Program description - what does this mean?

[zoondel]

The following is my question to and a response from a senior resident at a program I've applied to (edited to protect the innocent, but "key" words all there).

Question:
1. What are areas for improvement with respect to education and clinical training?
2. What will the program look like in 5 years?

Answer:
"The Hospital is a busy one and we see some amazing things but because of the high level of acuity and patient load, you sometimes have less time to read and build on your experience. In general, though, you learn so much from seeing and doing and the attendings and fellows are happy to teach on their cases. Conferences and morning reports are important, but as an intern, you dont have as much time to read on your own.

.Our chairman is really proactive and is taking initiative on progress. There is an upcoming careful analysis of the curriculum to increase educational opportunities and decrease the intensity of more "service-oriented" rotations. Most of us are excited about the direction our program is headed and the positive changes on the horizon that will make a great program even better."


If anyone has interpretive comments, I'd love to hear them. I'd rather save my thoughts until others have commented, so as not to color them.

Thanks everyone!




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[dragonfly99]

The interns are overworked and may not have time to attend conferences.
There may be too many patients/intern or admissions/intern on some of the services.
You will get loads of clinical experience.
We are trying to fix the overwork situation (but they don't mention what exactly is being done to address this).

 

[Winged Scapula]

I'd say dragonfly is right on the money with her interpretation.

 

[zoondel]

Thanks for the reply. Similar to what I thought, and I wanted to check.
Here's a follow-up question:

I'm choosing between the program mentioned above and a program with the following characteristics:

1. Busy service, but not as crazy as the above
2. Less variety and acuity of pathology than the above, but very good clinical exposure.
3. University program with focus on education, including attendings, residents, and med students as part of a team, working together. (vs. above, where med students are largely ignored, because residents are too busy to teach.)
4. Fewer specialty services, not a "name-brand" (but still a good rep), good fellowship matches, but not as "guaranteed".
5. Residents are very happy.

Is the "brand-name" program (overworked, not as happy) worth 3 years of a less-than ideal working environment? Is the less-prestigious program not wise in the current economy (vis-a-vis future job prospects)?

 

[Winged Scapula]

What do you want to do with your life?

There's no doubt that if you desire to be the Chief of X Specialty at Harvard or some other fancy pants place, then you should go to the most prestigious residency because names do matter in that case.

But by and large, for the vast majority of us, job prospects are not heavily dependent on such things and going to a residency program with good fellowship prospects and happy residents is probably the best choice.

 

[3dtp]

Or more succintly:
Sweatshop.
5 years: Maybe less of a sweatshop but we'll be gone by then.

My residency had a huge variety of path, but the things i've seen in practice are even more so. I'd go with happy residents, happy program with adequate time to learn. In my mind, no contest.

 

[dragonfly99]

If you just want to be a hospitalist or go into private practice general IM, I wouldn't go to the program where you are going to get beat up, work-wise.

If you want to do a specialty like GI, cardiology or hem/onc, or don't yet know if you do, then it may behoove you to suck it up and choose the program with the better fellowship matches. However, if there isn't a whole lot of overall difference in the fellowship matches, it might not be worth the extra pain.

Assume the program isn't going to change much (at least not very fast). So only go there if you think you can stomach the CURRENT work situation.

 

[zoondel]

Thank you all so much. While I didn't go on nearly as many interviews as some of my peers, this whole process has been pretty arduous.

I've been thinking along the same lines - I guess it's hard to pass up something that looks so good on paper.

I think I'll be going to the "happy" program for a second look just for completeness' sake.

 

[Blade28]

Remember that the name/prestige of the program doesn't matter if you're miserable every single day. Those are the residents who dread going to work; and while they're in the hospital, they just watch the clock and count down the hours until they can go home.