How common are "malignant" radiology programs?

[odyssey2]

From talking to PDs and other applicants, "malignancy" in radiology mostly relates to being overworked but it seems that truly malignant, unfriendly environments are pretty rare in this field. I've been told that even the most malignant radiology program is probably going to be easier than the most benign surgery program. Do you find this to be true or are there some genuinely awful places to train?

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[Neopolymath]

I'm just an applicant myself but I find it hard to notice any real, meaningful differences in the programs at all during interviews or researching them so I'm really doubting there are more than a couple malignant programs if any at all. They all seem the same.

 

[guytakingboards]

Malignancy can be interpreted pretty broadly. I don't agree with the sentiment that its mostly due to being overworked. I went to a program that in retrospect was probably pretty malignant but the bare minimum expectations weren't particularly high. We never came close to 60 hours/wk much less 80 but I spent a lot of time there unhappy, because the culture sucked.

I happily work long hours if I feel like: I'm being listened to, I'm being valued for my work, I enjoy the people that i work with and learn from. If every day is just a grind to get to the last modify time, that flat out sucks.

Are there radiology programs where the attendings are straight up yelling at you all day (like some surgery programs): probably not. Doesn't mean there aren't more than a few that'll make your experience unpleasant. I had friends who trained at name programs who straight up considered publishing their terrible experiences as an op-ed in the newspaper.

Unfortunately, super tough if not impossible to glean that from the limited interactions y'all have with programs during interview season. Especially because you probably won't have a lot of in-person time with actual residents to pick up on non-verbal cues. Good luck.

 

[Dave1980]

From talking to PDs and other applicants, "malignancy" in radiology mostly relates to being overworked but it seems that truly malignant, unfriendly environments are pretty rare in this field. I've been told that even the most malignant radiology program is probably going to be easier than the most benign surgery program. Do you find this to be true or are there some genuinely awful places to train?

There are some awful places to train. In my limited experience there is some overlap between easy surgery programs and rough rads programs.

 

[RealHumanBean1]

Malignancy can be interpreted pretty broadly. I don't agree with the sentiment that its mostly due to being overworked. I went to a program that in retrospect was probably pretty malignant but the bare minimum expectations weren't particularly high. We never came close to 60 hours/wk much less 80 but I spent a lot of time there unhappy, because the culture sucked.

I happily work long hours if I feel like: I'm being listened to, I'm being valued for my work, I enjoy the people that i work with and learn from. If every day is just a grind to get to the last modify time, that flat out sucks.

Are there radiology programs where the attendings are straight up yelling at you all day (like some surgery programs): probably not. Doesn't mean there aren't more than a few that'll make your experience unpleasant. I had friends who trained at name programs who straight up considered publishing their terrible experiences as an op-ed in the newspaper.

Unfortunately, super tough if not impossible to glean that from the limited interactions y'all have with programs during interview season. Especially because you probably won't have a lot of in-person time with actual residents to pick up on non-verbal cues. Good luck.

@guytakingboards Please name some names and save us poor applicants lol (even a DM would be appreciated)

 

[Clean7795]

Being (extremely) overworked and yelled at is rare. I've heard plenty of horror stories from older generation of rads but I don't think most training programs are like that anymore, though I'm sure some still exist.

More common issues are if there are bad work environments as mentioned above. In radiology you work closely with your colleagues and attendings, much closer than most other specialties since you literally a few feet from each other or a few rooms away from each other the entire day. I'm a bit out of the loop for residency applications but if interviews are all virtual this year and you haven't done any away rotations, tbh I'm not sure if you can really assess this at all.

The other issue is that some places might just be bad for learning if there is low attending involvement for cases/didactics, weak call structure, etc. Again this is hard to assess without an away or in-person interactions. Even going off program name is hard because you have some ivory tower programs that have too many fellows, and some community programs that treat you like a workhorse without enough teaching.

 

[Ask Jeeves MD]

Anyone want to start naming programs? If you want to DM me, I’ll post for anonymity

 

[Ask Jeeves MD]

From an anonymous source:

University of Missouri- Kansas City

There was some question about what malignant means in radiology but they said it was a revolving door of attending that left when a better opportunity presented. This lead to a poor teaching environment due to decreased coverage. They felt overworked because of this and had to self teach outside the reading room. The “culture of the program was also not great”, not sure what this means but it wasn’t expanded on.

 

[radsresident7]

WashU. The program is terrible. Most attendings are miserable and take it out on residents. Residents are called "worthless, ret*rds, pieces of ****s..." daily. There is no teaching and you're expected to know everything. If you make a mistake, you get ridiculed. We get kept away from lecture to do scudwork like answering phone calls. The workload is brutal. Residents faint during call and the PD calls them weak. PD took away all of the benefits you see on the program's page which are all lies. If anyone dares to bring up any issues she crushes them and makes their lives miserable.

 

[Ask Jeeves MD]

Had another person who want to share some info about the University of Missouri- Kansas City

It appears they have recently spent time in the department and corroborated that the residents had been overworked. There is new leadership that are aware of the problems and are trying to fix/improve them. From talking with the older residents residents they felt that the problems would be fixed by the time this year's applicants are R1s. They also said the environment was very friendly between residents and the attendings were excellent people.

 

[Ask Jeeves MD]

From an anonymous source:

University of Buffalo

Biggest red flag was that they lost accreditation years ago and the leadership when that happened are still there running the program now. It is a new program that is run by private group and provided no teaching with the residents being highly overworked.

 

[futureRADres]

Friends,
UT San Antonio, TX DRis a malignant program. I am an R3 resident of UT San Antonio, and I suggest you all read the post in SDN posted in 2019 here (.)
If you match at UTHSCSA, this will be your future in UTHSCSA Rad:

• Dr. Gomez, the PD, the happy twitter face, is not who he looks like. He is a new PD after he took the position of Dr. Kist, the previous PD, due to an 95% dissatisfaction rate in the ACGME resident survey. Like his predecessor, almost all residents are not happy with his performance as PD. Don't judge a book by its cover. The rumors are he will be replaced with another faculty member (Dr. Rohweder) next year, which is another awful choice for PD.

• Education: almost zero. Dr. Gomez does not believe in education; the residents should find everything they need to learn from the internet.

• Faculty members show up around 10 am and usually staff residents remotely. They come and staff the reports very quickly. Do not expect one-on-one teaching.

• Matching in radiology is hard, but worse when you match to a program that doesn’t care about residents. I wish someone had told me. Do not rank UT San Antonio EVEN if you are really desperate. You are going to be in a 4-year nightmare. Ask previous graduates about the things I listed.

Find any of the current residents and email them: How to find the residents' email: [Last name] followed by [First letter of first name] @uthscsa.edu

Teaching is the worst part of UTHSCSA rad and is getting worse each year.

We do not have didactics, no protected study time. All you get is noon-1pm lectures that are worth nothing.

• Board Pass rate: Awful. 2 out of 9 residents failed during last year's board exam. The reason is clearly that the program does not give you any time to study. We do not know how the results will turn out for this year yet.
• Extremely busy program. Think of 300 studies in one ED night. Calls are crazy. Long calls are 20 hrs, short ones are 11 hrs for one month in a row, with mostly no fellows after 10 pm. The night float rotation is awful. Most nighttime faculty members will not help you if you are behind the list. Specifically, ask the residents how the night rotation is.
• Flexibility/ Open door policy: There is no tolerance for feedback; if you start giving them feedback or complain about anything, expect nothing to change.
• If your annual in-service score is below the 30-40th percentile, you will be bullied and threatened by the Chair! You will not be allowed to do moonlighting that year.
• Between 2019 and 2020, 5 residents have been dismissed or have resigned!!!!
• Residents want to leave this program. If you don’t believe it, look at resident swap website.
• Even many faculty members are leaving. The faculty turnover is high, with the most common complaint being their salary.

 

[Rad2TheBone]

Friends,
UT San Antonio, TX DRis a malignant program. I am an R3 resident of UT San Antonio...

I'm an R3 at uthscsa. I completely disagree with the above post.

Dr Gomez has and continues to be an excellent PD with a strong emphasis on education. I haven't heard any replacement rumors. And no, 95% of us aren't unhappy.

We have plenty of education including board review series for 3rd years and daily noon conference + scattered tumor or case conferences. The acgme does not allow dedicated study only time for boards, instead we attempt to schedule more relaxed rotations during the 2nd half of your 3rd year.

Most faculty are in house and there at 8-830am. Obviously covid has caused some to read from home.

I am sorry you felt it was a 4 year nightmare, but that 100% is not my experience.

Everyone last year passed the boards, 2 people originally had to retake, doing so successfully. The fail rate last year for the US was 16%. Life happens. The past years before that was 100% on the first attempt.

We are a busy program. But more like 180-220 studies during Longshift (5pm to 7am). My max was 225, crazy night. We don't have 20hr shifts.

I have given tons of reasonable feedback over the years without concern and with success.

Inservice scores under 30% year after year may signal deficiencies and its reasonable that the program might have you stop moonlighting to encourage studying and improvement.

Residents leaving (and entering) happens. Sometimes it's personal choices, sometimes a resident isn't able to safely take care of patients, other reasons etc.

Faculty turnover has been really good overall, with the most changes occurring in neuro.

Overall I'm proud of my program, I'm super happy I choose it, and I would choose it again. I don't have anything to gain from writing this post (I'll have graduated before a current ms4 becomes an R1). But I don't want people to miss out due to one person's post/opinion. I do feel bad for the above poster who was unhappy while writing this, and I wish them the best in their career and life.

 

[radsresident-US]

I would say that it is not common but malignant programs exist. I would not say that “malignant rads = easy surg” or any such comparison. Again it is infrequent to find a truly malignant place, but when you do, they are really malignant and I have heard the many horror stories some of which are posted.

Long hours and busy shifts are the least of it, that’s just a busy program. It’s mostly lack of teaching with emphasis on scutwork like phone calls, some places that use residents as ultrasound techs. Then there are expectations that you know things without any teaching.

Probably the worst part about some programs is just straight up neglect - no prelims, draft only, attendings just delete your draft, dictate themselves, don’t talk to you, don’t let you touch anything in procedures - 4 years of a Med student rotation. I’m not sure it’s necessarily “malignant” but it’s crappy training and will feel that way when you get your first lawsuit as an attending.

 

[Gigem2636]

" futureRADres" who created the account under a week ago but claims to be a uthscsa R3, interesting choice of a username.... at any rate... I totally disagree with their vengeful appearing assessment of the program which is full of false statements. Current real R3 . Willing to answer questions from prospective applicant who may have been frightened.

 

[real3rdyear rad resident]

Simple math: Busy program = high volume of cases = great experience = good radiologist
Education and teaching: one example; imagine you are in the ED and you are getting prompt feedback from the faculty with a bonus of full article about that topic forwarded to your email ( golden spoon teaching).
Study time: very flexible schedule for the board exam takers.
Dr. Gomez (PD): very supportive, very scientific, great teacher and of course great program director.
Dr. Rohweder: Imagine you have a “ teacher” who can know exactly what is your weakness and work hard to improve it in a “magic” and satisfying way.
..........another REAL 3rd year in UT SA radiology program.