Texas Programs

[msbbc833]

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Does anyone have any opinions on these programs:

Memorial Southwest Houston
Baylor Dallas
Baylor Houston

 

[JustPlainBill]

Does anyone have any opinions on these programs:

Memorial Southwest Houston
Baylor Dallas
Baylor Houston

If by Baylor Dallas you mean Baylor Garland FM? --

Baylor Garland FM is a very nice, suburban program in terms of environment. Real family type of atmosphere, PD is a retired USAF Col who impressed me as really resident friendly. Dr. Tingle is the kind of guy that will play touch football with the residents (and I mean put on gym shorts and a TShirt and really play) at the resident retreat. Admin for the program is a really nice "grandmotherly" type. When I was there as a student, they were getting in a new crop of attendings with a few from the Waco program. So...

Inpatient - Pathology is not a strong but it's a community hospital based program -- standard stuff - CHF, Asthma, COPD, dehydration, etc. Very laid back inpatient part of the program -- handoff is at 7AM, residents have until 10 to see their patients and then do table rounds with the attending as a team. usually the attending would go see the patients after lunch with the team there in the physician's lounge. That's good and bad in terms of bedside teaching -- but I didn't get a lot of bedside teaching at my program anyway...and on some days the attending will do walk rounds with the team depending on mood/scheduling. You then have the rest of the day to get your floor work/admits/discharges done and one person (PGY2/PGY3) stays to sign out....again, very laid back.

Outpatient -- Standard FM fare with good, hands on instruction if you want it. Procedures are a little light but unless you're out in the boonies or at JPS, they will be....

OB -- my information is a little dated and they were trying to improve it when I was there -- used to be that you would work the L&D deck with the nurses and hope that the private OB would do some teaching when they came in to deliver. Hit or miss -- as I was done with my month, one of the attendings from Waco was trying to get OB privileged there.

Wound care -- they have a wound care clinic complete with hyperbaric medicine. Good place and you rotate through as a resident.

I don't know about the other rotations other than you do them at BUMC in Dallas.

One thing -- had one of the interns tell me that because it's a small program, you had to take call quite often so be aware of that.....

General view is that it's a weak program in terms of pathology...but it was very non-toxic and they worked hard to train their residents well....


Do yourself a favor and stay away from UTSouthwestern Family Medicine....

 

[msbbc833]

Thanks for the response! I am looking for a more outpatient care focused program, unfortunate to hear that it has heavy amount of call. Is the hospital FM opposed or unopposed? Any suggestions on FM programs in TX that have minimal call/are opposed?

 

[cabinbuilder]

Stay away from Texas Tech in Midland. Never saw a group of more lazy residents here. Everyone is foreign grad from the Middle East. They don't take care of the patients and aren't learning their medicine. A scary group and I have had to write a few up for patient endangerment.

 

[JustPlainBill]

Thanks for the response! I am looking for a more outpatient care focused program, unfortunate to hear that it has heavy amount of call. Is the hospital FM opposed or unopposed? Any suggestions on FM programs in TX that have minimal call/are opposed?

Remember that my knowledge of their call system was before the new rules that mandated no more than 24 hours for interns down from 32 hours (or something like that). To my knowledge, there's no more full 24 hour call as an FM resident/intern.

Hospital where the program is located is unopposed -- small community hospital right across the parking lot from the residency clinic building. Down at BUMC, there's other programs that you rotate through and will have to be agressive to get your experiences. I would definitely give it strong consideration for a good outpatient experience.

As far as call goes, you'll have to do a certain amount per ACGME requirements -- just a fact of life.

Piece of advice worth just what you're paying for it --- do NOT select your residency based on what your ideal job is --- this is the only time you can get supervised training and get your hands dirty. Go to the best training locale you can get -- lots of procedures, high acuity patients, good attendings and good environment -- because you never know what you'll wind up doing and the skills you'll need in the future. For example -- I'm trying to start working small EDs to moonlight or some urgent care work -- never removed toenails on live patients (just cadavers) and only have 1 intubation to my credit. That's rather limiting when you want to work ED or urgent care...so now, I'm fighting to get those procedures on the outside.

You may want to seriously look at the best kept secret in Texas as far as FM residency programs go -- UT Tyler Family Medicine. Lots of procedures, good environment, attendings who actually can teach and care about the residents, real team atmosphere. I almost switched it to #1 the night prior to lock in of choices but the schools for my kids left a bit to be desired. The week I interviewed, a middle schooler had stabbed a teacher with a pencil in the public schools which was a non-starter for me. There are private schools but I didn't know they had scholarships at the time and the tuition was $11K a year for 2 kids. Can't cry over missed opportunities but I serioulsy regret not going there.

again, stay away from UTSouthwestern.

 

[DermViser]

Remember that my knowledge of their call system was before the new rules that mandated no more than 24 hours for interns down from 32 hours (or something like that). To my knowledge, there's no more full 24 hour call as an FM resident/intern.

Hospital where the program is located is unopposed -- small community hospital right across the parking lot from the residency clinic building. Down at BUMC, there's other programs that you rotate through and will have to be agressive to get your experiences. I would definitely give it strong consideration for a good outpatient experience.

As far as call goes, you'll have to do a certain amount per ACGME requirements -- just a fact of life.

Piece of advice worth just what you're paying for it --- do NOT select your residency based on what your ideal job is --- this is the only time you can get supervised training and get your hands dirty. Go to the best training locale you can get -- lots of procedures, high acuity patients, good attendings and good environment -- because you never know what you'll wind up doing and the skills you'll need in the future. For example -- I'm trying to start working small EDs to moonlight or some urgent care work -- never removed toenails on live patients (just cadavers) and only have 1 intubation to my credit. That's rather limiting when you want to work ED or urgent care...so now, I'm fighting to get those procedures on the outside.

You may want to seriously look at the best kept secret in Texas as far as FM residency programs go -- UT Tyler Family Medicine. Lots of procedures, good environment, attendings who actually can teach and care about the residents, real team atmosphere. I almost switched it to #1 the night prior to lock in of choices but the schools for my kids left a bit to be desired. The week I interviewed, a middle schooler had stabbed a teacher with a pencil in the public schools which was a non-starter for me. There are private schools but I didn't know they had scholarships at the time and the tuition was $11K a year for 2 kids. Can't cry over missed opportunities but I serioulsy regret not going there.

again, stay away from UTSouthwestern.

What's wrong with UT Southwestern? It's quite an academic program isn't it?

 

[cabinbuilder]

What's wrong with UT Southwestern? It's quite an academic program isn't it?

Bill just told you, THEY DON"T TEACH YOU HOW TO BE A DOCTOR. Go where you will get good training.

 

[DermViser]

Bill just told you, THEY DON"T TEACH YOU HOW TO BE A DOCTOR. Go where you will get good training.

All he said was, "Do yourself a favor and stay away from UTSouthwestern Family Medicine....". He didn't go into detail why (malignant, etc.)

 

[cabinbuilder]

All he said was, "Do yourself a favor and stay away from UTSouthwestern Family Medicine....". He didn't go into detail why (malignant, etc.)

Umm, ok. I thought this statement of his was pretty clear about having bad training. [ For example -- I'm trying to start working small EDs to moonlight or some urgent care work -- never removed toenails on live patients (just cadavers) and only have 1 intubation to my credit. That's rather limiting when you want to work ED or urgent care...so now, I'm fighting to get those procedures on the outside.]

 

[JustPlainBill]

What's wrong with UT Southwestern? It's quite an academic program isn't it?

Legitimate question -- Yes, UTSW is VERY academic .... and that's part of the problem --- it is also sounds very malignant and cliquish -- if one of the attendings decides they don't like you, no matter what you do, you cannot redeem yourself. They have a reputation of picking a resident from each class and trying to fire them or get them to quit. To my understanding, they have been known to put interns on probation (reportable to the state medical board, thus affecting your license) for lacking clinical judgement -- hello, earth to UTSW -- interns by definition lack clinical judgement and that's what they're here to learn.

They've only recently hired 1 attending qualified to do inpatient procedures -- prior to that, they either watched NEJM videos and muddled their way through them or asked the IM residency to have their people come do the inpatient procedures. They put their residents with the midwives, med students, EMT students on the OB delivery deck where the FM residents are regularly treated with less respect than the UTSW med students in terms of getting deliveries. The other programs that need deliveries (EM, etc.) are over with the OB/Gyn residents/attendings getting their deliveries. The ICU experience is done in PGY2 and the residents are treated as PGY1's during that experience.

The major problem to my understanding is that the attendings seem to always look for the negative in a resident and rarely, if ever, are encouraging...supposedly there are a few that are nicer to work with but in general a residents shortcoming are magnified out of proportion...the PGY3 residents are asked to see 10 patients per half day at a county hospital (i.e. high acuity/complexity) and comments are made in the evals of whether or not they could keep up with their schedule....but yet supposedly the attendings are only required to see 4 - 5 (7 was the most) and regularly comment on how busy they are in clinic.

Asking for help/asking questions regarding patient care is really not a good idea --- rather than be used as an opportunity for education, it is used as a negative on reviews in terms of lacking clinical knowledge.

Hope that answers your question....again, this is second hand info from a colleague who is going through it right now....

 

[DermViser]

Legitimate question -- Yes, UTSW is VERY academic .... and that's part of the problem --- it is also sounds very malignant and cliquish -- if one of the attendings decides they don't like you, no matter what you do, you cannot redeem yourself. They have a reputation of picking a resident from each class and trying to fire them or get them to quit. To my understanding, they have been known to put interns on probation (reportable to the state medical board, thus affecting your license) for lacking clinical judgement -- hello, earth to UTSW -- interns by definition lack clinical judgement and that's what they're here to learn.

They've only recently hired 1 attending qualified to do inpatient procedures -- prior to that, they either watched NEJM videos and muddled their way through them or asked the IM residency to have their people come do the inpatient procedures. They put their residents with the midwives, med students, EMT students on the OB delivery deck where the FM residents are regularly treated with less respect than the UTSW med students in terms of getting deliveries. The other programs that need deliveries (EM, etc.) are over with the OB/Gyn residents/attendings getting their deliveries. The ICU experience is done in PGY2 and the residents are treated as PGY1's during that experience.

The major problem to my understanding is that the attendings seem to always look for the negative in a resident and rarely, if ever, are encouraging...supposedly there are a few that are nicer to work with but in general a residents shortcoming are magnified out of proportion...the PGY3 residents are asked to see 10 patients per half day at a county hospital (i.e. high acuity/complexity) and comments are made in the evals of whether or not they could keep up with their schedule....but yet supposedly the attendings are only required to see 4 - 5 (7 was the most) and regularly comment on how busy they are in clinic.

Asking for help/asking questions regarding patient care is really not a good idea --- rather than be used as an opportunity for education, it is used as a negative on reviews in terms of lacking clinical knowledge.

Hope that answers your question....again, this is second hand info from a colleague who is going through it right now....

Wow, thank you for answering, that's terrible but not surprising. I've heard UTSW tends to value IM (and its subspecialties) anyways and tends to overall be hardcore academic, with associated malignancy in general. They probably only have a Family Medicine program so that they can tell the state that they care about primary care.

 

[JustPlainBill]

Wow, thank you for answering, that's terrible but not surprising. I've heard UTSW tends to value IM (and its subspecialties) anyways and tends to overall be hardcore academic, with associated malignancy in general. They probably only have a Family Medicine program so that they can tell the state that they care about primary care.

Likely -- they've had trouble filling during the first round of match for the last 2 years or so I'm told -- also have a high number of IMG/FMG/Carribean grads --- nothing against them but that's typically a measure used to determine the strength of a program -- by MS4s ;->

 

[DermViser]

Likely -- they've had trouble filling during the first round of match for the last 2 years or so I'm told -- also have a high number of IMG/FMG/Carribean grads --- nothing against them but that's typically a measure used to determine the strength of a program -- by MS4s ;->

Yes. Very telling that some of their own UTSW med school grads who go for FM, don't stay at UTSW's FM program.

 

[TexasMDtoBe2016]

Can anyone comment on the differences between UTSW and BCM/UT Houston? All large academic institutions.

 

[JustPlainBill]

Can anyone comment on the differences between UTSW and BCM/UT Houston? All large academic institutions.

Sure -- UTSW FM at Parkland could not teach a bunch of Boy Scouts what to do inside of a Vegas cathouse -- simple enough? It's an opposed program where the specialists treat the residents worse than med students and for good reason -- until recently there was no FM attending on their hospital service who could do hospitalist procedures and they had to call in IM every time they needed a procedure done; Ortho has them watch all the pre-ops, ICU tasks the PGY2's as interns and for cards, you sit with a very angry cardiologist who basically criticizes you while you attempt to read EKGs -- In OB/Gyn, they do their deliveries with the midwives on the same side of Parkland that teaches MS3s and paramedics and they have to fight and toe the line in order to get a delivery, rather than being on the side with the Ob residents and every other residency that delivers where you could get some real training -- the only bright light in that program is the training at Children's where they actually take the time to teach you --

The residency itself it very toxic towards the residents -- they are looking for reasons to fail residents and a former PD had a reputation for picking one resident per class and attempting to either fail them out of the residency or make them quit -- asking questions is not tolerated -- for Christ's sake, they put an intern on probation (reportable to the TMB) for lack of clinical judgement -- hello, interns by definition have no clinical judgement --

Almost forgot -- the attendings will criticize the residents who can't keep up with the number of patient's on the schedule (usually anywhere from 5-12 per half day depending on where the resident is at in their training) but then they're only scheduled for 4-7 per 4 hour shift and complain they're overwhelmed due to the complexity of the patient -- the same patients the residents see ---

Do yourself a big favor -- stay the hell away from that program -- there's a reason they're a scramble program -- you have been warned --

 

[septoplasty]

Surprised programs like this exist.. but hot dang!

To the OP, coming from a program that's strikingly different, what the attendings above have said is 1000%+ applicable to picking a training program.

 

[Freezeout]

Anyone know much about JPS in Arlington? I'm doing an audition there in a week. Thanks in advance.

 

[ER1119]

Does anyone else have any comments about UTSW-FM program? It sounds like you had a terrible expereince JustPlainBill, but that was at least 12 years ago if you were in residency before the hours restriction. I interviewed with them recently and I was very impressed with their program. I went into the interview with the stuff that I read on SDN about them in the back of my mind, and I was pleasantly surprised. I felt that they were very open about their past short comings and I got the feeling that a lot of positive changes have been made. Any recent grads or current residents care to comment?

 

[JustPlainBill]

Does anyone else have any comments about UTSW-FM program? It sounds like you had a terrible expereince JustPlainBill, but that was at least 12 years ago if you were in residency before the hours restriction. I interviewed with them recently and I was very impressed with their program. I went into the interview with the stuff that I read on SDN about them in the back of my mind, and I was pleasantly surprised. I felt that they were very open about their past short comings and I got the feeling that a lot of positive changes have been made. Any recent grads or current residents care to comment?

Let's just say I graduated within the last 3 to 4 years -- is that recent enough? I am telling you, you have no idea what you're about to get into -- they mentioned their "shortcomings" and promised the moon plus $2, changes were being made, etc. and it wasn't until the match was over and we were there that suddenly all those changes went away -- We were actually told,"We want to train you to be the best FM docs you can be!" -- so I asked ,"What do you mean by that?" and was told, openly ,"We want to train the most FM docs to go out into the community and refer back to our specialists." -- if you want to be a referral monkey, go for it-- recall that they are a scramble program and have been for quite some time -- there's a reason they struggle to fill -- and those shortcomings are not in the past -- they're recent -- you have been warned -- there are several good programs in DFW (like Baylor Garland, Charlton Methodist, Plaza - Ft. Worth, JPS) and if you go to UTSW, it's all on you -- I am telling you in no uncertain terms, going there if you have any other option is a mistake, period -- probably the biggest one and the hardest to overcome that you will ever make in your professional career.

 

[Freezeout]

Anyone with any info or insight into JPS' program?

 

[JustPlainBill]

Anyone with any info or insight into JPS' program?

JPS used to be the big boy on the block -- The FM residency ran that hospital but now there's an EM/IM/Ortho/Psych/Ob so I don't know how big of a stick they swing there --- FM residents seemed to get good training for going out in the boonies and being ready to roll -- this was from a few years ago in the 2009-2010 timeframe -- YMMV -- put it this way -- most of the UTSouthwestern medical students go either there or to Waco for their training --

 

[NurWollen]

Can anyone comment on the program at Plaza Medical Center in Ft. Worth? Seems like it's in a cool area but a smallish hospital and it's opposed.

 

[JustPlainBill]

Rotated through Plaza as a student and had a few colleagues do a residency there --- from my experience/talking with my buds ---

1) PD is a very old school Oriental male -- firm but fair, but do NOT challenge him in front of others or things will get rough -- demonstrate proper respect at all times and know your place in the food chain.

2) Yes, program is opposed -- there's an IM residency and Surgery IIRC -- you'll do inpatient with IM and it's particularly brutal during morning report -- it's one of the reasons I didn't go there -- and that was with the former PD who was really cool and a good educator --- I've watched the IM department mentally break down an intern after 24 hours of being on call and skillfully roast them for their DDx, etc. Since I don't need that BS in my life, I didn't even apply.

3) Small hospital but it's mainly D.O.s -- good enough hospital to get a broad spectrum of what you'll actually see in the community and you follow your patients into the ICU -- or at least you did --

4) 2nd year is better with very little hospital work but more specialist/outpatient work in true family medicine.

5) otherwise, pretty chill program and you get out of it what you put into it.

I know a recent former Chief resident so let me chat them up and see if they can PM you or something --

You may also want to consider the program in Tyler and Conroe -- both are solid.

 

[AfterVisitSummary]

I think this is pretty outdated. I have had a great experience in the program. I had rotated through some of the other FM programs in Dallas too but this one was one of the nicest. JPS and waco also have pretty strong programs too but if you want something in Dallas proper, they are a little far out. I had ranked this program because I didnt really want to be on call all the time so the schedule was really nice and despite the comments from what seem to be of one disgruntled 2nd hand information person, don't regret my decision. We did a lot of inpatient procedures (paracentesis, thoracentesis, lumbar punctures, injections). It is true we do deliveries with midwives but I honestly liked that since it gave me basic skills for the plain easy deliveries and I am not doing and never planned on doing any OB in my own practice. I also got to work with an amazing OB faculty who we did IUDs and implants with. In one half day I got 12 IUDs! I am glad we do ICU as a PGY2 so I can know more when I do the rotation. The attendings are all pretty nice and I always found them to be very encouraging.
Take it from someone who is not using 2nd hand old information from "colleagues" or "friends" but actually experienced everything 1st hand..
I do have to mention if you plan on doing rural medicine this may not be the best program, but one of my seniors went into rural medicine and they seem happy and fine and just opened their own practice there. The program is working on expanding global health program also (eventhough I didnt get to experience it) so that's pretty exciting!
Also! I have had seniors who graduated to go into all sorts of things - fellowships, private practice and out of the current graduates one third of them are going into fellowships (sports, palliative, sleep).

 

[JustPlainBill]

I think this is pretty outdated. I have had a great experience in the program. I had rotated through some of the other FM programs in Dallas too but this one was one of the nicest. JPS and waco also have pretty strong programs too but if you want something in Dallas proper, they are a little far out. I had ranked this program because I didnt really want to be on call all the time so the schedule was really nice and despite the comments from what seem to be of one disgruntled 2nd hand information person, don't regret my decision. We did a lot of inpatient procedures (paracentesis, thoracentesis, lumbar punctures, injections). It is true we do deliveries with midwives but I honestly liked that since it gave me basic skills for the plain easy deliveries and I am not doing and never planned on doing any OB in my own practice. I also got to work with an amazing OB faculty who we did IUDs and implants with. In one half day I got 12 IUDs! I am glad we do ICU as a PGY2 so I can know more when I do the rotation. The attendings are all pretty nice and I always found them to be very encouraging.
Take it from someone who is not using 2nd hand old information from "colleagues" or "friends" but actually experienced everything 1st hand..
I do have to mention if you plan on doing rural medicine this may not be the best program, but one of my seniors went into rural medicine and they seem happy and fine and just opened their own practice there. The program is working on expanding global health program also (eventhough I didnt get to experience it) so that's pretty exciting!
Also! I have had seniors who graduated to go into all sorts of things - fellowships, private practice and out of the current graduates one third of them are going into fellowships (sports, palliative, sleep).

You are correct in that it's been a while since I went through Plaza. Nothing wrong with the program, I just didn't care for the IM department at the hospital and FM was required to rotate through there -- and I assume it's Plaza that you're talking about...

If it's UTSouthwestern you're referring to -- that's not second hand outdated information but first hand recent (2013) information.

 

[docdolphin]

Does anyone have insight/opinions on the programs at Texoma Medical Center or Methodist Charlton?

 

[JustPlainBill]

Does anyone have insight/opinions on the programs at Texoma Medical Center or Methodist Charlton?

Nothing recent -- my info on Charlton is about 6 years old ---

Charlton -- good program, prepares you for a community based practice, unopposed location, dual program; Residents seemed happy, worked well together and supported each other.

Texoma -- this is a new one -- I heard about it when I was in my first year in practice near Sherman, Tx. it was being developed as a rural medicine program with some help/interest from the ROME people at TCOM in Ft. Worth. TMC is a good hospital and the former Chief Medical Officer is a really nice oncologist who's easy to work with. don't know much more but it's worth a look.

You should also check out the osteopathic program in Durant, OK right across the border if you're going up in that area -- I met a few of the residents and they seemed to know their stuff.

hope it helps.

 

[eden91]

Nothing recent -- my info on Charlton is about 6 years old ---

Charlton -- good program, prepares you for a community based practice, unopposed location, dual program; Residents seemed happy, worked well together and supported each other.

Texoma -- this is a new one -- I heard about it when I was in my first year in practice near Sherman, Tx. it was being developed as a rural medicine program with some help/interest from the ROME people at TCOM in Ft. Worth. TMC is a good hospital and the former Chief Medical Officer is a really nice oncologist who's easy to work with. don't know much more but it's worth a look.

You should also check out the osteopathic program in Durant, OK right across the border if you're going up in that area -- I met a few of the residents and they seemed to know their stuff.

hope it helps.

Hello! Saw that this post is from last year. Can someone please post updates about Charlton Methodist and Baylor Garland FM programs regarding work hours and over all proficiency in training? Thanks!