Figuring Out Which Are Malignant Programs?

[alleycat82]

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Long time reader, first time poster. Getting nervous and excited about match coming up, but am a little worried about how to rank programs.

One of the programs that I had the best impressions of during the interview trail was Yale. The residents I met at the night before dinner were great, seemed to be happy, and the program layout seemed well thought out. But then I found out that a friend of a friend is a resident there, and had a chance to talk to her, and got a whole different story. Apparently, things are very rough there, and have gotten bad enough that an entire class joined together to write a letter about how bad things have gotten recently, and reading the letter really surprised me.

If I got such a wrong read on this program during my interview day, it makes me wonder if other programs are the same, and how much I actually know about a place that I a committing to for the next 3-4 years. Any thoughts on how to discern the difference? ROLs are due so soon, sigh

 

[Apollyon]

There's a guy that posts here that was a resident there, and he makes twice as much per year as I do, has an Aston Martin, and a gorgeous fiancée. I mention this because he never had anything bad to say about his residency, and he's an upfront guy.

I mean, malignant programs in EM are kind of difficult to have, as it's not the work hours (60 clinical per week, 72 total per week), and if the PD is the worst part, it's mondo easy to avoid them as much as possible. If you have a ****ty attending, you only have to work a finite number of hours with them (I had one like that, that was vindictive and nasty - I would count the hours until her shift or mine was over).

 

[WilcoWorld]

That is not a public letter, to post it here is in poor taste.
Please take it down.

 

[tanzaniancane]

That is not a public letter, to post it here is in poor taste.
Please take it down.

Agree with WilcoWorld - please take down the letter. It was never meant for a public forum.

 

[gro2001]

I've also had a very positive impression about the Yale program from the interview trail.

I have a different take on the letter though. It seems to me a very organized, mature and professional way of dealing with issues faced by residents. Instead of whining about their program and posting anonymous reviews online they've made an organized effort to address the issues with the program director and offered their thoughts on possible solutions. This is exactly the type of colleagues I would like to have. If I was a program director, I would be very proud that my PGY 2s not only have the professional qualities I mentioned, but take such ownership of the program.

But I agree with the previous posters that since the letter was not meant as a public address, the ethical thing would be to take it down.

 

[iridesingltrack]

Long time reader, first time poster. Getting nervous and excited about match coming up, but am a little worried about how to rank programs.

One of the programs that I had the best impressions of during the interview trail was Yale. The residents I met at the night before dinner were great, seemed to be happy, and the program layout seemed well thought out. But then I found out that a friend of a friend is a resident there, and had a chance to talk to her, and got a whole different story. Apparently, things are very rough there, and have gotten bad enough that an entire class joined together to write a letter about how bad things have gotten recently, and reading the letter really surprised me.

If I got such a wrong read on this program during my interview day, it makes me wonder if other programs are the same, and how much I actually know about a place that I a committing to for the next 3-4 years. Any thoughts on how to discern the difference? ROLs are due so soon, sigh

In all respect to your anxiety I would tell you not to worry about this letter. These R2's simply sound tired and overworked. Honestly, where is this not the case? Residency is a very difficult endeavor. The hours are long, the work is never-ending, and the "atta boys" are few and far between. But, these residents have articulated a very professional letter to a PD that sounds like he/she is open to hearing from them.

I agree with other posters, this sounds like a group of people that would be good to work with. There is nothing in this letter that strikes me as particularly "malignant," just exhausting...such is residency...everywhere.

FWIW, I also recommend taking the letter down.

iride

 

[Arch Guillotti]

I removed the letter (at least for now) since it was not meant to be for the general public and several users had complained or called for its removal. Your area mod may weigh in on this as well.

Most residencies put on a good face during the interview and also most residencies have some dirty laundry they don't want unveiled during the interview.

 

[spyderdoc]

I agree with removal of letter. I also did residency at YNHH, albeit finished almost 10yrs ago, so can't comment on current climate there.....Unfortunaltely, I am not the one with the Aston.

 

[SoCuteMD]

.

 

[nycqqe]

Most residencies put on a good face during the interview and also most residencies have some dirty laundry they don't want unveiled during the interview.

Yeah when people say that their program is "good" or "nice" that's just like your LOR saying that you are a "good" medical student. I tell applicants to look for programs where residents believe they are getting "one of the best trainings" possibly out there or that the administration "spoils" them. While it's impossible for people to know for sure that they are getting the best without trying the rest, but its a small field and residents generally know what's what, so as long as they believe they are getting some of the best, then they usually are not far off.

It's like a BMW owner might not have driven every car out there, but you gotta trust their enthusiasm for the love of their BMW, and be careful of the Toyota drivers that tell you they drive a good car that allows them to complete "well" all of their daily chores. At the end of the day, all residencies will prepare you well, but you might as well go to one that gives you some of the best trainings as well as spoiling you as a resident if possible.

 

[YaleEM resident]

Agreed, this was not the intended forum for that letter. Nonetheless, as a senior EM resident at Yale, I have been very happy with my experiences here over the past several years. I ranked Yale #1 when I was looking at residencies and have no regrets. The residents themselves are really a strength of this program. I have friends in all 4 classes, and we genuinely do enjoy each other's company both in and out of the ED. The Yale ED is always busy, and is a terrific place to learn. Our community EM experience at Bridgeport is an excellent complement to Yale. We all value our ICU months, elective time, toxicology at NYC PCC, a wide range of research opportunities readily available to us, and a supportive group of attendings in the ED. The program really does regularly solicit and act on resident feedback. In fact, in response to the recent letter by our PGY-2 class, changes have already been made to make Yale an even better place to train. I feel that my feedback is valued, and the program will continue to grow, based partially on direct feedback from residents. I certainly recommend that anyone come to Yale to get excellent training in EM that will prepare them for whichever career path they choose.

 

[Apollyon]

Unfortunately, I am not the one with the Aston.

Well, the "Spyder" makes me think you have the Toyota (you didn't strike me as a "Porsche" type).

 

[EMer4life]

I am disheartened that my class' letter has been distributed to the public and has now found its way onto SDN, a place where it can be misinterpreted. This letter was written with intention to improve our residency and was welcomed by our program's leadership. They even set up a town hall style meeting where all residency classes and numerous faculty/administrators could discuss areas of improvement. We are lucky to have leadership that is willing to listen to our concerns and look for ways to improve them. Such improvements are already in progress! Each and every residency has things that need to change - we simply want to improve and be the best that we can be.

I love being here and couldn't imagine being anywhere else. The people and experiences are amazing! I traveled far and uprooted my family to come to Yale and have not been disappointed with the education I have received. I know that from my experiences here, I am becoming a better physician everyday. Also, every prior resident now working as an attending to which I have spoken states that they feel prepared for anything.

From a more personal place... After experiencing recent personal hardship, I have been blown away by the support and love from my department. People worked extra shifts, switched their entire schedules, called, visited, cooked, and supported me through this rough period - this includes attendings as well. This is what great residencies are made of. I am happy to be a member of the Yale EM family.

Most importantly, we are SO far from being "malignant", as I hope my posting has helped you see.

Please feel free to email with questions or concerns. I'll be glad to help in any way that I can.

Sincerely,
Jenny 🙂
jennifer.davis "at" yale "dot" edu - to keep the spammers away

 

[leorl]

I work with a recent Yale graduate as one of my attendings, and have communicated with another who did fellowship there. I don't know much about Yale yet except for interview visits, but the one thing that sticks in my mind is how those two attendings say that being part of Yale residency / fellowship was the best decision they have ever made in their entire lives.

Other posters are correct - each residency has dirty laundry and despite this, most people feel that they are educated to a decent level by the time it is their turn to become attendings. It sucks if residency letters (my residency has them too) get out in public before those who drafted the letters are ready to formally present it. But the way the EM culture is and the standards upheld by the RRC comparative to other residencies really makes it difficult for any EM residency to be malignant. EM training is fairly standardized anywhere you go, and this makes our specialty really quite unique.