Points to Consider about CCF

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ClinicGasCA3

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These are some common complaints among CCF Gas Residents. These are opinions, nothing more. Take it or leave it. Hope it helps you.

FORCED REXING: Residents are forced to Moonlight at CCF. The Program Director claims the REX program (paid Resident Experience Program) is voluntary. When you mention “Mandatory Moonlighting” OR “Forced Rexing” he will tell you that you can stay and work as a resident under the 80 hour/week ACGME mandate or you can VOLUNTEER to get paid for the time you are here. Either way you are going to stay and work. If people complain, he threatens to keep the moonlighting pay and work residents into the ground.

Residents are a slave work force: This is Anesthesia, not Surgery, but Residents relieve CRNAs and SRNAs in the OR, so they can leave on time. Contract this with the MANY, MANY, MANY programs that use CRNAs to get Residents out of the OR on a daily basis to provide reading time to residents.

Resident Physicians supervised by Nurses at CCF: You are directly supervised by an RN and a LPN in the PACE clinic. They reprimand you, nag you about productivity, and find any reason to scold you if you tolerate it… they even try to tell you when you can go to lunch and monitor your lunch breaks down to the minute. They offer NO EDUCATIONAL VALUE to Physicians’ training… it is just easier for the Residency to have Nurses in charge of you, because the Anesthesia Staff Physicians don’t want to be involved.

CRNA/SRNA get Case Preference: Many times on big important rotations like Neuro, Vascular, ENT, and Cardiac you will be assigned to trivial cases while SRNAs and CRNAs are given the best learning cases. Expect to get an AV fistula while the SRNA gets the open AAA, the Control Desk says “This is a CRNA training program too”. There is a large and profitable CRNA presence here at CCF. These Nurses are treated as royalty. Residents ALWAYS relieve Nurses in the ORs, so they can go home and Residents finish the cases. Often the Nurses leaving at 3:30 PM go home while Residents are left in ORs without getting a break or lunch that day. Look for a better residency program that gives preference to Physicians in Training and not Nurses.

Pro-CRNA Program Director: Most of his very limited OR time is spent supervising CRNAs, 2 at a time, instead of teaching Residents… CCF is a RESIDENT TRAINING PROGRAM, so why does the Program Director work with Nurses over Residents. He is not alone, the immediate-past-Chair of Cardiothoracic Anesthesia ONLY works with Nurses and will never allow a resident in his OR. Find a better program where the Physicians will work with the Resident Physicians preferentially and not the Nurses.

Patients often refuse Resident Care at CCF: On the OB rotation RNs have an adversarial relationship with residents. Nurses talk patients out of Resident care and into only allowing Attendings to perform epidurals and spinals. This occurs 20-25% of the time, which sadly is a big improvement since efforts have been made to correct the problem.

Residents work for CRNAs: Huron Hospital is the realm of the CRNA. The attendings there tell residents to do whatever the CRNAs say. The attendings are private practice minded, not Acedemics. They tolerate residents because the must and allow CRNAs to run the show because it is profitable and the Attendings are lazy.

MALIGNANT: The Program Administrator is an unstable, unpredictable, and malignant person. She demands complete obedience then she berates, humiliates, and degrades Physicians at the Resident and Staff level openly and has never received even a word of caution from the Program Director. She has forced Residents into LOAs at least twice this year and “caused one Resident to quit Anesthesia all together”. She expects, even demands respect. She will tell you how much power she has, threatens to ‘lose your paperwork for vacation, reimbursements, etc… and GIVES ABSOLUTELY NO RESPECT WHAT SO EVER TO PHYSICIANS. The PD has encouraged this behavior and attitude for two decades and there is no change in sight.

When you visit the Cleveland Clinic, ask yourself about which residents you are ALLOWED to meet. The Program Director tells the Chief Residents to invite Residents to dinner that will portray the program in a positive light, the Anesthesia Control Desk arranges lunch relief for the applicant lunches only for Residents that will portray the program in a positive light. But, if you can’t find a better place to match you will learn first hand the truth of this program.

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I love the brutal honesty...if it is honesty. It is somewhat suspicious that this is your first post...however, you seem to have some inside information that only a resident would have.
If anyone else has similar complaints about CCF, please post so that those of us who are thinking about CCF can be as informed as possible.
 
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I'm not a CCF resident, but just remember to everyone that the previous was opinion as the poster stated. And everyone is entitled to that, whether it be a positive or negative one.
 
Applicants, are you listening?

All I know is that if I were to review my program as honestly, you better believe I would create a new login to do it as well.

Let the "troll" flames begin, but I can tell you all as a mid-level anesthesia resident that there are specific things mentioned here that most med students (applicants) wouldn't have a clue how to invent properly. I believe this is real.

BNE
 
Hot damn. That's some ****.

They're VERY high on my ideal list; I'd love to hear other opinions.

dc
 
I cannot speak for the authenticity of this post, but I interviewed there and did not rank them. The Residents seemed very unhappy and I'd say at least 15-20 came to the lunch portion of the interview.
 
I cannot speak for the authenticity of this post, but I interviewed there and did not rank them. The Residents seemed very unhappy and I'd say at least 15-20 came to the lunch portion of the interview.

Was the general overall feel I got doing 2 away rotations there as a med student. Awesome learning but you are going to pay a severe price to get it. Was told by more than one resident "buyer beware." I still think you will/would get excellent training there...you just have to put up with a lot.
 
MALIGNANT: The Program Administrator is an unstable, unpredictable, and malignant person. She demands complete obedience then she berates, humiliates, and degrades Physicians at the Resident and Staff level openly and has never received even a word of caution from the Program Director. She has forced Residents into LOAs at least twice this year and “caused one Resident to quit Anesthesia all together”. She expects, even demands respect. She will tell you how much power she has, threatens to ‘lose your paperwork for vacation, reimbursements, etc… and GIVES ABSOLUTELY NO RESPECT WHAT SO EVER TO PHYSICIANS. The PD has encouraged this behavior and attitude for two decades and there is no change in sight.


Isn't the PD at Cleveland Clinic John Tetzlaff...a dude?
 
Isn't the PD at Cleveland Clinic John Tetzlaff...a dude?

talking about different people. The program administrator is just that, an administrator(typically not doctors, atleast from my experience). Not the same as the program director.

These folks usually start off essentially as assistants, but get so good a their jobs that PD/Chair get reliant on them and wouldn't know what to do without them. In addition, getting a new trainee would be a nightmare since chances are good that they would have to go through a few of them to find someone as good, and even if they find someone as talented, this new person would still take a while to learn to navigate the system/bureaucracy. Hence, the longer this person has been around, the more hesitant PD/Chair is to cause any issue with them
 
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Hot damn. That's some ****.

They're VERY high on my ideal list; I'd love to hear other opinions.

Cleveland Clinic has a very unique feel to it. That feel is "This hospital's #1 mission is making money and we make no secret of it."

So, you get marketing EVERYWHERE you look, gleaming new buildings that look like airport terminals, pristine landscaping, etc. etc. You also are keenly aware that your every move is being watched and monitored (lest a protocol be violated or time=$$$ wasted) and that you are there only to provide free/cheap labor.

My only experience with the anesthesia program directly was actually somewhat positive, it seemed like the in-OR teaching was strong. The research department there is very strong.
 
Based on reading FAQ and past rankings threads, CCF is always up there. How in the world does a residency program that so clearly places the educational needs of a nurse above those of a physician become top ranked, or in reality, anything other than toilet bowl fodder?
 
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If CCF is such a malignant program and is such a grueling/undesirable residency...why are we just now hearing about this? I am sure this program did not become this way overnight.
 
Of all the places that I visited, I am least surprised to hear these things said of CCF. I had a resident during the lunch make a point of telling me where he would go were he to 'do it all over.' I also had a bit of a 'run-in' with the (I believe) program administrator over a simple question--a surprisingly big red flag to me as an interviewee.

In spite of these things and the gloomy picture painted here, I know that there ARE a lot of pros to training at CCF. Others have done well to point these things out in the past.
 
As a more than just slightly disgruntled resident in a program filled with many other more than slightly disgruntled residents I think I can answer your question.

Current residents do not benefit from running down their own program even in the form of honest reviews. Things would have to get pretty bad for someone to go to the applicant recruiting dinners and lunches etc. and really tell it like it is. Trust me, the program director, chief residents etc monitor recruitment efforts closely and people who are "troublemakers" are not "signed up" for the dinners at many places. Also, we do not benefit if our program doesn't fill -- more call, dinged prestige etc. The most disgruntled of residents actually self-exclude from the dinners, they don't want to give up any more of their time for the place as they have to. Also, the CA years pass like this: CA1- naive but learning, by then end you know the way it is. CA2- bitter but too busy to do anything about it, too much to lose to be a squeaky wheel. CA3- almost done, don't give a damn, **** recruitment efforts. You'll see. So most of what you hear at the dinners and lunches tends to be positive. If you do get something negative, there's probably a lot more under the surface so I think it should really prickle your ears when you hear it.

As to why more anonymous negative reviews aren't on scutwork.org and studentdoctor.net, well that I don't really know. I think only like 5-10% of my program still looks at studentdoctor to begin with. Also, scutwork seems to be pretty much dead, there hasn't been anything new posted on my program since 2005-2006. And when the honest but negative reviews pop-up, people just say it the person who has the problem, or site them as a "troll" etc. So they really don't seem to have much impact.

The sad truth of it all is that no matter what applicants are told or what vibe they pick up from residents, they still for the most part make their decisions based on prestige and national reputation and for the most part these things are immutable. People are still going to match CCF highly no matter what they hear. Of course, they'll feel differently about it about 6 months into their CA-1 year.

BNE
 
If CCF is such a malignant program and is such a grueling/undesirable residency...why are we just now hearing about this? I am sure this program did not become this way overnight.

Actually, its CCF in general. One of my attendings is a CCF grad in IM, and he basically summed up what someone previously said, CCF is about making money, and they don't really care about the individual. Why are they still such a highly regarded program? 1, MONEY. 2, MONEY, 3, Their size because of #1 and 2 gives them preferential patient load that other residency programs can't match.
 
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I can tell you that most of what was said by the OP is unfortunately true...I ended up ranking another cleveland program ahead of it when I matched a couple of year ago because of the same issues. CCF is a great place to train and the docs I know from their are solid but I am much happier at another program I matched at in Cleveland.
 
So I see CCF blows big chunks. How about any of the Chicago programs? Any of them care about nurses more than residents.

It's kind of disturbing that anesthesia in general is being run by a bunch of lazy MDs who support CRNAs over residents. This is really freaking sad.
 
As a more than just slightly disgruntled resident in a program filled with many other more than slightly disgruntled residents I think I can answer your question.

Current residents do not benefit from running down their own program even in the form of honest reviews. Things would have to get pretty bad for someone to go to the applicant recruiting dinners and lunches etc. and really tell it like it is. Trust me, the program director, chief residents etc monitor recruitment efforts closely and people who are "troublemakers" are not "signed up" for the dinners at many places. Also, we do not benefit if our program doesn't fill -- more call, dinged prestige etc. The most disgruntled of residents actually self-exclude from the dinners, they don't want to give up any more of their time for the place as they have to. Also, the CA years pass like this: CA1- naive but learning, by then end you know the way it is. CA2- bitter but too busy to do anything about it, too much to lose to be a squeaky wheel. CA3- almost done, don't give a damn, **** recruitment efforts. You'll see. So most of what you hear at the dinners and lunches tends to be positive. If you do get something negative, there's probably a lot more under the surface so I think it should really prickle your ears when you hear it.

As to why more anonymous negative reviews aren't on scutwork.org and studentdoctor.net, well that I don't really know. I think only like 5-10% of my program still looks at studentdoctor to begin with. Also, scutwork seems to be pretty much dead, there hasn't been anything new posted on my program since 2005-2006. And when the honest but negative reviews pop-up, people just say it the person who has the problem, or site them as a "troll" etc. So they really don't seem to have much impact.

The sad truth of it all is that no matter what applicants are told or what vibe they pick up from residents, they still for the most part make their decisions based on prestige and national reputation and for the most part these things are immutable. People are still going to match CCF highly no matter what they hear. Of course, they'll feel differently about it about 6 months into their CA-1 year.

BNE




I guess that my question to you is "How accurate is the report written by the original poster?"
 
As to why more anonymous negative reviews aren't on scutwork.org and studentdoctor.net, well that I don't really know.
BNE

I don't know why either. But this is EXACTLY why this forum is so valuable, and why the input from this forum's members is so important. One guy takes a few minutes to post his thoughts - and boom! - we've got a good discussion that gets folks a little riled up. Nice.

PLEASE offer up program reviews as you see fit, guys!!!!

dc
 
I guess that my question to you is "How accurate is the report written by the original poster?"

No way for me to know. I'm not at CCF. However I believe it to be truthful, or at least an exaggerated opinion of something truthful. Either way, I would view it as a huge red flag.

And I agree that such although such reviews are helpful, remember they are not as anonymous as one might think. And the posts are permanent. My guess is that if the CCF PD read this review, it would take him no more than 3 guesses to figure out who wrote it. This guy/gal almost certainly "complained" about these issues in house already. If some people are intimidated to such an extent as to not post simple generic questions on the internet, then you can imagine how most people might be reluctant to specifically bash their program here. It's much easier and safer to just push through residency with your head down...

Free advice is usually only worth what you paid for it. I jumped in on this thread because I think this is an exception.

BNE
 
No way for me to know. I'm not at CCF. However I believe it to be truthful, or at least an exaggerated opinion of something truthful. Either way, I would view it as a huge red flag.

And I agree that such although such reviews are helpful, remember they are not as anonymous as one might think. And the posts are permanent. My guess is that if the CCF PD read this review, it would take him no more than 3 guesses to figure out who wrote it. This guy/gal almost certainly "complained" about these issues in house already. If some people are intimidated to such an extent as to not post simple generic questions on the internet, then you can imagine how most people might be reluctant to specifically bash their program here. It's much easier and safer to just push through residency with your head down...

Free advice is usually only worth what you paid for it. I jumped in on this thread because I think this is an exception.

BNE





Ah...I thought that you were at the program as well. My mistake...
 
And I agree that such although such reviews are helpful, remember they are not as anonymous as one might think. And the posts are permanent. My guess is that if the CCF PD read this review, it would take him no more than 3 guesses to figure out who wrote it. This guy/gal almost certainly "complained" about these issues in house already. If some people are intimidated to such an extent as to not post simple generic questions on the internet, then you can imagine how most people might be reluctant to specifically bash their program here. It's much easier and safer to just push through residency with your head down...
BNE

You know what? As much as I've been begging for folks to post their experiences here, you have a very solid point. I appreciate folks offering their opinions on programs, but I guess I hadn't looked at it from that perspective.

dc
 
You know what? As much as I've been begging for folks to post their experiences here, you have a very solid point. I appreciate folks offering their opinions on programs, but I guess I hadn't looked at it from that perspective.

dc

I would measure carefully anything you read about programs here. With this being an anonymous forum, it is a breeding groud for disgruntled residents to grind their axe so to speak. You have to remember that no program is perfect. EVERY SINGLE PROGRAM HAS NEGATIVE POINTS! Yes even UCSF, Hopkins, Mass Gen, Brigham, Michigan, Wash U, CCF, Mayo, Duke and (insert name of any program here ____) all have "problems." I suspect that SOME of the statements are RELATED to the truth, but that much of it is embellishment. It is up to you to either believe it or not, but I promise those of you getting ready to interview that you will match at programs and find issues that you do not like about your "perfect program." You will not have heard about these things before you start. You will be a resident and as such there will be times when you are treated like dirt by everyone (from the cleaning ladies to the nurses to the attendings). That is the way medical training is, for better or worse.

In summary, there is no perfect program (although there are many naive MS4's out there that honestly think they exist). Pick your poison. If you are a complainer you will be miserable anywhere. Bottom line: you are going to be a resident and you will experience all that goes with it. Sometimes it will be great and other times not so great. Good luck with your interviews everyone and try to find the best place for you individually.

Stepping down off soapbox,

Ender
 
I would measure carefully anything you read about programs here. With this being an anonymous forum, it is a breeding groud for disgruntled residents to grind their axe so to speak. You have to remember that no program is perfect. EVERY SINGLE PROGRAM HAS NEGATIVE POINTS! Yes even UCSF, Hopkins, Mass Gen, Brigham, Michigan, Wash U, CCF, Mayo, Duke and (insert name of any program here ____) all have "problems." I suspect that SOME of the statements are RELATED to the truth, but that much of it is embellishment. It is up to you to either believe it or not, but I promise those of you getting ready to interview that you will match at programs and find issues that you do not like about your "perfect program." You will not have heard about these things before you start. You will be a resident and as such there will be times when you are treated like dirt by everyone (from the cleaning ladies to the nurses to the attendings). That is the way medical training is, for better or worse.

In summary, there is no perfect program (although there are many naive MS4's out there that honestly think they exist). Pick your poison. If you are a complainer you will be miserable anywhere. Bottom line: you are going to be a resident and you will experience all that goes with it. Sometimes it will be great and other times not so great. Good luck with your interviews everyone and try to find the best place for you individually.

Stepping down off soapbox,

Ender




yes, but there are "degrees of imperfection"
 
If you are a complainer you will be miserable anywhere.

Ain't that the truth. And, if you incessantly complain, just remember to use double-sided, extra sticky tape for that bullseye that's going to be placed on your back.

I've learned it's best just to suck it up, stay focused, do your time, and in the end grab your certificate and run like hell. AMFYOYO!

-copro
 
Academia.....

'Nuff said.

Fifedoms. Out of touch with reality. Often heavily funded with no real idea how the world outside the ivory tower works. Rare to find someone who actually worked on the outside. Teaching to the test, not to what actually happens. Varying degrees of ineptitude (I can say that at this point) protected by tenure. A lot of theory, but little adeptness at application. I can't tell you the number of times I've heard, from different practitioners, "This is the only way to do this type of case." :rolleyes:

I wonder how truly ill-prepared I'm going to be do deal with the time and economic realities in 10 months time. I'm sure I'm going to have another steep learning curve to work through. At least I recognize this now.

-copro
 
It's interesting that CCF has 150 CRNA's on staff but not one AA, even though CWRU has an AA school across the street from them and other major hospitals in the area like UH and Metro employ AA's. Shows you how powerful the CRNA's are at CCF.
 
Academia.....

I'm a Resident at Cleveland Clinic (CA-2). I think I'm pretty happy here, working 50-60 hours a week, taking 6 calls a month with half of those calls lasting until 11PM with next day off. I know CRNAs are a frequent complaint here but if not them I bet people would complain about something else I'm sure. I have a skewd prospective for sure having a military background. I did 7 submarine patrols lasting 3-4 months each in the North Atlantic with no days off and nevering leaving the job. So, if you don't physically beat me and take away my birthday I'm not going to notice you're being mean to me. Aneshesia Residency is a joke compared to other specialties. We make $60/hr to moonlight, we leave 7AM postcall for overnights, we never need lie about work hours, we get breaks and lunches. We make twice what everyone else makes :D:eek::laugh: Take complaints with a grain of salt. I do not know how good other places have it or how bad other places have it. I suspect there are complainers everywhere though. You get good solid training here at Cleveland Clinic.
 
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I'm a Resident at Cleveland Clinic (CA-2). I think I'm pretty happy here, working 50-60 hours a week, taking 6 calls a month with half of those calls lasting until 11PM with next day off. I know CRNAs are a frequent complaint here but if not them I bet people would complain about something else I'm sure. I have a skewd prospective for sure having a military background. I did 7 submarine patrols lasting 3-4 months each in the North Atlantic with no days off and nevering leaving the job. So, if you don't physically beat me and take away my birthday I'm not going to notice you're being mean to me. Aneshesia Residency is a joke compared to other specialties. We make $60/hr to moonlight, we leave 7AM postcall for overnights, we never need lie about work hours, we get breaks and lunches. We make twice what everyone else makes :D:eek::laugh: Take complaints with a grain of salt. I do not know how good other places have it or how bad other places have it. I suspect there are complainers everywhere though. You get good solid training here at Cleveland Clinic.

It sounds hard but fair in terms of money and reputation. Provided you don't mind 60 hours a week in the O.R. you should be able to deal with the rest of the complaints.
 
"If CCF is such a malignant program and is such a grueling/undesirable residency...why are we just now hearing about this? I am sure this program did not become this way overnight."

This is not news, although your arrival on the forum might be a recent event.

I had several friends who trained there, and they all said that you're treated as chattle. Others who interviewed there and wound up matching at Vandy, BW, etc. all felt the same. Nobody doubts that the training is good, but the price paid is extremly high.
 
As a more than just slightly disgruntled resident in a program filled with many other more than slightly disgruntled residents I think I can answer your question.

Current residents do not benefit from running down their own program even in the form of honest reviews. Things would have to get pretty bad for someone to go to the applicant recruiting dinners and lunches etc. and really tell it like it is. Trust me, the program director, chief residents etc monitor recruitment efforts closely and people who are "troublemakers" are not "signed up" for the dinners at many places. Also, we do not benefit if our program doesn't fill -- more call, dinged prestige etc. The most disgruntled of residents actually self-exclude from the dinners, they don't want to give up any more of their time for the place as they have to. Also, the CA years pass like this: CA1- naive but learning, by then end you know the way it is. CA2- bitter but too busy to do anything about it, too much to lose to be a squeaky wheel. CA3- almost done, don't give a damn, **** recruitment efforts. You'll see. So most of what you hear at the dinners and lunches tends to be positive. If you do get something negative, there's probably a lot more under the surface so I think it should really prickle your ears when you hear it.

As to why more anonymous negative reviews aren't on scutwork.org and studentdoctor.net, well that I don't really know. I think only like 5-10% of my program still looks at studentdoctor to begin with. Also, scutwork seems to be pretty much dead, there hasn't been anything new posted on my program since 2005-2006. And when the honest but negative reviews pop-up, people just say it the person who has the problem, or site them as a "troll" etc. So they really don't seem to have much impact.

The sad truth of it all is that no matter what applicants are told or what vibe they pick up from residents, they still for the most part make their decisions based on prestige and national reputation and for the most part these things are immutable. People are still going to match CCF highly no matter what they hear. Of course, they'll feel differently about it about 6 months into their CA-1 year.

BNE
that is true, and that bothers me. if you hear any stuff like this about a program, i wouldnt even consider ranking them. don't blow 3 yrs of your life for slightly higher prestige. the "great training" is in no means worth it. you'll regret it.
 
Long time lurker to SDN and felt compelled to weigh in as I saw this first hand. I did two away rotations at CCF my M4 year (2 years ago) and came away with a similar impressions. Outstanding training opportunities; YES. A lifestyle and program politics I wished to live for 4 years of my life; NO NO NO NO NO. During these rotations many residents voiced major concerns regarding CRNA/SRNA case preference and relief, 'forced REXing'/work hours, treatment/respect from program leadership that were addressed in the original post. Sadly, it appears little has changed over some two years since my experiences there. The 'light bulb' moment for me was at the interview lunch, which only ~10-20 out of >100 residents in the program attended and this was the ONLY interaction with residents the entire interview day, where a senior resident told me you could not pay him enough to train there again...scared me away completely... but I knew this all not only via what others were saying on SDN or other forums at that time, but from personal experiences including rotations and the formal interview.

I would suggest that applicants actually LOOK at programs they are interested via rotations or interviews, rather than solely discount a program based on a negative thread. It is good to lurk this forum regularly to feel out programs, but there is no substitute for experiencing it yourself and learning what a program has to offer to make YOU happy. Trust me, after 2-3 interviews it is EASY to detect disgruntled residents and malignancies within programs. Bottom line: if you are interested in a program DON'T be scared away based SOLELY on negative posts. Gather your concerns and ASK on interview day; the more residents you ask/email the easier your decision will be.

out.
 
I would suggest that applicants actually LOOK at programs they are interested via rotations or interviews, rather than solely discount a program based on a negative thread. It is good to lurk this forum regularly to feel out programs, but there is no substitute for experiencing it yourself and learning what a program has to offer to make YOU happy. Trust me, after 2-3 interviews it is EASY to detect disgruntled residents and malignancies within programs. Bottom line: if you are interested in a program DON'T be scared away based SOLELY on negative posts. Gather your concerns and ASK on interview day; the more residents you ask/email the easier your decision will be.

out.

This is solid advice.

Ender
 
You guys are really doing us a huge favor with your input/opinions.

For the residents that have gone thru this before, what are the things that you guys ask when something raises an eyebrow? Do you pull a random resident aside and ask for "the real deal"? Would you ever ask a faculty member/interviewer directly about your concerns?

Several people have told me that "You'll just know" when something is wrong, but much like ass*ole med students can keep their **** together for one interview day, I assume disasterous programs can do the same...

dc
 
You guys are really doing us a huge favor with your input/opinions.

For the residents that have gone thru this before, what are the things that you guys ask when something raises an eyebrow? Do you pull a random resident aside and ask for "the real deal"? Would you ever ask a faculty member/interviewer directly about your concerns?

Several people have told me that "You'll just know" when something is wrong, but much like ass*ole med students can keep their **** together for one interview day, I assume disasterous programs can do the same...

dc

I'll bet you are right in that programs can keep it together for one day. I am sure that there are places where they only let certain residents come around. To my knowledge I didn't see any of these programs on the trail, though my memory is a little hazy. I would think that the "red flags" would be visible if you looked closely.

I always told people interviewing at my program that sure there were lots of little things that I disliked about the program (remember that residents love to bitch and moan about everything) but that it was a great place overall and that I would comethere again in a heartbeat.

One of the reviews in a sticky somewhere had some info. about my program that was laughable at best. It wasn't necessarily totally wrong but I could obviously tell that it was just a tidbit of info that someone heard (probably years ago). So take everything with a grain of salt.

You have to figure out on your own if someone dissing a program is doing it because the program truly is bad or because they are a DB.
 
A few months ago I went to a panel discussion about the residency application process and Dr. Tetzlaff, the PD of the CCF program, was on it.

Interestingly, he specifically mentioned SDN as a great source of info, but warned the audience that they need to be careful because of what he perceived as disgruntled posters.

So, Dr. Tetzlaff, I know you read SDN. I hope you're listening.
 
FORCED REXING: Residents are forced to Moonlight at CCF. The Program Director claims the REX program (paid Resident Experience Program) is voluntary. When you mention “Mandatory Moonlighting” OR “Forced Rexing” he will tell you that you can stay and work as a resident under the 80 hour/week ACGME mandate or you can VOLUNTEER to get paid for the time you are here. Either way you are going to stay and work. If people complain, he threatens to keep the moonlighting pay and work residents into the ground.

My program didn't have moonlighting opportunities and we all thought things would be so much better if we did. However, some pointed to the CCF example as "being careful what you wish for". The ideal moonlighting model would be voluntary and allow only those interested in pursuing it. The moonlighting rate for residents is profoundly lower than the prevailing wage for CRNA's or attendings - it isn't fair to force someone to accept this arrangement. In my opinion, no moonlighting program at all is better than this one described.

Residents are a slave work force: This is Anesthesia, not Surgery, but Residents relieve CRNAs and SRNAs in the OR, so they can leave on time. Contract this with the MANY, MANY, MANY programs that use CRNAs to get Residents out of the OR on a daily basis to provide reading time to residents.

At my program, we never relieved CRNA's unless we were on call. Getting CRNA's out on time is one of the most important functions of any academic or private practice group. Doing it with call residents is ok. Doing it with voluntary moonlighters is ok too. Doing it with non-call residents or forced moonlighters is unacceptable.

Resident Physicians supervised by Nurses at CCF: You are directly supervised by an RN and a LPN in the PACE clinic. They reprimand you, nag you about productivity, and find any reason to scold you if you tolerate it… they even try to tell you when you can go to lunch and monitor your lunch breaks down to the minute. They offer NO EDUCATIONAL VALUE to Physicians’ training… it is just easier for the Residency to have Nurses in charge of you, because the Anesthesia Staff Physicians don’t want to be involved.

I don't know exactly what to make of this comment.

CRNA/SRNA get Case Preference: Many times on big important rotations like Neuro, Vascular, ENT, and Cardiac you will be assigned to trivial cases while SRNAs and CRNAs are given the best learning cases. Expect to get an AV fistula while the SRNA gets the open AAA, the Control Desk says “This is a CRNA training program too”. There is a large and profitable CRNA presence here at CCF. These Nurses are treated as royalty. Residents ALWAYS relieve Nurses in the ORs, so they can go home and Residents finish the cases. Often the Nurses leaving at 3:30 PM go home while Residents are left in ORs without getting a break or lunch that day. Look for a better residency program that gives preference to Physicians in Training and not Nurses.


I would not go to a residency program that concurrently trained CRNA's. At my program, we had some SNA rotators, but they never took any cases of educational value. The poster is right in that the SNA's are paying tuition dollars to be there while residents are being paid department dollars - this obviously has a "customer is right" attitude.

Pro-CRNA Program Director: Most of his very limited OR time is spent supervising CRNAs, 2 at a time, instead of teaching Residents… CCF is a RESIDENT TRAINING PROGRAM, so why does the Program Director work with Nurses over Residents. He is not alone, the immediate-past-Chair of Cardiothoracic Anesthesia ONLY works with Nurses and will never allow a resident in his OR. Find a better program where the Physicians will work with the Resident Physicians preferentially and not the Nurses.


The program director should ideally be the biggest resident advocate in the entire department. If this isn't the case, I would also look elsewhere.

Patients often refuse Resident Care at CCF: On the OB rotation RNs have an adversarial relationship with residents. Nurses talk patients out of Resident care and into only allowing Attendings to perform epidurals and spinals. This occurs 20-25% of the time, which sadly is a big improvement since efforts have been made to correct the problem.

I remember the first 20 or so epidurals I did and boy do I feel sorry for those poor women that I tortured. Unfortunately, it is the poor/uneducated/immigrant population that usually bear the brunt of resident learning experiences. If rich white women don't want a CA-1 doing their epidural, can you blame them? I wouldn't go to a program where my patients would refuse resident care.

Residents work for CRNAs: Huron Hospital is the realm of the CRNA. The attendings there tell residents to do whatever the CRNAs say. The attendings are private practice minded, not Acedemics. They tolerate residents because the must and allow CRNAs to run the show because it is profitable and the Attendings are lazy.

It sounds like the poster's beef is mainly with the attendings and not the CRNA's. That said, I think there is much to learn from CRNA's, especially older, experienced ones. Giving breaks to them as a resident, I picked up on little things that they did for their cases and incorporated the stuff I liked into my practice. As an attending, I rely on my CRNA's judgment to get the cases started/completed as efficiently as possible.

MALIGNANT: The Program Administrator is an unstable, unpredictable, and malignant person. She demands complete obedience then she berates, humiliates, and degrades Physicians at the Resident and Staff level openly and has never received even a word of caution from the Program Director. She has forced Residents into LOAs at least twice this year and “caused one Resident to quit Anesthesia all together”. She expects, even demands respect. She will tell you how much power she has, threatens to ‘lose your paperwork for vacation, reimbursements, etc… and GIVES ABSOLUTELY NO RESPECT WHAT SO EVER TO PHYSICIANS. The PD has encouraged this behavior and attitude for two decades and there is no change in sight.

Never underestimate the power of a program administrator/secretary to have an adverse effect on your life. It is bad enough when incompetence alone causes people hardships in terms of lost paperwork for vacations, licenses, etc. But when someone actually threatens to deliberately do these things?

I think everyone on this forum owes the original poster a debt of gratitude. It takes a lot of courage to come out and describe problems such as these in such detail. I don't know this poster personally - perhaps he or she does have an ax to grind and is taking some things out of context. However, I think that there is enough information here to keep all but the most desperate applicants from applying to this program. That's right, don't apply to this program unless this is the only way you can do anesthesia or if you really, really need to be in Cleveland. If applicants stopped applying to this program (program doesn't fill or fills with the least desirable applicants), the program director and/or chairman would have to take a hard look at themselves and clean things up. SDN can be a powerful agent for change - perhaps it can change this malignant program for the better.
 
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FORCED REXING: Residents are forced to Moonlight at CCF. The Program Director claims the REX program (paid Resident Experience Program) is voluntary. When you mention “Mandatory Moonlighting” OR “Forced Rexing” he will tell you that you can stay and work as a resident under the 80 hour/week ACGME mandate or you can VOLUNTEER to get paid for the time you are here. Either way you are going to stay and work. If people complain, he threatens to keep the moonlighting pay and work residents into the ground.

My program didn't have moonlighting opportunities and we all thought things would be so much better if we did. However, some pointed to the CCF example as "being careful what you wish for". The ideal moonlighting model would be voluntary and allow only those interested in pursuing it. The moonlighting rate for residents is profoundly lower than the prevailing wage for CRNA's or attendings - it isn't fair to force someone to accept this arrangement. In my opinion, no moonlighting program at all is better than this one described.

Residents are a slave work force: This is Anesthesia, not Surgery, but Residents relieve CRNAs and SRNAs in the OR, so they can leave on time. Contract this with the MANY, MANY, MANY programs that use CRNAs to get Residents out of the OR on a daily basis to provide reading time to residents.

At my program, we never relieved CRNA's unless we were on call. Getting CRNA's out on time is one of the most important functions of any academic or private practice group. Doing it with call residents is ok. Doing it with voluntary moonlighters is ok too. Doing it with non-call residents or forced moonlighters is unacceptable.

Resident Physicians supervised by Nurses at CCF: You are directly supervised by an RN and a LPN in the PACE clinic. They reprimand you, nag you about productivity, and find any reason to scold you if you tolerate it… they even try to tell you when you can go to lunch and monitor your lunch breaks down to the minute. They offer NO EDUCATIONAL VALUE to Physicians’ training… it is just easier for the Residency to have Nurses in charge of you, because the Anesthesia Staff Physicians don’t want to be involved.

I don't know exactly what to make of this comment.

CRNA/SRNA get Case Preference: Many times on big important rotations like Neuro, Vascular, ENT, and Cardiac you will be assigned to trivial cases while SRNAs and CRNAs are given the best learning cases. Expect to get an AV fistula while the SRNA gets the open AAA, the Control Desk says “This is a CRNA training program too”. There is a large and profitable CRNA presence here at CCF. These Nurses are treated as royalty. Residents ALWAYS relieve Nurses in the ORs, so they can go home and Residents finish the cases. Often the Nurses leaving at 3:30 PM go home while Residents are left in ORs without getting a break or lunch that day. Look for a better residency program that gives preference to Physicians in Training and not Nurses.


I would not go to a residency program that concurrently trained CRNA's. At my program, we had some SNA rotators, but they never took any cases of educational value. The poster is right in that the SNA's are paying tuition dollars to be there while residents are being paid department dollars - this obviously has a "customer is right" attitude.

Pro-CRNA Program Director: Most of his very limited OR time is spent supervising CRNAs, 2 at a time, instead of teaching Residents… CCF is a RESIDENT TRAINING PROGRAM, so why does the Program Director work with Nurses over Residents. He is not alone, the immediate-past-Chair of Cardiothoracic Anesthesia ONLY works with Nurses and will never allow a resident in his OR. Find a better program where the Physicians will work with the Resident Physicians preferentially and not the Nurses.


The program director should ideally be the biggest resident advocate in the entire department. If this isn't the case, I would also look elsewhere.

Patients often refuse Resident Care at CCF: On the OB rotation RNs have an adversarial relationship with residents. Nurses talk patients out of Resident care and into only allowing Attendings to perform epidurals and spinals. This occurs 20-25% of the time, which sadly is a big improvement since efforts have been made to correct the problem.

I remember the first 20 or so epidurals I did and boy do I feel sorry for those poor women that I tortured. Unfortunately, it is the poor/uneducated/immigrant population that usually bear the brunt of resident learning experiences. If rich white women don't want a CA-1 doing their epidural, can you blame them? I wouldn't go to a program where my patients would refuse resident care.

Residents work for CRNAs: Huron Hospital is the realm of the CRNA. The attendings there tell residents to do whatever the CRNAs say. The attendings are private practice minded, not Acedemics. They tolerate residents because the must and allow CRNAs to run the show because it is profitable and the Attendings are lazy.

It sounds like the poster's beef is mainly with the attendings and not the CRNA's. That said, I think there is much to learn from CRNA's, especially older, experienced ones. Giving breaks to them as a resident, I picked up on little things that they did for their cases and incorporated the stuff I liked into my practice. As an attending, I rely on my CRNA's judgment to get the cases started/completed as efficiently as possible.

MALIGNANT: The Program Administrator is an unstable, unpredictable, and malignant person. She demands complete obedience then she berates, humiliates, and degrades Physicians at the Resident and Staff level openly and has never received even a word of caution from the Program Director. She has forced Residents into LOAs at least twice this year and “caused one Resident to quit Anesthesia all together”. She expects, even demands respect. She will tell you how much power she has, threatens to ‘lose your paperwork for vacation, reimbursements, etc… and GIVES ABSOLUTELY NO RESPECT WHAT SO EVER TO PHYSICIANS. The PD has encouraged this behavior and attitude for two decades and there is no change in sight.

Never underestimate the power of a program administrator/secretary to have an adverse effect on your life. It is bad enough when incompetence alone causes people hardships in terms of lost paperwork for vacations, licenses, etc. But when someone actually threatens to deliberately do these things?

I think everyone on this forum owes the original poster a debt of gratitude. It takes a lot of courage to come out and describe problems such as these in such detail. I don't know this poster personally - perhaps he or she does have an ax to grind and is taking some things out of context. However, I think that there is enough information here to keep all but the most desperate applicants from applying to this program. That's right, don't apply to this program unless this is the only way you can do anesthesia or if you really, really need to be in Cleveland. If applicants stopped applying to this program (program doesn't fill or fills with the least desirable applicants), the program director and/or chairman would have to take a hard look at themselves and clean things up. SDN can be a powerful agent for change - perhaps it can change this malignant program for the better.


Great post...especially the part in bold.

BNE
 
I am a CA-3 at the CC Institute of Anesthesiology. We have a great residency program, but like any Big Program (Hopkins, Columbia, Mayo etc,) we work a little harder than smaller programs, but still average 50-60 hours a week. Residents average 4-5 Calls a month, with 2 late calls and 2-3 overnight Calls. Late call residents go home around 9pm, and still get the post call day off. WE ARE NEVER EVER SUPERVISED BY CRNAs, if anything we do not have enough CRNAs and would benefit from more nurses to help with breaks and lunches. In our Preop Clinic, residents see patients and discuss them with the staff and not with nurses. The only nurse involved in resident activities is the Coordinator of our Preop Clinic who's in charge of the day-to-day activities of the Clinic, and not supervising residents.

We arguably do more cases than any hospital in the nation, and with such great caseload comes a lot of clinical experience. CRNAS NEVER GET ASSIGNED TO BIGGER CASES THAN RESIDENTS. THERE ARE OCCASSIONAL DAYS WHERE A SENIOR CRNA WITH AN SRNA WOULD BE ASSIGNED TO AN OPEN AAA, AND A NEW CA-1 GETS A CEA, but as a CA-2 OR 3, YOU ONLY GET BIG CASES.

IN CARDIAC AS A CA-2, AND 3, YOU DO MORE HEART CASES IN THE TOTAL 5 MONTH PERIOD THAN EVEN MOST CARDIAC FELLOWSHIPS IN THE NATION, AND DO NOT NEED A FELLOWSHIP TO DO HEARTS COMING FROM THIS PROGRAM. WE ALSO HAVE A GREAT TEE ROTATION.

With regards to the moonlighting issue, when you stay past 5PM on a weekday, you are paid $60/hr, and this is purely voluntarily. There are occasional days when the ORs are so busy that you might be asked to stay till 6 or 7pm, and on those days, the department pays for your dinner. The weekend moonlighting is 100% OPTIONAL, AND VERY COMPETITIVE. RESIDENTS HAVE TO SIGN UP WEEKS IN ADVANCE FOR THESE $80 AN HOUR (7AM-5PM) SHIFTS.

In my experience this is a great training program and the benefits are limitless. I am even more optimistic about the future of this program because of our new Institute Chairman, Dr. Brown. He's actively involved in addressing the issues important to residents so hopefully there will be less disgruntled residents posting stuff out there.
 
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As an anesthesia intern at CCF I was surprised to read the above comments. I spoke with a few of the CA-3’s about this post and thought it would be helpful to provide some prospective.


Hours and forced moonlighting: A resident’s day at CCF is supposed to end at 5:00pm. When cases go longer, the clinic tries to find volunteer moonlighters to fill the rooms and send people home. The moonlighting pay is $60 an hour. Moonlighting is quite popular as it gives you the opportunity to significantly bump up the paltry resident pay. However, when moonlighters cannot be found forced moonlighting does occur. According to a CA-3 I spoke with this occurs about once every 10 days or so. The downside is that you have to stay longer that day; the upside is that you make an extra $60 an hour for every hour you past 5pm.


CRNA/SRNA tension: There is definitely tension between the SRNA and Anesthesiology residents. Much of it is probably a reflection of the national tension between the groups. Several comments were raised about SRNA’s getting good cases over residents. I spoke at length with two of the CA-3s about this. I am told that this does happen especially if an SRNA has not seen a particular case and the resident has their numbers. While not ideal from our perspective, it is worthwhile to note that both CA-3s had easily met their numbers with one telling me that she got all of her required numbers in the first half of CA-2 year! There are a lot of very good cases to go around at CCF.


Program Administrator: The above comments about the program administrator I simply disagree with. The administrator is an MBA who is very self confident has been around for a long time. Many find her intimidating and she does demand respect. However, she also cares deeply about the residents and to call her malignant is grossly unjust. I vividly remember one of the early intern lectures about substance abuse in anesthesiology residents. As she described residents she personally knew who became addicted and subsequently torpedoed their careers she literally broke down in tears recalling and describing the scenes. She then spent the next hour trying to impress on us the danger and discouraging even the thought of experimentation. These are not the actions of a malignant person.


Like anything different people will give you different perspectives on a program. Be cautious in reading too much into a single post. I am loving life as an intern. I think I am going to put in 45 hours a week this month and that’s not atypical. You will be hard pressed to find a better intern year anywhere. I don’t care much for Cleveland, but the cost of living is dirt cheap and the resident pay goes very far here. Most of my class does not plan on staying in Cleveland or Ohio which is where the benefits of CCF reputation come in handy.
 
i wasn't going to post as i answered everyone questions privately, but i couldn't resist and wanted to back up what my classmate had to say. the intern year here is sweet and I have had very different and more positive experiences with the PACE clinic staff, the PD and the program coordinator.
as far as forced moonlighting, the residents will be in the ORs until the cases are done at every program i rotated at, at least you get paid extra for it. i was at another program until 9pm ( not on call ) with my resident, as a med student. she didn't get late pay and came in the next day. this at a program that advertises its residents work 50-55 hours a week. not.
if you go to a good program you are going to work, period. you have to to be a good anesthesiologist. you can't just learn this from books.
is ccf perfect? no, 'course not. but you guys know i ranked it number one and still would. i felt it was the best opportunity for great training, tough cases, top fellowships, and a sweet intern year with as little as possible of my time wasted.

...and narcus, couldn't resist my two cents -- i almost never do as I am told. ;-)
 
... the residents will be in the ORs until the cases are done at every program i rotated at, at least you get paid extra for it.

Ain't that the truth.

-copro
 
On a slight side note and I dont intend this to jack the thread but.....

Has anyone noticed that med students are becoming softer and whinier these days (not all but this has in my opinion become a trend)? It seems like a lot of people are complaining about their hours lately. Now, a lot of hospitals seem to be shifting to less and less call for med students. One med student was even whining about having to stay post call while the night float resident got to go home. Christ, when I was a student we did 80-100 hour weeks on some clinicals. I dont think not having students take overnight call is doing them any favors. Do you really want the first time you stay up overnight to be when youre an intern and actually are responsible for patients? I think the hours while rough are needed, and especially in anesthesia decrease appropriately as you go along (80-100 as student, 60-80 as intern, 60's residency).

Back to the original post. I would have liked to have had a system in place where I got paid to stay past 1700. It wasnt common in my program, but it did happen occasionally (maybe once every 1-2 weeks depending on rotation). If its frequent then I can understand the complaint. Every program is going to have some slave labor aspect to it. thats residency. The difference for me was when you are staying late for a stretch and either the senior resident running the board or attending notices and tries to get you out earlier the next day. Its the little things that count. The SRNA/CRNA thing is messed up if its true though.
 
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