UT Houston’s Malignant Anesthesiology Program

[Anonymous5454]

I am morally obligated to warn others about UT Houston’s malignant anesthesiology program.

The malignant faculty do check these forums. So, naturally, they will try to negate what I say, but I hope student doctors will hear my message.

Malignant in the past, malignant currently, and will be malignant in the future.

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[Dr. Rude]

Specify please.

 

[DolphinVA]

I am morally obligated to warn others about UT Houston’s malignant anesthesiology program.

The malignant faculty do check these forums. So, naturally, they will try to negate what I say, but I hope student doctors will hear my message.

Malignant in the past, malignant currently, and will be malignant in the future.

Perhaps some details would help.

 

[aneftp]

What qualifies as malignant? No 15 min morning breaks? No uninterrupted 30 min lunch Break?

Not getting u out right at 3pm?

Working post call?

Cause those are real world life complaints of CRNAs?

Or are they real? Line being being left in room for hours? Or not getting out for lectures?

 

[sevo00]

Yes let’s hear what the actual complaints are

 

[Status Sciaticus]

 

[KetamineForAll]

Damn that sucks. If someone is abusing fentanyl, that needs to be addressed ASAP. What is the definition of "workhorse?" One of my co-residents back in the day called our program work horse and when I asked her to pull up her hours logs, she worked 57 hours. Yes, that is more than some, but compared to most residencies, thats not bad. If someone comes to steal your procedure, tell them "Hell no." I'm really sorry about your attendings belittling y'all, that sucks. Had a buddy one time tell an attending (privately) that he was being an dingus and he didn't learn well that way. It actually worked out in his favor, as the guy respected him.

 

[anaesthetic]

To preface my post, I will say that I do not personally know the program dynamics at UT Houston nor anyone there, so I will not attempt to discount anyone’s experiences as a trainee in that program.

That being said, I was a chief resident at a big “workhorse” program. Many of the complaints detailed in OP’s post (before it was removed) could have applied to my program:
- We worked 55-70 hrs/week depending on the rotation.
- We did relieve CRNAs on occasion depending on the rotation.
- We had some attendings who belittled us and yelled at us.
- We had residents cry from said experiences, and some did abuse substances throughout training.
- We did a lot of overnight call and did a lot of things on our own as senior residents.

Would I say our program was malignant? Not at all, and that’s with me having a lot of disagreements with program leadership throughout my chief year. We pushed for better resident experiences, changed the structure of a lot of bad rotations (or eliminated them completely), and made sure the malignant attendings got reprimanded for their actions. Our program wasn’t perfect by any means, but we tried to leave it better than what it was for the current/incoming residents.

I think the most important measure of a program’s value and degree of “malignancy” is its willingness to change. Even though I disliked and disagreed with a lot of the administrative staff at my program, I will give them credit in that they were willing to listen to us and enact change where we thought there should be change, although not always in the direction or magnitude that we pushed for.

I’m sure some of my co-residents would say that our program was malignant, depending on their own experiences and anecdotes. When I think of a malignant program, I think of it not in terms of bad work hours, or bad attendings, or bad culture even. It’s a program that gives its residents very little power and refuses to acknowledge its shortcomings or enact change regardless of resident feedback.

Maybe that’s UT Houston, maybe not.

 

[Arantius]

Interesting... I interviewed there years ago and I felt the residents got amazing training, seemed tired but aren’t they all?! I actually ranked really high but didn’t match there- went out East instead. It’ll be hard to convince me it’s a BAD program with respect to training (incredible rotations, faculty, case logs etc).

I’m 8 years out of residency and listen- residency sucks. But now hear this: the real world sucks MORE. Wait until your first year out when you’re coding a sick as **** patient prone in a shi**y small “hospital” with circulatory literally having a panic attack and no one around capable of being any kind of help. And an a**hole spine surgeon yelling at you to fix it... and miraculously yes you save the patient and everyone is fine but is anyone thankful or do they even acknowledge what you did? NO. Just keep cranking out the RVUs and whatever you do don’t cancel a patient for *that* surgeon or he will fire your group.

How’s that for malignant.

 

[Arantius]

Interesting... I interviewed there years ago and I felt the residents got amazing training, seemed tired but aren’t they all?! I actually ranked really high but didn’t match there- went out East instead. It’ll be hard to convince me it’s a BAD program with respect to training (incredible rotations, faculty, case logs etc).

I’m 8 years out of residency and listen- residency sucks. But now hear this: the real world sucks MORE. Wait until your first year out when you’re coding a sick as **** patient prone in a shi**y small “hospital” with circulatory literally having a panic attack and no one around capable of being any kind of help. And an a**hole spine surgeon yelling at you to fix it... and miraculously yes you save the patient and everyone is fine but is anyone thankful or do they even acknowledge what you did? NO. Just keep cranking out the RVUs and whatever you do don’t cancel a patient for *that* surgeon or he will fire your group.

How’s that for malignant.

Sorry meant to say “circulator” nurse.

 

[Blockit]

Interesting... I interviewed there years ago and I felt the residents got amazing training, seemed tired but aren’t they all?! I actually ranked really high but didn’t match there- went out East instead. It’ll be hard to convince me it’s a BAD program with respect to training (incredible rotations, faculty, case logs etc).

I’m 8 years out of residency and listen- residency sucks. But now hear this: the real world sucks MORE. Wait until your first year out when you’re coding a sick as **** patient prone in a shi**y small “hospital” with circulatory literally having a panic attack and no one around capable of being any kind of help. And an a**hole spine surgeon yelling at you to fix it... and miraculously yes you save the patient and everyone is fine but is anyone thankful or do they even acknowledge what you did? NO. Just keep cranking out the RVUs and whatever you do don’t cancel a patient for *that* surgeon or he will fire your group.

How’s that for malignant.

THIS. ^^^^

 

[Blockit]

By the OP’s standards my university residency was also “malignant”. And that was 20 years ago. Looking back on it now, private practice has been worse for all the reasons the astute Arantias stated.

 

[Southpaw]

The residents were the workforce at my residency. CRNAs didn’t take call. No SRNAs. We did everything at all hours including transplants. We worked hard and I got excellent experience. Nothing has surprised me as an attending. I’m thankful for the resident experience and I really enjoyed it. I still probably barely worked 55-60 hours a week.

Education was great. Lectures were awesome. Hospital had a wonderful local coffee stand that I loved getting coffee from everyday. I felt respected by my attendings. I look back at those years as some of the best of my life.

 

[Urzuz]

I’m 8 years out of residency and listen- residency sucks. But now hear this: the real world sucks MORE. Wait until your first year out when you’re coding a sick as **** patient prone in a shi**y small “hospital” with circulatory literally having a panic attack and no one around capable of being any kind of help. And an a**hole spine surgeon yelling at you to fix it... and miraculously yes you save the patient and everyone is fine but is anyone thankful or do they even acknowledge what you did? NO. Just keep cranking out the RVUs and whatever you do don’t cancel a patient for *that* surgeon or he will fire your group.

How’s that for malignant.

It sounds like you have a ****ty job.

The “real world” is way better than residency and it’s not even close.

 

[CubsDynasty]

Can we just delete this thread if OP doesn’t substantiate their post? Just a resident who got bad feedback? Working hard doesn’t malignant make a program.

 

[anaesthetic]

Can we just delete this thread if OP doesn’t substantiate their post? Just a resident who got bad feedback? Working hard doesn’t malignant make a program.

They did, briefly, before they took it down. Some complaints about work hours, culture, malignant attendings, being belittled, residents crying, residents abusing substances, residents being pressured to lie about the program, senior residents stealing procedures from junior residents, etc. On the surface, it doesn’t seem much different than any other big program, but we don’t really know what the program’s response to all this is, which matters a lot IMO.

 

[CubsDynasty]

Didn't see that, thanks for clarifying. Without details its hard to say more. Sounds like an email from a PD saying lets talk about things amongst ourselves before social media.

 

[teacher2md]

I went to a residency that was traditionally “family-friendly”. We worked about 50ish hours per week averaged over all rotations.

I feel that I got fantastic training, and have been comfortable doing all types of cases, (cardiac, neuro, OB, regional, peds, etc) with a fairly easy transition into being an attending.

I sought out extra rotations as a CA3 in areas that I knew I was weaker. I also think the fact that we had few fellows to dilute the training experience was beneficial.

 

[TPT69]

I am a current resident at UT-Houston. I'll preface by saying that I ranked the program highly and I am extremely happy here.

In terms of work hours, I work 50-55 hours/week in the main OR and less on subspecialties. Weekday calls are 3 PM to 7 AM in main OR and every subspecialty rotation, usually once per week, and you do not work post-call ever unless optionally moonlighting which is never forced. Weekend day calls are 24 hours but only occur either once (usually) or twice (sometimes) per month.

The clinical complexity is excellent. The patients are incredibly sick, the cases are very complex, and it is the busiest trauma center in the nation. This makes for some very stressful experiences, especially early on as CA-1's are really not shielded from big, sick cases at all on call. It can be overwhelming starting out, but I think I am better for having been put in those situations and having to have made intraoperative medical decisions on my own. There are no M&Ms, only quality conferences where select cases of educational value are presented by an objective presenter.

There are situations in the main OR where residents will relieve AA's at 5 PM. This is a frustrating part of being an integral, necessary part of a large-scale dynamic OR board, but in the context of the overall hours worked I don't think it necessitates a public shaming of the program.

In terms of malignancy, there are 1-2 attendings in the main OR who have a tendency to be blunt with residents. I have never witnessed or heard of a time in an OR where an attending yelled at a resident. I have not personally witnessed any overt abuse of residents by faculty, but I have submitted negative evaluations of faculty. In response to my negative evaluations, the program director addresses the (anonymous) evaluation with the attending and I have seen real, actual change in the relationship of some previously blunt attendings in terms of the way they interact with residents and their overall behavior. The program director is particularly aggressive about fostering and comfortable environment for residents and recuriting faculty who are personable and like to teach.

In terms of residents abusing substances, I've never seen or heard about this but I would encourage the OP to go through the proper channels of reporting this so that the resident can get help before the situation worsens.

 

[Coffee PRN]

I am a current resident at UT-Houston. I'll preface by saying that I ranked the program highly and I am extremely happy here.

In terms of work hours, I work 50-55 hours/week in the main OR and less on subspecialties. Weekday calls are 3 PM to 7 AM in main OR and every subspecialty rotation, usually once per week, and you do not work post-call ever unless optionally moonlighting which is never forced. Weekend day calls are 24 hours but only occur either once (usually) or twice (sometimes) per month.

The clinical complexity is excellent. The patients are incredibly sick, the cases are very complex, and it is the busiest trauma center in the nation. This makes for some very stressful experiences, especially early on as CA-1's are really not shielded from big, sick cases at all on call. It can be overwhelming starting out, but I think I am better for having been put in those situations and having to have made intraoperative medical decisions on my own. There are no M&Ms, only quality conferences where select cases of educational value are presented by an objective presenter.

There are situations in the main OR where residents will relieve AA's at 5 PM. This is a frustrating part of being an integral, necessary part of a large-scale dynamic OR board, but in the context of the overall hours worked I don't think it necessitates a public shaming of the program.

In terms of malignancy, there are 1-2 attendings in the main OR who have a tendency to be blunt with residents. I have never witnessed or heard of a time in an OR where an attending yelled at a resident. I have not personally witnessed any overt abuse of residents by faculty, but I have submitted negative evaluations of faculty. In response to my negative evaluations, the program director addresses the (anonymous) evaluation with the attending and I have seen real, actual change in the relationship of some previously blunt attendings in terms of the way they interact with residents and their overall behavior. The program director is particularly aggressive about fostering and comfortable environment for residents and recuriting faculty who are personable and like to teach.

In terms of residents abusing substances, I've never seen or heard about this but I would encourage the OP to go through the proper channels of reporting this so that the resident can get help before the situation worsens.

Just out of curiosity if you are willing to share, what year of training are you in? I find senior residents to usually be more jaded/critical of their program while CA-1s/early CA-2s are often still in their honeymoon phase.

 

[Arch Guillotti]

Closing. I think we can all read between the lines here.