Discrepancy in residencies...

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Chickenandwaffles said:
Gutonc is typically joking and being a d*ick, and is frequently hilarious even though his comments are frequently douchy and dickish as he points out. I have yet to see him not respond to someone without a snide remark. His advice is regardless pretty helpful even if he's a d*ick. You should again read my post, you seem to have trouble with that. People who actually *know me*, you know in REAL life, have never suggested that I lack insight. it's as if I say, for example, that you are a gambling, serial killer douche bag just because you are a jerk on this site. I don't know you in real life, so what I say in this site about you is irrelevant.

I don't think it's hard to understand. I also don't get why you are still posting to me. You disagree with my ideas, fine. You think you are great and I'm bad, fine. Why not move on? I'm sure you can be doing something more productive other than having yet another *nemesis.*
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I think you might be the only one that thinks you're putting me in my place. I'm bored and I'm messing with you. You keep responding. Pretty simple. You said some douchey things and I've been picking on you. No need to get all misty eyed about it.
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Chickenandwaffles said:
That's ED, I didn't apply for ED. Like I said, you don't have to agree with me. If you think that sub-50k is ok, that's your choice. I don't think that's cool for one, and for two, I think pay should be much higher in residency.
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I didn't know that PGY salaries varied based on specialty. I figured all PGY-1 salaries paid one number, all PGY-2 salaries paid a second number, etc. regardless of specialty.
 
DermViser said:
I didn't know that PGY salaries varied based on specialty. I figured all PGY-1 salaries paid one number, all PGY-2 salaries paid a second number, etc. regardless of specialty.
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They don't vary usually. I know for a fact that my residency paid the same for every specialty based on PGY. Benefits such as vacation time, book fund etc. were individualized by the department.
 
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ram006 said:
Sorry, my feathers got all ruffled after the janitor and sob story comments... I think I'm gonna take the day off...
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Oh I know… I was getting a bit perturbed myself last night. Sometimes it's a good idea just to step away rather than be drawn into silly arguments where neither side will agree with each other.
 
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Winged Scapula said:
Oh I know… I was getting a bit perturbed myself last night. Sometimes it's a good idea just to step away rather than be drawn into silly arguments where neither side will agree with each other.
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When I saw that I had like 20 alerts this morning, I knew I'd missed an interesting night...
 
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rokshana said:
well i guess chickenandwaffles IS really done with this thread...
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Seriously though, to address your previous post, cutting resident salaries has been proposed. The last TMA (Texas Medical Association) meeting a few weeks ago addressed this issue. While, thank God, I don't think they'll be able to just pull the rug out from under people already in training. They are considering reducing the number of GME funded positions and maybe (pure speculation on my part) this could ultimately lead to putting an expiration date on residency funding as a whole. None of this is set in stone obviously but it is incredibly scary to think someone could be 200k in debt and expected to work for free during residency. I'm not so sure hospitals would be rushing to pick up the tab...
 
ram006 said:
Seriously though, to address your previous post, cutting resident salaries has been proposed. The last TMA (Texas Medical Association) meeting a few weeks ago addressed this issue. While, thank God, I don't think they'll be able to just pull the rug out from under people already in training. They are considering reducing the number of GME funded positions and maybe (pure speculation on my part) this could ultimately lead to putting an expiration date on residency funding as a whole. None of this is set in stone obviously but it is incredibly scary to think someone could be 200k in debt and expected to work for free during residency. I'm not so sure hospitals would be rushing to pick up the tab...
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Pretty sure the ACGME would take issue with proposals of that sort and programs that tried it might have some accreditation problems.

DO residencies actually have some unfunded spots in specialties like Derm, but the ACGME forbids it.
 
Raryn said:
Pretty sure the ACGME would take issue with proposals of that sort and programs that tried it might have some accreditation problems.

DO residencies actually have some unfunded spots in specialties like Derm, but the ACGME forbids it.
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I'm sure they would, but if the government says no more funding for you I'm not sure what power they would have. Other sources can certainly be used to make up the difference but decreasing clinical revenues would make it difficult for some hospitals.

Unfunded spots are precisely the issue at hand. Found this pretty easily. Trying to get the slides from the last meeting to post.

https://www.aamc.org/newsroom/reporter/march2012/276736/budget.html
 
Residency funding is federal. A state medical association-- political juggernauts that they are-- can pass any number of inane policy resolutions, but even if they got the ear of their state legislature it won't impact GME.

Seriously, was C&W *banned* for this thread? That seems a little totalitarian to me.
 
BlondeDocteur said:
Residency funding is federal. A state medical association-- political juggernauts that they are-- can pass any number of inane policy resolutions, but even if they got the ear of their state legislature it won't impact GME.

Seriously, was C&W *banned* for this thread? That seems a little totalitarian to me.
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Right. It wasn't so much a matter of the TMA or Texas passing policy to cut funding for GME positions but rather the discussion of a federal issue at a state medical association meeting. The link to the ACS bulletin from 2012 does a pretty good job of laying out the issues. The proposals to cut GME are real. They hopefully are just too crazy to ever come to pass. It might turn in to another SGR kick the can down the road for 20 years thing.
 
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BlondeDocteur said:
Seriously, was C&W *banned* for this thread? That seems a little totalitarian to me.
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I'm surprised, after all your years on SDN, that you would think that. Multiple TOS violations are typically needed (except in the case of Spammers or return bannees) to be removed.
 
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ram006 said:
Right. It wasn't so much a matter of the TMA or Texas passing policy to cut funding for GME positions but rather the discussion of a federal issue at a state medical association meeting. The link to the ACS bulletin from 2012 does a pretty good job of laying out the issues. The proposals to cut GME are real. They hopefully are just too crazy to ever come to pass. It might turn in to another SGR kick the can down the road for 20 years thing.
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The Institute of Medicine is poised to release it's "GME Funding" recommendations. Despite huffing a lot of paint thinner and making pronouncements about the need for an increase in Medicare cap spots, no one seriously thinks that is in the cards. More likely scenario is a decrease in *Medicare* spots/calls for commercial insurances to pay-into a pool/States to pay-in. The later two options may occur in some places and will undoubtedly be primary care focused. I'm sure other state medical groups will be weighing in soon.
 
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Troubling times in the kingdom indeed...

As a PRS hopeful going the independent route I find the issue troubling. Playing devil's advocate a bit, If I were someone with no medical knowledge holding the GME funds and you told me there were people doing two residencies paid for by federal dollars the second of which was plastic surgery that's probably where I would start making cuts... Hoping that doesn't happen in the next two years.
 
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ram006 said:
Here's a pretty decent publication from the ACS. It's long though.

http://www.facs.org/ahp/aca/section-9.pdf
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This is an awesome article and my guess is that this is *exactly* what the IOM will propose. I especially like the idea of direct support of training programs. Good lord I want to get the hospital middle men out of education. I understand I'd be trading them for Feds, they couldn't be more opaque than the hospitals.
 
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Winged Scapula said:
I'm surprised, after all your years on SDN, that you would think that. Multiple TOS violations are typically needed (except in the case of Spammers or return bannees) to be removed.
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I am surprised. I mean he (I think C&W's a he?) got a little heated, defensive and lost his sense of humor but it didn't seem to cross any bright lines. So why was he banned?
 
Raryn said:
Pretty sure the ACGME would take issue with proposals of that sort and programs that tried it might have some accreditation problems.

DO residencies actually have some unfunded spots in specialties like Derm, but the ACGME forbids it.
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well, if there was a big revamping (and it would have to be pretty big) of medical education….they could decide that medical school was a 2 parter…the 1st 3 years being a didactic base(since the 4th year isn't all that intense) and then the remaining 3-5 years an apprentice base…all tuition based…imagine the debt load then!
 
BlondeDocteur said:
I am surprised. I mean he (I think C&W's a he?) got a little heated, defensive and lost his sense of humor but it didn't seem to cross any bright lines. So why was he banned?
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Again, I think you've been around SDN long enough to know that we do not comment on individual administrative actions. Its not fair to the individual user and you would prefer the same.

Suffice it to say that it was appropriate and was not done based soley on the behavior in this thread.
 
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Winged Scapula said:
Again, I think you've been around SDN long enough to know that we do not comment on individual administrative actions. Its not fair to the individual user and you would prefer the same.

Suffice it to say that it was appropriate and was not done based soley on the behavior in this thread.
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good riddance...
 
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BlondeDocteur said:
I am surprised. I mean he (I think C&W's a he?) got a little heated, defensive and lost his sense of humor but it didn't seem to cross any bright lines. So why was he banned?
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If you look at C&W's other threads she's (or he) started, this isn't really that surprising. It sucks that he/she has ruined chicken and waffles for me.
 
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DermViser said:
If you look at C&W's other threads she's (or he) started, this isn't really that surprising. It sucks that he/she has ruined chicken and waffles for me.
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i'm hoping they don't reincarnate as spicy chikfila sandwhich....
 
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Winged Scapula said:
Hard to ruin chicken and waffles...hmmmm.
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True. Although everytime I eat it I'll laugh at the SDN poster whining about everything, and I mean everything. She's a PM&R resident, for goodness sakes, married to someone who makes six figures. Life is quite good for her.
 
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C&W was a she? I thought I was arguing with a dude...
 
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