residency programs with good supervision

[waxedapathetic]

i will be matching to general surgery next year and wanted to know from others which programs offer a good amount of resident supervision.

at my program where i am a student, i feel like residents have too much responsibility that is beyond their skill level. interns are left on call alone in the SICU and interns run the general surgery outpatient clinic at our busiest hospital. (upper level residents are also in the hospital, but it is the expectation that they won't be called unless crap really hits the fan.)

i love taking responsibility and working hard. and i know it is important to get out of your comfort zone. my only concern is that in these situations, the patient care suffers and residents never learn to do things the RIGHT way. perhaps this is just the nature of the beast. plus, our chiefs seem to know their stuff well.

1) if you know residency programs that have a good balance of responsibility and supervision, please let me know.

2) if you have thoughts on this as a topic, in general, please enlighten me.

thanks everyone.

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[waxedapathetic]

if my examples dont illustrate a lack of supervision, let me say that it is the opinion of residents in all of the surgical specialities that their is very little supervision in our program.

 

[filter07]

Usually programs in a county setting tend to have less supervision, and private hospitals have more supervision. Academic centers have a mix of both, but all of surgery is trending towards more supervision.

 

[njbmd]

i will be matching to general surgery next year and wanted to know from others which programs offer a good amount of resident supervision.

at my program where i am a student, i feel like residents have too much responsibility that is beyond their skill level. interns are left on call alone in the SICU and interns run the general surgery outpatient clinic at our busiest hospital. (upper level residents are also in the hospital, but it is the expectation that they won't be called unless crap really hits the fan.)

i love taking responsibility and working hard. and i know it is important to get out of your comfort zone. my only concern is that in these situations, the patient care suffers and residents never learn to do things the RIGHT way. perhaps this is just the nature of the beast. plus, our chiefs seem to know their stuff well.

1) if you know residency programs that have a good balance of responsibility and supervision, please let me know.

2) if you have thoughts on this as a topic, in general, please enlighten me.

thanks everyone.

One of the things that comes with increasing experience (as you go through the years in residency) is a strong knowledge of your limitations. Few of us (resident or attending) are willing to put patient safety ahead of independence. What looks like non-supervision to you as a medical student may not be the case at all. For example, after putting in my 5th chest tube, I didn't need a more senior resident/attending to supervise me inserting a chest tube.

If I ran into a problem (on anything) that I couldn't solve safely, I could consult by phone if necessary. If I knew that there was a situation that was beyond my experience, I asked for help. My best chief resident/attending always said, "Call me when you need me but need me when you call me". That turned out to be the case most of the time in my experience. Even today, as a newer attending, I frequently ask a more senior surgeon for advice and assistance. Again, I am always aware of my limitations.