Wookin' pa nub at MLK

[radgal]

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Does MLK/Drew count as all the wong pwaces?

I'm at a malignant southeastern program that is thinking of canning my behind due to problems with the administration. Rather than sweat out another year with these overbearing slugs, I'm thinking of jumping ship (am currently a PGY-II) to MLK/Drew, which I'm told always has open spots.

Their website doesn't list any openings for PGY-III beginning in July 2005, and neither does the SAEM website list any PGY-III openings in the entire country.

BUT... there are only going to be 12 third-years next year at Drew, and they have funding for 14 slots (the current interns and incoming intern class all have 14 residents, and they've graduated 14 people a year in the past).

Anyone (esp you MLK residents out there) know if there are slots open? I'm hesitating to contact their residency director yet because he might call my RD and it could lead to trouble before I officially announce that I want out.

Any advice, tips, etc., would be much appreciated.



RadGal

 

[Febrifuge]

A Google News search for the latest on the MLK/Drew situation would be prudent, I would think.

 

[GeneralVeers]

I'll be an intern at MLK/Drew in July. What sort of problems have you had with administration at your current hospital?

The last thing the MLK/Drew program needs is more underachieving, problem residents (like myself).

 

[radgal]

A Google News search for the latest on the MLK/Drew situation would be prudent, I would think.

I'm aware that the hospital is in trouble and that the residency is in trouble, but if it can just eke out one more year of existence, I'll be fine. Then the whole hospital can go to hell...!

What makes me a "problem resident" prolly won't even apply at other programs, as it has to do with a certain unusual requirement of our program that goes against my personal/political belief system. As far as I know, no other program in the country has this unique requirement. I won't reveal further or it'll give away who I am and where I am.

Besides, I'm counting on MLK/Drew being willing or open enough ("desperate", if you will) to let someone in like me even if I have had one run-in with my program's administration over said unusual requirement.

Would love to move to LA, too! (Even if Drew's atmosphere is "straight outta Compton".)



RadGal

 

[Febrifuge]

It's difficult to restrain my curiosity, but unless you feel like sending a PM, I'll just say good luck and all the best.

- F., hoping to not be a 'problem resident' someday, yet sure there's a chance

 

[GeneralVeers]

As long as you're reasonably sane, have a sense of humor, and won't smack me for my Simpsons/Monty Python references I will have no problem with you coming to MLK/Drew.

After visiting the hospital for one hour last month and touring the E.D., I can definitely say that from APPEARANCES only, it's not as bad as I expected. I've worked in county E.D.s that have worse facilities than Drew. We'll see how my perceptions change once I have to work there. From what I understand the massive problems with corruption don't necessarily extend to the Emergency program, and most the residents do quite well on their boards.

BTW Los Angeles is beautiful. My apartment is one block from the beach, so that even if MLK/Drew blows major chunks, on my off days I can relax by the beach.

 

[EMApplicant]

As long as you're reasonably sane, have a sense of humor, and won't smack me for my Simpsons/Monty Python references I will have no problem with you coming to MLK/Drew.

After visiting the hospital for one hour last month and touring the E.D., I can definitely say that from APPEARANCES only, it's not as bad as I expected. I've worked in county E.D.s that have worse facilities than Drew. We'll see how my perceptions change once I have to work there. From what I understand the massive problems with corruption don't necessarily extend to the Emergency program, and most the residents do quite well on their boards.

BTW Los Angeles is beautiful. My apartment is one block from the beach, so that even if MLK/Drew blows major chunks, on my off days I can relax by the beach.

Dude, your attitude rocks. I have no doubt that you will do fine at MLK. 👍

 

[Quimby2]

I am a current MLK resident. I suppose jumping ship really depends on just how bad your current program is. My program here is generally thought of as pretty bruttal in terms of relations with faculty (with only a couple of exceptions).

There are openings in all classes here (except the incomming class --so far).

If you transfer here, i wouldn't be too concerned about the possibility of the hospital shutting down; after all, you just get bounced to another program should that occur. Either way, you make out just fine if you don't care where you live. I would read the LA Times concerning current problems; it's a pretty accurate description of what is occuring at the hospital.

The upsides of the program: accuity of pts, ER schedule, Los Angeles location, in-house moonlighting as a second year.

Downsides: Horrible off-service rotations, malignant staff (secretaries and most faculty), poor reputation on the outside (???), very weak full-time faculty, lack of on-the-floor teaching, big publuic relations problem, non-standard of care tx/dispo of patients, uncertain future of the program, no outside hospital rotations, EM faculty are very inbred (almost all trained at MLK).

I believe the conditions at the hospital are at a trough right now and may improve over the next several years; however, the reputation may take longer to repair and the current administration in the EM dept. is NOT one that is being replaced at the top. I suspect many of the EM program's deficiencies will persist until the heads of the EM program resign and get replaced with leading faculty that are respected in the academic community
(This may not happen for a very long time though).

In terms of contacting the PD here and the risk of your current PD becoming offended, I would be creative. Explain that you need to leave for family reasons, spouse's new job, dry climate for your arthritis. --You get the idea.

Best Wishes.

 

[drifter]

Radgal,

Tread lightly when looking into transferring residencies in the same field. Some faculty seem to take it a little personal when a resident wants to leave. I too considered leaving my residency due to professional/personal reasons. However, I chose to stay because I would have had to take a year hit on PGY level. We did have resident transfer out successfully my first year and another made an unsuccessful attempt last year. So here are my observations:

Both cases caused the faculty to get pretty ticked off and there was a fair amount of animosity to go around.
The resident that got a position elsewhere had a position promised to him before he told my program he was leaving. He is happy with his decision to leave.
The resident who failed to transfer to another program did tell my program before he applied but ended up not getting the spot. Things were fairly tense for a while but have improved, mainly because he is damn good.

Most of the programs in the southeast have a pretty good rep, so you may want to try to work it out - you only have a year left (except MS). But if the situation is intolerable, be honest with your program director, but you might want to feel out your prospects a little first. Diplomacy is key.

And in retrospect, I should have taken the hit.

 

[Captain Kirk]

I am a resident at King/Drew. There's one person leaving from the PGY-1 class at the end of June. In the PGY-2 class, there's 3 open spots. Our program director still has some pride as we are by far the best (and most functional) program in the hospital. And this being the case, it hasn't been as easy as it may seem for people to transfer into the program. Afterall, 2 of these PGY-2 spots have been open for almost 2 years - and quite a few people have applied for them. He'd rather have spots open, then ******ed residents. Up until now (can't speak for the future) our residents have been high caliber doctors, and all have gone on to pass boards and land decent jobs. The place has PLENTY of problems, but it's important for all of us King grads, past, present, and future, to tell the world that we are competent, well-trained, and have learned to do a lot with very little. Little help, support, resources - and in spite of a disabled hospital, and bad reputation of the hospital. I feel like I'm on M*A*S*H, but I learn true emergency medicine. It's a good place (for EM) - if it survives. And hopefully our colleagues will continue to (or come to) appreciate our great training here.

If you are a good test taker and have good numbers, you'll probably have no problem transferring into King. Overall, I used to really like the place - but after awhile, I'm not so sure. With the LA Times lurking, and working under a microscope, practicing defensive medicine (and not "realistic" or "appropriate" medicine), everyone asking "what's going on over there at King," and of course defending yourself to your colleagues (as I've done above) - get's old. What the above poster stated about the attendings, is very true. No outside rotations. Just existing in your own little (dysfunctional) world, with no knowledge of how "others" do emergency medicine. Everyone's on edge, and the work environment sucks as morale is very low - as you can imagine. Sometimes we wish they would just close the place already.

Anyway, I ramble. Good luck with your decision.

 

[GeneralVeers]

Thanks for your insight on the program. In your opinion has the work environment changed there since Navigant took over management? Supposedly they were trying to improve nursing coverage, and allocation of resources but I haven't heard any objective opinions.

I'm not worried about the EM months. I've worked at several dysfunctional county hospitals (Shands Jacksonville anyone?) and usually don't have a problem. I'm more concerned about the off-service rotations. Are they bearable?

 

[Captain Kirk]

I think Navigant is in on the "plot" to close the place. I do think it's a plot. We hear about our "mistakes" from DHS or the newspaper the next day! Someone is reporting these things to the public. I'm not saying they shouldn't have a "plot" to close the place, but call a duck a duck. If you want to close the place, just say it's f*cked up, we're closing. Don't do this song and dance, pretending to "help," and in the end, things are worse. And in the meantime, people suffer.

Do you know they pay Navigant nurses something like 50,000/mo!! That's more than my frikin' entire year's salary. And they are doing nothing. Sure, the nursing is better, as in we have some now. But radiology coverage is nonexistant, and that can be a problem. Surgery and (many) of the surgical subspecialties including neuro and neurosurg are run by PAs. PAs who are not motivated (perhaps for their own reasons), and cringe at any illusion of "work." Have you read the latest in the Times? They're calling many of the senior faculty crooks and running 'em out. This may or may not be true, but in the meantime, who's staffing the hospital? They're not willing to pay top salary to get competent doctors/nurses to come and stay at King - but they'll pay navigant millions.

I have so many gripes, I can't begin to discuss even the most basic ones. It's obvious what's wrong. They pay people to do nothing at King. For instance, we have a person who answers the box, and all they can say is "MLK base." They can't take the run, they can't do anything, except answer a ringing phone ad call an MD or MICN to take the run. And we have no MICNs most of the time, so the residents are pulled from the floor, sometimes up to 20+ times a shift, to take a 10 minute telephone run. That adds up to hours of wasted time for the physician - each shift!! If we're going to be a base station, we need to staff it, or get rid of it.

It's lots of things like this, asinine things that make us angry. The portrayal to the community and surrounding hospitals that King Drew Medical Center is a "real" medical center, open your doors, patients are told (and trust) we can handle certain problems, but the hospital cannot (and never had any intention of) delivering. It puts us, ER physicians in a very difficult position.

Sure, we're EDAP, but have no pediatric designated area. Sure, we have cardiology and CT surgeons, but we don't do emergency caths. Sure we have surgery, but no pediatric surgeon. Get a 7 year old appy, you're looking to transfer him to Harbor or USC. And of course they're mad, wondering why we can't handle a simple appy. Have a vascular injury? Well, it very difficult activating an angio team without radiologist. GI bleed? Yeah, we have GI fellowship, but they claim that so few of their attendings actually scope, it's difficult to get an EGD done emergently. Or ERCP? One guy, who works on Monday afternoon (or whatever). What about the patient who comes in on Friday morning? Completey screwed!! And you watch the patient bleed out, with family at the bedside. What can you do? Try to transfer? To where?

Off service rotations aren't that bad. Call isn't bad, and anything else can be tolerated. I actually enjoyed my off-service rotations, kind of as a break from really having to work or think. I was out of the department, and really could relax and not worry what other's thought of me. When you're in your department, other's opinions may matter.

This is way too long. But, as I said, we residents can go on and on...

 

[southerndoc]

This thread really has me curious exactly what obligations the OP has that are against his religious views. What could a program possibly demand that would go against one's religion and expect him/her to do it against his/her religion?

I hope you find a program that is more tolerant of your religious views.

 

[GeneralVeers]

Some Catholic hospitals won't allow birth control, emergency contraception, or abortion to be discussed with patients in the Emergency room. I work at a small Catholic community hospital (as a med student for pay), and while they are not fascist about it, the disapproval for these types of treatment is there. It's a continuing beef among the Emergency staff that if needed they couldn't give women the correct treatment.

My guess would be that some hospitals take this to extremes, and pro-choice female residents would have a conflict with the hospital admins. Being pro-choice myself I sympathize with them, but if I was in a temporary 3 year residency position I probably wouldn't waste my time arguing with them.

 

[LADoc00]

I am a resident at King/Drew.

Dude you are one brave SOB. Seriously, LA Times runs DAILY articles about "Killer King", over half the departments have no chairman due to mass firings/illegalities and you are staying on the mother of all sinking ship. MLK is like the Medical version of Enron! But worse b/c people are dead....

In all honesty though, that is being loyal to a hospital, someone out there will likely give you a solid job after just for sticking it out I would guess.

AND I agree Navigant is pillaging MILLIONS from the county of LA, its insane. The whole thing reeks of a giant scam!!!

 

[BeatArmy]

I've worked at several dysfunctional county hospitals (Shands Jacksonville anyone?) and usually don't have a problem.

As an MS1-to-be at UF interested in EM, I'm curious as to what you mean about Shands Jax. Feel free to be as specific or general as you like. Or PM me if you want to be really nasty.

 

[GeneralVeers]

Dude you are one brave SOB. Seriously, LA Times runs DAILY articles about "Killer King", over half the departments have no chairman due to mass firings/illegalities and you are staying on the mother of all sinking ship. MLK is like the Medical version of Enron! But worse b/c people are dead....
[/B]

Some of us (like myself) really didn't have another choice if we wanted to do EM. It was either MLK or end up in a speciality I didn't like.

At worst if the program folds I'll end up at another LA County facility.

 

[radgal]

This thread really has me curious exactly what obligations the OP has that are against his religious views. What could a program possibly demand that would go against one's religion and expect him/her to do it against his/her religion?

I hope you find a program that is more tolerant of your religious views.

It isn't a religious problem, in fact. I have no religion. It's a humanist problem, a political difference with an autocratic regime in place at our ED that crushes (reasonable and legitimate) dissent with an iron fist. It is an unwillingness to take residents seriously, and a willingness to tolerate (even applaud) verbal abuse and racial slurs. I have a hard time taking these things lying down.

Residents have no recourse to changing abusive faculty behavior. To whom can I report the Department Chair? To the Hospital Chair, who is his best pal? At least in our national government we have three branches that can apply (in theory, anyway) checks and balances; but there's nothing residents can do to challenge the a$$holes who make the rules and then bend them at their whim.

Perhaps I should just "wake up to the real world", take it on the chin, and keep my head up. I don't know. I'm in a real funk these days, hoping I can survive these last 13 months of residency.

- RadGal

 

[Quimby2]

Real world??? Not in residency; it starts from the begining with our "contract" that I doubt would hold up in any court. Don't get too madened --in three years you'll be in the real world. Then we'll all have the freedom to say, "the heck with this place" and go find a better job.

Residency is not the real world. It's just a pretty crummy part of the journey to get there.

It will likely be just fine in the end. 🙂

 

[DrDre']

Radgal,
I am a lowly M3 but wanted to share my opinion.

If I could find a residency to slide into that residents were happy in, I would consider fleeing.


However, I think the MLK posters have very honestly described their experiences and you would end up being just as unhappy at the new place. Their bosses don't sound too supportive either.

In terms of the real world, it can be a lot worse than residency but you have the choice to move on.

I think I can honestly say that I know what you are going through. I worked at a paramedic service for 4 years. We had a sort of PTSD consultant come in who investigates and solves problems on a company wide basis. SHe said we had the most malignant work environment she had ever seen in 80 investigations.

Made us feel better that we were "suffering so well".

We got rid of that boss and replaced him with two who were 20 times more draconian. The first guy was just an ignorant tool who enjoyed a little sexual harassment, the following ones made everyone suffer. We lost probably 20% of our service. Dissent was not acceptable. People were ordered not to talk about contronversial issues or personnel issues.

If it were me, I would stay and gut it out. It is the devil you know. You won't burn any more bridges.

Good luck with your decisions, I feel for you, Dre'

 

[pushinepi2]

As an MS1-to-be at UF interested in EM, I'm curious as to what you mean about Shands Jax. Feel free to be as specific or general as you like. Or PM me if you want to be really nasty.

PM'd you re: Shands Jax. There's also quite a bit of information on that program right here on the SDN EM forum. Search for "UF Emergency Medicine" or "Shands" and you'll find some interesting commentary. Good luck in Gainesville.

 

[LADoc00]

Radgal,
I am a lowly M3 but wanted to share my opinion.

If I could find a residency to slide into that residents were happy in, I would consider fleeing.


However, I think the MLK posters have very honestly described their experiences and you would end up being just as unhappy at the new place. Their bosses don't sound too supportive either.

In terms of the real world, it can be a lot worse than residency but you have the choice to move on.

I think I can honestly say that I know what you are going through. I worked at a paramedic service for 4 years. We had a sort of PTSD consultant come in who investigates and solves problems on a company wide basis. SHe said we had the most malignant work environment she had ever seen in 80 investigations.

Made us feel better that we were "suffering so well".

We got rid of that boss and replaced him with two who were 20 times more draconian. The first guy was just an ignorant tool who enjoyed a little sexual harassment, the following ones made everyone suffer. We lost probably 20% of our service. Dissent was not acceptable. People were ordered not to talk about contronversial issues or personnel issues.

If it were me, I would stay and gut it out. It is the devil you know. You won't burn any more bridges.

Good luck with your decisions, I feel for you, Dre'

Where is this? MLK?

 

[DrDre']

LA,
Sorry, are you asking me this question? I have never worked at MLK. Just commenting on that which other posters have brought up.



I worked somewhere else as a paramedic.

Sorry to confuse the subject. Dre'

 

[MAC10]

Any of the current MLK residents know if the Anesthesiology program is still open? If not, did the residents get to transfer to other LA programs?

 

[anonymousEM]

I'm not worried about the EM months. I've worked at several dysfunctional county hospitals (Shands Jacksonville anyone?) and usually don't have a problem. I'm more concerned about the off-service rotations. Are they bearable?[/QUOTE]


WOW, I'm not sure how the original poster meant this but as a resident working at Shands JAX, I'm not feeling the county pain as much as I'd thought I would. Yes there is overcrowding like everywhere in the country, but we have good techs and nurses. I am NOT expected to start my own IVs, wheel pts to XRay etc. I get the luxury of seeing as many sick patients and doing as many procedures as I possibly can. There is nothing that's "off limits" to a certain PGY level. Interns intubate primarily from day one. I am actually friends with and hang out with my classmates and the nurses and the techs outside of work. OUr attendings are around and supervise what's going on consistently while not taking away the residents' responsibility to supervise and teach medical students and younger residents. Our med students get to do as many procedures and take care of as many pts as they are interested in doing. We have one of the nation's most complete simulation labs with manequins that have pulses and trismus and whatever painful combination of nightmare case features they can dream up for us to intubate/code/ultrasound/place lines etc....that being said, the environment is not for everyone. We don't get a ton of money for books or conferences. The hospital isn't very pretty (Though the new residents quarters have a gym, 2 42" plasma tvs and some other sweet stuff that no EM resident ever has reason to go to past 1st year calls). The lectures are changing for the better but so far reading has had to be a personal priority.

I can't say enough how happy I am at Jax. I worked a lot as an intern but as a PGY 3 I work a little less than the clinical attendings. I have a life, I'm having fun and learning a lot. If you're curious rotate at Jax and see for yourself. OK, I'll get off my soapbox now. Would be happy to answer any specific questions personally if you prefer.

 

[GeneralVeers]

I wanted to go to JAX for all the reasons you just decscribed. Many outside programs have referred to it as dysfunctional and even malignant. I saw no evidence of malignancy, but it was definitely a bit more chaotic than your average program.

 

[Paws]

It isn't a religious problem, in fact. I have no religion. It's a humanist problem, a political difference with an autocratic regime in place at our ED that crushes (reasonable and legitimate) dissent with an iron fist. It is an unwillingness to take residents seriously, and a willingness to tolerate (even applaud) verbal abuse and racial slurs. I have a hard time taking these things lying down.

Residents have no recourse to changing abusive faculty behavior. To whom can I report the Department Chair? To the Hospital Chair, who is his best pal? At least in our national government we have three branches that can apply (in theory, anyway) checks and balances; but there's nothing residents can do to challenge the a$$holes who make the rules and then bend them at their whim.

Perhaps I should just "wake up to the real world", take it on the chin, and keep my head up. I don't know. I'm in a real funk these days, hoping I can survive these last 13 months of residency.

- RadGal

I dunno, this sort of sounds like alot of regular jobs and situations to me ... gotta learn to duck and dodge the #$%^ coming at you. I would just zip my lip and wait out my time, learning everything I possibly could in the meantime.

 

[Paws]

It isn't a religious problem, in fact. I have no religion. It's a humanist problem, a political difference with an autocratic regime in place at our ED that crushes (reasonable and legitimate) dissent with an iron fist. It is an unwillingness to take residents seriously, and a willingness to tolerate (even applaud) verbal abuse and racial slurs. I have a hard time taking these things lying down.

Residents have no recourse to changing abusive faculty behavior. To whom can I report the Department Chair? To the Hospital Chair, who is his best pal? At least in our national government we have three branches that can apply (in theory, anyway) checks and balances; but there's nothing residents can do to challenge the a$$holes who make the rules and then bend them at their whim.

Perhaps I should just "wake up to the real world", take it on the chin, and keep my head up. I don't know. I'm in a real funk these days, hoping I can survive these last 13 months of residency.

- RadGal

I dunno, this sort of sounds like alot of regular jobs and situations to me ... gotta learn to duck and dodge the #$%^ coming at you. If it was me, I would just zip my lip and wait out my time, learning everything I possibly could in the meantime.

 

[GeneralVeers]

I dunno, this sort of sounds like alot of regular jobs and situations to me ... gotta learn to duck and dodge the #$%^ coming at you. If it was me, I would just zip my lip and wait out my time, learning everything I possibly could in the meantime.

I agree with you.

It's only for three years anyway. I would tend to ignore it, and just press on with my daily routine. It's not like she's going to be in that residency spot for 10 years.

MLK will have to be pretty rotten for me to want to transfer out.