tried to post a residency review on scutwork, but the webmaster never posted my review. when i emailed to see what's up, he/she never got back to me. the reviews on that site are really dated, is that website being update anymore?
Seems like it's dead. We're putting together a more detailed system which I was hoping to have available for testing last week. It was delayed.
We might need to push out a temporary solution this week because I know there is a lot of demand for it.
good. I've got a detailed review of my program that, I think, will be valuable to anyone thinking of ranking U. of Arkansas.
Some information that I wish I had known before taking my position in this program:
I am a resident at University of Arkansas. My day starts at 6:00 for a typical case, slightly earlier, around 5:45am for a bigger case. Lecture in my program is daily at 6:00am and generally lasts around twenty to thirty minutes. Cases in the main OR, where adult anesthesia is provided, begins on most days at 7:15. On Tuesdays of each week there is conference where there is a lecture and an M&M from 6:00 to 7:30.
When you are in the OR, morning break and lunch is usually provided by your attending or the team leader, who is typically a CA-2 or CA-3. Average days end anywhere from six or seven in the evening to as late as eight, which is fairly common.
Call is variable based on month, number of residents rotating through the main OR and other variables of that nature. Late call (approximately 4 times per month) you will be most likely leaving anywhere from seven to midnight, but could be later depending on the case load and number of emergency/add-on cases. There are around seven 24-hour calls per month. Currently our program is experimenting with a night-float system, whereby residents take turns working twelve-hour night shifts. I will not comment on this as it may not prove to last.
An important point to note: At the University of Arkansas CA-1s, CA-2s, and CA-3s all take THE SAME AMOUNT of call. Many American programs give more call to CA-1s then CA-2s -- with CA-3s getting the least amount of call. The rational is that CA-3 should be spending more time preparing for boards then CA-1s. Please see below for the University of Arkansas most recent (and atrocious) board passing rate.
Currently there is a major thrust by the University of Arkansas to expand the ORs and expand the hours during which these ORs are run. Last year U. of Arkansas total OR cases were 8,000. As of now, (with 1.5 weeks left in 12/06) our total cases performed are 11,000. The motto which is now being made (no joke) is that we should be running 7 ORs by 7 OClock PM. To make a long story short: hours are long and getting longer.
Not coincidentally, I have seen an increase in the number of hours I have worked each year and each month since I have been in the program. All other residents have noted the same. I will say again, this is part of a concerted effort to expand the number of cases being performed in order to generate revenue for a poor university hospital that is without an endowment. Prospective anesthesia residents take heed: this is a WORKFORCE PROGRAM and the thirteen plus hour days that I am currently putting in will only get worse in the future. I have recently calculated my most recent average workweek within a one-month span in the main OR (we, like most programs, are required to log our hours): I logged an average of just over 77 hours.
The University of Arkansas anesthesia program sends its residents to Arkansas Childrens Hospital (about 1.5 miles from the main university hospital) for a total of six months of pediatric anesthesia. Working hours are similar at this hospital as compared to the main university hospital. Call at the childrens hospital is similar in number. The most notable difference in this rotation is the nature of the call. While on call you are responsible for doing most of the pre-ops for the next days inpatients and add-on cases. You are also responsible for making sure residents and attendings get breaks and lunches. You are also responsible for making sure post-ops are done on all patients. Doing these pre-ops and post-ops and giving breaks to attendings and residents occupies most of your day and evening while on call. Hence, call days at Arkansas Childrens Hospital is a non-learning, (paperwork) experience -- for the most part. On a positive note because you spend six months at this childrens hospital you will have a very strong background in peds when you graduate. Few other programs in the nation will give you this amount of experience. But it comes at a price: the hours are long, twelve hour days are about average on a non-call day.
The academic/demographic background of the attendings, both at the main university hospital and at the childrens hospital, is a majority FMG. The University of Arkansas anesthesia departments chair is an FMG (from the Philippines) and one of the co-program directors is an FMG (from Pakistan), the other co-PD is an American.
The percentage of FMG anesthesia faculty at the University of Arkansas is 83%. The percentage of anesthesia faculty at Arkansas Childrens Hospital, where we do our peds rotations, is 75%. Some are excellent, some are atrocious. Most are poor didactically and there are three major reasons for this.
Number one: the language difference between American English speakers and those that speak English as a foreign language is often large. It is difficult to understand many of their accents, not too mention their oftentimes broken English. On a side note you may wish to know that on many occasions I have overheard my FMG faculty speak to one another in their mother tongue, right in the middle of the OR, in front of me and other American, English only speaking graduates. I have found this rude and disheartening -- after all, I have no idea if they are talking about me. Many other residents have said the same.
Number two: the cultural difference makes interaction difficult as well. Most of the FMGs come from the Middle-East or India. Many, (but not all), have radically different and often profoundly negative viewpoints on a womens place in the workforce, and other core, western cultural values. Americas societal and political place in the world is often denounced. You will find a very dark, anti-American attitude here amongst the University of Arkansas and Arkansas Childrens Hospital anesthesia faculty.
Number three: most of them are here in Arkansas for only three years because they are fulfilling visa requirements. For those not enlightened in the nuances of becoming an American citizen as an MD, please read on:
Arkansas is considered by the federal government as an underserved area. FMGs come to Arkansas because in order to attain a J-1 visa, (one of the first steps in American citizenship), they must serve three years in a medically underserved area. These FMGs have no true desire to live Arkansas, and they have little to no desire to teach. They have come to Arkansas simply to serve their three year stint, and then they leave. Consequently there is high turnover amongst the faculty.
You may be curious to know what percentage of the residents are FMG: Currently the percentage of anesthesia residents who are FMG is approximately 25%. This percentage has dropped in recent years as the popularity of anesthesia among US graduates has increased.
Clinically you will be exposed to many, and highly sick patients. There is probably no other program in the south that exposes its anesthesia residents to more neurosurgery cases. However hearts are a major weak spot in the program. It is often difficult for residents to get their number of hearts cases. Regional anesthesia, especially peripheral nerve blocks, are another weak spot in our program. Turnover and speed are placed at higher premiums then learning techniques other than general anesthesia.
There is a high attrition rate amongst the residents. In the current CA-3 class five residents left or were fired. In the current CA-2 class one left (medical reasons) and one committed suicide.
The pass-rate for the boards is poor. Almost TWENTY FIVE PERCENT (three out of thirteen) of the 2006 graduating class FAILED TO PASS THE 2006 WRITTEN BOARDS.
If you match for internship you will spend four grueling months on surgery rotations as a scut-monkey.
The city of Little Rock is two hundred thousand in population. There is little to no night- life. The local airport is a national airport and to fly to almost any major city on the west or east coast you will have to skip around at least one other airport (Dallas/Ft. Worth or Memphis). On an up-note, real estate is amazingly cheap. You can buy a lot of house for 150 250K. Totally affordable on a residents salary.
On another positive note, the program was just given four years of accreditation by the ACGME.
Take the above information as you will. Ive tried to present a realistic viewpoint based on hard facts and my personal experience as a resident. And make no mistake; the numbers that have been quoted above ARE absolute, indisputable facts. Bottom line: if you dont mind spending four years working long, long hours, with FMG faculty, with a poor, board passing rate, in an unknown program in the south . . . this program is for you.
My program is headed in the same direction. we are averaging 70 hrs/wk. AND IT IS INCREASING WITH INCREASING SCUTWORK.
lonestar and coprolalia -- would you mind sharing which programs?
i have only experienced one anesthesiology residency program and it is definately NOT this way. thanks for making me appreciate the program i am rotating at.
its a sad state of affairs if all the programs in the country are becoming work horse programs with limited focus on the educational aspect..
There's a massive physician shortage in the U.S. (contrary to the b.s. party-line that COGME was spouting off for years) and the population is getting older and sicker. Factor in the belief that every American, whether they can afford it or not, is entitled to the gold standard of care and the million dollar work-up, or they're going to sue you if you make a mistake, and you've got the recipe for disaster. Everyone is working harder, longer, and doing more paperwork and needless tests. People that would NEVER have gone to the OR ten years ago are routinely doing so now, and expecting to always have a good outcome. As the old saying goes, **** rolls downhill... and right now residents (in all disciplines) are bearing the brunt of this.
Why do you think there is a strong move afoot to extend the anesthesia residency from four to five years, for example? More exploitation - pure and simple. They're argument is that you can't learn everything you need to know in four years (intern + 3 anesthesia) anymore. Well, if they'd actually teach us something instead of making us do 900 lap choles maybe it'd only take four years.
I just REALLY feel bad for those of you who'll be coming out of med school in the next 4-5 years. You're really going to have it bad. Sure, you'll be limited to your 80-hour work week, but unlike the old days where you might actually get some break time during those 80 hours (like for sleeping and eating and doing your bodily functions), you're going to be expected to be up and working every minute of it.
It's sad. Really sad. The whole system is totally screwed up, and I don't care where you go - if you think you're going to have a cush anesthesia residency, you're in for a rude awakening.
-copro