St. Peter's University Hospital/Drexel College of Medicine, New Brunswick, NJ??

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Omar Mukhtiar

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Hi

I am an FMG with good scores, both parts high 90s. Interviewed i 6 programs one of which was SPUH at New Brunswick, NJ. Got a good response but found the residents quaint & subdued. I didnt get a feeling of enthusiasm or cameraderie.

Then I cam across this from one of the older posts discussing "malignant programs" :


Extremely malignant program.
A sadist PD with an extremely bad attitude towards residents. Sarcasm galore in morning reports where residents are verbally abused & told things like " you may end up getting a divorce but you will learn medicine"-PD.

The faculty is mostly recruited from ex-residents either from SPUH or from UMDNJ-RWJ whose part this program has been in the past. They will not speak up aginst the PD or his malpracticies.

Several residents have either left or have been asked to leave for trivial issues or for trumped up charges because they spoke up against the PD or some of the ex-Chief Residents.

Several faculty have left since this program's inception because the PD's arrogant & boorish behaviour.

The program secretary is in cahoots with the higher up & acts extremely snobbish.

The assistant-PD has not personality of her own & tows the PDs line. She has her eyes set on his chair when he quits.

The program tends to make tall claims, but has achieved little since starting. No fellowships have started yet despite the PD having promised to start them in 2005. You will be told how they are getting a Pulm or Sleep fellowship with JFK soon or a GI fellowship with UMDNJ-RWJ (who will not recruit an FMG to their program).

The PD has practised racism against FMG (surprising as he is an FMG himself). There are ACP articles about him when he was a PD in UMDNJ-RWJ, about how he worked to make that program IMG free. Now that he is running a community program, he recruits the FMGs and then makes them work in his sweatshop, taking verbal liberties with them when addressing them. So do a lot of the faculty, the program coordinator & the senior nursing staff.

He has fired numerous FMGs & at least 1 AMG (who left medicine altogether). Most of them went on to other University programs & are now in fellowships. Surprising, since his program have produced fellows that one could count on less than 3 fingers.

There is no support to a person's fellowship application & the PD REFUSES to write LORs if the resident is not in his good books (brown-noses him or his cronies).

He is said to have gone after some residents who left his program in a slanderous way & tried to report them to state boards or their new PDs, ABIM & ECFMG, usually to no effect.

Be careful if you intend to step into this minefield.
Here is a sample of the PD's email showing how malicious the inside workings of the program are. This was in response to an ANONYMOUS email sent to the PD by a serving resident of the program:


From: Resident SPUH [mailto:xxxxxxx]
Sent: Monday, April 02, 2007 1:44 PM
To: xxxxxxxxxx
Subject: Confidential: Resident issues that are never discussed



Dear Dr.ccccc

You are a man whom I consider to be my mentor and father-figure, I have deep
respect for you and that is the reason I am sending you this email. I know
that you will do all you can in your power to help us residents. Our program
has all the elements to become the very best however, there are still many
issues that scar our residency. You always say that "this is your program"
then why is it that every single resident is unhappy.



Problem 1: The unhappiness has nothing to do with work and work hours,
everyone works very hard everyday to provide the best patient care. We work
everyday with fervor and enthusiasm but there is no appreciation for our
work. We only get the raw end of the stick. A single mistake on part of a
resident mars all the work he/she has ever done. Every order we write, there
is a fear that it might be on the projector and we will face public
humiliation. The fear that we are constantly being watched and scrutinized
adds immense stress and fear.



Problem 2: Everyday only the simplest and least complicated cases are
presented in morning report, we never get to engage in a discussion of
interesting or complicated cases because of fear of sitting in the "hot
seat". The residents do not provide astute differentials and this decreases
the interest of the whole exercise. Even with so much emphasis on morning
report, the educational experience and learning is limited. After talking
amongst lot of residents and seeing morning report at other programs, we had
a few suggestions:

1. We should use the white board during morning report to discuss the
differential of the chief complaints.

2. Shift the focus from the detail of history asked to actual discussion of
a case in terms of management which would give us a feel of approaching a
patient and in the process realise our shortcomings on history/physical and
order sheet. Our objective is to learn from your experience and knowledge.
We feel that a healthy discussion would stimulate our brains to think wider
and more objectively.



Problem 3: We appreciate and acknowledge your effort to improve the
electives. There is a responsibility of both the resident and the preceptor
to make the time meaningful. It our endeavor to put in our best and learn
because this education forms the basis of our professional career. What we
request of you is to trust us. The fear of loosing credit for a rotation
takes away the enthusiasm and charm of learning. Electives are now perceived
as jail-time. The concept of threat to make residents work adds stress and
burden to our work and creates an atmosphere of rebellion. All you had to do
is just ask us to be more responsible and we would have responded.



Problem 4: Elective logs were started as a part of monitoring the residents
and to enhance the learning. The concept is excellent in the inception
however, the realisation of the goal is not achieved. Please do not take it
in the wrong way but writing logs is not possible in real time. Most of the
electives we see 4-5 patients everyday and on clinic days we may see up to
10 or more. On an average it takes 30 min to write for a single patient.
Here is what happens: most electives we get free by 5 PM then spend 1-2
hours reading Harrissons for board review. Around 7PM, we head back home and
then after a very quick dinner start work on logs for 2-3 hours. In these
2-3 hours we are able to finish only 3-4 patients. Clinic days we get free
after 6PM and there is less time and enormous number of patients. What
happens is that by the weekend we have a backlog of 10-15 patients and the
whole weekend is spent writing up logs. Logs have become a painful chore and
decreased learning in the elective to a bare minimum. Every one's goal is to
finish logs, all day the only discussion is how many logs do we have left.
There is no more time to pick and read Harrison's. Reading of textbook is
longer done. It also has a immense effect on our personal lives as we find
no time for ourselves or our family during electives.

Our suggestion: We are evaluated by a pre and post test. Logs should be
modified so that we pick the most interesting case for the day and write
notes on it making a total of 5 well researched cases a week. This will give
us time to actually read and concentrate and make meaningful patient logs
which will benefit us much more. Please consider this because there is an
extreme mental stress associated with this exercise esp. when it comes with
the fear that we might not get credit for our work. Also, there was a
mention that there is plan to start this exercise on MTS floors and ICU,
even the thought of doing it is scary. Please please do not start them it
will create a situation which will not be humanely possible to manage.



LAST PROBLEM: This is singularly the most important of all problems. "Every
one shouts at us" Nobody is polite to the residents, we are humiliated and
our self respect is shattered. Our chief is extremely impolite, she shows no
concern for resident issues and does not provide any cushion. She shouts at
residents and her message to us is that we are worthless. This kind of
behaviour is unwarranted, all of us are colleagues and there should be a
code of professional conduct. We are treated like inmates with her being a
jailer. Every small event is made a big issue and new rules are made
everyday. This adds to the confusion and chaos.



Every resident in under extreme stress and nobody appreciates the program.
Nobody has the courage to speak in residency council meetings because of the
fear that they might be singled out and eventually be expelled. There is a
depression amongst residents. The one thing our program lacks is resident
happiness. None of the residents endorse or recommend this program to
juniors and medical students. I have sincerely written this email to you so
you can address these issues. You are like our father who takes care of his
children in the best possible manner. We are not bad, every one works to win
your appreciation and respect. Give us the chance....



Yours sincerely,

Anonymous IM resident

SPUH


From: Kxxxxxxxx
Sent: Thu 4/5/2007 4:33 PM
Cc: [names removed]

Subject: FW: Confidential: Resident issues that are never discussed

Dear Residents,

I received this anonymous email a few days ago. It is regrettable that one
has to resort to this method when I have always welcomed all of you to come
in and talk to me. I am not sure if this a majority or a minority view. It
really does not matter if only one of you has these feelings.

Before I write my response to the letter I like you to keep the following
FACTS in mind.

1. 10 out of 19 PGY1, 8 out of 13 PGY2, and 7 out of 11 PGY3 residents
FAILED the in - training examination. Two PGY 3 residents scored below the
11th percentile. Four PGY 2 residents scored below the 13th percentile. Five
PGY1 residents scored below the 13th percentile. Lay people would do better.

There are residents who did extremely well. If I put a PGY 1 resident who
scored the 98th percentile with a PGY 3 resident who scored 11th percentile
- Is it fair to the PGY 1 resident?

What do you think happens to patients when a team consists of a PGY 3 and
PGY1 residents who score 11th and 5th percentile respectively?

2. During the last OSCE only four out of ten residents passed the station.

3. Majority of residents failed the last elective post tests. What would
happen if there were no logs?

4. There were 196 delinquent charts last week.

5. In spite of all efforts we continue to fail the counter signature
requirements (by the joint commission)

6. Last week 10 residents were absent in the board review. 17 residents were
absent in the morning report. 9 residents were absent in the noon
conference. 4 residents were absent in grand rounds.

7. This academic year 37 residents have called in sick. Epidemiologically
this is not possible.

Now I shall respond to the concerns in the letter.

It is not true that your work is not appreciated. It is true that you are
watched. It is not true that I do not trust you. However my trust is always
accompanied by VARIFICATION (trust and verify)

We are dealing with lives of other people. The program spends enormous
amount of money and other resources to support you.

Morning report:

The MR is a unique American tool for the department chair to monitor quality
of care. In most institutions it has degenerated into a quasi grand rounds
type of activity and has been handed over to the CR. It is not my role to
entertain you during the MR. When a patient with HTN and hyperlipemia comes
in with chest pain and has a 20 mm difference of BP in both arms and the
patient is given heparin - what do you expect me to do?

Our MR is attended by at least 12 faculty and they all contribute. Show me
one program in the country where there is so much participation from the
faculty. The letter states that we do not discuss complicated cases because
of fear. This is untrue. Is Wegner's granulomatosis complicated enough?

The letter demands dispensing with history and physical and focusing on
management. If you believe that you have learnt all elements of H & P, why
so many failed in the OSCE?

In summary the MR will NOT change.

Elective Logs:

The program leadership adopted the concept of PORTFOLIOS for the residents.
Portfolios demonstrate your efforts. They stimulate innovation and
imagination. Recently we added the patient logs during electives. The
purpose is to stimulate you to form good habits of looking up. It enhances
scholarship. We have just started this and we learn as we go along. I am
perfectly willing to modify the requirements after we get some experience.

The letter describes the log as "a painful chore ". This is pathetic and
shameful and does not appreciate the intent behind it.

In summary the logs will stay and will be modified as we review them.

I am deeply disturbed about the perception of a harsh environment. The
program is committed to utmost professionalism at all times by everyone. I
am aware of infractions in this regard and I am truly sorry for it. You have
my word that no such behavior will be tolerated in the future. I ask you to
report to me directly if you ever feel insulted by anyone in this
institution. I am instituting an anonymous evaluation system for the program
director, the associate program directors, the chief resident and the
residency office staff. You will be able to evaluate our performance every
quarter.

I particularly object to the statement that no resident recommends this
program to medical students. This is simply not true. During the recruitment
at least nine of you came to see me to recommend your friends for residency.

Finally, it is my responsibility to monitor high quality patient care and as
a byproduct facilitate a robust education program. I learnt a long time ago
that students and residents will perform at the level of expectations. I
will not preside over a program where even one resident will fail the
boards. I cannot and will not dumb down the process so that some of you will
be comfortable with ignorance.

I invite all to come and see me and discuss further. Thank you,

NK





Here are some links showing the anti-FMG prejudices of the PD before he left the UMDNJ-RWJ & moved over to SPUH & the response from some practising FMG physicians to it:


http://www.acpinternist.org/archives/1998/02/change.htm

http://www.acpinternist.org/archives...05/letters.htm

Members don't see this ad.
 
1) Does anyone have any info on what this program is like?
2) If this info is true, should I be considering this program in my Rank Order List?

3) If I get good vibes from the PD before the match, is it a ploy to make the next 3 years of my life miserable?

4) If they dont list any fellowships in their program yet, how good is it that they will have fellowships when I pass out? I desperately want to sub-specialize.

Please help me make a decision. Contribute & please give some information if you are a former resident/faculty about your experiences while in the program............:scared:
 
1) Does anyone have any info on what this program is like?
2) If this info is true, should I be considering this program in my Rank Order List?

3) If I get good vibes from the PD before the match, is it a ploy to make the next 3 years of my life miserable?

4) If they dont list any fellowships in their program yet, how good is it that they will have fellowships when I pass out? I desperately want to sub-specialize.

Please help me make a decision. Contribute & please give some information if you are a former resident/faculty about your experiences while in the program............:scared:

If someone went through the trouble and possible exposure to post all of that negative information, regardless of whether it is true, that should gave you an idea of the happiness of the residents or perhaps, quality of individuals in the program. I am not taking sides, let me be clear.

I tell all my medical students the same thing -- rank ONLY the programs that you will be happy at. If you're having doubts, then maybe you should not rank the program. Remember that if it's on your list, then you have a chance of matching there. Even if it's the last program on your list. And believe me, I've seen it before where applicants have matched at the last spot on their list.

Always go with your gut feeling. You've heard this before and I'll reiterate again that if you felt positively about a program, then go with your gut. In the end, most residency programs are exactly the same. ACGME governs all programs in the US... so all interns will cap at 10 patients, hours are capped at 80 hrs / week, etc. Go with your happiness factor, because what matters most is where you will be happy. You will be working side-by-side with many many fellow residents, and if you're not happy, it'll show.

I don't believe SPUH has any fellowships yet, but I believe their recent affilitation with Drexel may help. However, applying for fellowships is NOT the same as applying for residencies. Fellowships is more about connections / networks / publications / research, rather than scores etc. I tell all my med students this -- If you're thinking about fellowship, go to the best university program you can get into.

Thanks for the thread.
 
Members don't see this ad :)
tarlovcyst,

your posts have an amazing amount of insight for a fourth-year student in the midst of the application process. how so knowledgeable?
 
tarlovcyst,

your posts have an amazing amount of insight for a fourth-year student in the midst of the application process. how so knowledgeable?

I like to blend in as a medical student. Not trying to deceive anyone, but I feel that everyone's advice should be taken equally, regardless of student or advisor status.
 
1) Does anyone have any info on what this program is like?
2) If this info is true, should I be considering this program in my Rank Order List?

3) If I get good vibes from the PD before the match, is it a ploy to make the next 3 years of my life miserable?

4) If they dont list any fellowships in their program yet, how good is it that they will have fellowships when I pass out? I desperately want to sub-specialize.

Please help me make a decision. Contribute & please give some information if you are a former resident/faculty about your experiences while in the program............:scared:

I agree with the above posts. If you already have doubts about the program and you actually don't feel like the residents have good camarderie, then chances are your gut feeling is right. Not to mention the negativity illustrated by that email, whether true or not. Unless you're prepared to deal with the politics, you may not want to rank this program.
 
There are two sides to every story. Decisions to rank a program should not be determined by "I heard that..." or "xxx is racist/snob/blahblahblah." Be sure to speak to a person DIRECTLY who has a story to tell. From the emails posted above, the PD didn't seem to act inappropriately. If infact what he said about the majority of the residents failing the inservice exams is true, then I'm afraid I would have to side with him (I'm sorry, but there's no way such a high percentage of residents should be failing these exams). It seems to me the residents are not performing well enough academically to be trusted to the extent they would like, and therefore need constant supervision. Now, is this the fault of the PD for selecting unqualified applicants? Is there inadequate training in the residency? The blame could go back and forth, but ultimately it seems to me the residents need this type of micromanagement if they're failing tests, not showing up to morning report and board review classes, taking excessive sick days. The only thing I read that seems like BS busywork is the logs.

The question you have to ask yourself is not only can you work with the PD for 3 years, but will you enjoy working with residents that have the qualities mentioned above? You need to look at the whole environment, not just the PD.
 
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