Important Questions For Residency Interviews

[exPCM]

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From the ABP: "Each institution sponsoring a pathology training program should develop individual sick, vacation, parental, and other leave policies for the resident. However, one year of approved training credit toward ABP certification requirements must be 52 weeks in duration, and the resident must document an average of 48 weeks per year of full-time pathology training over the course of the training program. Any additional leave must be made up. Unused vacation and other leave time may not be accumulated to reduce the overall duration of training."

The ABP gives programs tremendous latitude on how they count the 48 weeks per year of training. This leads to some important questions.

1) How much time do you give residents off for fellowship and/or job interviews?
Background: Most programs give 3 wks/yr of vacation (12 weeks total over 4 years) which would leave a total of 4wks off (1 wk/yr) for interviews/relocation. However more malignant programs will not give time off for interviews and insist that residents burn up their vacation time to interview.
2) Do you count time at CME and/or board review courses toward the 48 weeks/yr of pathology training?
Background: Again this varies from program to program. IMHO, it sucks when malignant programs make residents use vacation to take the Osler course.
3) Do you count time at the AP/CP board exam in Tampa toward the 48 weeks/yr of pathology training?
Background: Again this varies from program to program. IMHO, it sucks when malignant programs make residents burn up 3 or 4 days of vacation (including travel time to get to Tampa and then back home) to take the boards.
4) Do you give residents credit for weekends and holidays worked to offset time missed during the week?
Background: The ABP allows a program to count it as a full week of pathology training if a resident works on say Monday, Wednesday, Thursday, Friday, and Saturday and is out on Tuesday. However, some programs will not credit this as a full week and will deduct the day out on Tuesday from the residents' vacation time.

All of these issues can lead to significant variation in time off during residency which can be quite important. I have seen some residents from more malignant programs who were forced to burn up almost all their vacation time in order to interview for competitive fellowships.

 

[gbwillner]

Awesome post. Thanks!

 

[raspberry009]

This poses a significant problem for those who are needing to take maternity leave.

Let me clarify it is the board that is malignant about time off, not the residency programs. Some programs will let you do a "research" month to fudge some of that time and still get you to graduate on time. But unfortunately my program will not and I can't even use all the vacation time that is allotted to me because the pathology board has very little wiggle room.

Therefore, if I'm planning on starting a family during residency, I cannot use all the vacation time each year and use it instead for CAP presentations, ect, that don't count as my time off for the board so I can save weeks for maternity leave later on... if that were to happen.

I don't blame the hospital, because they are playing by the rules set by the board. It's the board that needs to be blamed for this so other programs don't have to fudge things to get their residents out on time. I don't even get to use all the vacation time that the hospital has given me.

 

[exPCM]

This poses a significant problem for those who are needing to take maternity leave.

Let me clarify it is the board that is malignant about time off, not the residency programs. Some programs will let you do a "research" month to fudge some of that time and still get you to graduate on time. But unfortunately my program will not and I can't even use all the vacation time that is allotted to me because the pathology board has very little wiggle room.

Therefore, if I'm planning on starting a family during residency, I cannot use all the vacation time each year and use it instead for CAP presentations, ect, that don't count as my time off for the board so I can save weeks for maternity leave later on... if that were to happen.

I don't blame the hospital, because they are playing by the rules set by the board. It's the board that needs to be blamed for this so other programs don't have to fudge things to get their residents out on time. I don't even get to use all the vacation time that the hospital has given me.

Unfortunately your program is not being truthful if they say all the rules are set by the ABP. The ABP only mandates 48 weeks of full-time residency per year averaged over 4 years. The programs have a lot of latitude in how they count those 48 weeks. In my experience the ABP will be happy to verify this and answer any other questions you have in this regard. Whether CAP presentations count as part of the 48 weeks of training or whether you must take vacation to do a presentation at the CAP is totally up to your residency program. Malignant programs will make you use vacation to do a CAP presentation instead of counting it as part of your 48 weeks of training/yr.
You already stated that some programs allow residents to do a research month and yours does not. Apparently you are not at a resident-friendly program. Not letting you use all your vacation time sounds like another huge red flag. It sounds like they are being jackas**s and then trying to shift the blame to the ABP. That being said, again you are allowed 16 weeks off over 4 years by the ABP. I am sorry to see that apparently your program refuses to let you take a full 16 weeks off during your residency.
FYI, Yale lets their residents do six months of research in their residency: see http://www.yalepath.org/residency/
Arizona also lets their residents do research electives: see http://residency.pathology.arizona.edu/training.htm
Johns Hopkins allows research electives: see http://pathology.jhu.edu/department/residency.cfm
University of Wahington allows research electives: see http://www.pathology.washington.edu/academics/residency/description/
UNC allows research electives: see http://www.pathology.unc.edu/resident/research.htm
etc., etc., etc.
So just because somebody lies to you, doesn't mean you have to believe the lies.

 

[TypicalTuesday]

For those of us in the application process right now, any info. on which programs are "malignant" and which are not?

 

[yaah]

Stuff changes so much year to year at places that I wouldn't really trust too much that I heard from random people on the internet. At least, I wouldn't trust it without confirming part of it myself. There were things I heard on my interview travels 5 years ago that no longer apply at at least half of the programs I visited.

 

[raspberry009]

Unfortunately your program is not being truthful if they say all the rules are set by the ABP. The ABP only mandates 48 weeks of full-time residency per year averaged over 4 years. The programs have a lot of latitude in how they count those 48 weeks. In my experience the ABP will be happy to verify this and answer any other questions you have in this regard. Whether CAP presentations count as part of the 48 weeks of training or whether you must take vacation to do a presentation at the CAP is totally up to your residency program. Malignant programs will make you use vacation to do a CAP presentation instead of counting it as part of your 48 weeks of training/yr.
You already stated that some programs allow residents to do a research month and yours does not. Apparently you are not at a resident-friendly program. Not letting you use all your vacation time sounds like another huge red flag. It sounds like they are being jackas**s and then trying to shift the blame to the ABP. That being said, again you are allowed 16 weeks off over 4 years by the ABP. I am sorry to see that apparently your program refuses to let you take a full 16 weeks off during your residency.
FYI, Yale lets their residents do six months of research in their residency: see http://www.yalepath.org/residency/
Arizona also lets their residents do research electives: see http://residency.pathology.arizona.edu/training.htm
Johns Hopkins allows research electives: see ]http://pathology.jhu.edu/department/residency.cfm[/url]
University of Wahington allows research electives: see http://www.pathology.washington.edu/academics/residency/description/
UNC allows research electives: see http://www.pathology.unc.edu/resident/research.htm
etc., etc., etc.
So just because somebody lies to you, doesn't mean you have to believe the lies.

Thanks for the clarification. I'll have to do more research.

 

[exPCM]

For those of us in the application process right now, any info. on which programs are "malignant" and which are not?

On paper the Arizona program looks good in terms of resident benefits ( http://residency.pathology.arizona.edu/training.htm ) although I am not personally familiar with the program.
1) yearly vacation of 22 working days 🙂
2) ten paid holidays a year 🙂
3) one day/month accrual of sick leave
4) family and medical leave provided as eligible
5) practice insurance
6) tuition allowances for the resident, spouse, and dependents 🙂
7) counseling services

 

[yaah]

Programs vary quite a bit, from my experience, in terms of some of the side benefits like parking and health care. Our program, for example:

Parking is partially subsidized (I think 20% of the monthly fee), the rest is a pretax deduction. of course, you don't HAVE to get a parking permit, you can just take a city bus or live close enough - all employees here have free access to the city bus system. Some programs have free parking, although that seems to be rare.

Health care is also partially subsidized, I think the hospital pays for at least 75% of the monthly premium (I pay something like $20 a month) - obviously that varies if you have dependents.

4 weeks vacation (I think), don't get 10 holidays though, I think there are only 6 (7 if you include the day after thanksgiving).

The family, medical leave I think is pretty standard. Our institution has a house officer union which negotiates comparatively better benefits, although I don't think it is a huge difference. There certainly are counseling services and things like that.

The tuition allowance is a nice perk though.

A lot of programs will provide you with a list of their benefits when you interview, although bear in mind they generally only list the favorable things! It's also important to ask about book and educational funds, travel stipends, things like that. Most programs will pay for you to present at conferences, but some have this come out of your educational fund (which I find odd, since it seemingly rewards those who don't present). But as we have seen on these forums before, book funds vary great from program to program.

I don't really know if there are any truly "malignant" programs anymore (at least if you judge malignancy by the standards of the past). These days, "Malignant" is more likely to refer to unsupportive programs or ones where residents are marginalized, as opposed to simply being overworked. These things you can get at during residency interviews - asking what residents actually do with their days (remember, being busy should not always be considered a BAD thing - if every resident goes home at 5pm perhaps you should consider they aren't learning very much), and also asking about elective time and things like that. And while I do not condone stereotyping in general, many of the programs that do marginalize residents (no preview time, grossing lots of small biopsies, lots of paperwork to fill out, etc) are often ones that have a high proportion of IMGs.

The questions in the OP are good ones to ask - I am not even entirely sure what our program's stance on this is. I do know that conferences, job interviews, etc, do not count towards vacation time - but I am not sure if there is a LIMIT to conference attendance. Last year I had something like 15 days away for conferences, meetings, boards, etc (almost all of it done during elective months though), and no one complained.

 

[raspberry009]

Here is what I currently understand. I will get back to you again if I'm wrong. Here, they take the 48 weeks of full time training quite literally. We get 3 weeks of vacation each year plus all holidays. I have to divide this up for it to make sense to me.

For the hospital: 3 vacation week plus all holidays. Sick leave is not counted against holidays this nor is CAP presentations or any other poster presentations. You can carry over 1 week of vacation from year to year. Interview days count has holidays.

For the ABP: 4 weeks which includes all holidays and sick leave. Also in any given rotation, in order for it to count you cannot miss for than 5 days within that month. So a 2 week vacation must be at the end of one rotation and at the beginning of another. CAP presentations, ect. Do not count as holidays. Interview days count as time away from the rotation and you cannot miss more than 5 days within one month. If your covering for a peer, you cannot miss more than 5 days on your month covering autopsy if your on micro...ect. (This is how I have at it explained to me).

Assuming the above is true (from what I understand): lets say I've used up all three weeks (4 weeks by the ABP if you include the holidays) of my vacation time every year and I need to leave for maternity leave during my forth year. I have 3 weeks for vacation plus an additional 4 weeks for a total of 7 weeks to use for maternity leave and interviews. Which is reasonable. You just can't get pregnant more than once or get really sick and need to take leave longer than a few weeks. If this does happen you can sit for the boards at a later date (October is it?) or take an extra year.

So I guess I'm not sure why this would be called malignant. But I have heard many programs allowing people to do "research" and never have to come into work but just write a small paper off of a few articles that they read at home. That is not allowed here. If you're doing a research month you really need to be here and working on something on a daily basis.

Does this clarify?

 

[exPCM]

Here is what I currently understand. I will get back to you again if I'm wrong. Here, they take the 48 weeks of full time training quite literally. We get 3 weeks of vacation each year plus all holidays. I have to divide this up for it to make sense to me.

For the hospital: 3 vacation week plus all holidays. Sick leave is not counted against holidays this nor is CAP presentations or any other poster presentations. You can carry over 1 week of vacation from year to year. Interview days count has holidays

These are some peculiar rules your hospital has implemented. This has nothing to do with any ABP guidelines. You do not have to get back to me. I have already researched this issue at length.

For the ABP: 4 weeks which includes all holidays and sick leave. Also in any given rotation, in order for it to count you cannot miss for than 5 days within that month. So a 2 week vacation must be at the end of one rotation and at the beginning of another. CAP presentations, ect. Do not count as holidays. Interview days count as time away from the rotation and you cannot miss more than 5 days within one month. If your covering for a peer, you cannot miss more than 5 days on your month covering autopsy if your on micro...ect. (This is how I have at it explained to me).

Basically I have posted the Arizona benefits above and they are within ABP guidelines. The 4 weeks off per year does not have to include holidays. Thus as above with Arizona they have their 4 weeks of vacation per year plus 10 holidays off. Multiple other programs give 4 weeks of vacation as well (eg. South Alabama http://www.southalabama.edu/usahealthsystem/pathology/resprogram.html , Chicago http://pathology.bsd.uchicago.edu/residency/resinfo.htm#vacation ). The ABP is fine with this. Again the ABP gives programs wide latitude on how they count the 48 weeks/yr so that the programs can even count weekends and holidays worked to offset weekdays missed if they wish. There are no ABP rules on missing 5 miss days a month or 2 week rotations being at the end of one month or beginning of another. However it was explained to you has nothing to do with any ABP requirements

Assuming the above is true (from what I understand): lets say I've used up all three weeks (4 weeks by the ABP if you include the holidays) of my vacation time every year and I need to leave for maternity leave during my forth year. I have 3 weeks for vacation plus an additional 4 weeks for a total of 7 weeks to use for maternity leave and interviews. Which is reasonable. You just can't get pregnant more than once or get really sick and need to take leave longer than a few weeks. If this does happen you can sit for the boards at a later date (October is it?) or take an extra year.

I don't understand your mathematical calculations here!

So I guess I'm not sure why this would be called malignant. But I have heard many programs allowing people to do "research" and never have to come into work but just write a small paper off of a few articles that they read at home. That is not allowed here. If you're doing a research month you really need to be here and working on something on a daily basis.

I have posted numerous programs that allow research rotations and I could list more if I had to.

Does this clarify?

The people at your program have their own warped and twisted method of interpreting the 48 week rule and that is not the ABP's fault. I must say also that I am no great fan of the ABP either - $2200 for AP/CP combined as well as $1800 for AP and CP individually seems excessive to me. Plus the ABP justified raising their exam fees a few years ago partly to offset higher costs when they implemented board testing in Dallas, Deerfield (near Chicago), and Tucson as well as in Tampa. However they did not reduce their fees when they changed back to giving the boards in Tampa only. (see http://www.abpath.org/200106newsltr.htm and http://www.abpath.org/200301newsltr.htm). So I am not a cheerleader for the ABP but I can not see blaming the ABP for your program's arbitrary rules