MAIMONIDES Medical Center IM program under PROBATION

[docstarbucks]

Hey folks,

There is insider information that the Internal Medicine program at Maimonides Medical Center is under threat of probation. It is under the ACGME's radar. An ACGME meeting in January 2012 will conclude the fate of the numerous citations the institution has received.

While the hospital is one of the best equipped in New York City in terms of community hospitals, it is the bad attitude of the management towards residents that has produced a terrible ACGME survey leading to the citations.

The hospital is actually one among a few in NYC which are in profit. However, the residents are paid among the least in NYC. Residents are overworked, with a lot of service responsibilities interfering with academics. The entire focus is on discharging patients, whether or not clinically indicated, as turnover is what pays the hospital. That is possibly one of the factors leading to the hospital being in profit, though. So, instead of spending on residents, the hospital spends on professional case managers who in turn pressurise residents to discharge patients everyday. The hospital is reluctant to hire PAs to do the scut work as their viewpoint is "...it takes 3 PAs to do the same work as a resident... that would cost us millions of dollars..." The hospital calls itself "not-for-profit" nevertheless.

Whatever teaching occurs is grossly sub-par. Private attendings have very poor knowlege/attitude/practice quotients. There are small groups which inter-consult each other for the most trivial things (guess why). The academic environment, if any, is killed by pressure of service responsibilities, including calling several attendings for consults requested by the private attendings.

The culmination of all the above is what led to a disastrous ABIM exam outcome for the batch that just completed in June, with 7 out of 23 residents FAILING the ABIM exam. THAT INCLUDES 2 OF 3 CHIEF RESIDENTS!

On a side note:
The program director himself is hardly interested in residents' welfare. For him, the most important thing on rounds at the beginning of a day is to identify which new patient belongs to which private attending (even though the interaction between the patient and that attending happened several decades ago). He ends up getting the simplest of patients (alcohol-drunk, cellulitis etc) and all the complex service cases end up being transferred to younger attendings trying to make a mark.
Being a jewish program in the heart of a stiflingly orthodox jewish community, a lot of fussy importance is given to celebrating jewish holidays and weekend breaks (Shabbos), creating rather unfair schedules to non-jewish residents.

BOTTOMLINE:
So if you are interviewing there, carefully consider your options. It is actually not a bad idea to go for this program after all, as things are going to change. Nevertheless you need to be brave and bite the bullet.
Most of the current residents are apprehensive about the outcome of the ACGME meeting in January. It can affect all of the fellowships too. But the program has great infrastructure inspite of a pathetic management. Being cited by the ACGME for several factors, that is hopefully going to change. Hopefully for the good for the residents.

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[honeycomb3]

I went for an interview today at Maimonides and they are not under probation.

 

[member654321]

docstarbucks just curious, how did you find this information out? I just did a rotation in IM at Maimonides and the residents said that they are not under probation.

 

[docstarbucks]

I went for an interview today at Maimonides and they are not under probation.

I've edited the post to take care of the semantics. Thanks for pointing that out.

 

[docstarbucks]

docstarbucks just curious, how did you find this information out?

Does it really matter how?

Please ask the residents around. There is no smoke without fire.
How is it that everyone quotes that he/she is happy while the annual ACGME surveys have gone downhill?

By the way, if you have rotated at Maimonides, you would know that the program director is always available for questions, comments and criticisms.

 

[DrWBD]

I'm disappointed to read this. I had a great experience rotating through Maimonides as a medical student (admittedly some years ago).

 

[speakeasy]

I'm so surprised to be reading this on this forum, the fact is that MAIMONIDES MEDICAL CENTER IS NOT ON PROBATION. I do not know where docstarbucks got the "insider information" from. I am a PGY2 resident in this program and will tell you the truth.

The ACGME publically publishes a current list of programs on probation (http://www.acgme.org/adspublic/). To see the list of programs or institutions in ACGME trouble, choose the "Accreditation Decisions" report, then from the drop down choose "Programs (or institutions) with unfavorable decisions". You won't find any dept at Maimonides Medical center listed there.

I have worked in this hospital for 2 years, and have never been above the work hour limit, we residents definitely go less than 80 hrs a week during busy floors, and even work less than 40hrs a week on some electives. I think it is an overstatement to say we are overworked.

The attendings and program director are very approachable and friendly, so much so that we even have a say in which private attendings remain on the teaching staff.

It is interesting that everyone on this forum who has been at Maimo either as a student or rotator does not agree with docstarbucks opinion of this program, and it also amazes me that (s)he changes his mind saying " the program director is always available for questions, comments and criticisms" after someone disagrees with him.

Hey guys, Doctors are intelligent people who do thorough research before making decisions. IF you get an interview at Maimonides, go for it with an open mind and find out for yourselves what the truth is.

Speakeasy signing out......

 

[jdh71]

My favorite has to be last year's Vandy thread though. That one was special.

 

[maimonidesrocks]

Hey Docstarbucks - you must be a loser for spreading false information about your own program.maybe you are frustrated that you didnt get into a fellowship or something.
Maimonides is not under probation and is one of the the best community hospital in new york.we have all fellowships and specialities like ortho,emergency med,paediatrics.the fellowships here are one of the best in new york like cardiology,pulmonary critical care.if you are a good resident and are dedicated to your work you will get the fellowship of your choice.
about ABIM boards, results have been bad all over including hosp like NYU,BETH ISRAEL so draw your own conclusion.
with so many hospitals shutting down every month ,if you want to listen to rumors by ppl like docstarbucks,its your loss
every hosp has its strengths and weakness,maimonides def has more strengths than weakness.please draw your conclusion after interviewing and meeting residents and fellows here.
its in one of the safest neighborhoods in new york city,with good patient load.residents never exceed work hour limits.
good luck!

 

[docstarbucks]

...you must be a loser...
...about ABIM boards, results have been bad all over including hosp like NYU,BETH ISRAEL so draw your own conclusion...
...with so many hospitals shutting down every month... .

Why do these people NOT read my post properly before becoming so defensive about the probation?
I clarified that Maimonides is under THREAT of probation which might or might not happen, the fate of which is to be decided in a meeting in ACGME in January. It is likely that it will NOT happen (as the management claims that it has managed to give ACGME "satisfactory answers").

But no one can deny that the program has been cited by ACGME for several shortcomings. And those citations came because residents had things to say in the anonymous ACGME survey, that they otherwise wouldn't or couldn't.
Now, what conclusions would you draw from this? Some possibilities are:
1) Management is great. They are open to criticism. Residents are nuts.
2) Management is great. They are "open to criticism" but don't care. Residents are nevertheless nuts.
3) Management is terrible. They are "open to criticism" but don't care. Residents are helpless.
4) Management is terrible. They are hostile and not open to criticism. Residents are helpless.

It is unfortunate if no one saw the sarcasm in the statement "the program director is always available for questions, comments and criticisms".
The true character of a management is reflected by how it handles criticism about weaknesses. One potential option is to recruit "students/residents" to post things in the forum. If these people can truly take criticism, why are they posting vehement denials in this forum?

And then there is justification that residents in other hospitals in NYC also failed ABIM!
What is this person trying to say by "draw your own conclusion"? Well, here are some possible conclusions:
1) Hospitals in NYC are great, including Maimonides. They do their best to teach and train residents. Residents are pathetic.
2) Hospitals in NYC are great, including Maimonides. But they don't know how to teach and train residents. Residents are nevertheless pathetic.
3) Hospitals in NYC are terrible, including Maimonides. They 'try' their best to teach and train residents. Residents are good but helpless.
4) Hospitals in NYC are terrible, including Maimonides. They don't know how to teach and train residents. Residents are good but helpless.

Who is this person trying to WARN (?!) by saying "...WITH SO MANY HOSPITALS SHUTTING DOWN... if you want to listen to rumors, it is your loss"? Does (s)he mean something like "... no matter what anyone says, ONLY WE STAND TALL and can save you..."?


ONCE AGAIN, THE BOTTOMLINE:
No one can disagree that every hospital has strengths and weaknesses. Strengths are apparent on their websites.
My intention is NOT to scare people away from interviewing or matching into this program.
It surely has all its positives. People should definitely interview at Maimonides and know more about the positives by talking to the residents and fellows.

However, to quote an earlier post, doctors are intelligent people who do thorough research before making decisions. I feel it also helps the doctors to know:
a) There are negatives too
b) What those negatives potentially are

👍

 

[LoudBark]

What is Maimonides board pass rate (percent) for the last 3 to 5 years?

 

[speakeasy]

What is Maimonides board pass rate (percent) for the last 3 to 5 years?

I do not have the facts, but remember that the program director said it had been >80% when I started PGY1

 

[DrWBD]

What is Maimonides board pass rate (percent) for the last 3 to 5 years?

The ABIM has board pass statistics for training programs on their website.

http://www.abim.org/pdf/pass-rates/residency-program-pass-rates.pdf

 

[whowhat]

aa

 

[whowhat]

I'm one of the Maimo people, you must be living behind a smoke screen if you totally disagree with docstarbucks. It is true that maimo have received citations from ACGME and it has to defend them, otherwise it will be on probation.

All the maimo fellows/resident who are on defense are part of the problem. The change begins with recognizing the problem and changing to make ouselves better. Maimo is not a bad place, neither it is resistant to change.

The problem is the change has to be in the evidence based and academic manner. For example, the private attendings ... OMG!!! the current culture among residents fosters unhealthy competition for fellowships that needs to be changed as well. The current dinosaur ways of teaching needs to be changed, just cause we have been doing it for ages does not mean it has to remain that way.

 

[rainu]

Q about probation is debatable. few things are crystal clear

1.Residents are treated like DOORMAT. Some time the way nurses, cafeteria staff, some attendings,management teat you make you feel that you should have kept you dignity at home before entering hospital premises.
2.Education:high board pass rate(66%), speak volumes about quality of education. 1 out of 3 chiefs cleared board(Impressive...isn't).
3.Non supportive management and staff.As per PD "You have to apologize in every situation, doesn't matter if its your fault or not"
4.research: LMAO..you are not suppose to utter these words here.Rules are clear: practice age old medicine and make money. hospital has hired huge team of people just to force residents to discharge more and patients and some time even document wrong diagnosis so that hospital can be reimburse in a better way...and as per Assoc PD if you wont help hospital in making money then it eventually gonna effect you residency spot as program who doesnt make money get wont able to function.