Why UT Southwestern did not fill

[anesthesia1]

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Hey guys, it is my understanding that UTSW combined St. Paul categoricals with there own (Parkland) and they therefor decreased their overall categorical positions. They did not go unfilled.

 

[dr-dre]

Hey guys, it is my understanding that UTSW combined St. Paul categoricals with there own (Parkland) and they therefor decreased their overall categorical positions. They did not go unfilled.

I don't believe this is true. I have a friend who scrambled into a medicine spot at UTSW after failing to match in medicine (only ranked 2 medicine programs that were top tier).

I can appreciate the loyalty you are showing to UTSW, but I am extremely skeptical of the:

#1 Unmatched diamond theory: Why fill your program with a bunch of people who didn't even consider being there in the first place? This will surely make for an unhappy batch of residents. Sadly, my friend will be one of them 🙁 .

#2 St. Paul's taking categorical positions theory: See above.

Yes, other programs such as UCLA, Wash U and Vandy have failed to fill all their categorical positions in the recent past. Hell, UCLA-Harbor, UVa and Dartmouth also did it this year. But NONE of those programs failed to fill 9 categorical positions. This is a colossal number.

Rather than brainstorm excuses as to why UTSW didn't fill, perhaps the residency leadership should consider what really went wrong so the mistake doesn't happen twice.

 

[swedcrip]

it seems like a pretty grueling residency to me. my guess is their own residnents aren't shy about letting applicants know that.

 

[anesthesia1]

Hey guys, it is my understanding that UTSW combined St. Paul categoricals with there own (Parkland) and they therefor decreased their overall categorical positions. They did not go unfilled.

I am going into anesthesia when I finish my residency in medicine in 3 months. Have fun playing with HTN and CHF and talking all day and not doing s...

 

[Fantasy Sports]

I am going into anesthesia when I finish my residency in medicine in 3 months. Have fun playing with HTN and CHF and talking all day and not doing s...

Yes, because we know that two of the major causes of death in the US don't deserve to be "played" (= worked) on.

Have fun with the nurse anesthesiologists (taking over your job) and surgeons (who are doing the real work) and not doing s... 🙄

 

[anesthesia1]

thanks med student for the insight. laughing all the way to the bank!

 

[Fantasy Sports]

thanks med student for the insight. laughing all the way to the bank!

Surprise surprise, another anesthesia resident who could care less about patients...

I'm assuming you mean the blood bank, since in 10 years that's about the only way you'll earn more than a nurse anesthesiologist.

That's the best part about people picking specialties solely for money... ironically, they have no understanding of economics (replaceable, lower cost labor + better technology= less demand= lower salary).

 

[swedcrip]

What all this anesthia discussion has to do with IM or Southwestern is beyond me.

 

[the citizen]

I am going into anesthesia when I finish my residency in medicine in 3 months. Have fun playing with HTN and CHF and talking all day and not doing s...

Maybe UTSW didn't fill because they let anesthesia1 talk to applicants??

 

[Fantasy Sports]

Maybe UTSW didn't fill because they let anesthesia1 talk to applicants??

 

[UTSouthwestern]

Surprise surprise, another anesthesia resident who could care less about patients...

I'm assuming you mean the blood bank, since in 10 years that's about the only way you'll earn more than a nurse anesthesiologist.

That's the best part about people picking specialties solely for money... ironically, they have no understanding of economics (replaceable, lower cost labor + better technology= less demand= lower salary).

You shouldn't be talking about economics and midlevel providers when you consider how nurse practitioners, PA's, and midwives, optometrists, and even chiropractors are pushing for more medical and surgical priveleges/autonomy than ever. If you think anesthesiologists are the only ones who hospitals might consider reducing the numbers in favor of midlevels, you had better think twice. I won't even begin to talk about salary issues as the numbers speak for themselves and reimbursement over the past three years has stayed steady in some states and increased in others, especially Texas.

In any event, anesthesia1's choice of words and tone weren't the most appropriate.

As for Southwestern not filling, nine St. Paul residents were slated to be absorbed into the Southwestern program, but two decided not to continue with internal medicine. One transferred into the UTSW anesthesiology program and another moved to the west coast. I don't know who the latter person is, but I just met the former one who is rotating on the anesthesiology service at Parkland. Regardless, the medicine department is very happy with their match list and their fellowship placement this year for cards, GI, heme-onc, pulm-cc, and allergy/immunology is going spectacularly well as usual.

 

[swedcrip]

You shouldn't be talking about economics and midlevel providers when you consider how nurse practitioners, PA's, and midwives, optometrists, and even chiropractors are pushing for more medical and surgical priveleges/autonomy than ever. If you think anesthesiologists are the only ones who hospitals might consider reducing the numbers in favor of midlevels, you had better think twice. I won't even begin to talk about salary issues as the numbers speak for themselves and reimbursement over the past three years has stayed steady in some states and increased in others, especially Texas.

In any event, anesthesia1's choice of words and tone weren't the most appropriate.

As for Southwestern not filling, nine St. Paul residents were slated to be absorbed into the Southwestern program, but two decided not to continue with internal medicine. One transferred into the UTSW anesthesiology program and another moved to the west coast. I don't know who the latter person is, but I just met the former one who is rotating on the anesthesiology service at Parkland. Regardless, the medicine department is very happy with their match list and their fellowship placement this year for cards, GI, heme-onc, pulm-cc, and allergy/immunology is going spectacularly well as usual.

so were they going to make the St. Paul residents start over as PGY-1's? Otherwise that doesn't make sense.

 

[CCMD2005]

UTSouthwestern did not fill because they have failed to keep up with the current trends in internal medicine and people don't want to go to arcane medicine programs, they want to go to dynamic ones. Look at the results, many people from UTSW DID NOT match into competitive fellowships last year. Also UTsouthwestern1, how does UTSW know that there cardio, pulmonary, etc. fellowship matching is going "great" this year if these specialties match doesn't come out until June??? It's plain and simple, UTSW refused to change and now is being left in the dust by other programs. Maybe this will give them the impetus to change, I hope so, for the sake of all the patients in Dallas who rely on smart IM interns and residents at Parkland to get better.
-CC

 

[Fantasy Sports]

You shouldn't be talking about economics and midlevel providers when you consider how nurse practitioners, PA's, and midwives, optometrists, and even chiropractors are pushing for more medical and surgical priveleges/autonomy than ever. If you think anesthesiologists are the only ones who hospitals might consider reducing the numbers in favor of midlevels, you had better think twice. I won't even begin to talk about salary issues as the numbers speak for themselves and reimbursement over the past three years has stayed steady in some states and increased in others, especially Texas.

In any event, anesthesia1's choice of words and tone weren't the most appropriate.

As for Southwestern not filling, nine St. Paul residents were slated to be absorbed into the Southwestern program, but two decided not to continue with internal medicine. One transferred into the UTSW anesthesiology program and another moved to the west coast. I don't know who the latter person is, but I just met the former one who is rotating on the anesthesiology service at Parkland. Regardless, the medicine department is very happy with their match list and their fellowship placement this year for cards, GI, heme-onc, pulm-cc, and allergy/immunology is going spectacularly well as usual.

I do in fact realize the nature of midlevel practioners and their effect on medical economics, but it is obvious that the greatest inroad into upper level practices have been allowed by greedy anesthesiologists who maximized their profits in the short term by allowing midlevel providers greater privileges, but hurt their profession in the long-run. Its unfortunate this has happened, because while this is likely to hit anesthesiologists first, other specialties might fall to the same pressures unless they learn from the mistakes that some greedy anesthesiologists made.

How did you already find out about fellowship placement for this year? I thought those results didnt come out til later in the year.

 

[swedcrip]

I do in fact realize the nature of midlevel practioners and their effect on medical economics, but it is obvious that the greatest inroad into upper level practices have been allowed by greedy anesthesiologists who maximized their profits in the short term by allowing midlevel providers greater privileges, but hurt their profession in the long-run. Its unfortunate this has happened, because while this is likely to hit anesthesiologists first, other specialties might fall to the same pressures unless they learn from the mistakes that some greedy anesthesiologists made.

How did you already find out about fellowship placement for this year? I thought those results didnt come out til later in the year.

guys, can you take the anesthesia discussion somewhere else (hint, anesthesia forum)

i know for some fellowships (that aren't run through a match) that people know where there going months ahead of time. back when I was interviewing in late October there were last year residents with fellowship offers (had either accepted or were weighing multiple ones)

 

[Fantasy Sports]

i know for some fellowships (that aren't run through a match) that people know where there going months ahead of time. back when I was interviewing in late October there were last year residents with fellowship offers (had either accepted or were weighing multiple ones)

Can you explain how some people know ahead of time and other's don't? I thought fellowship programs generally informed acceptees around the same time. I could be wrong, but I would be interested to hear the facts since I only know what people have mentioned to me.

 

[AJM]

Can you explain how some people know ahead of time and other's don't? I thought fellowship programs generally informed acceptees around the same time. I could be wrong, but I would be interested to hear the facts since I only know what people have mentioned to me.

The different specialties all have their own selection processes. Some are run through the Medical Specialties Matching Program run by the NRMP: http://www.nrmp.org/fellow/match_name/msmp/about.html
The fellowships that do this are pulmonary, cards, ID, and this year rheum is joining the match. For people applying in these specialties, Match Day is in the end of June, typically in their 2nd year if they are planning on immediately entering the fellowship when done with their residency.

The remaining fellowships are not run through the match, and are more similar to normal job applications. These applicants usually know which program they'll be going to anywhere from October to January or so of their 2nd year. There's no set date, as these programs have a sort of rolling admissions. So this group of people have already completed the application process for the year, whereas the applicants going through the match are just starting to interview now.

 

[krkuhl]

no clue if ther were unfilled spots for the reason UTsouthwestern listed (i imagine he has some good insight there) but we had a student scramble and match for a PRELIM surgery position there.

i interviewed there and let me tell you--if it werent for professional courtesy and not looking like a complete ass, i would ahve walked right back out and drove my happy little ass back home after the first 15 minutes. i had by far the worst experience there.

--arrive to a sea of black coats--only a few interview days so there are about 80 applicants crammed in a room. that many applicants in one day meant tons of people interviewing, some of which werent happy about having to take time off to interview
--"lecture" by the dean or whomever he was. i seriously felt like i was either in the army or in gradeschool. lectured about "the quickest way to get a trip down to my office is to act unprofessional" and such. then proceeded to brag about hjow hard they work and that it beats you down but builds you up to a better physician.
--the students i met from SW were horrible. mind you, this is a blatant stereotype but most of them were unfriendly, couldnt care less about talking to other students and answer questions about their school, and couldnt wait until the free alcohol at the end of the day (liver rounds). arrogance was abound.
--my actual interviews with the staff were fantastic--they were actually very nice and friendly, low stress and not at all what i expected from them.

due to these experiences, i didnt even rank UTSW on my list--i would have rathered scramble or take a year off than go there. JMHO and 2 cents.

 

[UTSouthwestern]

Just to put a final note on this situation: I spoke with the PD and we did indeed give our "unmatched" positions to the incoming St. Paul residents. However, after this year, the residency will contract by nine spots.

 

[yesh]

I am going into anesthesia when I finish my residency in medicine in 3 months. Have fun playing with HTN and CHF and talking all day and not doing s...

Prostitutes also get paid for doing rote work and taking abuse.....you give credence to your future title "surgeon's b#@!@"

 

[pufftissue]

Hey guys, it is my understanding that UTSW combined St. Paul categoricals with there own (Parkland) and they therefor decreased their overall categorical positions. They did not go unfilled.

If there is one thing I've learned, programs that don't match always, always, without reservation, have issues.

Whether it's too malignant, poor location, horrible teaching, whatever, there's no way anyone should continue to make excuses or spin things positively for anything other than it creates a spot for someone to at least be a resident physician.

UTSW didn't match b/c of the arrogancy that pervades the place. They got greedy and reality hit them. That's the obvious answer and I think it's the correct one.

 

[Fantasy Sports]

If there is one thing I've learned, programs that don't match always, always, without reservation, have issues.

Whether it's too malignant, poor location, horrible teaching, whatever, there's no way anyone should continue to make excuses or spin things positively for anything other than it creates a spot for someone to at least be a resident physician.

UTSW didn't match b/c of the arrogancy that pervades the place. They got greedy and reality hit them. That's the obvious answer and I think it's the correct one.

It's interesting that a top 10 program would contract its residency spots. Does this have precedent among other top programs without funding trouble?