Thoughts on USC or NYU?

[bikerchick]

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Does anyone have any thoughts on either of these general surgery programs? I've heard some vague rumors that they are malignant programs, though I have no idea what that means. Asides from the geographic differences, does anybody know of any red flags or if one program is stronger than the other? Ultimately, I would like to do academic surgery and intend to take time out for research and pursue a fellowship, although I haven't decided which particular fellowship yet.
Thanks very much!

 

[size_tens]

I interviewed at USC. My impression is that with a new hospital and chairman of surgery things are changing for the better. They had some problems with faculty retention a few years back but that is turning around with recent new hires. The fellowship match list at USC looks quite strong IMO. I don't have any first-hand knowledge of NYU but it seems to be a very solid program from what I've heard.

 

[Blade28]

USC seemed malignant to me back when I was an MS-IV rotating there (2004) but I haven't been there since and don't know how the recent changes have affected the G Surg program there.

 

[MS3B]

USC seemed a bit malignant to me. Many of the malignant staff of the previous era, if they were malignant, are still there. However, some of the residents are very slick so they can survive. I don't know about NYU. I enjoyed my visit to USC so I am not completely critical of them.

 

[MS3B]

My impression is that with a new hospital and chairman of surgery things are changing for the better.

Tom DeMeester is out?????

 

[size_tens]

Tom DeMeester is out?????

Yes Starnes has taken over as chairman

 

[BlondeDocteur]

Btw, I will say--without editorializing-- that NYU has a very distinct surgical culture. Some people take to it like ducks to water, and others are miserable. They're very proud of their history and (in my very humble opinion) the residency still has a distinctly hierarchical, military flavor to it. But as I said, most residents there love it.

 

[logistic]

I had a negative experience during my interview at NYU.
Red flags included:
- M&M conference where the residents were interrupted multiple times during their presentation of the case for input by the chairman and were made to answer multiple choice questions - each time an answer choice came up on the screen, it would be accompanied by a Powerpoint animation (answer choice flys in like a tornado) with sounds (like a taxi cab honking)
- it sounded like the 4th yr. experience at Tisch was a little too "staff-dependent" with how much you were able to do in the OR
- if I remember correctly, the entire 5th yr. is spent at Bellevue with a patient population that primarily does not speak English. Also, just a little too much emphasis on Bellevue vs. other academic programs where they were proud of the operating being done at levels PGY3-5.

I think you will have to go on both interviews to get a feel for a program. I really think that you can gain a lot of information by going on these interviews, especially if you are able to see an M&M in addition to everything else.

 

[logistic]

My definition of maligancy is lack of interest by the faculty in teaching their residents or in listening to their concerns about how to improve the educational experience.
What is excluded in this definition is a demand for resident excellence that may or may not include intimidating residents in order to get them to prioritize residency over other activities. But this definition might be what others describe as malignant.

 

[SLUser11]

My definition of maligancy is lack of interest by the faculty in teaching their residents or in listening to their concerns about how to improve the educational experience.
What is excluded in this definition is a demand for resident excellence that may or may not include intimidating residents in order to get them to prioritize residency over other activities. But this definition might be what others describe as malignant.

I should warn you about having such a loose definition of "malignancy." There have been innumerable abuses of residents done in the name of a "demand for excellence," and you could be headed into a lion's den if you don't steer away from such programs.

As a matter of fact, a lack of interest in teaching is horrible in its own right, but is not malignancy by any means. People can have non-malignant personalities and still be horrible teachers.

Honestly, your post sounds like what certain PDs....concentrated in the NE....specifically NY.....want to hear to justify their bad behavior....and maybe you're telling us what you think WE want to hear.....


Your last sentence sums it up. From your post, I have decided that you have no idea what malignancy actually means, but have assigned it to certain qualities that you don't personally like in programs.

 

[SocialistMD]

From your post, I have decided that you have no idea what malignancy actually means, but have assigned it to certain qualities that you don't personally like in programs.

I do think you are right, though; there is a generally accepted definition for malignant, and I don't think it is logistic's. I think most of us choose Merriam-Webster's 1c as our definition: passionately and relentlessly malevolent or aggressively malicious. I guess the finer points of being malevolent or malicious are up for debate, but I don't think the general consensus is that those things include a lack of interest in teaching but don't include intimidating residents.

 

[Winged Scapula]

Hell I would have begged for a lack of faculty interest over some other behaviors I've seen.

 

[logistic]

There was an attending I had who was known for making people during their core clerkships cry. He was described as being 'malignant.' After rotating with him, he turned out to be a great teacher, one of my inspirations to go into surgery, and I realized that what others were calling malignant really just turned out to be his demand for performance. That's why I think about maligancy in the way I described in the post above. Because I've seen what my classmates are calling malignant and I disagree with their definition.

 

[Winged Scapula]

There was an attending I had who was known for making people during their core clerkships cry. He was described as being 'malignant.' After rotating with him, he turned out to be a great teacher, one of my inspirations to go into surgery, and I realized that what others were calling malignant really just turned out to be his demand for performance. That's why I think about maligancy in the way I described in the post above. Because I've seen what my classmates are calling malignant and I disagree with their definition.

You are entitled to your belief. We all are.

That said, I think most of us would agree that ROUTINELY making students or residents cry is more of a statement about this attending's attitude and behavior than it is of the students/residents.

There is nothing wrong with demanding perfection, but if you have to humiliate and intimidate people to get there and to teach, then I'm sorry, that DOES fit the definition that most of us have in regards to malignancy. I had nothing but disrespect (and perhaps not a little bit of hatred) for my attendings that used intimidation tactics...it never made me a better surgeon nor motivated me to learn. I suspect I am no different from any other person in that regard.

 

[SocialistMD]

A blue cube:

As I said before, everyone is entitled to his/her personal definition of malignant, but when you know your definition isn't the commonly used definition it doesn't help in a conversation anymore than my description of the picture above.

There is no reason to routinely make people cry, even if you are trying to make them better. If it is one person, then they may be overly sensitive, but if it is routine, then it means you are out of bounds, not the rest of society. It is great to have high-level expectations, but it is not okay to berate and belittle people in an attempt to make them reach your level of "excellence."

 

[logistic]

Socrates was either hated or considered the wisest man in Greece. He used intelligent questioning to expose weakness in critical thinking and gaps in knowledge. Those that took their discussions with him to focus their studies considered him wise. Those that hated him felt attacked, ashamed...maybe even cried.

It is not malignant to use questions to determine the where the end of one's knowledge is and thus where their studying should begin.

And now to commiserate with other newbies who ave previously ventured to post on a potentially controversial issue:

After observing the replies after my previous post, I feel I have entered the 'no spin zone,' authored by the foxnews personality who uses apparently objective facts (like the dictionary entry used above) and supposedly witty tactics (like the whole ball/cube thing) to distort comments and blunt subtleties that are appropriate when discussing nebulous concepts such as malignancy. This term is used so freely that its exact definition is hard to pin down and varies depending on the user, and - it would seem - the region of the USA the user is from.

 

[SocialistMD]

After observing the replies after my previous post, I feel I have entered the 'no spin zone,' authored by the foxnews personality who uses apparently objective facts (like the dictionary entry used above) and supposedly witty tactics (like the whole ball/cube thing) to distort comments and blunt subtleties that are appropriate when discussing nebulous concepts such as malignancy. This term is used so freely that its exact definition is hard to pin down and varies depending on the user, and - it would seem - the region of the USA the user is from.

"No spin zone," huh? Being equated to a Fox News personality, let alone Bill O'Reilly, is certainly a first for me.

Despite my apparently pedestrian antics, I still think my point is valid. Be it from a dictionary or cultural norms, there is a general feeling amongst a strong majority of people in the surgical field as to what defines malignancy, and it has more to do with humiliation and intimidation (either of which gave been known to lead to "routine crying") than an interest in education.

I completely agree that asking questions is not malignant. However, you must acknowledge that asking the same question over a cup of tea or while dunking your head repeatedly into a cold bucket of water are vastly different in terms of their malignancy. As guilty as I am of using sensationalized examples, you are of being too black and white in a field of gray.

Making a resident stand in the corner of the OR because s/he could not identify a vessel or broke a knot is malignant, be it in the interest of "teaching a lesson" or not. If countless other surgeons can figure out another way to be an equally effective teacher, there is no reason to intimidate, humiliate or belittle.

 

[SLUser11]

"No spin zone," huh? Being equated to a Fox News personality, let alone Bill O'Reilly, is certainly a first for me.

Despite my apparently pedestrian antics, I still think my point is valid. Be it from a dictionary or cultural norms, there is a general feeling amongst a strong majority of people in the surgical field as to what defines malignancy, and it has more to do with humiliation and intimidation (either of which gave been known to lead to "routine crying") than an interest in education.

I completely agree that asking questions is not malignant. However, you must acknowledge that asking the same question over a cup of tea or while dunking your head repeatedly into a cold bucket of water are vastly different in terms of their malignancy. As guilty as I am of using sensationalized examples, you are of being too black and white in a field of gray.

Making a resident stand in the corner of the OR because s/he could not identify a vessel or broke a knot is malignant, be it in the interest of "teaching a lesson" or not. If countless other surgeons can figure out another way to be an equally effective teacher, there is no reason to intimidate, humiliate or belittle.

I don't know when or why you lost your soft side, but you are slowly becoming my favorite poster on SDN.

 

[Winged Scapula]

I don't know when or why you lost your soft side, but you are slowly becoming my favorite poster on SDN.

He has gotten a little bitter over the last few weeks hasn't he?

 

[Blade28]

I don't know when or why you lost your soft side, but you are slowly becoming my favorite poster on SDN.

I think it was sometime during the first few months of his PGY-2 year. 😉

 

[Plastikos]

I know nothing of NYU.
USC has long had a rep for being malignant and some of it is likely deserved and linked to specific faculty. I loved it, though i didnt do the foregut rotation (demeester and co.) which carries a large burden for that reputation. Its a place where youll have to work hard for sure, but i didnt find it malignant in the sense that i view the term.
I do feel like a lot of people these days throw malignant around too lightly. Working your butt off and being answerable to pimping is not malignant. How you are treated as a person and the manner in which you are questioned is. EG...mult choice questions during m/m...unnecessary, asking questions more to find a hole in knowledge and humiliate as opposed to finding an area where you can teach your resident, etc./.

Not pimping or requiring better from you by your teachers can also be malignant. SC had a great conviction for teaching and excellence to its students, and one would think this goes for the residency as well. Not that the opposite couldnt be true.

 

[NJA61479]

I am a third year G-surg resident at USC who originally hails from the East Coast. I had heard about many different programs during my application and interview process that were "malignant." One of them was USC. Since getting here, I laugh whenever I hear that people have also heard and chosed to believe this rumor. Coming from the East Coast, the West Coast is pretty cushy. Every surgery program has one or two attendings who residents find intimidating or chose to avoid. Overall I think that people's impression of USC is based on some attendings who were around 5+ years ago and have since left. Since then it has been a pretty nice place to work. Now with our new state of the art county hospital and our new chairman, things are on the up and up. The program is great and will only get better over the next few years as the new chairman has been given the greenlight to hire almost 20 new attendings. Things will surely pick up and get busier which is great for all of us.
Of note, I actually ranked NYU higher than USC in spite of hearing rumors about NYU being a nasty place to work. Since then I have actually spoken to multiple residents there who have confirmed the rumors to be true. I am very thankful that I didn't end up there.