Do 8-5 residencies exist?

[deleted57552]

If you do not want to do much scutwork, it is best to steer clear from the high profile programs. At these programs, stress trickles down from the top of the pyramid. Attendings will want most of the grunt work to be done by the residents because they don't have time for this. Why? Because they are under a specific set of pressures themselves...pressures that residents will not understand until they become junior staff themselves.

Attendings need to publish and become experts in a focused area to get promoted; therefore, the menial aspects of service work gets in their way and residents can suffer. Protected time is a huge issue and having to hold your hands and actually teaching you may take away from that.

Perhaps applicants can think of this and ask insightful questions on their interviews. You can ask, "What proportion of faculty get promoted and what is the timeframe?" along with the companion questions "What is the publication record of most faculty?" and "Is teaching valued in promoting faculty?" If you ask this to the chair of the dept, he/she may wonder, "Why the hell are you asking me this as a medical student?" That's OK...just force them to answer the questions. Because the answer will have relevance to how you will be treated by faculty, especially junior faculty, at the place you will call home during your residency training.

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[malchik]

I think this is a very good point. How junior faculty are treated, their expectations, their morale, has a huge impact on residency training. Another good question to ask, or at least to investigate, is the extent of junior faculty turnover.

 

[yaah]

What seenthelight says are good points, except consider that at many big programs, a lot of the scutwork is done by PAs or ancillary personnel. Some medium sized programs are limited in PA staffing or support staff, and residents have to do more.

A related question to ask on publications of junior faculty is how often residents are involved in the publication. If all recent publications do not include residents or fellows, that might mean resident input is not welcome or encouraged, or that residents do not have time or motivation to participate.

 

[deleted57552]

What seenthelight says are good points, except consider that at many big programs, a lot of the scutwork is done by PAs or ancillary personnel. Some medium sized programs are limited in PA staffing or support staff, and residents have to do more.

Good point yaah. It's all about how certain issues balance out and different kinds of programs have their own set of issues. I think teaching can suffer when the staff are put under tremendous pressures to become leaders in their fields by publishing a lot (and therefore, not perishing). That's when signout tends to be rushed, there is less teaching, more of a mentality of "let's just get the work done so that we (meaning I) can get out of here and do my projects", and more ordering around of residents to do menial tasks without much explanation, etc. Then at programs without much ancillary staff, there is this rushed mentality secondary to limited support systems. I guess the ideal academic departments (in terms of teaching residents), where most of the residency programs are housed, are a rare breed given increased volume (which seems to be a national trend) and increased academic-related pressures placed on faculty. Again, I think you brought this up at some point...the value of teaching and rewarding such efforts are often underappreciated.

A related question to ask on publications of junior faculty is how often residents are involved in the publication. If all recent publications do not include residents or fellows, that might mean resident input is not welcome or encouraged, or that residents do not have time or motivation to participate.

Definitely a good question to ask at residency interviews. The trend here could be influenced by two intertwined variables:
(a) # fellowships in the program - big programs have more fellowships especially the desirable ones; there is competition within which leads to residents thinking that they have to do projects to get ahead and to suck up to the fellowship directors.
(b) proportion of residents interested in academics vs. private practice - has interesting implications as those who do private practice may actually have a bit more of an incentive to do projects; see (a)

This was based on where I did my training though so this may or may not apply to some programs. But generally, I agree with you yaah.