Malignant programs

[ckdgusdl88]

This must have been discussed but it is a topic worth keeping current.
What are some programs that have a reputation for being malignant?
What are some programs that gave you the malignant vibe on the interview trail?

I understand this is subjective and there can be disagreement, but it is helpful for applicants to know what other people think.

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[doc MD]

what would your definition be a malignant program?

 

[DermViser]

Good luck. I can almost guarantee you that no one will straight come out and say (not on SDN, which is not a fully anonymous forum) which programs are malignant or gave a malignant vibe as the derm community is very small and there are so few residents to begin with (esp. the ones with only 1 resident per year).

Every derm program knows with people they interview that they will all be ranked, it's a question of where in that rank list.

Edit: There was a program with a resident who was about to graduate from her derm residency program talking about how malignant it was in the Dermatology forum, and what signs to look out for, but can't find it at the moment.

 

[ckdgusdl88]

One thing I've heard is that NYC programs and programs with lots of private practice attendings tend to be malignant.
People agree?

 

[DermViser]

One thing I've heard is that NYC programs and programs with lots of private practice attendings tend to be malignant. People agree?

I don't know it that's the case, as much as the level of volume you'll be getting in that area. For example, if you're a dermatology resident at Columbia or NYU Langone, yes, you will be very very busy. You may not have an attending who is willing to be nice all the time as you're zipping thru patients, as the day progresses. Derm is a completely outpatient based, RVU dependent field.

Also, some dermatology programs set very high educational standards for their derm residents and if you don't meet them, you'll be made to know it.

 

[pain monster]

cincinatti - egotistical faculty, residents didn't seem very happy.
SLU - mandatory research project every year, residents said this sucked. Some high strung faculty.
Wright state - faculty literally told me to not rank them. WTF??
Einstein - unhappy residents.

 

[asmallchild]

cincinatti - egotistical faculty, residents didn't seem very happy.
SLU - mandatory research project every year, residents said this sucked. Some high strung faculty.
Wright state - faculty literally told me to not rank them. WTF??
Einstein - unhappy residents.

Just as a headsup, I would venture the vast majority of programs have a requirement to do some sort of research project every year as it is an ACGME requirement. My program required an actual publication every year. In the end, not a big deal and not a smart way to decide whether or not a program is correct for you.

 

[DermViser]

cincinatti - egotistical faculty, residents didn't seem very happy.
SLU - mandatory research project every year, residents said this sucked. Some high strung faculty.
Wright state - faculty literally told me to not rank them. WTF??
Einstein - unhappy residents.

Try trolling harder, Mr. 3 posts.

 

[pain monster]

Long time lurker, matched derm this cycle and am about to start intern year. I interviewed at these places and would be GLAD to answer more questions.

 

[dermappca]

While I do not know if Wright State is malignant or not, a dermatopathologist from their program told me during my interview that I was too qualified to go there & that their program was "terrible with only 1 full time faculty". I later learned from one of the residents that he was about to leave the program.

 

[DermViser]

While I do not know if Wright State is malignant or not, a dermatopathologist from their program told me during my interview that I was too qualified to go there & that their program was "terrible with only 1 full time faculty". I later learned from one of the residents that he was about to leave the program.

You also have to consider that it's in Dayton, Ohio. Just like other specialties, the top cities people want to go to are LA/NYC/Boston, etc.

My point is that no matter how bad the program is, no Dermatology applicant is going to take a program off their rank list and increase their risk of going unmatched. They may drop a program in rank down his/her list, but they aren't going to not rank that program and increasing their risk of going unmatched.

Realize also you're an MD/PhD as well.

 

[ckdgusdl88]

You also have to consider that it's in Dayton, Ohio. Just like other specialties, the top cities people want to go to are LA/NYC/Boston, etc.

My point is that no matter how bad the program is, no Dermatology applicant is going to take a program off their rank list and increase their risk of going unmatched. They may drop a program in rank down his/her list, but they aren't going to not rank that program and increasing their risk of going unmatched.

Realize also you're an MD/PhD as well.

Yes, it is true that a program will rarely be taken off the match list by an applicant. However, there are quite a lot of stronger applicants for whom the list is long enough that being put on the bottom of the list is essentially writing that program off. In derm, programs do not compete to get filled, but they do compete for better applicants. I don't understand why Dermviser has to be so defensive.

Please keep airing out whatever negative qualities you've noticed in residency programs during interviews or heard through the grapevine. You can also PM me.

 

[DermViser]

Yes, it is true that a program will rarely be taken off the match list by an applicant. However, there are quite a lot of stronger applicants for whom the list is long enough that being put on the bottom of the list is essentially writing that program off. In derm, programs do not compete to get filled, but they do compete for better applicants. I don't understand why Dermviser has to be so defensive.

Please keep airing out whatever negative qualities you've noticed in residency programs during interviews or heard through the grapevine. You can also PM me.

I apologize if you thought I was being defensive. I am the last one to defend a malignant program and I think transparency is important. You and everyone are free to continue it openly in the thread. My point is what do you actually think the result of it is going to be? Do you think any derm applicant in their right mind would a) turn down an actual interview or b) drop it off their rank list based on that information

Those are the ONLY 2 real solutions you have in the NRMP match to avoid a malignant program.

Guess what in Derm -- nearly everyone is a strong applicant ---> high class rank, high board scores, high clerkship grades, has some type of research the only difference being how much/what type/and with who. Also, what med school you attend is also different and can affect the number of interviews you have and get as well. Even the strongest applicant at the top of the Derm applicant pool (which is already a self-selected group), is still going to rank every single program they interview at regardless, than risk going unmatched in Derm.

There is no such thing as a too strong applicant for derm.

 

[pain monster]

Sure but if you get an invite for Wright State and Iowa on the same day and can only choose one...

 

[sluggs]

This is Derm, right? You work in an office doing punch biopsies and prescribe steroid cream. How can a program be malignant? Occasional zit popping duties on a saturday morning?

 

[asmallchild]

This is Derm, right? You work in an office doing punch biopsies and prescribe steroid cream. How can a program be malignant? Occasional zit popping duties on a saturday morning?

Malignancy can extend beyond simple work hours.

How are the residents treated? Derm has some surprisingly vicious personalities.
Is academic time/didactics protected? Or are residents routinely summoned for service activities during didactics?
How is the consultation service/in-patient service run? And is it actual consultation work? At some programs, residents are used as scutmonkeys to answer clinic calls
How are the clinics staffed? Are the attendings using residents as mules to push 80-100+ patients in 8 hours?

Malignant may be too strong a word but I assure you seeing 80 patients/day x 5 days and then scrambling home to study so you don't get reamed out in didactics is just as unpleasant as an 80hr week on the wards

 

[redblue]

Malignancy can extend beyond simple work hours.

How are the residents treated? Derm has some surprisingly vicious personalities.
Is academic time/didactics protected? Or are residents routinely summoned for service activities during didactics?
How is the consultation service/in-patient service run? And is it actual consultation work? At some programs, residents are used as scutmonkeys to answer clinic calls
How are the clinics staffed? Are the attendings using residents as mules to push 80-100+ patients in 8 hours?

Malignant may be too strong a word but I assure you seeing 80 patients/day x 5 days and then scrambling home to study so you don't get reamed out in didactics is just as unpleasant as an 80hr week on the wards

are these questions (bolded) you can ask during interviews?

 

[username456789]

This is Derm, right? You work in an office doing punch biopsies and prescribe steroid cream. How can a program be malignant? Occasional zit popping duties on a saturday morning?

I'd suggest that you're lost, but I also understand it must be nice to occasionally peer in to catch a glimpse of what happiness and success look like from the outside.

There's a bit of obvious discordance, though. Your status says "Attending Physician", but your entry-level trolling is that of a starry-eyed pre-med.

 

[asmallchild]

are these questions (bolded) you can ask during interviews?

Absolutely. I wouldn't ask them in an accusatory manner but those are legitimate questions to ask both residents and attendings. And compare the answers to see if there are any inconsistencies.

 

[DermViser]

This is Derm, right? You work in an office doing punch biopsies and prescribe steroid cream. How can a program be malignant? Occasional zit popping duties on a saturday morning?

Your attempt at trolling needs some work. I thought the ICU would be too busy for you to troll. Guess not.

 

[DermViser]

Sure but if you get an invite for Wright State and Iowa on the same day and can only choose one...

But your chances aren't equal at those 2 institutions.

 

[dermathalon]

This is Derm, right? You work in an office doing punch biopsies and prescribe steroid cream. How can a program be malignant? Occasional zit popping duties on a saturday morning?

What a garbage post...clear trolling. Call us when you need to get bailed out of another stasis derm that you've admitted for bilateral cellulitis or perhaps you can call us for a "maculopapular rash" on the body that turns out to be pemphigus that you were treating with vanc/clinda since anything eroded is clearly an infection. Or better yet, we can help take care of that full body atopic derm flare that you've been treating with hydrocortisone 1% but only for two weeks because let's be sure we don't thin the skin. After all, all steroids are the same right? We'll be more than happy to help.

__
Einstein has a strong chair. I can't speak to every single resident but many of them are happy.
Cincinnati has some stellar faculty now that really care about residents.
I am silent on Wright State and SLU because I just don't know enough to make an informed comment.

I can't speak for Dermviser but I think I agree with the sentiment: we have to be careful on a forum like this where people can post anything to make a large group of the potential applicant pool less interested in a program for personal gain. I'm not saying that is what is happening but we all need to be aware.

For the record when I interviewed there were a couple programs where I just literally dropped them entirely off the rank list. As crazy as it sounds, I would rather go through the entire match again rather than match to these programs. A lot of thought has to be put in to entirely dropping a program from a match list. I only did this with two programs and both programs have now changed and I would not drop them again if I applied this year. I was told at another program secretly by one of the faculty that I should probably go elsewhere for a better environment. However, it not a malignant program so I still ranked that program (would have been happy if I matched there).

 

[pain monster]

But your chances aren't equal at those 2 institutions.

What does this mean? If I have rotated at neither place and get invites from both, am I supposed to somehow judge how much they will like me and my position on their rank list before deciding which to attend? OR, should I determine where I would be happier?

Einstein has a strong chair. I can't speak to every single resident but many of them are happy.
Cincinnati has some stellar faculty now that really care about residents.
I am silent on Wright State and SLU because I just don't know enough to make an informed comment.

I can't speak for Dermviser but I think I agree with the sentiment: we have to be careful on a forum like this where people can post anything to make a large group of the potential applicant pool less interested in a program for personal gain. I'm not saying that is what is happening but we all need to be aware.

For the record when I interviewed there were a couple programs where I just literally dropped them entirely off the rank list. As crazy as it sounds, I would rather go through the entire match again rather than match to these programs. A lot of thought has to be put in to entirely dropping a program from a match list. I only did this with two programs and both programs have now changed and I would not drop them again if I applied this year. I was told at another program secretly by one of the faculty that I should probably go elsewhere for a better environment. However, it not a malignant program so I still ranked that program (would have been happy if I matched there).

Thanks for your admittedly, much more valid input. Despite the "malignancies" perceived, I didn't drop anywhere from my rank list. I'll be more careful about throwing around the word malignant and affecting the application pool, but I feel that it's fair to voice my impressions from my interview day.

 

[DermViser]

What does this mean? If I have rotated at neither place and get invites from both, am I supposed to somehow judge how much they will like me and my position on their rank list before deciding which to attend? OR, should I determine where I would be happier

Meaning looking at your stats/app, looking at who they match, etc. For example, one great thing about the prior match lists (we used to have 2000 to present, don't know what happened to the ones before 2010) is you can see which programs are very inbred. So if you had a conflict btw an inbred program and another program on the same date, you would want to go with one that isn't as inbred (unless you're at that institution). I won't list any programs out loud here that are inbred, but it's obvious if you look at the lists.

 

[pain monster]

Ah ok, that makes sense.

 

[ckdgusdl88]

Meaning looking at your stats/app, looking at who they match, etc. For example, one great thing about the prior match lists (we used to have 2000 to present, don't know what happened to the ones before 2010) is you can see which programs are very inbred. So if you had a conflict btw an inbred program and another program on the same date, you would want to go with one that isn't as inbred (unless you're at that institution). I won't list any programs out loud here that are inbred, but it's obvious if you look at the lists.

I concur. Even by looking at stats from 2010 on, some programs scream inbred, and I've dropped a program from my apply list because even if I get an interview there, I would have to fly across the country for essentially no chance.

 

[dermathalon]

I concur. Even by looking at stats from 2010 on, some programs scream inbred, and I've dropped a program from my apply list because even if I get an interview there, I would have to fly across the country for essentially no chance.

I think we need to be careful to not over-predict the future based on the past. I know that we do this all the time but then we risk missing out on hidden opportunities when the tides are just starting to change at a program. You never know how many internal applicants a program will have for any given year and if there are any new fresh perspectives on an admissions committee. I don't recommend just dropping programs because you think that they are inbred. No program is 100% inbred and I beseech all of you to really put a lot of thought into dropping a program if you are going to drop programs on inbredness. I myself have advocated for not applying to all programs and so I am an advocate of dropping programs but please do not do this solely based on looking at previous match lists. If you are an absolute rockstar, you can afford to do this (as much as people say even strong applicants blah blah, some applicants will totally blow your socks off to the max and will definitely match as long as they are not arrogant.there can't be more than five in the nation each year but these five have the privilege of not needing to apply everywhere). Still it has to be done carefully and it is still a calculated risk. Otherwise, be honest. If you have holes, then think twice about dropping programs based on rank lists. It's worth going on the interview (if you get it) and then taking that chance rather than leaving it on the table. Sometimes a program is trying to improve an inbred appearance and this alone could be the year that you apply. You never know.

My two cents and I appreciate that there may be dissenting opinions.

 

[DermViser]

I think we need to be careful to not over-predict the future based on the past. I know that we do this all the time but then we risk missing out on hidden opportunities when the tides are just starting to change at a program. You never know how many internal applicants a program will have for any given year and if there are any new fresh perspectives on an admissions committee. I don't recommend just dropping programs because you think that they are inbred. No program is 100% inbred and I beseech all of you to really put a lot of thought into dropping a program if you are going to drop programs on inbredness. I myself have advocated for not applying to all programs and so I am an advocate of dropping programs but please do not do this solely based on looking at previous match lists. If you are an absolute rockstar, you can afford to do this (as much as people say even strong applicants blah blah, some applicants will totally blow your socks off to the max and will definitely match as long as they are not arrogant.there can't be more than five in the nation each year but these five have the privilege of not needing to apply everywhere). Still it has to be done carefully and it is still a calculated risk. Otherwise, be honest. If you have holes, then think twice about dropping programs based on rank lists. It's worth going on the interview (if you get it) and then taking that chance rather than leaving it on the table. Sometimes a program is trying to improve an inbred appearance and this alone could be the year that you apply. You never know.

My two cents and I appreciate that there may be dissenting opinions.

I agree with you. Sorry, I should have clarified, I was referring to the example given when you have 2 derm interviews on the same day that conflict, and you can not switch around dates, and you have no choice but to attend one interview and drop the other. So in that case, with respect to inbredness, I was referring to looking at trends for more than 1 year, i.e. programs that year after year tend to match internal candidates and/or research fellows - and there are programs like that (which I won't name here). So it's a question of playing the odds.

There will always be of course, Derm applicants who are the top 5 applicants that year, but those people will get a ridiculous number of interview invites to begin with, and be able to rank long past what is necessary to relatively ensure a match.