Programs on Probation?

[toxic-megacolon]

What Gen Surg programs are currently on probation (either from ACGME or ACS) Is there a list somewhere online?

---

Members don't see this ad.

 

[AlloImmune]

What Gen Surg programs are currently on probation (either from ACGME or ACS) Is there a list somewhere online?

You can check the status of the individual programs on the ACGME website. This website also lists the date that the program was last reviewed and the accreditation information for each program. The link is http://www.acgme.org/adspublic/. From that page, click on view accredited program history.

 

[Balthazur]

Rush University in Chicago, while not on probation yet, they may be soon. They had a review by ACGME and the word is that their proposed changes will not meet the requirements and they will be put on probation. They are being reviewed for gross duty hour violations and lack of academic teaching hours. Many of the residents there are very unhappy and several of the 2nd, 3rd and even a few 4th years are looking for open positions elsewhere.

The "official" word is that it will not happen until mid Jan (after interviews are over). That way they can tell you what they want you to hear on your interview.

It is a shame really, it used to be such a high-caliber program. It has gone downhill the last few years. Even many attendings have left for greener fields elsewhere.

 

[Doc Ivy]

Rush University in Chicago, while not on probation yet, they may be soon.

I can corroborate this, my PD at Northwestern gave me the heads up about rush and told me not to even apply to Rush

 

[Smurfette]

Rush University in Chicago, while not on probation yet, they may be soon. They had a review by ACGME and the word is that their proposed changes will not meet the requirements and they will be put on probation. They are being reviewed for gross duty hour violations and lack of academic teaching hours. Many of the residents there are very unhappy and several of the 2nd, 3rd and even a few 4th years are looking for open positions elsewhere.

The "official" word is that it will not happen until mid Jan (after interviews are over). That way they can tell you what they want you to hear on your interview.

It is a shame really, it used to be such a high-caliber program. It has gone downhill the last few years. Even many attendings have left for greener fields elsewhere.

Any program put on probation MUST under ACGME and Match rules disclose this fact to applicants. Thus, if Rush (or any other program) is put on probation in January (or before or after), all applicants will receive official notification of this fact.

Keep in mind that quite a few programs at present (and I am not naming names here) are being threatened with probation due to work hours. In recent years, Duke, UChicago and Northwestern surgery programs have all been on probation, but fixed the problems and recovered without incident. And if you look at the ACGME website, 13 programs (including UCLA) are currently on probation (which I think is more than double than when I applied to GS 2 yrs ago). That being said, it is wise to avoid programs in turmoil (on probation, new chairman, lots of residents leaving) as you may not know what you're getting into....

 

[Doc Ivy]

Smurfette,

Any knowledge of why UCLA is on probation

 

[Smurfette]

Smurfette,

Any knowledge of why UCLA is on probation

I don't know why...but I'm sure some of the West Coasters on SDN may have an idea?

 

[uclachris]

DISCLAIMER THIS IS 2nd HAND KNOWLEDGE.

From a former resident of General Surgery at UCLA who subsequently switched fields and locations...

Basically massive work hour violations. Extremely malignant. They have a new PD, he started 2 months after they went on probation. I spoke to him at the ACS and he seemed pretty nice. My chair hasn't voiced any concerns about the program and one of my letter writers (big name) said its a fantastic program.

So punchline. It was malignant and had work hour violations. New PD. It's better.

If anyone has anything to add to this please let me know because as a UCLA Alumnus, I would like to get back home!

Best,
C

 

[toxic-megacolon]

On the interview trail last year, I also heard they were low on some cases or counting things like central lines as "vascular cases."

 

[asu03]

I can corroborate this, my PD at Northwestern gave me the heads up about rush and told me not to even apply to Rush

I was really interested in Rush until I read these posts. From prior years' feedback, it sounded like they were the most laid back (yet still solid) academic program in Chicago. I'm trying to decide whether to interview there b/c their dates conflict with other programs. Basically, it's between U of Chicago, which I've heard is very very malignant, vs. Rush, which I used to be really interested in but now it sounds like they're having problems. Could you give any more input on what your PD may have told you as reasons not to apply? Thank you so much for any advice!
Any other input on these programs would be greatly appreciated, too!

 

[Doc Ivy]

Could you give any more input on what your PD may have told you as reasons not to apply? Thank you so much for any advice!
Any other input on these programs would be greatly appreciated, too!

He didn't get into a lot of details, but he did mention work hour violations and a lack of didactics, can't remember if he said their PD was staying or leaving so DO NOT quote me on that. That's all I know, but the tone of his comments was enough to have me not apply.

 

[Balthazur]

I was really interested in Rush until I read these posts. From prior years' feedback, it sounded like they were the most laid back (yet still solid) academic program in Chicago. I'm trying to decide whether to interview there b/c their dates conflict with other programs. Basically, it's between U of Chicago, which I've heard is very very malignant, vs. Rush, which I used to be really interested in but now it sounds like they're having problems. Could you give any more input on what your PD may have told you as reasons not to apply? Thank you so much for any advice!
Any other input on these programs would be greatly appreciated, too!

Rush has a lot of internal problems right now. I am good friends with several residents there, and I hear about it all the time. There is a huge lack of educational sessions. A lot of this is due to the residency coordinator position being vacant for months now. It is being filled by multiple persons who work in other areas. Rumor has it that they are having trouble filling it because nobody from inside wants it.

Many of the attendings are annoyed by having to teach residents (thus don't let them do much)--especially in specialty areas. I know of one case (my friend ranted for hours about this one night) where the patient was prepped, draped, and ready to proceed and the residents (and anesthesia) sat there for 2 hours waiting for the attending to come in and tell them to proceed......before walking out and letting the senior operate with the instructions of "page if you have problems"!!!! This being only the second time the senior has even attempted the procedure!! 9-1/2 hours to do a case that should have taken 2 hours topps--canceling the 3 following cases in the process. The patient had to go back to the OR 2 days later with a "complication" as well.

And for the most part, you don't operate much (as primary surgeon) until your senior year. Many of the PGY-2 and PGY-3's (occasionally 4's) are religated to holding traction and watching the seniors AND MED STUDENTS do most of the work. Thus they have to "fudge" their log books to get credit. Thus, some of the seniors are not proficient enough at some basic skills that they should have mastered as a PGY-2 or 3.

It really is a shame and I hope the program can find someone to turn it around and get it out of this downward spiral. Unfortunately, does not look like it will happen any time soon.

My (and my friend's) advice is to look elsewhere to start your surgical career.

Just my $0.02

 

[asu03]

Thank you Balthazur and Doc Ivy. It is really helpful to get the inside scoop, and this information has definitely helped me to make a decision. I know that every program will have its quirky attendings and problems, but it sounds like overall the residents are unhappy and not getting what they need. And more than anything, I'm looking for a place where the residents are happy with their program. Thanks again for the input!

 

[Bovie9]

On the interview trail last year, I also heard they were low on some cases or counting things like central lines as "vascular cases."

You can't log central lines as vascular cases. You can log the insertion of a central line, and I suppose it would be considered a vascular case... BUT, it won't be COUNTED as a vascular case. If you actually look through you case log, you'll find that although you enter them, small things are not counted as cases in their category- lipomas, partial mastectomy, amputations, etc.

 

[FreakyFriday]

Slap on the wrist for NRMP violation but means nothing, no effect on the program.

Accredited as 5 year program (requires unofficial 2 years unpaid research)

In-transition to new (in-house) Chair, which will make program better

Four hospitals (VA, county, academic, HMO), skills lab and weekly lectures

Operative load is average, strong point is research.

Almost everyone goes on to fellowship

Good resident-attending relationships, very laid-back.

 

[cilia2007]

Smurfette,

Any knowledge of why UCLA is on probation

Just interviewed there last week. According to the official letter they sent out, it was because 1) there wasn't enough protected time for conferences in GS, 2) some of their subspecialties (ortho and uro) were over hours, and 3)a lot of the residents didn't log their cases in the new computer system when it was switched over? (didn't understand this last bit; what I got was that the cases were logged, then the systems switched but the data didn't transfer, and various people said forget it, i'm not re-entering all that data!)

they claim to have fixed all their problems and expect to be fully accredited when they're site-visited again (their mock site visitor said they should apply for an early site visit, because they're ready). hope that helps!

 

[surgical06]

maybe its just wishfull thinking, but i have a hard time believing medstudents do work while a PGY 1,2,3 holds a retractor. I really like Rush, but don't know much about their current situation. are there any rush residents here who can shed some light on this subject.

 

[Gaffud]

Please refer to post on "Which gen surg interview to go to?" regarding Rush.

Mike Gaffud

 

[Balthazur]

maybe its just wishfull thinking, but i have a hard time believing medstudents do work while a PGY 1,2,3 holds a retractor. I really like Rush, but don't know much about their current situation. are there any rush residents here who can shed some light on this subject.

I am very close to a few of them and I know for a fact that this is true. Many interns go well over a month without scrubbing in to the OR as they are stuck doing nothing but scut work on the floors all day long. Things like transporting patients from their room to x-ray and back.

Many of the interns have logged less than 20 cases so far this year, whereas interns in other programs have logged well over 100 cases so far.

To make things worse for them, their director of resident education has taken another job starting in January. No clue when it will be filled. They still have not filled the residency coordinator position in 5 months of vacancy.

 

[surgical06]

I am very close to a few of them and I know for a fact that this is true. Many interns go well over a month without scrubbing in to the OR as they are stuck doing nothing but scut work on the floors all day long. Things like transporting patients from their room to x-ray and back.

Many of the interns have logged less than 20 cases so far this year, whereas interns in other programs have logged well over 100 cases so far.

To make things worse for them, their director of resident education has taken another job starting in January. No clue when it will be filled. They still have not filled the residency coordinator position in 5 months of vacancy.

all 5 of your post in your history at SDN have been about rush in a negative light. what is your motivation in providing this forum with the information you have given.

 

[imtiaz]

I am very close to a few of them and I know for a fact that this is true. Many interns go well over a month without scrubbing in to the OR as they are stuck doing nothing but scut work on the floors all day long. Things like transporting patients from their room to x-ray and back.

Many of the interns have logged less than 20 cases so far this year, whereas interns in other programs have logged well over 100 cases so far.

To make things worse for them, their director of resident education has taken another job starting in January. No clue when it will be filled. They still have not filled the residency coordinator position in 5 months of vacancy.

you all know me, im an intern at rush. i love it here, its been a wonderful experience. im going to dispell some of the myths that people are spreading.

#1-we are not on probation. that is absolutely FALSE information.

regarding the scrubbing cases thing. i have right now about 38 cases (this includes central lines) but it also includes above/below knee amputations, port-a-caths, PEG tubes, open G tubes, some endoscopy, some first assisting, ive even scrubbed open hearts with the cv attendings. you get out of it what you put into it. and i havent even done the intern-heavy operating services yet. (the breast/thyroid/etc service) if you want to get into the OR, get your floor work done quickly and efficiently. if you cant work quickly then frankly you arent going to get to the OR. rush isnt a community program, and you cant expect to be logging 100s of cases your intern year. its not realistic. but you will log some.

dont believe everything you read.

 

[Winged Scapula]

regarding the scrubbing cases thing. i have right now about 38 cases (this includes central lines) but it also includes above/below knee amputations, port-a-caths, PEG tubes, open G tubes, some endoscopy, some first assisting, ive even scrubbed open hearts with the cv attendings.

Thank you for clarifying things "from the horse's mouth".

I do want to add that while from the junior resident stand-point the procedures you've listed above sound like "cases" - things like central lines, amputations, port-a-caths, first assisting, etc. do not count toward your case log totals as required by the ACS so while they are all good practice (and things you need to know how to do) I wouldn't get wrapped up in the "numbers" games because these types of cases will not count in the end (at least as far as the ACS figures).

You'll be suprised at the things you do which "don't count".

 

[SLUser11]

Thank you for clarifying things "from the horse's mouth".

I do want to add that while from the junior resident stand-point the procedures you've listed above sound like "cases" - things like central lines, amputations, port-a-caths, first assisting, etc. do not count toward your case log totals as required by the ACS so while they are all good practice (and things you need to know how to do) I wouldn't get wrapped up in the "numbers" games because these types of cases will not count in the end (at least as far as the ACS figures).

You'll be suprised at the things you do which "don't count".

What I sometimes wonder about is if some residents are logging cases as "surgeon junior" when they're really a first assistant. There is a great deal of subjectivity when it comes to determining whether you did a case or assisted on a case, especially during the first couple years of residency.

When you are at a program where either 1. the residents don't operate a whole lot/don't operate until late in their residency, or 2. a program is deficient in a certain area (liver/pancreas, pediatrics), are you then forced to take credit for cases that you don't really deserve?