UTSW Gen Surg

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SurgGuy521

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What's the story on UT Southwestern's Gen Surg program. I've heard from residents there the following things, all a bit red flags for me.

  • Lots of issues with the New (2013) Chair
  • New PD (Brian Williams) as of this summer. I googled him and it was like he almost didn't exist. Anyone know who he is?
  • They've had issues with case numbers. Apparently two graduates a few years ago didn't meet min ABS case numbers and they got in trouble
  • Resident attrition. People leave as early as 3 months into intern year and late as PGY4
  • Faculty turnover.
  • They won't interview IMGs or anyone not "traditional" for their program (read: not a prototypical white kid straight out of residency)
I'm confused because they seem to have an okay reputation, but my insider says it's falling apart. I would love to be in Dallas though. Anyone else have any info?

Thx

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Agreed. That PD seems well-trained and well-qualified on paper...not someone who doesn't "exist."

I don't want to discourage this new poster, however, as certainly rumors should be brought up and then addressed. @balaguru is a UTSW grad and can speak intelligently about any recent changes. In general, they have an excellent reputation.

As far as resident attrition, this occurs at every program, with a 20% rate nationally. When you have such a big program (12+ residents/year), you are going to have 2+ residents leaving every year.
 
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It's odd how that opening post is written though, names along with vague comments, oddly stated questions, and "falling apart" innuendo. :rolleyes:

UTSW Surgery is so big, powerful, and influential that it does feel that it's an aircraft carrier sometimes, but they work up hard there, covering thousands of patients. Thirteen GS residents per year, dozens of fellows, massive heart and trauma surgery programs. Recent GS leadership turnover corresponded with the move into two new hospitals and the normal changes in tenured personnel, which seems to happen at UTSW every ten years or so. True that UTSW is a conservative program with a dislike for nontraditional resident candidates, but plenty of women and a modest amount of "diversity", same across all residencies.
 
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Agreed. That PD seems well-trained and well-qualified on paper...not someone who doesn't "exist."

Well he has been busy...

ImageUploadedBySDN1473722772.001829.jpg




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What's the story on UT Southwestern's Gen Surg program. I've heard from residents there the following things, all a bit red flags for me.

  • Lots of issues with the New (2013) Chair
  • New PD (Brian Williams) as of this summer. I googled him and it was like he almost didn't exist. Anyone know who he is?
  • They've had issues with case numbers. Apparently two graduates a few years ago didn't meet min ABS case numbers and they got in trouble
  • Resident attrition. People leave as early as 3 months into intern year and late as PGY4
  • Faculty turnover.
  • They won't interview IMGs or anyone not "traditional" for their program (read: not a prototypical white kid straight out of residency)
I'm confused because they seem to have an okay reputation, but my insider says it's falling apart. I would love to be in Dallas though. Anyone else have any info?

Thx

I graduated in 2013. I never met the new chair. I occasionally call some of my old attendings to discuss patients. My brother is the nephrology program director. I would characterize my knowledge of the current state of affairs within the UTSW surgery dept as pretty limited, but I have heard the rumors. I will respond to each of your statements.

1. The rumor is that the chair wants to transform UTSW into more of an academic place like the names you see in various top 10 lists. I have always felt that the strength of UTSW as a place to train was that it could put you on track to be an academic surgeon if you wanted but could also turn you into an above average community general surgeon without additional fellowship training. It would be sad to me if somehow the program's focus on promoting graduated autonomy and training true general surgeons were lost while transforming the program into a specialty driven institution with fellows everywhere. I have also heard rumors that faculty pay under the new chair is terrible.
2. As an example of how out of touch I am, I didn't even know Brian Williams was the new PD. He is just about perfect for the job: former military, Harvard residency, Grady for trauma, etc. He appeared to genuinely enjoy being an educator for students and residents. I enjoyed being on his service.
3. This may be true of any large program: it's possible to skate by and avoid the OR by sending junior residents in so you can bug out early. If anybody failed to get their numbers I bet this was the reason. I frequently stuck around post trauma call to cover cases my colleagues couldn't. I also traded one of my co-chiefs for an extra month of surg onc which is the most demanding month for chiefs in order to get more HPB cases. I would have met my numbers without having done all that by just doing what was expected of me.
4. I had never heard of an intern leaving after 3 months but I wouldn't be surprised if that did happen. UTSW takes 13 categoricals each year. Attrition in general surgery is about 20-25%. Do the math. I suspect in the case of the intern, he or she wasn't just leaving UTSW but the entire medical field. I can't come up with a likely career path in medicine after a move like that unless it was related to some significant medical or family event. There were a few residents that I knew who did not have their contracts renewed after PGY4. While sad, in every case the residents had multiple opportunities to fix deficiencies including counseling, being assigned a proctor, repeating a clinical year, etc. If we are going to talk the talk about policing our own and graduating safe surgeons then we have to walk the walk.
5. See my answer to #1.
6. Absolute rubbish. I was a Indian guy with shoulder length hair and a nontraditional path into medicine. One intern class had 3 IMG categoricals: 2 from the Royal College of Surgeons Ireland and 1 from Ross (a Caribbean school) and they were all very good residents. One intern class had 10 women and 3 men. There have been multiple openly gay residents and fellows. Lastly, Brian Williams is black.
 
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1. The rumor is that the chair wants to transform UTSW into more of an academic place like the names you see in various top 10 lists. I have always felt that the strength of UTSW as a place to train was that it could put you on track to be an academic surgeon if you wanted but could also turn you into an above average community general surgeon without additional fellowship training. It would be sad to me if somehow the program's focus on promoting graduated autonomy and training true general surgeons were lost while transforming the program into a specialty driven institution with fellows everywhere. I have also heard rumors that faculty pay under the new chair is terrible.

Dr. Michael Choti is out as Chair; Dr. Robert Rege has returned as Interim. Choti came from Johns Hopkins, culture shock took its toll... UTSW surgery and Baylor Dallas general surgery residency programs have for decades focused on operating room talent. There's not a city in the north half of Texas that doesn't have a UTSW or Baylor-Dallas trained general surgeon at the main community hospital.
 
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Dr. Michael Choti is out as Chair; Dr. Robert Rege has returned as Interim. Choti came from Johns Hopkins, culture shock took its toll... UTSW surgery and Baylor Dallas general surgery residency programs have for decades focused on operating room talent. There's not a city in the north half of Texas that doesn't have a UTSW or Baylor-Dallas trained general surgeon at the main community hospital.
I really hate when a new chair comes in and tries to change the entire makeup and culture of a place. By my satelite campuses has had a new chair for <1 year for this exact reason. Both brought in a name that had ideals of grandeur in a private "university" hospital dominated by the private docs and basically the private docs rebelled enough and forced these chairs out. But both times forced out many of the better attendings to try to replace them with their own people. My home institution hired a new chair (the interim) from within, and she has kept much of what was excellent about my program and has tried to augment and expand upon them. I'm all about outside blood and new perspective, but to want to change the lifeblood of a place is just asinine.

I think we are going to see more and more of these massive academic residencies as more and more health systems merge.
 
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[QUOTE="thedrjojo, post: 1827844]

I think we are going to see more and more of these massive academic residencies as more and more health systems merge.[/QUOTE]

Yep which is why it's so important to not burn the bridges: today's competition is tomorrow's partner.




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I think we are going to see more and more of these massive academic residencies as more and more health systems merge.

Yep which is why it's so important to not burn the bridges: today's competition is tomorrow's partner.

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Just like today's medicine resident calling an unusual consult is tomorrow's referring physician... ;)
 
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Something is wrong with the UTSW program setup and screening if you have multiple people not meeting case numbers and a 20+ % attrition rate. That's just baffling from a traditionally respectable program like UTSW.
 
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Something is wrong with the UTSW program setup and screening if you have multiple people not meeting case numbers and a 20+ % attrition rate. That's just baffling from a traditionally respectable program like UTSW.

but i hear you get a custom pair of cowboy boots made for you, if you're into that sort of thing
 
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but i hear you get a custom pair of cowboy boots made for you, if you're into that sort of thing

Yep. Lucchese, will do it custom for any Texas medical program when asked. I still have my intern-year pair from 1986, similar to Obama's custom Lucchese Longhorn ostrich-skin boots; photo from August, 2010 in the Texas basketball locker room (royalty free photo):

us-president-barack-obama-tries-on-a-pair-of-cowboy-boots-at-the-university-f32e92.jpg
 
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I'm just happy if my program will buy me a couple of books a year
 
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Does anyone know anything about UTSW's call schedule? I know it came up at the resident dinner but I realized I never wrote it down. Thanks!
 
As far as resident attrition, this occurs at every program, with a 20% rate nationally. When you have such a big program (12+ residents/year), you are going to have 2+ residents leaving every year.

Out of curiosity, where did you find this number and is this just for general surgery? A 20% attrition rate seems enormously high.

Is this unique to surgery or are there other specialties too with such high attrition rates?

I always just assumed the overwhelming majority of all residents completed their training.
 
Out of curiosity, where did you find this number and is this just for general surgery? A 20% attrition rate seems enormously high.

Is this unique to surgery or are there other specialties too with such high attrition rates?

I always just assumed the overwhelming majority of all residents completed their training.

There are other specialties with higher attrition rates, most namely psychiatry and OB/GYN. There are of course many with lower attrition rates but all specialties have residents who leave.

Remember those attrition rates include not only people that leave of their own volition but those who are fired or deceased.

A 20% attrition rate means that 80% complete or in other words "an overwhelming majority".


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There are other specialties with higher attrition rates, most namely psychiatry and OB/GYN. There are of course many with lower attrition rates but all specialties have residents who leave.

Remember those attrition rates include not only people that leave of their own volition but those who are fired or deceased.

A 20% attrition rate means that 80% complete or in other words "an overwhelming majority".


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Thanks for the reply. When I said overwhelming majority my mind was thinking of a number closer to 95%. 20% attrition is 3-4 times the US senior non-match rate, which blows my mind. I guess I just never had any idea how many people never finish residency.

It baffles me that after so many years of school and the piles of debt, there are still that many people who are either bad enough to get fired or quit to do something else. I'm assuming the mortality rate, while significant, isn't one of the larger drivers of the 20%.
 
What's the story on UT Southwestern's Gen Surg program. I've heard from residents there the following things, all a bit red flags for me.

  • Lots of issues with the New (2013) Chair
  • New PD (Brian Williams) as of this summer. I googled him and it was like he almost didn't exist. Anyone know who he is?
  • They've had issues with case numbers. Apparently two graduates a few years ago didn't meet min ABS case numbers and they got in trouble
  • Resident attrition. People leave as early as 3 months into intern year and late as PGY4
  • Faculty turnover.
  • They won't interview IMGs or anyone not "traditional" for their program (read: not a prototypical white kid straight out of residency)
I'm confused because they seem to have an okay reputation, but my insider says it's falling apart. I would love to be in Dallas though. Anyone else have any info?

Thx

They only interview prototypical white kids huh?

 
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Get used to it, economic demographics. Educated, white American males go where there is power (over one's career) and money. Medicine, going forward, is losing an enormous amount of talent.
 
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Top left?

And damn, that's a LOT of women in one surgery class! Not at all saying that's a bad thing, before the SJWs come.
That guy isn't black bra lol. But it really doesn't matter. Residency applicants should be ranked based on the fit of that specific person to that specific program no matter the race or gender. I think for the most part programs do that.
 
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