So the Yale EM thread suddenly got deleted...

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
DrMom said:
The OP requested that the thread be deleted. Nothing sinister here.
Click to expand...

After he got threatened by co-residents and attendings, what a great place to work. Too bad future applicants won't be able to see it
 
I read through that whole thread, but must have missed the faculty post. what was the post mainly about? I gotta here this one haha
 
DoctorLacrosse said:
I read through that whole thread, but must have missed the faculty post. what was the post mainly about? I gotta here this one haha
Click to expand...

It was one attending mainly about refuting the OP's accusations. The bulk of his response was fine. But then he said the OP was acting cowardly for doing it anonymously through an anonymous internet site and challenged him to come to his office or the PD's office to complain about changes the program was making (I can't speak for Yale's program or what their response would be to publicly voicing concerns, but it would be perfectly accepted at my program and my proposals would be voted on by the faculty and residents at the end of the year). Calling the OP cowardly in his approach is not a statement I'd support, but an understandable defense mechanism if someone anonymously called you out online.

I also don't support calling the faculty member out for being defensive by facetiously implying that he's not a good academic physician for some comments made on an anonymous internet site. Otherwise, everyone on this site would have to be called out for comments they made at one point or another in some internet argument.
 
DrMom said:
The OP requested that the thread be deleted. Nothing sinister here.
Click to expand...

I don't care that much to be honest, so whatever answer is fine, but:

How can one person request that posts by others be deleted?

I can someone deleting their own post and then even requesting that "quoted" posts are deleted, but to request that other people's posts be deleted? Or an entire thread be deleted?

HH
 
Hamhock said:
I don't care that much to be honest, so whatever answer is fine, but:

How can one person request that posts by others be deleted?

I can someone deleting their own post and then even requesting that "quoted" posts are deleted, but to request that other people's posts be deleted? Or an entire thread be deleted?

HH
Click to expand...

This isn't something new. For example: donors can delete their own posts and if this is the first post of the thread the entire thread is deleted. It is done more than you realize.
 
Time and again, people type "mods, please delete", and it doesn't occur. People are told time and again "if you are a donor, you can delete threads". Average users can't.

I think that people asking for threads to be deleted, and it doesn't happen, to occur much more frequently. The whole thing seems to be more than a bit sketchy, and, for a rare instance, was a more realistic discussion than the usual "It's great here! You'll love it! You work hard, but play hard! Procedures are great! No scut!"

"Every meal a feast, every formation a parade, every paycheck a fortune!"

In fact, #13 from the Terms of Service: "Once you've posted on the site, it's there forever. We do not delete posts except in extreme cases. Even if we can remove a post that you regret posting, they are often permanently cataloged in sites like Google or the Internet Archive."

This was an extreme case? Really? Perhaps the extremity meter needs severe recalibration. Or is the administration in violation of the TOS in this case?
 
DrMom said:
The OP requested that the thread be deleted. Nothing sinister here.
Click to expand...

Apollyon said:
Time and again, people type "mods, please delete", and it doesn't occur. People are told time and again "if you are a donor, you can delete threads". Average users can't.

I think that people asking for threads to be deleted, and it doesn't happen, to occur much more frequently. The whole thing seems to be more than a bit sketchy, and, for a rare instance, was a more realistic discussion than the usual "It's great here! You'll love it! You work hard, but play hard! Procedures are great! No scut!"

"Every meal a feast, every formation a parade, every paycheck a fortune!"

In fact, #13 from the Terms of Service: "Once you’ve posted on the site, it’s there forever. We do not delete posts except in extreme cases. Even if we can remove a post that you regret posting, they are often permanently cataloged in sites like Google or the Internet Archive."

This was an extreme case? Really? Perhaps the extremity meter needs severe recalibration. Or is the administration in violation of the TOS in this case?
Click to expand...

👍
 
and by doing so, the value of residency reviews and anonymous posts has been diminished.

HH
 
So now you know everybody, if you say reveal the ugly truths about your program here, your entire thread may be deleted. It really is too bad.
 
Recopied from cached version on google (of note I have no affiliation with Yale)

It has been weighing on my conscience for the past several weeks that I have lied to many of your faces. I met you at our interview lunches and dinners and sang the praises of our program, glossing over all the major deficiencies of this residency. *I want to set the record straight here and give you my honest thoughts about the Yale EM program.*

The one word that sums this place up is, well, malignant. The faculty and the administration are not interested in resident development or in resident happiness whatsoever. Every year, I see residents who don't quite fit in to the Yale culture,*downright tortured by the faculty and by the administration. I've been fortunate not to be one of those residents. I have managed to "succeed" here by flying under the radar. But if you happen to be one of the "problem" residents in this place - and there are several every year, you won't succeed. When it comes time to find a job at the end of the program - if you even make it that far, well you will be completely on your own. Our chairman won't even know your name, so she won't be of much help. Our program director will write you a letter detailing every failing and every negative thing anyone has ever said about you. Sure - the one or two residents they like will get decent jobs, but everyone else? So much for the "Yale" name... I started out positive that I would be an academic ER doc,, but because I chose this program, that won't be possible for me. And chances are,*it won't be for you either if you come here.*

Our interim program director is a complete blowhard. He is one of those people who considers any opinion that differs from his to be categorically wrong. If you have an opposing viewpoint, he will try to hurt you in whatever way he can. He did it to the former program director. She took this program from the brink of ACGME probation and almost singlehandedly turned it into a top notch academic EM program. Well, it turns out that he didn't quite agree with her approach to certain curricular matters, so he plotted to have her removed from her position - and she is now treated like trash here. *She is a complete outcast among the faculty. She had her failings, but she she didn't deserve that. And if you think he will help YOU when it comes time to get a job? He won't stake his self-inflated reputation on you.*

As for the ED itself - half the attendings couldn't care less about resident education. To them, you are free labor. They get to sit on their behinds checking their email while you bust your ass taking care of patients. You might be drowning in charts, and they won't lift a finger to help you. Some of them might WANT to teach, but they haven't picked up an EM journal since they graduated from residency themselves, so the concept of evidence-based practice is completely lost on them. One thing you will be really good at when you graduate is calling consults. We do a lot of that here. Reduce a fracture? Most of us have never done that. We call ortho for that. Speaking of ortho - our entire orthopedics education here consists of sitting in an outpatient orthopedist's office for two weeks, watching him examine patients. We don't have any inpatient ortho education whatsoever.*

And another thing, if you are thinking about having a baby while you're here - forget it. They may talk the talk about how accommodating they will be regarding maternity/paternity leave, but they will make your life impossibly difficult if you try to take any of that time.

You may think that this is just the rant of a disgruntled resident. To be honest, I'm not that disgruntled. I will leave here very shortly with a decent job and some great friends, but it's been a constant struggle to stay off the radar. I've spent x number of years here feeling that anything I do that might call attention to myself could potentially make me a target of the administration. I cannot speak my mind, I cannot ask questions, and I CERTAINLY cannot try to change things for the better. Doing so might bring the ire of the administration and then my career would be in jeopardy. I definitely did feel this way before the program director changed, but I feel this way a thousand times more now.

So there it is. My honest take on the Yale EM program. Do with this information what you want. Use it to help guide your decision or don't. I just wanted to clear my conscience. *Good luck to you all in the match!
 
thread should have been locked, not deleted, imo, as nothing more useful or constructive was to be gained. I'm no mod tho..

To above person, if it was cached on your google, just use the account you used before to post it...it was already anonymous...
 
Last edited:
Why can't the cached version just go in the stickied review of Yale EM? If the TOS say that only under extreme circumstances can it be deleted, then the mods should uphold that. Otherwise, it's hypocrisy.
 
b-real said:
Why can't the cached version just go in the stickied review of Yale EM? If the TOS say that only under extreme circumstances can it be deleted, then the mods should uphold that. Otherwise, it's hypocrisy.
Click to expand...

Seriously? You've been on SDN for 10 years - are you just realizing this?

The next step is for mods - en masse - to gang up and say 1. their jobs are so hard 2. they're volunteer and unpaid and 3. you don't know what it is like!
 
Apollyon said:
Seriously? You've been on SDN for 10 years - are you just realizing this?

The next step is for mods - en masse - to gang up and say 1. their jobs are so hard 2. they're volunteer and unpaid and 3. you don't know what it is like!
Click to expand...

LOL, en masse, kinda like how those Yale residents jumped in to defend their program?
 
I stopped commenting on the other thread because it got too.... awkward.
However, having seen this before (more than once), I can tell you what is going to happen.

The person posting likely wasn't as anonymous as he thought. If he felt that way about the program, he had probably made it known to other residents/attendings before. Some probably shared those viewpoints. However, once word got out about the public posting he was basically stuck as it became an "us against them" problem. Somebody would have figured out who it was pretty quickly. Their classes aren't that big, and he even made mention of what year he was. When people commented on the posting by the attending, it suddenly because "us against the world." They don't need that kind of ink on Sugar Mountain (bonus points for who gets the movie quote). Thus, it was likely taken down because the OP desperately needed it down to save his career.

This isn't the only program that has had this kind of dissent amongst the ranks. Remember, it wasn't an individual person last year that complained, it was an entire class. However, only one of them posted the letter they wrote. Then, many others came up and basically shouted it down and that post got removed.

In the end, this may or may not hurt Yale in the match this year. But what it will do is divide the residents into two groups. One is the group that is "keep your head down and get the work done", which is a type of apathy. The other is the angry group that wants to change the status quo. That mentality will become evident in the future, and it will be obvious to candidates when they come interview. Either they won't get to see a sizeable group of the residents, or the questions will be answered very vaguely. They'll start to miss out on people who want to spend their residency not fighting with attendings.

I don't envy the next 4 months in New Haven. I'm sure staff meetings will be unpleasant experiences.


Also, I agree with Apollyon about the mods. They pretty much do whatever they want and then make excuses afterwards. I bet some pressure came from both sides at Yale since there were so many quotes that couldn't be edited by the OP.
 
Dr.McNinja said:
I stopped commenting on the other thread because it got too.... awkward.
However, having seen this before (more than once), I can tell you what is going to happen.

The person posting likely wasn't as anonymous as he thought. If he felt that way about the program, he had probably made it known to other residents/attendings before. Some probably shared those viewpoints. However, once word got out about the public posting he was basically stuck as it became an "us against them" problem. Somebody would have figured out who it was pretty quickly. Their classes aren't that big, and he even made mention of what year he was. When people commented on the posting by the attending, it suddenly because "us against the world." They don't need that kind of ink on Sugar Mountain (bonus points for who gets the movie quote). Thus, it was likely taken down because the OP desperately needed it down to save his career.

This isn't the only program that has had this kind of dissent amongst the ranks. Remember, it wasn't an individual person last year that complained, it was an entire class. However, only one of them posted the letter they wrote. Then, many others came up and basically shouted it down and that post got removed.

In the end, this may or may not hurt Yale in the match this year. But what it will do is divide the residents into two groups. One is the group that is "keep your head down and get the work done", which is a type of apathy. The other is the angry group that wants to change the status quo. That mentality will become evident in the future, and it will be obvious to candidates when they come interview. Either they won't get to see a sizeable group of the residents, or the questions will be answered very vaguely. They'll start to miss out on people who want to spend their residency not fighting with attendings.

I don't envy the next 4 months in New Haven. I'm sure staff meetings will be unpleasant experiences.


Also, I agree with Apollyon about the mods. They pretty much do whatever they want and then make excuses afterwards. I bet some pressure came from both sides at Yale since there were so many quotes that couldn't be edited by the OP.
Click to expand...

I don't normally post much on SDN, but I wanted to give props to a very insightful post. Thanks.
 
Dr.McNinja said:
I stopped commenting on the other thread because it got too.... awkward.
However, having seen this before (more than once), I can tell you what is going to happen.

The person posting likely wasn't as anonymous as he thought. If he felt that way about the program, he had probably made it known to other residents/attendings before. Some probably shared those viewpoints. However, once word got out about the public posting he was basically stuck as it became an "us against them" problem. Somebody would have figured out who it was pretty quickly. Their classes aren't that big, and he even made mention of what year he was. When people commented on the posting by the attending, it suddenly because "us against the world." They don't need that kind of ink on Sugar Mountain (bonus points for who gets the movie quote). Thus, it was likely taken down because the OP desperately needed it down to save his career.

This isn't the only program that has had this kind of dissent amongst the ranks. Remember, it wasn't an individual person last year that complained, it was an entire class. However, only one of them posted the letter they wrote. Then, many others came up and basically shouted it down and that post got removed.

In the end, this may or may not hurt Yale in the match this year. But what it will do is divide the residents into two groups. One is the group that is "keep your head down and get the work done", which is a type of apathy. The other is the angry group that wants to change the status quo. That mentality will become evident in the future, and it will be obvious to candidates when they come interview. Either they won't get to see a sizeable group of the residents, or the questions will be answered very vaguely. They'll start to miss out on people who want to spend their residency not fighting with attendings.

I don't envy the next 4 months in New Haven. I'm sure staff meetings will be unpleasant experiences.


Also, I agree with Apollyon about the mods. They pretty much do whatever they want and then make excuses afterwards. I bet some pressure came from both sides at Yale since there were so many quotes that couldn't be edited by the OP.
Click to expand...

It's a good thing someone reposted the thread from google cache then. :laugh:
 
Dr.McNinja said:
I stopped commenting on the other thread because it got too.... awkward.
However, having seen this before (more than once), I can tell you what is going to happen.

The person posting likely wasn't as anonymous as he thought. If he felt that way about the program, he had probably made it known to other residents/attendings before. Some probably shared those viewpoints. However, once word got out about the public posting he was basically stuck as it became an "us against them" problem. Somebody would have figured out who it was pretty quickly. Their classes aren't that big, and he even made mention of what year he was. When people commented on the posting by the attending, it suddenly because "us against the world." They don't need that kind of ink on Sugar Mountain (bonus points for who gets the movie quote). Thus, it was likely taken down because the OP desperately needed it down to save his career.

This isn't the only program that has had this kind of dissent amongst the ranks. Remember, it wasn't an individual person last year that complained, it was an entire class. However, only one of them posted the letter they wrote. Then, many others came up and basically shouted it down and that post got removed.

In the end, this may or may not hurt Yale in the match this year. But what it will do is divide the residents into two groups. One is the group that is "keep your head down and get the work done", which is a type of apathy. The other is the angry group that wants to change the status quo. That mentality will become evident in the future, and it will be obvious to candidates when they come interview. Either they won't get to see a sizeable group of the residents, or the questions will be answered very vaguely. They'll start to miss out on people who want to spend their residency not fighting with attendings.

I don't envy the next 4 months in New Haven. I'm sure staff meetings will be unpleasant experiences.


Also, I agree with Apollyon about the mods. They pretty much do whatever they want and then make excuses afterwards. I bet some pressure came from both sides at Yale since there were so many quotes that couldn't be edited by the OP.
Click to expand...

Which program are you referring to with the letter from the entire class?
 
medstudentmed said:
Which program are you referring to with the letter from the entire class?
Click to expand...

The Yale class opened a dialogue of improvement with the faculty a couple years back by writing them a letter as a group identifying areas they thought could use improvement in their program. Someone posted a copy of that private letter on sdn. This was against the wishes of the letter writers and taken down.
 
Rendar5 said:
The Yale class opened a dialogue of improvement with the faculty a couple years back by writing them a letter as a group identifying areas they thought could use improvement in their program. Someone posted a copy of that private letter on sdn. This was against the wishes of the letter writers and taken down.
Click to expand...

You see, that's the problem. If they had complaints, they should be known to everyone. That's how people choose where to go and not go. And the complaints were not ticky tack problems either. The entire class had a big problem with how things were going down. The fact that they didn't want them publicly known lends more evidence to "residents not having any power" than "they didn't want to seem picky." They were more worried about being crushed by the residency than they were about being perceived as "weak" by the outside observer.

I'm sure one could find that document again if one tried hard enough. I would bet many people downloaded it and saved it. Especially residents having problems at their own residencies. It was well written and had thoughtful suggestions, not lame "fix this or we'll revolt" type stuff.
 
Dr.McNinja said:
You see, that's the problem. If they had complaints, they should be known to everyone. That's how people choose where to go and not go. And the complaints were not ticky tack problems either. The entire class had a big problem with how things were going down. The fact that they didn't want them publicly known lends more evidence to "residents not having any power" than "they didn't want to seem picky." They were more worried about being crushed by the residency than they were about being perceived as "weak" by the outside observer.

I'm sure one could find that document again if one tried hard enough. I would bet many people downloaded it and saved it. Especially residents having problems at their own residencies. It was well written and had thoughtful suggestions, not lame "fix this or we'll revolt" type stuff.
Click to expand...

I don't quite share that opinion, though I am more of a passive, private person. I figured they just wanted to improv their program internally, not gripe about it on the internet. Though the letter was deleted before I saw it that time it was posted. I guess I may be lucky to be at a program that already has an open dialogue between us and our administrators.
 
Personally I am really bothered by the fact that people seem to accept the notion that Yale residency would act in retaliation and vengeance against the residents that spoke out, as if that is okay. It is WRONG that anyone should worry about the careers of the residents that shared their opinions, even if anonymously on a public forum and even if the opinions are not shared by others in the same program. Not to be cheesy but as physicians we should be held at a higher standard and physicians in power cannot be expected to act like street thugs that will kick anyone's ass to protect their street cred, especially at an institution as reputable as Yale. I would have expected the residents and the faculty members of Yale to be more insulted by people suggesting that the career and the well-being of the OP would be in Jeopardy. I wanted them to speak out just as strongly as they had, "what kind of third rate insitution do you think we are? expecting us to act in vengeance against one of our own with different opinions? we want ALL of our residents to do well even if ones that don't agree with us" but sadly that hasn't been the case.
 
Reposted Yale faculty response to the original thread from google cache -

Those of you who are tuned into this blog will be aware of a similar post that was remarkably similar about a year ago: "I am bound by my high sense of honor to let you know about the Yale program…"

I am not sure who put this post up. However, I feel compelled, particularly for potential applicants, to make sure that this is viewed for what it is, an anonymous posting on the internet. I can only trust that the millennial generation will be discerning enough to understand this, and to do their homework when choosing the program that will likely make the most difference in their ultimate career outcome.

This post is purposefully timed as applicants make up the match list to negatively impact the residency.

If I had to guess, I would surmise this is a Yale senior resident who has a personal vendetta against the residency director, likely due to a personality conflict coupled with a recent change that reduced elective time from six months to five, with a requirement that elective time above this level be both 1) justified educationally and 2) earned through compliance with norms of the residency, something they were probably not able to do. I would guess that this person came to this residency assuming they would have the right to spend six months doing "whatever" and getting paid by Medicare. With due respect to many residents who never took advantage of this, it was in fact part of the culture when I joined the faculty here about 10 years ago. May not appeal to someone such as this, but tightening this up is the right thing in a program that is continuing to improve.

I am personally not always the most soft and fuzzy attending, but those who know me know I care deeply about this program -- have spent my career here building the point-of-care ultrasound infrastructure -- educational, clinical, and research. I wouldn't have done this unless I wanted to, and in general I have found it very rewarding. However it has come at a sacrifice -- financially and in terms of time with my family. And as my career has moved more to research I am less involved with the clinical and day to day teaching -- I may have been guilty of checking my email during a slow part of a shift -- but it was to respond to a mentee about a project, now being in a place to actually mentor students and residents regarding real research. I know the interim program director also may not be the most soft and fuzzy, but those of you who have not stood in his shoes cannot come close to understanding how hard he has worked to move this program in the right direction.

And in July the new program director will come in, who was (without prompting) described to me by a source I trust as "the best boss I ever had".

Yale is not for everyone -- if you want to finish quickly and go straight to a community job this may not be your place. However, academically and clinically I would put us up against any program in the country -- I wouldn't have done this ten years ago -- but I continue to see improvement each year.

-High acuity, high volume -- new ED coming online, in process of acquiring other hospital in town
-Great mix of attending in terms of experience and interests
-Top notch POC ultrasound! (SIX Philips Ultrasound Sparq machines recently purchased for delivery later this month)
-Leading EMS program (chief is editor of AEM)
-Premiere Global Health Fellowship (affiliation with London STMH)
-Investigator initiated funding by faculty at or near the top of EM programs nationally -- provides opportunity for experienced mentorship for those interested in a research career
-Ongoing collaborations and opportunities throughout Yale
-Many other things I am leaving out.

And, for the most part, great residents who work hard and are better each year. No program is perfect and there are many things that could continue to be improved, but anyone who has been part of any residency (or any family) understands that.

I invite the coward who posted this to sign his or her name, and/or to come see me in my office. The senior faculty are accessible, and are interested in helping residents and the program. I went out of my way yesterday to help get a late interview for a senior resident in a fellowship he was interested in a particular part of the country.

If applicants or others would like to discuss the Yale program past, present, future with someone who is interested and involved, but not the program director, please feel free to contact me. I also know there are also many residents at different levels here who would be willing to honestly discuss their experiences here, for better or worse.

While no doubt me putting a post up here may be spun as self serving and damage control, believe me when I say the biggest harm here (if it keeps quality applicants away from what would be a good fit for them) will be to the current first- and second- year residents; and noone is being helped.

Sincerely,

Chris Moore MD
Associate Professor
Department of Emergency Medicine
Yale University School of Medicine

[email protected]
203-687-6776
 
nycqqe said:
Personally I am really bothered by the fact that people seem to accept the notion that Yale residency would act in retaliation and vengeance against the residents that spoke out, as if that is okay. It is WRONG that anyone should worry about the careers of the residents that shared their opinions, even if anonymously on a public forum and even if the opinions are not shared by others in the same program. Not to be cheesy but as physicians we should be held at a higher standard and physicians in power cannot be expected to act like street thugs that will kick anyone's ass to protect their street cred, especially at an institution as reputable as Yale. I would have expected the residents and the faculty members of Yale to be more insulted by people suggesting that the career and the well-being of the OP would be in Jeopardy. I wanted them to speak out just as strongly as they had, "what kind of third rate insitution do you think we are? expecting us to act in vengeance against one of our own with different opinions? we want ALL of our residents to do well even if ones that don't agree with us" but sadly that hasn't been the case.
Click to expand...

This is one of the most idealistic/naive posts I've seen in this forum. There are very few professions where you can badmouth your company in public and not expect to be summarily terminated. Freedom of speech applies to public life, not your workplace. If you had freedom of speech in corporate life, then there would be no need for whistle-blower laws. Letting your bosses know you hate them and wanting to stay employed by those bosses are diametrically opposed. It works if your bosses' boss likes you more than he does your boss, but that's almost never the case in residency.

The OP took a risk (hopefully having weighed the possible consequences) to write that post, knowing it would hurt their program. Either the OP figured they could stay anonymous (ie they're actually an intern or something) or felt so strongly about warning potential applicants that it was worth getting fired. To pretend that risk shouldn't exist shows a blindness to reality that is disturbing in someone who's going to have to deal with sub-optimal conditions their entire career (especially if it's in EM).
 
Arcan57 said:
This is one of the most idealistic/naive posts I've seen in this forum. There are very few professions where you can badmouth your company in public and not expect to be summarily terminated. Freedom of speech applies to public life, not your workplace. If you had freedom of speech in corporate life, then there would be no need for whistle-blower laws. Letting your bosses know you hate them and wanting to stay employed by those bosses are diametrically opposed. It works if your bosses' boss likes you more than he does your boss, but that's almost never the case in residency.
Click to expand...

Check and mate. You only pull stupid **** like this after you're gone. And even then it isn't a good idea.
 
Dr.McNinja said:
Check and mate. You only pull stupid **** like this after you're gone. And even then it isn't a good idea.
Click to expand...

Especially considering the person identified themselves as a 3rd year and talks about having a baby...that narrows it down to less than 5 people according to Yale's website...shouldn't be difficult to guess who the poster is...for people at the program.
 
Dr.McNinja said:
Check and mate. You only pull stupid **** like this after you're gone. And even then it isn't a good idea.
Click to expand...

Agreed... worst idea ever. Like I said in that original thread. Either the poster was a troll or had balls.

Apparently, as it turned out, the OP was not a troll... and had the latter.
 
link2swim06 said:
Especially considering the person identified themselves as a 3rd year and talks about having a baby...that narrows it down to less than 5 people according to Yale's website...shouldn't be difficult to guess who the poster is...for people at the program.
Click to expand...

Going to be a rough four months while they sweat those people. They probably already figured out who it was already.
 
Apollyon said:
And therein lies the rub; for all the bluster, ironically, the reputation for malignancy is reinforced, again.

Sometimes ya can't win fer losin'...
Click to expand...

Wonder if next year, come match time, an internal memo goes out to the rez NOT to post on SDN and keep gripes internal.

There are enough of these Yale bashing posts that almost anyone could post one every year, without actually been a resident there. Tradition-like. Heh.

So nice to have gone to a little known program.
 
I would like to go on record and try to argue that I'm not being duplicitous. I think the dialogue is very important. I simply think the manner in which this individual did it is poor. However, I'm sure this came about because of the (real or perceived) lack of change made after the letter was posted last year. Remember, someone that had a copy of that letter had to post it. The only people with that letter where those residents and the faculty. I doubt someone culled it off the desktop of a workstation down in the ED. So at the very least, one person is getting very frustrated, and at the time an entire class was frustrated with the decrease in interest in their education, and an increase in their workload without any help from the people "in charge."
I'm sure at some point the EM RRC will come up with something similar to "caps" for EM residents, as they can be beneficial if the time is spent learning. This isn't the only residency that has had a volume problem, and simply telling people to "see more patients" isn't going to work. I don't think 16 active patients on the "sick" side of an ED is appropriate for a early second year resident. On the other hand, I don't pretend to know what is an appropriate number either, because everyone has their own pace. Going home and charting for 4 hours because you don't (or can't) chart during your shift (during residency) is not helpful. In the real world, I would argue that you should only do it if a mass casualty event is happening, or you're working RVUs and choose to see extra patients for extra money at the expense of working late.
Remember, in residency we should be learning from the people there supervising us. Not all education is read. The most frustrating attendings in residency are the ones that don't give rationale for what they're doing, but don't let you do something you want to do. I can go be a scribe somewhere else. I'm working here because I'm here to be taught, not to do just what you want to do.
 
I'm a pathologist. This is one of the more compelling threads I have read. Doubt it would ever occur in path because our residencies are so small that there is no anonymity. Can only imagine how a potential applicant would be interpreting this all.
 
mlw03 said:
I'm a pathologist. This is one of the more compelling threads I have read. Doubt it would ever occur in path because our residencies are so small that there is no anonymity. Can only imagine how a potential applicant would be interpreting this all.
Click to expand...

Am I mistaken, or weren't you a mod here on SDN in the past? I ask because, if you were, you would have more stories of "nothing sinister here". As is said, a likely story...
 
Apollyon said:
Am I mistaken, or weren't you a mod here on SDN in the past? I ask because, if you were, you would have more stories of "nothing sinister here". As is said, a likely story...
Click to expand...

Nope, never been a moderator on SDN. Just a long-time user since my pre-med days.
 
Your post was eloquent and thorough, however you miss one point. People come to this forum to give and to receive advice and opinions. People want honest opinions. So if someone is trying to determine if program X is the right program for them, they may solicit opinions or search for them on this site. Its nonsensical to say that residents should only say positive things or nothing at all, if they have negative opinions. Its called being honest, and people here appreciate it. Its not trashing a program. Its stating an honest opinion for the benefit of others who are now in the position to decide on a program.

Yes, there are risks to posting online. And one should consider them. However, the "shut up and deal" kind of mentality you're promoting is ridiculous.


Birdstrike said:
(Disclaimer: This post applies to no specific person, program, specialty or anything or anyone whatsoever. I know no one connected to the program in question. Any similarities to any real person, place or institution anywhere, is purely coincidental. I speak purely of generalities.)


Have A Poker Face (and learn how to play the game)​


Yes, in medical training they have you in a vice. The culture of medical training can really suck at times. They can treat you like crap and your future depends on them. It's not a free market. The system is closed. If you're unhappy, you can't apply for a new residency 3 months later, and again 6 months after that until you find the perfect fit for you, like in other industries. It shouldn't be that way. But it is, so you've go to learn how to play the game. There's a certain amount of "suck-it-up-ness" that you have to have. Part of that means keeping your mouth shut. Some of it is "rookie hazing" and some of it is a "test" of your mettle. You will be rewarded for having a poker face when confronted with this BS. Loose lips, sink ships.

So much of life is playing the hand you're dealt, even if your cards aren't as good as you'd hoped. You may have matched at a place with bipolar egomaniacs for attendings. That sucks. However, here's the rub: If you're entire future, earning potential, career, medical degree and the reputation of your residency certificate rides on bipolar egomaniacs who've set up the worst program the country, you still don't trash your program in public, be it on the hospital overhead speakers or on a public internet forum like SDN. What you do is you stroke bipolar-egomaniac ego, as painful as it is. You want these guys giving you high fives, not plotting your destruction.

When it's all said and done, your salary will be 4-6 or more times what it is as a resident and your attendings helped make it happen. Even if you think they're total jerks, and you think they could have made it much easier for you, they will have helped make this happen.

If you really want to place constructive criticism and make your program better, vent to the president of Graduate Medical Education. It's their job to listen to this stuff. Or, if you want to write an anonymous letter to ACGME 6 months after you've graduated, so that you can help improve the program for the next generation of coming trainees, fine. But no one really ever does this, because by the time you're done, you realize how petty and meaningless all this stuff was. Trashing your program online, using specific people, by name (or names that can easily be looked up online) - that's a no no.

1. There's no such thing as an "Anonymous Internet Forum". Anytime you make a post online you should ask yourself this question, "Can I live with myself if tomorrow the whole world knows it was me that made this post?" If you can't answer yes, don't post it. Internet posts are admissible in court. All internet posts are traceable if necessary. Getting slapped with a slander lawsuit, is not fun.

2. Trashing your program makes your program, look bad. Yes, your program. Do you want to graduate from a program known as dysfunctional, or a program that loses its accreditation? No. There's hundreds of subtle ways you can let applicants know you're unhappy, without saying those words, and without launching a salvo online.

3. Trashing your program doesn't make it better. It makes it worse, by lessening the caliber of applicants it can pull and by lessening the caliber of academic attendings it can attract.

4. Unfortunately, if a residency class is too proactive, pointing out very real flaws in a program that rightfully do need to be changed, they may do so at their own expense. They may enhance the program for future classes, yet risk harming their own education and risk being seen as a group of whiners. You shouldn't have to think this way, but unfortunately in certain malignant environments, you do. "Sucking it up", as painful as that can be with certain personalities, often can turn the tables so that those most malignant can become your best allies. At the end of your last year, do you want hustle taps, or knives in the back?

5. What comes around, goes around. Medical specialties are small. You may see the same people at meetings over the years. You may interview at jobs where people know people you've known. Don't burn bridges. Ever. Even if you're certain you can swim through alligator infested waters.

6. If you want to talk about your attendings over a six pack with close friends, do it. Say anything you want. It'll probably be good for you. Just don't do it online, on Facebook or otherwise in public.


Have a poker face.


Play the game.


.


.


.
Click to expand...
 
despite the spelling/diction errors, Birstrike is right on 😉 took me a while to learn some of his lessons, but they are very true, especially #'s 3 and 5.

boogabear - that's what private messages are for... if one feels comfortable doing that. airing the dirty laundry in a public forum is a bad, bad idea. if one feels absolutely compelled to bring something up, they do so at their own risk.
 
You must log in or register to reply here.

Similar threads

CajunMedic
And so the expansion continues...
Replies
14
Views
2K
xaelia
xaelia
B
EM Alliance
Replies
1
Views
975
RustedFox
RustedFox
RustedFox
CHOO-CHOOOO! ALL ABOARD THE AUTISM EXPRESS. TRAIN THREAD.
Replies
22
Views
1K
xaelia
xaelia
E
Houston EM forum
Replies
3
Views
1K
HemeOncHopeful19
H
Boatswain2PA
Best EM podcasts?
2
Replies
64
Views
4K
Janders
J
Top