient) before hand but then shows up for cases; and similarly, if a patient in your "continuity clinic" needs surgery, is it difficult to schedule the pt so that you can be in the case? in other words, is it rare to be able to follow a pt from pre-op to post-op?
i'm guessing Cedars is not a resident-run program? Do you feel that attendings run the show (ie, the "primary provider") and the residents are more like assistants? i apologize in advance if you take offense to this comment but it's just what i've been told by some.
thanks again for your input!- Joined
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If a program is on probation, for any reason, it is not a great sign.
We always hear the "oh, it is just a reporting or paperwork issue". Well, if it is such a small issue, than it should not have been a problem avoiding probation! That is a huge negative, and I would strive to avoid a program that is either too disorganized to properly administer the program or cares so litttle about it's residents as to put the training program at risk over such small issues.
I am of the opinion that a program on probation for any reason is a program to be avoided.
We always hear the "oh, it is just a reporting or paperwork issue". Well, if it is such a small issue, than it should not have been a problem avoiding probation! That is a huge negative, and I would strive to avoid a program that is either too disorganized to properly administer the program or cares so litttle about it's residents as to put the training program at risk over such small issues.
I am of the opinion that a program on probation for any reason is a program to be avoided.
a few answers/comments:
sosodefjeff
1. the computer system was instituted prior to my arrival, so I have only known the computer based system. I know that last year chiefs were not using the computer based system consistently throughout their 4 years.
2. I have found the most difficulty recording primary care Clinics/triage are fairly fast paced and it is easy to forget a hypertension here, a derm there, etc. which adds up. We have started a system of collecting patient labels at each clinic and recording stats immediately after clinic (I now enter my stats in my PDA as I go). ob stats are fairly easy to record ie NSVD vs LTCS... Mostly I think we were just not very good at accurate record keeping (myself included, however over a period of 4 years it could be a real problem). Administration is definitely monitoring us monthly
3. we are supposed to hear from RRC within 60 days as to the particular citations
4. no, I didnt get phone call J
Thejaybee
You are definitely correct about the computer system requiring specific cases with case ids, attendings, hospital, CPT codes, etc. This requires residents to be extremely diligent in obtaining this info at the time of the case and logging it in a timely manner (my poor excuse we are pretty busy and logging in cases was not a priority now it is!)
I would also agree with you that when I started, our program did not educate us on the importance of this record keeping. L
I know that my numbers and the numbers of my classmates and our interns are definitely adequate.
My personal comment I think the computer system is good thing, it will now reflect the true experiences of residents. To inflate numbers is to only hurt oneself because then you are not obtaining the training/experience you will need once you leave residency!
Luvob
For private patients, we not have much involvement in preoperative management. We operate with the private attending and care for the patient postoperatively. Patients that come in through the ER (ectopics, torsions, D and Cs, etc) however (private or otherwise), we do perform the work-up and operate
Cedars can accept a certain number of clinic patients for surgeries. In this case, the resident can choose which attending they want to staff the case and participate in the case themselves. They are responsible for the entire management of the patient.
Other cases, such as D and Cs for stable patients are a bit more tricky to schedule and usually end up going to County
No offense taken to your comment in regards to the private attendings patients it does sometimes feel like we are the assistants. With the attendings that we work with on a regular basis, our involvement is much greater, as is their level of trust.
Sorry for such a long post
sosodefjeff
1. the computer system was instituted prior to my arrival, so I have only known the computer based system. I know that last year chiefs were not using the computer based system consistently throughout their 4 years.
2. I have found the most difficulty recording primary care
Clinics/triage are fairly fast paced and it is easy to forget a hypertension here, a derm there, etc. which adds up. We have started a system of collecting patient labels at each clinic and recording stats immediately after clinic (I now enter my stats in my PDA as I go). ob stats are fairly easy to record ie NSVD vs LTCS... Mostly I think we were just not very good at accurate record keeping (myself included, however over a period of 4 years it could be a real problem). Administration is definitely monitoring us monthly
3. we are supposed to hear from RRC within 60 days as to the particular citations
4. no, I didnt get phone call J
Thejaybee
You are definitely correct about the computer system requiring specific cases with case ids, attendings, hospital, CPT codes, etc. This requires residents to be extremely diligent in obtaining this info at the time of the case and logging it in a timely manner (my poor excuse we are pretty busy and logging in cases was not a priority now it is!)
I would also agree with you that when I started, our program did not educate us on the importance of this record keeping. L
I know that my numbers and the numbers of my classmates and our interns are definitely adequate.
My personal comment I think the computer system is good thing, it will now reflect the true experiences of residents. To inflate numbers is to only hurt oneself because then you are not obtaining the training/experience you will need once you leave residency!
Luvob
For private patients, we not have much involvement in preoperative management. We operate with the private attending and care for the patient postoperatively. Patients that come in through the ER (ectopics, torsions, D and Cs, etc) however (private or otherwise), we do perform the work-up and operate
Cedars can accept a certain number of clinic patients for surgeries. In this case, the resident can choose which attending they want to staff the case and participate in the case themselves. They are responsible for the entire management of the patient.
Other cases, such as D and Cs for stable patients are a bit more tricky to schedule and usually end up going to County
No offense taken to your comment in regards to the private attendings patients it does sometimes feel like we are the assistants. With the attendings that we work with on a regular basis, our involvement is much greater, as is their level of trust.
Sorry for such a long post
hey all,
I'm also a Cedars resident currently, and want to tell you all that CalifOB is absolutely correct. First, I'll have to apologize for the upcoming verbosity. Apparently cedars residents like to leave long message...
Regarding your questions above, the computerized system was instituted the year I came on board. It's really a non-intuitive and bothersome system. Unfortunately, it's a universal evil with ACGME. Honestly, as an intern, I wasn't even aware that the system is used by ACGME to track volume for programs. We've always had an overabundance of cases, and never had reason to worry about the volume. Therefore, tracking was rather lax on the residents' part. Over the past year, that's certainly been fixed. Our volumes, as indicated in the letter that was sent out, are some of the best in California. I can assure you all that we have more volume than we'll ever need. Where else will you have onc fellows who stand aside while the intern does the hysterectomy AND lymph nodes!?
Also, for those interested in fellowship, there really isn't any concern. In my class, three of us are applying to fellowship (MFM/REI/REI); and honestly, none of us are concerned about our future match in excellent programs. Fellowships only look at the quality and reputation of the program as a whole, and at your accomplishments during your four years there. As a group, we've all had a plethora of publications, presentations, abstracts, and strong training. The reputation of our program and hospital, and the reputation of the attendings that support us, are excellent.
In addition, this probationary status is only temporary. The reason it says that it goes until 2009 is because the ACGME really isn't concerned about the things they've cited. If these were serious problems, they would be hovering over us and running back within a year to make sure any gross violations were corrected. We're likely going to ask them to come back within the year anyways to show them the true numbers that have all now been corrected. This will likely be taken care of by the time I graduate.
Even if this probationary status had happened 3 years ago at the match, I still wouldn't have changed my mind. I graduated from UCLA, and did my ob-gyn clerkship at Cedars-Sinai during 3rd year of med school. I absolutely fell in love with the program, its residents, and attendings during my six weeks there. The group of residents we have are some of the most intelligent, hard-working, fun, cohesive residents I've met. Some of my closest friends, confidantes, wonderful future colleagues will be a result of these treasured years I've had here.
Each program has its risks and benefits, so to speak. This small bump in the road for us is rather unsubstantial. Like I told many applicants during the season, go where you feel like you will be most productive, supported, and form the strongest professional bonds. As any of our interns will attest, this camaraderie can be felt starting from your first weekend at the resident retreat... especially when your kayak flips and you're being saved from the lake by coresidents.
Anyways, like CalifOB, I'd be happy to answer any questions you may have. Happy matching!
I'm also a Cedars resident currently, and want to tell you all that CalifOB is absolutely correct. First, I'll have to apologize for the upcoming verbosity. Apparently cedars residents like to leave long message...
Regarding your questions above, the computerized system was instituted the year I came on board. It's really a non-intuitive and bothersome system. Unfortunately, it's a universal evil with ACGME. Honestly, as an intern, I wasn't even aware that the system is used by ACGME to track volume for programs. We've always had an overabundance of cases, and never had reason to worry about the volume. Therefore, tracking was rather lax on the residents' part. Over the past year, that's certainly been fixed. Our volumes, as indicated in the letter that was sent out, are some of the best in California. I can assure you all that we have more volume than we'll ever need. Where else will you have onc fellows who stand aside while the intern does the hysterectomy AND lymph nodes!?
Also, for those interested in fellowship, there really isn't any concern. In my class, three of us are applying to fellowship (MFM/REI/REI); and honestly, none of us are concerned about our future match in excellent programs. Fellowships only look at the quality and reputation of the program as a whole, and at your accomplishments during your four years there. As a group, we've all had a plethora of publications, presentations, abstracts, and strong training. The reputation of our program and hospital, and the reputation of the attendings that support us, are excellent.
In addition, this probationary status is only temporary. The reason it says that it goes until 2009 is because the ACGME really isn't concerned about the things they've cited. If these were serious problems, they would be hovering over us and running back within a year to make sure any gross violations were corrected. We're likely going to ask them to come back within the year anyways to show them the true numbers that have all now been corrected. This will likely be taken care of by the time I graduate.
Even if this probationary status had happened 3 years ago at the match, I still wouldn't have changed my mind. I graduated from UCLA, and did my ob-gyn clerkship at Cedars-Sinai during 3rd year of med school. I absolutely fell in love with the program, its residents, and attendings during my six weeks there. The group of residents we have are some of the most intelligent, hard-working, fun, cohesive residents I've met. Some of my closest friends, confidantes, wonderful future colleagues will be a result of these treasured years I've had here.
Each program has its risks and benefits, so to speak. This small bump in the road for us is rather unsubstantial. Like I told many applicants during the season, go where you feel like you will be most productive, supported, and form the strongest professional bonds. As any of our interns will attest, this camaraderie can be felt starting from your first weekend at the resident retreat... especially when your kayak flips and you're being saved from the lake by coresidents.
Anyways, like CalifOB, I'd be happy to answer any questions you may have. Happy matching!