I used to work at SLU and left because, well frankly, the ship was sinking, there were too many holes in the ship, and there were too many people in the university that weren't allowing the holes to be plugged in.
The turn-over rate for an average psychiatrist there was about 2 years (or at least that's what several people in the department were saying). This is well worse than the industry-standard.
I had nothing going for me. The pay was terrible. Many universities will at least give an outstanding retirement package such as 25 years you get half your salary the rest of your life, but SLU didn't. So the pay was terrible and it didn't include the incredible retirement package at many institutions. I was bringing in a large amount of money, over twice what some other doctors were bringing in, but they wouldn't pay me anymore than the standard salary, and this was despite that I was working more, triple boarded (although one of those board certifications IMHO is BS, but still that's 2 certifications), and I was rated within the top 1% of teaching doctors in the institution.
There were a whole slew (no pun intended) of problems within the institution that weren't being fixed. With a few exceptions I didn't feel I was in a good environment. Security took 30 minutes to show up to the unit if patients became violent. Nurses would go into a room, lock the door, while the patients punched each other.
While I love teaching even that didn't keep me going. A big morale killer for me was several residents, at least while I was there, were pretty much saying they came to SLU to get their green cards, they really wanted to be a (insert Internal medicine, anesthesiologist, surgeon, etc) but no other program took them, and not because they loved psychiatry. When I asked several residents to do a research project with me all of them turned it down with inappropriate responses. E.g. "I'm not a scientist why do I want to do research?" Me-"Cause as a physician you are a scientist or at the very least used a science-based field to practice." Some barely spoke English to a degree where it was not acceptable but if I brought it up I was given dirty looks as if I was anti-immigrant.
Another huge morale killer was one meeting we were told of a physician who was offered a position, turned it down and took an almost identical position at Washington U for $50K less per year. I was like WTF? Guy's willing to make that much less money and still not join?
I attempted to fix some of those problems and my immediate superior would block me on every move. When I brought it to the chair of the department he agreed with me, and allowed me to move forward and even expressed shock at the problem (e.g. security taking 30 minutes to show up to the inpatient unit). The problem being that I could tell the chair was going to get sick of this place months to years down the road, and that immediate superior was planning on staying there long-term and would always outrank me and cut me off. I had no theory that could fit why this guy would do these things other than that he wanted the department to do poorly hoping it'd make the chair want to leave sooner so he could get up the ladder faster.
The final nail in the coffin was when the chair allowed me to implement my idea to fix the security issue (security would have ID cards that opened the doors instead of their ring of over 50 keys and not know which one worked, also the time response would be reported to security) the same idea my immediate superior kept blocking, the same bozo then wrote a department-wide e-mail saying how it was his idea all along and that he implemented it. Literally that's when I said to myself "eff this place."
This occurred about 7 years ago, so those issues I'm sure aren't the same issues now, but I can tell you several of the same problems that prevented the institution from improving are likely still there because they were institution-wide and not just the department.
After I left Washington U offered me a job, and I considered it, but I had enough colleagues who were Washington U graduates talk me out of it.
