Disclosure: I am a recent graduate of the anesthesiology residency at Stony Brook. Class of 2013. I have no financial ties to this institution. I currently work as an attending in another academic hospital with an anesthesiology residency.
I heard about this post and thought additional information should be reported while the faceless masses of this forum throw their opinions around and pass premature judgement on the training that takes place within the Anesthesiology Department at Stony Brook and the program director, Chris Gallagher.
Generally speaking, it is the pervue of any program director to be concerned about anesthesiology board pass rates. The goal is to have a 100% of residents passing on the first attempt. This is no different at Stony Brook. As for the program director at Stony Brook, he is already a full professor which implies both job security and that somebody higher-up must have thought he was a good clinician / educator / administrator. Having worked with the program director closely last year, the motivation behind a lot of what he does is to make sure all his residents pass the boards like a coach who wants his players to succeed.
The yearly in-training exam (ITE) is a predictor of how well one will do on the boards (
http://www.ijme.net/archive/3/predictors-of-success-on-a-board-certification-exam.pdf) so it is fair that those who do poorly on the ITE become the focus of the program director. The in-house written tests mentioned in the original post are a recent development so I cannot comment on them but since the ITE is administered only once per year this may be the best way to guage the core competency of "medical knowledge" and to motivate residents to stay on top of their studies and at least stay off the program director's radar by doing well on exams.
As for the infringement on free time for extra "study hall", I don't think it's anyone's idea of a good time away from the grueling hours of being in the ORs for both the residents and the program director. I rather think it is commendable that the program director would dedicate extra time on the weekends (unpaid, I am sure) to make certain residents come in to see them study and provide some strucuture. Residency is not like your typical job. It is more like an apprenticeship and sometimes the responsibilities of your training and demands on your time exceed what is considered normal. Again, residents who have done well on the yearly ITE and demonstrate a good fund of medical knowledge are not likely to be bothered by the program director about this issue. Laslty, I think I would want to be reminded that I am lacking in the "medical knowledge department" by my program director and that I am at risk to fail the written boards instead of having this be a non-issue and progress through residency thinking that everything is going well. The fact that the program director spends this extra time tells me that he thinks its important enough to disrupt residents during their "off-hours".
Currently, there is an interim chairman for the department so this may be a consideration for medical students considering Stony Brook anesthesiology for their training. But six months is hardly a long period of time to find and select the next chairperson. I would submit that while having a nationally-recognized chairperson is helpful for networking purposes and to obtain a quality fellowship or job post-residency, it is the program director who is more involved in your training and knows you best as a resident. This is the person fellowhip program directors and private practice employers call to get the scoop on a certain resident, knowing that most anesthesia chairpersons lack any profound knowledge about the strengths and weaknesses of each resident. Chris Gallagher tells you at the residency interview, the first day of intern year, and throughout the residency that you are "working for his phone call." While this could be misconstrued as a threat like a prison warden to a parole board, I think he means that he is going to tell it like it is when it comes to a recommendation since his reputation is also on the line. So long as you are satisfying the responsibilites and demands of your training, he will go to bat for you and support your post-residency aspirations. And that's all you really ever want from your program director.
As mentioned in another post, there are numerous aspects of residency that the program director cannot control such as the work habits of the CRNAs and 24-hour call schedules. Stony Brook is likely one of the few residency programs to have residents take true 24-hour in-house calls and I recall many sleepless calls doing cases until the morning or starting cases randomly in the early morning hours to seemingly accomodate a VIP patient or a surgeon's schedule but I also recall many calls where I slept for a good chunk of the call after scheduled cases were completed. Ironically, I am writing this post on-call now and feel that this 24-hour call experience from residency has prepared me well for the rigors of being an attending anesthesiologist on call at a big inner-city hospital.
Also, you know who often brought in donuts at 5:00 AM for the call team and came in on Thanksgiving and Christmas call to deliver donuts for the lucky residents on call during the holidays? The program director. But I digress.
Yes, it is busy in the Stony Brook ORs but this is likely the case at many residency programs and it is always an ongoing struggle to balance clinical training / service with protected time to study and read to shore up one's medical knowledge. But no anesthesiology program is perfect, without a blemish, and all its residents being happy. It's unfortunate that someone compiled all the warts of a residency program into an anonymous internet post and associated it with a program director who has dedicated a significant portion of his professional career to residency education.
To reiterate, the Stony Brook residency is NOT "malignant" nor the program director a "douche" as menionted by other participants in this "discussion".
I encourage any applicants considering Stony Brook for residency to look beyond the original and subsequent posts and recognize that there are many positive aspects of training at Stony Brook such as the lack of fellows to compete with for interesting cases, great sub-specialty exposure, good support staff (i.e. nursing and anesthesia techs), opportunities to go on medical missions and provide anesthesia, good clinician educators, and the program director who may go to extremes but with good inentions. The list goes on and is too lengthy for this already ridiculously long post.
If you want to say that Stony Brook is a 2-hour drive from New York City and in the middle of suburbia or that the residents are occassionally overworked or that the program does not allow for moonlighting or overtime resident pay then this would be accurate. But I can honstly say that I am happy and satified with my residency experience at Stony Brook and consider myself lucky to have trained with some great anesthesiologists there including Chris Gallagher.
Mark Kim, MD
