Do you like your program?

[Guest]

Junior resident here. I wonder if this happens only in my program or pretty common in other programs but I don’t recall seeing it in my sub-is. Chief has no autonomy in running the service, he has to staff every minor detail with attendings. They micro manage everything from surgical decision to drain output. Poor autonomy in the OR, most of staff stay even during closing. What makes me more frustrated is the inconsistency where staff changes his mind and plan of care at least 3-4 times on consults and make us feel as a joke service at the hospital especially when we have a patient under other services.

[Guest]

Sounds about right.

[Guest]

sounds like UCSD

[Guest]

(05-06-2020, 11:12 AM)Guest Wrote: Junior resident here. I wonder if this happens only in my program or pretty common in other programs but I don’t recall seeing it in my sub-is. Chief has no autonomy in running the service, he has to staff every minor detail with attendings. They micro manage everything from surgical decision to drain output. Poor autonomy in the OR, most of staff stay even during closing. What makes me more frustrated is the inconsistency where staff changes his mind and plan of care at least 3-4 times on consults and make us feel as a joke service at the hospital especially when we have a patient under other services.

This is incredibly common across the country, especially at the big name academic places. That's why I always tell med students to think long and hard about what kind of program they want to be at. There are some places where you can have it all (big name and OR autonomy) like UCSF, BNI, Mayo but if it came down to a choice I'd personally much rather be at Carolinas or UT Memphis over a place like Columbia or Stanford. Other people would prefer the opposite.

[Guest]

Attendings end up managing patients when residents do a poor job of managing attendings.

[Focus]

(05-06-2020, 03:43 PM)Guest Wrote: Attendings end up managing patients when residents do a poor job of managing attendings.

There is great wisdom here. You should be doing your attendings side before your own

[Guest]

(05-06-2020, 03:43 PM)Guest Wrote: Attendings end up managing patients when residents do a poor job of managing attendings.

great quote. from a senior resident, pacific nw

[Guest]

(05-06-2020, 03:42 PM)Guest Wrote:

(05-06-2020, 11:12 AM)Guest Wrote: Junior resident here. I wonder if this happens only in my program or pretty common in other programs but I don’t recall seeing it in my sub-is. Chief has no autonomy in running the service, he has to staff every minor detail with attendings. They micro manage everything from surgical decision to drain output. Poor autonomy in the OR, most of staff stay even during closing. What makes me more frustrated is the inconsistency where staff changes his mind and plan of care at least 3-4 times on consults and make us feel as a joke service at the hospital especially when we have a patient under other services.

This is incredibly common across the country, especially at the big name academic places. That's why I always tell med students to think long and hard about what kind of program they want to be at. There are some places where you can have it all (big name and OR autonomy) like UCSF, BNI, Mayo but if it came down to a choice I'd personally much rather be at Carolinas or UT Memphis over a place like Columbia or Stanford. Other people would prefer the opposite.

That’s good because most people don’t have the choice to be at UCSF or Columbia

[Guest]

I love my program. I would come here again. Just be honest with yourself when your ranking programs about the style of the program you want. You should know the balance between operative autonomy and research you want. Just be honest with yourself, not try to impress others. Do you want to have a big research experience? Go to Columbia or a program that will give 2 dedicated research years. Do you want to operate a lot and have a lot of autonomy? Look at Miami, Pitt, USCs of the country.

That’s why I never understand why applicants tell me things like their MGH and Barrow. Those 2 programs are night and day different.

Realize EVERY program will have jerks in it. But your best chance to succeed and be happy is to be honest with yourself and rank accordingly. There are no real surprises when it comes to experiences within a program. You know the character and more or less what to expect...

[Guest]

(05-06-2020, 03:43 PM)Guest Wrote: Attendings end up managing patients when residents do a poor job of managing attendings.

What is meant by this, exactly?