PGY-1 Medicine Program changing schedule from what was advertised

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FIREitUP

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I am about to start my prelim year in medicine and was recently informed of my schedule only to find that it is much worse than what was advertised. I have more weeks of overnights and an extra month of ICU compared to what the program stated they were offering. Notably, the prelim residents have a much worse schedule than that of the categorical residents.

My question is, is there anything that can be done about this blatant bait and switch? Isn't something like this against the rules?
 
I doubt there is anything you can do.

Also, it has been my experience that prelim interns and interns from other services tend to get crummier assignments than their categorical counterparts. The seniors / chiefs / attendings who make the assignments protect their own.
 
Prelims had it way, way easier than categoricals at my program.

That said, OP, this sucks.
 
FIREitUP said:
I am about to start my prelim year in medicine and was recently informed of my schedule only to find that it is much worse than what was advertised. I have more weeks of overnights and an extra month of ICU compared to what the program stated they were offering. Notably, the prelim residents have a much worse schedule than that of the categorical residents.

My question is, is there anything that can be done about this blatant bait and switch? Isn't something like this against the rules?
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No and no.

My program changed call schedules 4 times during my intern year. Everybody survived. You will too.

Feel free to make a stink if you want. But you will lose...badly.
 
So long as the program doesn't violate ACGME duty hour rules, and meets the rotation requirements for a prelim year, then no. There's nothing you can do. This occurs at all levels; internships, residencies, and fellowships... they all change their rotations from time to time with little to no notice.

"Hey, remember that OB rotation we swore you'd never have to do? Umm, well you'll be doing it in October."
 
Out them. You can't save yourself but you can help next year's batch
 
gutonc said:
No and no.

My program changed call schedules 4 times during my intern year. Everybody survived. You will too.

Feel free to make a stink if you want. But you will lose...badly.
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I figured. I'll just keep my mouth shut, then.

Psai said:
Out them. You can't save yourself but you can help next year's batch
Click to expand...

Will do as my year comes to a close.
 
gutonc said:
Why? They didn't break any rules. S*** happens. Life goes on.
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Because if they are spouting the same BS schedule to the next batch of interns with no real plan to follow through with it, it is good info. Not sure where the "why" question comes from

Sent from my SM-G900V using SDN mobile
 
MLT2MT2DO said:
Because if they are spouting the same BS schedule to the next batch of interns with no real plan to follow through with it, it is good info. Not sure where the "why" question comes from
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How do you know it's BS? As I mentioned...s*** happens. My program (one of the most resident coddling academic IM programs around) changed call schedules on 3 of the 4 inpatient services a total of 3 times (4 different call schedules) over the course of my intern year. All due to external forces that weren't anticipated at the beginning of the year (short 2 interns at the beginning, lost one mid-way to illness, hospital GME made internal changes, etc). We all could have gotten pissed off and raised hell about it on the interwebs. Instead, we went to work and finished the year.
 
OP, as others have already said, don't be penny-wise and pound-foolish. You should focus on the bigger picture here, which is completing your prelim year successfully. None of the scheduling BS affects your lifelong income and career compared with getting that piece of paper. I had some scheduling legerdemain during residency too. Probably most of us did. It's only one year. Suck it up and move on.
 
Crayola227 said:
since it's your prelim year there are ways that they can hurt you going forward
don't burn bridges
Click to expand...

Once I get my certificate and move on to my categorical program I fail to see how they can hurt me, especially since I am moving to another state. I think people have the right to know what they're getting into.
 
gutonc said:
How do you know it's BS? As I mentioned...s*** happens. My program (one of the most resident coddling academic IM programs around) changed call schedules on 3 of the 4 inpatient services a total of 3 times (4 different call schedules) over the course of my intern year. All due to external forces that weren't anticipated at the beginning of the year (short 2 interns at the beginning, lost one mid-way to illness, hospital GME made internal changes, etc). We all could have gotten pissed off and raised hell about it on the interwebs. Instead, we went to work and finished the year.
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We have also had multiple changes requiring call to be switched around and more work for both first and second years. This was an unforseen change.

If the program is already making changes to the schedule two months after the match that seems fishy.

Again I only mentioned the schedule as being BS if the program has no intention on following through with what they are laying out.

My guess is in 4 months the OP will have a better idea if this schedule change was warranted or a symptom of something bigger. If it's the latter the OP would be doing future candidates a favor, sharing this knowledge.

Sent from my SM-G900V using SDN mobile
 
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FIREitUP said:
Once I get my certificate and move on to my categorical program I fail to see how they can hurt me, especially since I am moving to another state. I think people have the right to know what they're getting into.
Click to expand...

For the rest of your career, people at that program will be asked to verify you training and skills as a physician. These requests come from every medical board and every hospital you apply to for the rest of your career.

Also, medicine is not that big a field - people talk.

Finally, you have no idea why it changes. Organizing resident schedules is a complicated task for departments with lots of residents and lots of services to cover.
 
FIREitUP said:
Once I get my certificate and move on to my categorical program I fail to see how they can hurt me, especially since I am moving to another state. I think people have the right to know what they're getting into.
Click to expand...
really? you don't see how?
ANYplace you are from now on with have a say in the next license, job, credentialing that you will have to do...

plus medicine is a small small world and people talk...PDs talk..even across specialities...get branded as a whiner, complainer, slacker, etc...it can most certainly follow you...
 
gutonc said:
Why? They didn't break any rules. S*** happens. Life goes on.
Click to expand...

Because it's a clear bait and switch. I would have liked to know if my future program director was selling me a pile of dog**** so I can rank them lower. They all say that prelims and categoricals are treated the same but obviously this is not the case in op's situation. It doesn't matter what the scenario is. If there's changes to be made, it should be made fairly across the board. If anything, the categoricals should get the tougher schedule. IM is only 3 years.
 
Psai said:
Because it's a clear bait and switch.
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Again...no it wasn't. That was the plan at the time. Plans change.

I can't argue with the prelim/cat thing but perhaps the OP would prefer more time in Women's Health clinic instead (I sure wouldn't...and I was in IM). And it's a rare program that really has truly "fair" splits between prelim and cat.
 
gutonc said:
Again...no it wasn't. That was the plan at the time. Plans change.

I can't argue with the prelim/cat thing but perhaps the OP would prefer more time in Women's Health clinic instead (I sure wouldn't...and I was in IM). And it's a rare program that really has truly "fair" splits between prelim and cat.
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How do you know that was the plan at the time?

If it wasn't that is one thing, but again you're doing your own assuming.

Sent from my SM-G900V using SDN mobile
 
MLT2MT2DO said:
How do you know that was the plan at the time?

If it wasn't that is one thing, but again you're doing your own assuming.
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Yes I am. But you are assuming there was something malicious here which is the far less likely scenario. SDN "wisdom" that PDs are only out to screw their residents, notwithstanding
 
gutonc said:
Yes I am. But you are assuming there was something malicious here which is the far less likely scenario. SDN "wisdom" that PDs are only out to screw their residents, notwithstanding
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Actually I wasn't I simply said "if". Also it's not PDs overtly attempting to screw over residents I would be concerned about, so much as showing the program in a different light to vi for better candidates.

Again I don't know if this is the case but IF it is, this info should be passed on.

Sent from my SM-G900V using SDN mobile
 
During my PGY2 year, my residency program decided that they disliked the traditional balance of PGY2/3 (where 2s get minimal elective time and 3s have a much easier year), and would be instituting rebalancing to shift more inpatient work to the PGY3s... the following year. We complained. We put together a petition. And then we worked additional inpatient the following year, did our work, and are all graduating later this week.

It sucks, but schedule changes happen, for a wide variety of reasons. Do your work and understand that time in training is limited.

Plus, schedule changes happen in the real word too. I know people that have signed on for jobs with an understanding of a call schedule, then it turns out someone quits/retires/gets pregnant and their call schedule worsens. You do what you need to.
 
Raryn said:
During my PGY2 year, my residency program decided that they disliked the traditional balance of PGY2/3 (where 2s get minimal elective time and 3s have a much easier year), and would be instituting rebalancing to shift more inpatient work to the PGY3s... the following year. We complained. We put together a petition. And then we worked additional inpatient the following year, did our work, and are all graduating later this week.

It sucks, but schedule changes happen, for a wide variety of reasons. Do your work and understand that time in training is limited.

Plus, schedule changes happen in the real word too. I know people that have signed on for jobs with an understanding of a call schedule, then it turns out someone quits/retires/gets pregnant and their call schedule worsens. You do what you need to.
Click to expand...

Except in a residency I have essentially no option to leave. Anyhow, thanks all for the comments. Interesting to see how much fear these programs have struck into trainees. Hopefully I can survive this horrible year.
 
FIREitUP said:
Except in a residency I have essentially no option to leave. Anyhow, thanks all for the comments. Interesting to see how much fear these programs have struck into trainees. Hopefully I can survive this horrible year.
Click to expand...

You have a valuable advanced degree.

You're a physician.

You have a job that pays more than what the average American makes.

You are presumably healthy.

Many people would kill to have any one of those, let alone all of them.

Just as I survived doing an extra month of Trauma (because they had a weak prelim on service and we got pulled to back him up in the more difficult rotations), you will somehow survive this "horrible year". Maybe you might even consider that doing more ICU might provide valuable skills and a level of confidence that carries you throughout your career.
 
Psai said:
Because it's a clear bait and switch. I would have liked to know if my future program director was selling me a pile of dog**** so I can rank them lower.
Click to expand...
MLT2MT2DO said:
How do you know that was the plan at the time?
Click to expand...
gutonc said:
Yes I am. But you are assuming there was something malicious here which is the far less likely scenario. SDN "wisdom" that PDs are only out to screw their residents, notwithstanding
Click to expand...

I'm just imagining the PD sitting in his torch lit office, twirling his moustache and laughing to himself as he imagines the look on applicants faces when they get their actual schedule.

latest



"I'll get you next time, interns!"
 
and this is why I fully recommend a chill Transitional Year to anyone who can get one.

I have yet to meet a radiologist who was not a PD to say that their intern year was helpful. 6 months would have sufficed. Programs need to become categorical and have few wards months and to start Rads training earlier.
 
I don't know, looking back I'm starting to believe that "what doesn't kill you, makes you stronger."

Life is unfair and yes there are people who are unfair but at the end of the day, it's all about perspective and building on your experiences. My advice is to take it one day at a time. Although my intern year sucked, I established relationships with people who I still keep up with today. I'm not saying to just suck it up and deal with it but pick your battles wisely.
 
omg

I'm the first to support 99% of resident whining about working conditions, and I gotta say, this is weak ****ing sauce
of all the things, gtfo

get over this and then spend the rest of your time thanking a deity you have a spot and feeling by turns nervous, terrified, excited, proud, exhausted
 
How unfair this is really depends on the Prelim/Categorical divide. Something changed that lead to the schedule change. Is the work really distributed that unequally and did the schedule change make the difference worse? Or is it sucking a little more for everyone because a couple PGY2s ended up quitting?

The ACGME survey will give you the chance to express your feelings about the program.
 
Crayola227 said:
omg

I'm the first to support 99% of resident whining about working conditions, and I gotta say, this is weak ****ing sauce
of all the things, gtfo

get over this and then spend the rest of your time thanking a deity you have a spot and feeling by turns nervous, terrified, excited, proud, exhausted
Click to expand...

lmao who are you?
 
keep your head down and your mouth shut...get your certification and move on

when you are an attending you can stick up for the people at whatever program you work for or within your specialty college....you are powerless and vulnerable right now, don't let that medical degree convince you otherwise
 
I agree with just about everything you guys have said. Though my frustration comes from the fact that I chose this program over one that is closer to me (and that I have rotated at and enjoyed) because it was supposedly more relaxed and less "academic". Had I known my schedule had the potential to be structured like this, I wouldn't have ranked this prelim program as high as I did. I know if I was a program director I would want to be as forthright as possible.

After all, isn't one of the underlying tenets of medicine honesty and respect?
 
FIREitUP said:
Except in a residency I have essentially no option to leave. Anyhow, thanks all for the comments. Interesting to see how much fear these programs have struck into trainees. Hopefully I can survive this horrible year.
Click to expand...

If you start with this attitude, yes, your year will suck. It will be absolutely horrible. Maybe it you go in with an open mind and a commitment to learn, you'll end up enjoying it and the time will pass before you know it.

Your choice.
 
Winged Scapula said:
Just as I survived doing an extra month of Trauma (because they had a weak prelim on service and we got pulled to back him up in the more difficult rotations), you will somehow survive this "horrible year". Maybe you might even consider that doing more ICU might provide valuable skills and a level of confidence that carries you throughout your career.
Click to expand...
Are you implying, in the General Residency Issues forum, that residency training has a value to the actual resident not just to the institution at which they labor? That may be a TOS violation.
 
FIREitUP said:
I agree with just about everything you guys have said. Though my frustration comes from the fact that I chose this program over one that is closer to me (and that I have rotated at and enjoyed) because it was supposedly more relaxed and less "academic". Had I known my schedule had the potential to be structured like this, I wouldn't have ranked this prelim program as high as I did. I know if I was a program director I would want to be as forthright as possible.

After all, isn't one of the underlying tenets of medicine honesty and respect?
Click to expand...

You are assuming that this was dishonest and/or disrespectful. More likely, they had to shift people around to get all the services covered. An extra month of ICU and some extra night float really doesn't sound all that bad.

Something tells me you'll make it through. Then, you can move on to whatever R2 position you have lined up in whatever specialty you have chosen.

Who knows, you might even get something out of the experience.
 
gutonc said:
Why? They didn't break any rules. S*** happens. Life goes on.
Click to expand...
And you know what? Having to do another month of ICU and more night float will make the OP a better Doctor, and smarter, regardless of what he's doing next year.

As I end my PGY3 year I've been quite vocal about residents bitching re: responsibility. This isn't the family reunion, no cake walk here.

Amirite?
 
Bacchus said:
And you know what? Having to do another month of ICU and more night float will make the OP a better Doctor, and smarter, regardless of what he's doing next year.

As I end my PGY3 year I've been quite vocal about residents bitching re: responsibility. This isn't the family reunion, no cake walk here.

Amirite?
Click to expand...

Seems like such a shame to deny those excellent educational opportunities to the categorical residents.
 
All schedules in residency are tentative. Unforeseen things happen. Things that should have been foreseen get brought to people's attention. Chiefs need to rework schedules multiple times to accommodate legitimate things but with so many moving parts people get screwed. You will get a different schedule than advertised at some point. You will end up with an extra weekend or overnight or icu stint somewhere along the way. And someone else will have a schedule you'll perceive as "better" at some point. That's just real life. You can't whine that you got "baited and switched" or call out the program because of this. Because frankly it happens to everyone at some point and would happen at the other programs you were probably considering too.
 
Psai said:
Seems like such a shame to deny those excellent educational opportunities to the categorical residents.
Click to expand...
Most of the time the categoricals end up with more icu and night float spread over the subsequent 2-4 years than the prelims going into advanced specialties will ever do, so it's all good.
 
Law2Doc said:
Most of the time the categoricals end up with more icu and night float spread over the subsequent 2-4 years than the prelims going into advanced specialties will ever do, so it's all good.
Click to expand...

Which is what they signed up for. You know, unlike op.
 
Psai said:
Which is what they signed up for. You know, unlike op.
Click to expand...
Again, OP "signed up" for an intern year at a particular program, and that's exactly what he got. He was shown a tentative schedule, not one written in stone. Going in the program assumed this would be relatively accurate but shortly thereafter it changed- sucks. But he could have gotten equally screwed somewhere else, as their tentative schedules are all also subject to change. No places guaranty their schedules. I know plenty of people who signed up for objectively cushy intern years that became very rough when a couple of co-residents left for family reasons. It happens. That's part of the risk when you are looking for an easy ride rather than something less maleable like geography.
 
Thats fine but I would rather take my chances at a place that doesn't have a history of lying to their applicants
 
It's vanishingly rare to have extra residents just lying around waiting to be plugged into any potential gaps. When gaps unexpectedly appear during the year, elective time gets converted into inpatient months. It's not fair to the existing residents to have them lose all their elective time if a gap opens prior to the year starting. In addition, if you have already committed all of your elective time to covering a known hole then if a resident goes down during the year there's no backup.

Psai's argument appears to be that they should shaft the categorical interns (referring to increased night float, I think the more ICU months is a non-starter) to keep the prelim spots as cushy as advertised. I am very interested in hearing a defense of that argument as arguably the intern schedule played some role in the categoricals' decision to rank the program. What would you do as PD if you had an unexpected vacancy post-Match?
 
Psai said:
Thats fine but I would rather take my chances at a place that doesn't have a history of lying to their applicants
Click to expand...
I'd bet there are no programs that have never had to amend some statement they made during recruiting at some point during the course of the residency -- zero. Things change. That's reality. Either someone leaves or something they used to offer becomes impractical or someone says something off the cuff that creates an unrealistic expectation. That's not a "history of lying" that's just the risk of allowing people to see tentative things, works in progress, earlier on.
 
MLT2MT2DO said:
Because if they are spouting the same BS schedule to the next batch of interns with no real plan to follow through with it, it is good info. Not sure where the "why" question comes from

Sent from my SM-G900V using SDN mobile
Click to expand...

Exactly. Get done with prelim year and then out them. It's that simple.

When I'm done with residency in ~30 days or so, I'll be posting a rather honest report about my program (both the good and the bad - and fortunately there was a lot more good than bad).
 
C'mon kid, my 13 year old gets bent out of shape by change... you're an adult now, with a salaried job. Get used to it.

EDIT: This happens even to Faculty.

Actual conversation:

Dr HH (my Chair): Dr Goro, you're now going to be the coordinator of the X course.
Me: (thinking "Where in my contract does it say I have to do that?") Um, really?
Dr HH: (reading my mind) In the part of your contract that says I determine your teaching responsibilities.


FIREitUP said:
I am about to start my prelim year in medicine and was recently informed of my schedule only to find that it is much worse than what was advertised. I have more weeks of overnights and an extra month of ICU compared to what the program stated they were offering. Notably, the prelim residents have a much worse schedule than that of the categorical residents.

My question is, is there anything that can be done about this blatant bait and switch? Isn't something like this against the rules?
Click to expand...
 
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