Malignant surgery programs

[SomeFakeName]

I was wondering if you guys could let me know some of the malignant general surgery programs out there. I realize "malignant" may mean different things to different people, but generally speaking I mean those programs that are know to have low resident morale and comradrarie (sp?) due to abrasive faculty, uncaring administration, poor nursing support, etc. I'd like to hear about any program (community as well as university).

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[dr. strangelove]

I'm a graduating 4th year medical student at the university of washington. I can tell you that the UW here in seattle is an extremely malignant program. Not only to medical students, but also to residents. There a lot of egos floating around and you can expect to be the recipient of much maligned attitudes. This is not just me, you can ask any other student here and you will undoubtedly find out the same thing. You can expect to get yelled at for moving your head to stretch your neck because it distracts the surgeon, for talking about anything non-surgical during an OR case, even if the resident brings it up and the attending does not approve, and there have been cases of medical students being told off for simply asking if they may ask a question (and this did not occur at an inappropriate time, i.e. acute hemorrhage, etc). The residents here look extremely worked over, and morale is not very good. My advice to any who are interested in surgery would be to steer clear of this program. Yes, you may get into the best fellowships following training, and you will certainly be 'prepared', but i think the route they put you through is unnecessary and unwarranted. Also, as i'm contemplating gsurg, many of the residents here have told me that they would not come here if they could help it. I hope this helps.

 

[triathlete411]

Hey Dr. Strangelove,
I must say that I was pretty disappointed to read your negative comments about U.of Washington. I am seriously considering it for a general surgery residency. Do you see any improvements coming in the near future? Are they going to try to comply with the RRC 80hr/wk requirements? I have only heard good things about Dr. Pelligrini and can't imagine that he would run a malignant program. I certainly hope changes are on the way.

 

[dr. strangelove]

I hope it does change, but I do not see that happening in the near future. The prevailing thought is that they are a high-caliber program and do not need to change.

80 hour weeks? Not here. I'm not sure when the next review will be or was, but I don't know how they are going to pass. The bottom line is that the residents are overworked and not happy. It's a powerful statement when residents say they wouldn't come here if they could go back and redo it. The ones that are would gladly just live at the hospital and would be happy anywhere no matter what. This isn't just coming from my experience, but those of my classmates and friends who have graduated within the last couple years and have gone on to surgery programs elsewhere. I encourage you to not take my word for it but contact other medical students here if you don't truly believe me, I believe you will hear similar stories.

You will know surgery when you leave here. However, if you have a wife, family, or any other interests then you may want to think about it. It's hard to work you butt off and still get disrespected.

 

[triathlete411]

Dr. Strangelove,
Unfortunately, I believe you. We have a couple of surgery interns at my school who interviewed at UW and said basically the same thing you did. I guess that's why they are here and not there.
I wish it weren't the case because I think living in Seattle would be great. Thanks for the reply.
By the way, I would prefer to have a husband over a wife

 

[dr. strangelove]

oops, sorry about the wife/husband thing. I should have been more universal. I apologize about that!

 

[LaCirujana]

Although I didn't attend UW, while I was on the interview trail last year, not a single one of the UW students I met was applying to their own program.

Other programs with "reputations"--although I will freely admit I have absolutely ZERO data to base these statements on other than reports from people who have interviewed or attended school/residency at these places:

University of Colorado
Mass General
Brigham and Women's
UAB
U. of Louisville (sorry, RIO)
Hopkins
MUSC

I'm sure I've heard of others, but those were the ones that came to mind immediately.

 

[dr. strangelove]

It wasn't too many years ago either that the UW surg program didn't even take their own students from Seattle. Although, as Kim pointed out, most UW students don't want to apply to the program anyhow (and the ones who do and go, are ones who would go through any abuse to be a surgeon).

 

[Samoa]

I wonder what was the rationale for not taking their own students?

 

[droliver]

LaCirujana,

I too had heard stories about Louisville before I came. It used to be that when you heard the interview buzz on where malignant programs were, you routinely heard UofL, UAB, & Cinncinnatti mentioned. All 3 are fantastic programs to me, and tended to get their rep. due to their chairman's personalities. Honestly, I was just so impressed with how professional the interview process was here & a number of the very prominent people here that I was sold (as was another of my classmates who also ranked it #1 & ended up here - in context we were both top 10 with high in our class with high board scores & had plenty of options on where to look at).

I think that the feedback you get from students applying for surgery from somewhere can really give you some good insight. If there's problems they know about it & tell everyone they meet when they interview. Last year we ended up with 7 students from here (all great) that wanted to stay here as their #1 choice - I thought that said a lot about how they viewed both their med school training in surgery here as well as the atmosphere in the program. We also had a few other students who were great that really wanted to look elsewhere (usually for geographic preferences). I wish we had so many good ones like that every year & that we could redshirt them

UAB has had a soaring buzz as far as I can tell since Dr. Kirby Bland took over 2 years back in a program that had about the lowest morale of anywhere a few years ago. We have had 3 students match there in the past 2 years.

As far as the work-week hours go, we made dramatic changes this past July to come into compliance with the pending 2003 ACGME regulations. It has allowed us some time to see what works to get it tweaked by next year & has been HUGELY popular with the junior-housestaff (they get home @ ridiculously early times post call or else. It has made my work as a chief a little harder especially being short handed @ clinic, but rarely do I approach 80 hrs/week in the hospital these days. There will be some real growing pains at other places as they also make some of these changes & it will hurt the smallest programs the most I think.

 

[Nephrectomy101]

Trying to revive this thread since it's been awhile... Is UW in Seattle still as malignant as these posts made it sound??

 

[MrBeauregard]

Bump x2.

I'm also wondering about MUSC, since it was on the list of one of the earlier posters. Anyone have any insight into MUSC's program currently?

Thanks.

 

[Guile]

Trying to revive this thread since it's been awhile... Is UW in Seattle still as malignant as these posts made it sound??

I interviewed at UW. Definitely did not get that vibe at all. In fact a few of the residents said that "traditional" surgery attitudes and poor behavior simply was not tolerated. They said it just didn't happen. So I was surprised to read the above. Maybe they've made some positive changes since 2002. But interviews are very hit or miss. Programs can hide things very well for a few days a year. At least one of their interns was a UW grad. He also went to UW for undergrad and grew up in Seattle. I'm sure coming from UW he had other options and decided to stay, so I think that says a lot about a place. I didn't rank it highly for other reasons though.

 

[Green Grass]

Louisville. Heard it from multiple attendings and residents.

 

[sponch]

I interviewed at UW. Definitely did not get that vibe at all. In fact a few of the residents said that "traditional" surgery attitudes and poor behavior simply was not tolerated. They said it just didn't happen. So I was surprised to read the above. Maybe they've made some positive changes since 2002. But interviews are very hit or miss. Programs can hide things very well for a few days a year. At least one of their interns was a UW grad. He also went to UW for undergrad and grew up in Seattle. I'm sure coming from UW he had other options and decided to stay, so I think that says a lot about a place. I didn't rank it highly for other reasons though.

I have a friend who spent time there for an away and things have changed. It's a lot nicer now.

 

[Guile]

Louisville. Heard it from multiple attendings and residents.

I suppose everyone has a different definition of malignant, but the sense that I got from the place and from talking to people is that you'll work your butt off, but it didn't seem outright malignant (hostile co-residents and attendings, etc.).

 

[bucks2010]

Just curious, but how do you think it would affect your experience on rotations if you went to med school with a reputation for being malignant? Obviously you'd be working more and the attendings/ house staff may not have good attitudes, but do you think you still would've been drawn to a career in surgery even though you spent several weeks at a malignant home program?

 

[SLUser11]

Just curious, but how do you think it would affect your experience on rotations if you went to med school with a reputation for being malignant? Obviously you'd be working more and the attendings/ house staff may not have good attitudes, but do you think you still would've been drawn to a career in surgery even though you spent several weeks at a malignant home program?

Most of us here on SDN came from malignant home programs....or at least a large percentage.

 

[Guile]

Just curious, but how do you think it would affect your experience on rotations if you went to med school with a reputation for being malignant? Obviously you'd be working more and the attendings/ house staff may not have good attitudes, but do you think you still would've been drawn to a career in surgery even though you spent several weeks at a malignant home program?

This is a good question. I come from a program that isn't malignant at all. However a few of my classmates interested in surgery had malignant experiences while on their rotations and are now doing radiology. I think it can definitely impact your career plans. Even though it's easy to know that programs are different and you can go to a different program for residency, it's difficult when you're on that rotation and getting beat on and not having a good time. It's hard to separate your experience on a malignant rotation from a career in that specialty.

 

[JayDoc06]

Jon 2727 (Medical Student):

I bet you didn't hear that from anyone who actually trains/trained here did you? This label irritates me because whole categories of otherwise talented applicants avoid us because of these types of rumors. But if an applicant wants to make an important decision based on speculation, so be it.

Obviously, I am a resident at Louisville. I didn't go to school here. When I told my med school chairman that I was debating between UAB and Louisville, he said "Oh you don't want to go to Louisville, etc.." but gave no real reasons. As it turns out, a Louisville graduate was one of his previous fellows and they didn't get along at all personally. All of a sudden, as far as my chairman was concerned, Louisville is no good.

Many surgeons around the country, "know" that Dr. Polk is malignant (not Chairman for over 5 years now.) He has given more ABS oral exams than anyone EVER. No doubt, some of his exploits during these exams are legendary. Some of these attendings who seem to know so much about which programs are malignant or not, just may have encountered him at some point, either on orals or maybe he said their paper was stupid at a meeting. Or maybe they read Jon2727's insightful post...

He does have a very colorful personality. I'll tell you this though, NOBODY CARES MORE ABOUT TRAINING RESIDENTS TO BE QUALITY GENERAL SURGEONS THAN DR POLK. The program he built over 35 years carries this mentality. Once you are a Louisville resident, he saw you as his responsibility, and he will go to the mat for you.

It is interesting hearing of medical students who graduate here and go on to other programs who then go on to call Louisville malignant. Nearly all of them were terrible students, who weren't residents here because we flat out didn't want them.

If you need a hug every time you feel sad, or you can't tolerate the demands of taking ownership of your patients, then Louisville might be "Malignant", but there is no place I would rather be.

 

[Guile]

Jon 2727 (Medical Student):

I bet you didn't hear that from anyone who actually trains/trained here did you? This label irritates me because whole categories of otherwise talented applicants avoid us because of these types of rumors. But if an applicant wants to make an important decision based on speculation, so be it.

Obviously, I am a resident at Louisville. I didn't go to school here. When I told my med school chairman that I was debating between UAB and Louisville, he said "Oh you don't want to go to Louisville, etc.." but gave no real reasons. As it turns out, a Louisville graduate was one of his previous fellows and they didn't get along at all personally. All of a sudden, as far as my chairman was concerned, Louisville is no good.

Many surgeons around the country, "know" that Dr. Polk is malignant (not Chairman for over 5 years now.) He has given more ABS oral exams than anyone EVER. No doubt, some of his exploits during these exams are legendary. Some of these attendings who seem to know so much about which programs are malignant or not, just may have encountered him at some point, either on orals or maybe he said their paper was stupid at a meeting. Or maybe they read Jon2727's insightful post...

He does have a very colorful personality. I'll tell you this though, NOBODY CARES MORE ABOUT TRAINING RESIDENTS TO BE QUALITY GENERAL SURGEONS THAN DR POLK. The program he built over 35 years carries this mentality. Once you are a Louisville resident, he saw you as his responsibility, and he will go to the mat for you.

It is interesting hearing of medical students who graduate here and go on to other programs who then go on to call Louisville malignant. Nearly all of them were terrible students, who weren't residents here because we flat out didn't want them.

If you need a hug every time you feel sad, or you can't tolerate the demands of taking ownership of your patients, then Louisville might be "Malignant", but there is no place I would rather be.

So basically, anyone who criticizes Louisville either has a beef with a Louisville graduate or is a terrible medical student? You're doing a great job combating that malignant rumor.

He has given more ABS oral exams than anyone EVER.

[citation needed]

 

[JayDoc06]

No.

What I am saying is that when you evaluate opinions, you do not know where they are getting their information or what it is based on. I am simply speculating that most people who label Louisville as malignant probably have very limited information. They might be recognizing that "Hire 'em and Fire 'em" Polk is a funny nickname and it therefore must be true. On the contrary, he is notorious for giving people many many chances to get it right. I would bet even more that they have no personal experience to base their claims on.

What I am also saying is that sometimes attendings (and chairmen, as my anecdote was trying to convey [the pleural of anecdote is not data...]) formulate their overall impression of malignancy or good/bad based on unique but probably limited personal experiences.

I also grant that people have different ideas of what "malignant" means. Some think its attendings yelling at residents. Others think it is an atmosphere of intimidation. Others think it's working hard. My guess is that those who do have in-depth personal knowledge of our program and label it as "malignant" (ie the medical students I was referring to in my post yesterday), probably do think working hard, being asked to take ownership of your patients, and being held accountable is "malignant". In my opinion, those are the most important characteristics of a surgeon. (As an aside, please my previous post in http://forums.studentdoctor.net/showthread.php?p=6141710#post6141710 #28 for what I think about patient ownership.)

As I recall interview experiences as an applicant, read all these posts, participate in interviews for 5 years, ponder the mysteries of how students create their rank lists, it is clear that there all different types of programs. Louisville isn't for everyone. In my opinion "malignancy" is a label given by people who probably have either incomplete information or some anecdote/interaction in the past. If you are not silly enough to make important decisions based on what they read on SDN, give Louisville a look. (Ironic that I am using SDN to try to change opinions isn't it?)

It is no small wonder that most medical students who do away rotations here as 4th years end up still wanting to come here for residency.

 

[Buzz Me]

Most of us here on SDN came from malignant home programs....or at least a large percentage.

Interesting...probably true, but how did you come up with this?

 

[Green Grass]

My information comes from a Louisville trained surgeon.

This doctor did say they left LU a great surgeon, got the fellowship they wanted, and loved living in Louisville. They don't deny that the training is outstanding, but felt that the residents were unfairly treated.

Jon 2727 (Medical Student):

I bet you didn't hear that from anyone who actually trains/trained here did you? This label irritates me because whole categories of otherwise talented applicants avoid us because of these types of rumors. But if an applicant wants to make an important decision based on speculation, so be it.

Obviously, I am a resident at Louisville. I didn't go to school here. When I told my med school chairman that I was debating between UAB and Louisville, he said "Oh you don't want to go to Louisville, etc.." but gave no real reasons. As it turns out, a Louisville graduate was one of his previous fellows and they didn't get along at all personally. All of a sudden, as far as my chairman was concerned, Louisville is no good.

Many surgeons around the country, "know" that Dr. Polk is malignant (not Chairman for over 5 years now.) He has given more ABS oral exams than anyone EVER. No doubt, some of his exploits during these exams are legendary. Some of these attendings who seem to know so much about which programs are malignant or not, just may have encountered him at some point, either on orals or maybe he said their paper was stupid at a meeting. Or maybe they read Jon2727's insightful post...

He does have a very colorful personality. I'll tell you this though, NOBODY CARES MORE ABOUT TRAINING RESIDENTS TO BE QUALITY GENERAL SURGEONS THAN DR POLK. The program he built over 35 years carries this mentality. Once you are a Louisville resident, he saw you as his responsibility, and he will go to the mat for you.

It is interesting hearing of medical students who graduate here and go on to other programs who then go on to call Louisville malignant. Nearly all of them were terrible students, who weren't residents here because we flat out didn't want them.

If you need a hug every time you feel sad, or you can't tolerate the demands of taking ownership of your patients, then Louisville might be "Malignant", but there is no place I would rather be.

 

[idiot07]

How many years ago did he graduate? Like everywhere else things have changed a lot. Our new boss is nowhere near as volatile as Dr. Polk (Who really does care about resident education above all else and can be a really charming and likeable guy, FYI). We're compliant with the work hours. We have midlevels out the wazoo. There's less tolerance for difficult personalities and angry tirades across the program. Some of the older residents joke that it's a "resort" program, now.

I don't think this is nescessarily unique to us, but a trend in medicine and surgery as a whole.

Yes, we probably still work harder than most other places. This is not a place to go to if you just want to get by. There is very little tolerance for either laziness or negligence here, and you'll be corrected if you screw up. However, this is usually in a fair and reasonable manner. More over, the larger egos usually found at larger academic insitution are absent, at the resident and attending level. Education is the number one priority along with patient safety. No one is out to get you or make life miserable, we're all just trying to the best surgeons possible and take care of patients like our own family.

 

[SLUser11]

My guess is that those who do have in-depth personal knowledge of our program and label it as "malignant" (ie the medical students I was referring to in my post yesterday), probably do think working hard, being asked to take ownership of your patients, and being held accountable is "malignant". In my opinion, those are the most important characteristics of a surgeon.

I know that you are trying to defend your program, and I appreciate your passion. I personally am a big supporter of Louisville, and I think it is a top tier program based on the quality of training.

I will say, however, that you may be unintentionally propagating the malignant stereotype of your institution. Instead of getting angry, I would stick with the "come see for yourself" approach. Students who are motivated will check it out, and rank it highly if it's a good fit.

I do the same thing for Wichita. Many people have pre-formed opinions of what it's like to train here, so all I can do is convince people to schedule the interview and see for themselves. Some people still walk away with a negative opinion, but usually they weren't a good fit anyway.

Interesting...probably true, but how did you come up with this?

It's sort of an educated guess based on our collective storytelling over the last 6 years. I know that I personally came from a "malignant" program. While I didn't think the people were too bad, I did think the training was inefficient and unnecessarily painful, and it played a big part in me choosing to switch environments for my residency.

 

[Guile]

JayDoc, you don't have to try to convince me. I visited and really liked it. I hold Louisville in very high regard. I think it has an excellent training program. You guys are hiring outstanding new recruits with great pedigrees. I liked the residents I interacted with (great showing for the dinner the night before), and I enjoyed talking with you too. I just think you might be going about your defense of the program a bit wrong. I agree with SLUser's recommendations. It's difficult and frustrating your program suffers from these rumors. It really does make your program a hidden gem. Probably the best way to combat them is to talk about how much you've enjoyed your time there and how solid your training is.

 

[JayDoc06]

You guys are right. My efforts to defend my program probably do come across differently and even counter-productive, hopefully not to a fault. In the end, if people are interested in learning more, they should check us out themselves. In reality, the label will probably persist, but that won't stop me from doing my "best" to combat it.

 

[Doctorbarrio]

Can anybody tell me anything about MUSC General Surgery. I come from Morehouse School of Medicine at Grady Memorial Hospital in Atlanta, GA. The toughest, most malignant place on earth to study medicine. Yes I now have amazing clinical skills but at the expense of grey hair and I look like I'm 60 years old LOL. Thank you.

 

[Shorin-Ryu]

I interviewed at UW. Definitely did not get that vibe at all. In fact a few of the residents said that "traditional" surgery attitudes and poor behavior simply was not tolerated. They said it just didn't happen. So I was surprised to read the above. Maybe they've made some positive changes since 2002. But interviews are very hit or miss. Programs can hide things very well for a few days a year. At least one of their interns was a UW grad. He also went to UW for undergrad and grew up in Seattle. I'm sure coming from UW he had other options and decided to stay, so I think that says a lot about a place. I didn't rank it highly for other reasons though.

Interviewed at U of W too. Great program, amazingly talented people, faculty, fellows and residents alike. However, they overly used the word "perfect" and that was a bit of a red flag for me.