"Sketchy" Programs

[mm78]

Which programs have sketchy characteristics? Includes:
People "leaving" after 1 year
People spending more time in residency
Graduates state more than just a few attendings are not so nice
You name it except something like not enough hearts or heads

I'm sure to get heat for this one, or just maybe some honesty. I feel this will be helpful for ALL applicants. It's important for us students. I'm willing to take your private messages and just post them as anonymous.

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[mm78]

After 300+ views, nobody wants to spill any beans about their program. What can I say?

 

[coprolalia]

There's no such thing as a perfect program, and at least one person will be unhappy wherever you go. That's life.

What should be important to you is:

1) Board pass rate.
2) Whether or not program is on probation (or got less than a four-year approval during the last RRC review).
3) If there is high faculty turn-over.
4) Case load and whether or not you have to go "off site" to meet your case requirements (which can be a real pain in the ass).
5) The physical environment you will be training in (e.g., is the equipment up to par, is the hospital dirty, are the call rooms dirty, does the staff seem warm and embracing or hostile, is the patient population one you'll like to interact with, etc.).

These things may seem minor, especially the last one, but you're going to be spending 3 or 4 years in that place. It's much nicer to be in a "facilitative" instead of "fend for yourself" environment. You need to be asking these things on the interview, and trusting your Spidey sense when something ain't addin' up...

-copro

 

[HoyaBlue02]

What about programs that are looking for a new department chair? I worry that a new chair might "clean house" or change the feel of the program. True?

 

[guitarguy]

Depends. No straightforward answer to this question. I would avoid programs where the chair has been pushed out due to political problems or scandal. Is the chair leaving the department? If so, is he taking his research program and ‘groupies’ to another institution? If so, there could be a large void in the program during the adjustment period. Or is the chair simply stepping down, but remaining on faculty – in that case, it would be unlikely that major drastic changes occur. How long has this person been chair? If he’s only been the chair for a short period of time, and he’s already stepping down or leaving, that could spell trouble. On the other hand, if he’s stepping down willingly after a long ‘reign’, it could be very good for the program to have fresh and new ideas from the top. Is the chair who is leaving the main talent in the department, or are there many other faculty who hold their own name as well?
Bottom line: depending on the circumstances, a new chair could be a really good thing or a really bad thing. As an applicant, you’re probably not fully aware of the answers to the above questions, but try to get those answers through your correspondence with residents at that program.

 

[Colba55o]

5) The physical environment you will be training in (e.g., is the equipment up to par, is the hospital dirty, are the call rooms dirty, does the staff seem warm and embracing or hostile, is the patient population one you'll like to interact with, etc.).

These things may seem minor, especially the last one, but you're going to be spending 3 or 4 years in that place. It's much nicer to be in a "facilitative" instead of "fend for yourself" environment. You need to be asking these things on the interview, and trusting your Spidey sense when something ain't addin' up...

-copro

Suprised at how trivial this last point has been to fellow applicants. On several interviews when the tour leader has asked us if we want to see places like the ORs or the cafeteria most of the group is disinterested. At one place we didnt even go to the ICU because the overwhelming sentiment was that it was unnecessary and lunch was waiting.

Fact is we ARE going to be spending a lot of time in the ORs. They're not all alike as people say. Differences include equipment, space, attitudes of the OR staff. Do the nurses and techs at least try to feign a smile when they see yet another group of applicants, or do they shout "excuse me" because you are standing in their way? And yeah bunny suits are a biaatch but get over it.

One program I saw that touted its hours of didactics per day, had a small cramped underlit conference room that was not conducive to learning, especially at 3PM every day.

Maybe I'm overanalytical but these little details matter and will play a role in how miserable the next 4 years will be

 

[fakin' the funk]

Suprised at how trivial this last point has been to fellow applicants. On several interviews when the tour leader has asked us if we want to see places like the ORs or the cafeteria most of the group is disinterested. At one place we didnt even go to the ICU because the overwhelming sentiment was that it was unnecessary and lunch was waiting.

Fact is we ARE going to be spending a lot of time in the ORs. They're not all alike as people say. Differences include equipment, space, attitudes of the OR staff. Do the nurses and techs at least try to feign a smile when they see yet another group of applicants, or do they shout "excuse me" because you are standing in their way? And yeah bunny suits are a biaatch but get over it.

It's true that those little details absolutely matter for the next 3-4 years - but personally my decision-making process is more long-term than that. I'm one of those people who believes OR tours and questions about the details of the call schedule are useless since (to me) those things on their own aren't gonna make you go to a place or not. Long-term things, e.g. location and placement of grads, quality of clinical training including volume and acuity, attending style and teaching, fellowships, alumni network, are what I'm looking for. My $0.02.

 

[2ndyear]

What about programs that are looking for a new department chair? I worry that a new chair might "clean house" or change the feel of the program. True?

If you look in the back of Anesthesiology, you will find that many many departments are looking for chairs. And plenty are very well known places that are frequently in the top picks of very competitive applicants. Solid places don't close or anything due to change in chairs. Things happen, people retire, move to other places, etc. I wouldn't read too much into this one.

 

[amyl]

i will second the whole importance of the day to day environment, stupid little things can make you hate life everyday. i loved my program anyway but the skyway was a great fringe benefit...walking several blocks super early every morning and late at night in the snow would have really pissed me off.
i matched at my program while there was an interim chair....the chair or lack thereof was pretty low on my list of things important to me...might be more of a concern elsewhere at a different kind of program. new chairs are good i think.... motivated to make some changes, etc. our new chair has listened to residents and made a few suggested changes... but change is a process. in general, probably not too much will change.

 

[coprolalia]

If I could (and I can), I'd like to add just one more thing...

Never underestimate the power of resident solidarity. This is an important thing. You will be doing the bulk of the work in your department. If you have good camraderie and can stick together, you have a lot more power than you realize. But, solidarity is key. If you're not getting that vibe from whichever program you're looking at highly, I'd stay away.

-copro