List of Crappy Gross-horse programs

[Tiki]

It is called stockholm syndrome.

No, I'm just at a pretty good program (thankfully!). We have a lot of very well-known attendings who also happen to be pretty good teachers. I'm sad to be leaving in two months but time to move on.

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[dfer84]

It's important that we know what we're getting ourselves into, and pathology programs are variable in quality. I hate using rumor, but sometimes a half-truth is better than no truth. Getting a good approximation of the program's specimen volume and PA staff is helpful in predicting the grossing load. These programs may not be "malignant" in the traditional sense, but it's nigh time we started naming places that may compromise our training with heavy grossing loads and other service oriented work. Here are some that have been churned through the rumor mill:

- Virginia Commonwealth
- Stony Brook on LI, although may be due to recent PA shortage
- George Washington has a big grossing load allegedly
- Mount Sinai in NYC- huge grossing volume, lots of "scut", but non-malignant
- Brown has a heavy grossing volume as well
- I have not heard anything about Roosevelt-St. Luke except on here

 

[Q1Q2]

i confirm stony brook. residents here don't write reports except for the gross description.

ps before you post your dirt, make a new username just for this confession thread.

 

[Substance]

i confirm stony brook. residents here don't write reports except for the gross description.

ps before you post your dirt, make a new username just for this confession thread.

Good information. Thanks!

Keep them coming, and make anonymous accounts if you have to.

 

[sirenomelia]

It's important that we know what we're getting ourselves into, and pathology programs are variable in quality. I hate using rumor, but sometimes a half-truth is better than no truth. Getting a good approximation of the program's specimen volume and PA staff is helpful in predicting the grossing load. These programs may not be "malignant" in the traditional sense, but it's nigh time we started naming places that may compromise our training with heavy grossing loads and other service oriented work. Here are some that have been churned through the rumor mill:

- Virginia Commonwealth
- Stony Brook on LI, although may be due to recent PA shortage
- George Washington has a big grossing load allegedly
- Mount Sinai in NYC- huge grossing volume, lots of "scut", but non-malignant
- Brown has a heavy grossing volume as well
- I have not heard anything about Roosevelt-St. Luke except on here

I know on fact residents at VCU gross < 1/2 a day on SP only. You should get your facts straight prior to maligning places.

 

[Substance]

I added St.Luke's Roosevelt in NY as a program to avoid given its probationary status and the reports of it having an excessive grossing volume with little to no teaching.

 

[pathology12]

Can we quantify this a bit? At what point would you consider yourself a gross-horse?

When on a surg path rotation, is your program considered a crappy gross-horse program if you are spending 50% of your time in the gross room? 40%? 30%?

At my program I would estimate that 30% of our time on surg path is spent grossing with the remaining time for preview/report formulation/signout with attending. I would not consider this being a gross horse at all, even though it often includes doing a couple hours of biopsies and smalls. Others in the program do consider this being a gross-horse. Help me out, are we a crappy gross-horse program?

Compared to this are your programs better or worse in terms of percentage of time spent grossing?

 

[Johnny Sunshine]

i confirm stony brook. residents here don't write reports except for the gross description.

No. This is simply false. The residents write full reports on their specimens at Stony Brook. I have no idea what this person means.

 

[Ombret]

I think this thread is hilarious but maybe we are discussing a species that is actually extinct in the wild. No one has shown up to confirm any bona fide examples of crappy gross-horse programs. The RRC is currently pretty attentive to balancing service v. teaching so any program with a major problem on that front is going to get cited when it comes up for review.

Anyway, there are plenty of angles, besides excessive grossing, that could make a training program miserable. How about low case volume (OK--you will not be miserable but you won't learn anything), inefficient workflow, picky/idiosyncratic staff, indifferent administration or program director, or low esteem for pathology among other departments in the hospital?

 

[Substance]

I think this thread is hilarious but maybe we are discussing a species that is actually extinct in the wild. No one has shown up to confirm any bona fide examples of crappy gross-horse programs. The RRC is currently pretty attentive to balancing service v. teaching so any program with a major problem on that front is going to get cited when it comes up for review.

Anyway, there are plenty of angles, besides excessive grossing, that could make a training program miserable. How about low case volume (OK--you will not be miserable but you won't learn anything), inefficient workflow, picky/idiosyncratic staff, indifferent administration or program director, or low esteem for pathology among other departments in the hospital?

Those are great criteria to consider as well and should be taken into account.

But there are still crappy gross-horse programs abound.

 

[sbp]

No. This is simply false. All residents write full reports on all of their specimens at Stony Brook, NY on Long Island. I have no idea what this person is thinking.

As a previous stony brook resident i can say that the residents are grossing approx q4 with pa help and are expected to preview all cases and come up with a diagnosis with graded responsibility. They even use voice recognition software to gross and sign-out, so as you progress it is expected that the resident have the diagnosis in the computer before sign-out, to fascilitate faster turnaround time.

 

[Unty]

Those are great criteria to consider as well and should be taken into account.

But there are still crappy gross-horse programs abound.

I was told that Howard has a case volume of 5,000 a year a few years back. Is that program closed?

 

[mlw03]

I was told that Howard has a case volume of 5,000 a year a few years back. Is that program closed?

I have no idea if the statement about caseload is accurate, but the program is not closed. I know some of their residents at present.

 

[Q1Q2]

No. This is simply false. All residents write full reports on all of their specimens at Stony Brook, NY on Long Island. I have no idea what this person is thinking.

based on the words "all" used twice and "full" used once, you seem to be saying that 100% of residents puts a final diagnosis (I'll leave out "notes" and "comments") on 100% of the specimens they gross when working with 100% of attendings. is that what you intend to say?

if that is not what you intend to say, could you estimate on what percentage of specimens that you gross do you add a final diagnosis for each specimen in the actual report before meeting with the attending (across all attendings and pgy's)? what would you estimate this percentage is for pgy1's, pgy 2's, pgy 3's, pgy 4's?

 

[Johnny Sunshine]

based on the words "all" used twice and "full" used once, you seem to be saying that 100% of residents puts a final diagnosis (I'll leave out "notes" and "comments") on 100% of the specimens they gross when working with 100% of attendings. is that what you intend to say?

Let me clarify. At Stony Brook residents are supposed to view the slides and write a full report on each case (including notes/comments, if appropriate) before it ever goes to the attending. This is the ideal.

In reality, of course this does not happen a perfect 100% of the time. For example if the workload is heavy some cases of low educational value may go directly to the attending (appendicitis, hernia sac, etc.). Also, occasionally the resident may simply run out of time for signout and their turn for grossing comes up again, in which case any lingering unfinished cases are usually dropped off with the attending.

I assume what you meant to say is that sometimes things get busy and you run out of time to finish some cases. However, this is a big difference from your original post, which made it seem like residents at Stony Brook never write any reports at all. The vast majority of the time, residents write a full report on each of their cases.

 

[sirenomelia]

I think this thread is hilarious but maybe we are discussing a species that is actually extinct in the wild. No one has shown up to confirm any bona fide examples of crappy gross-horse programs. The RRC is currently pretty attentive to balancing service v. teaching so any program with a major problem on that front is going to get cited when it comes up for review.

Anyway, there are plenty of angles, besides excessive grossing, that could make a training program miserable. How about low case volume (OK--you will not be miserable but you won't learn anything), inefficient workflow, picky/idiosyncratic staff, indifferent administration or program director, or low esteem for pathology among other departments in the hospital?

Some places Saturday is an expected routine workday. I know the U Hawaii program historically had been. That would bite.

 

[Enkidu]

Some places Saturday is an expected routine workday. I know the U Hawaii program historically had been. That would bite.

Do pathology residents get weekends off? That is about 8 days off a month?

 

[mlw03]

Do pathology residents get weekends off? That is about 8 days off a month?

It's probably program specific, but in general I think if you're not on call for a given weekend, you're off duty. But some programs may require resident grossing on a Saturday. Just have to ask.

 

[Q1Q2]

Let me clarify. At Stony Brook residents are supposed to view and write a full report on each case (including notes/comments, if appropriate) before it ever goes to the attending. This is the ideal.

In reality, of course this does not happen a perfect 100% of the time. For example if the workload is heavy some cases of low educational value may go directly to the attending (appendicitis, hernia sac, etc.). And, very occassionally, if the workload is unusually massive or full of complex time-intensive cases, the resident may run out of time and need to do a grossing day again, and therefore must drop off any unfinished cases with the attending.

I assume what you meant to say is that sometimes things get busy and you run out of time to finish some cases. However, this is a big difference from your original post, which made it seem like residents at Stony Brook never write any reports at all. The vast majority of the time, residents here write all of the reports.

we could both be right--you might be an exceptionally good case and/or i might be an exceptionally bad case. this question might clarify it. if you had to estimate the percentage of cases for which the average (not you necessarily) stony brook resident contributes directly to the diagnosis/non-gross report, what would this % be approximately for each pgy 1-4? also please do not count cases when you previewed/"diagnosed" it but didn't contribute to the report before the attending. i'm not asking for the % correct. you can count a report even if the attending completely replaces it. i won't argue with your numbers. i'm honestly curious, and it might help out future applicants to know what goes on. would it be something like 20/40/60/80? 50/70/90/90? please give your best guess of the % broken down by pgy 1/2/3/4. thank you.

 

[DoctrAwesome]

I am currently one of the residents at SUNY Stony Brook and would like to share what I feel are the pros and cons of our program and also provide some details on the surgical pathology rotation here given the topic of this thread as I think some of the posting here has been unfair.

If you are interested in a comprehensive description of our program please visit this link:
http://pathinfo.wikia.com/wiki/SUNY_at_Stony_Brook_Program

It was written by one of our residents in Dec. 2010 and it remains a good description of our program today and I will reiterate some of it below. Things that have changed since then include an increase in autopsy numbers (now a little over 100 cases per year) and the addition of both a hematopathology fellowship and a surgical pathology fellowship.

Pros of our program
Working conditions: Every resident has their own desk, computer, and microscope. There are spacious resident rooms that were renovated in 2009.

Specimen variety: Residents get extensive experience with bread and butter type of cases and above average exposure to uncommon cases. For example, there are 1-3 Whipples scheduled weekly. The surgery dept recently picked up an orthopedic oncologist and we are now getting some interesting bone/soft tissue resections.

Faculty: The attendings for the most part will spend a lot of time at the scope teaching you. They will all without hesitation go to the gross room to help you orient an unusual specimen or teach you how to gross it. They will push you to succeed as a pathologist and help you get started on research projects.

Chairman: Our chairman has been here for a few years and is responsive to resident feedback. He strongly supports our involvement in research whether it is clinical in nature, more bench heavy, or somewhere in between. The department covers all expenses for residents to attend national meetings to present their work (6 of our 12 residents presented at USCAP this past spring). Our residents recently wanted to split the costs for a DVD review series and when the chairman heard about it he bought the series with department money.

Vacation/Benefits/Salary: The salary is relatively good (~$55,000 for starting PGY1 and increasing 3-4k each subsequent year). We also each get an $800 book fund per year. Our health insurance coverage is great and there is dental and vision coverage as well.

Location: Manhattan is easily accessible by car or train. The climate is pleasant, great beaches and parks, good schools.

Call: Call is taken at home and over the course of 4 years is essentially q12. Both AP and CP call are mild, maybe 50% of the time you will have to stay to cover frozen sections on Friday evening and CP calls typically require 1-3 phone calls per weekend.

Cons
Location: Long Island is a relatively expensive place to live. Depending on the time of day, there is a fair amount of traffic on the roads.

Cytology: The number of cytology specimens (particularly GYN) is low for an institution of our size (4k-5k cytology specimens per year). The opportunities for residents to perform FNAs are few.

CP call: Some of the more challenging CP related calls (mostly blood bank) go straight to the CP attending on call and bypass the resident. It makes CP call easier on us and we discuss the cases at a weekly CP conference but are not a part of some of those real-time decisions.

Description of Surgical Pathology Rotation: On a given month 3 residents, a pathology assistant, and a tech are responsible for the surg path service. The tech is available in the afternoon to take care of biopsies. The PA is full-time and her entire day is spent in the grossing room. There are approximately 22,000 surgical specimens per year.

Residents on the surg path rotation are on a 4-5 day sign-out cycle, and the PA is the main grosser on the days on which a resident is not on the schedule. The resident is responsible for grossing the majority of bigs, about half of the frozen sections (PA covers other half), some smalls, and few biopsies on their grossing day (Day 1). Day 1 of a cycle is spent entirely in the grossing room. On Day 2 you gross whatever you have leftover and fixed from the day before and you start previewing cases. On a good day all grossing can be completed on Day 1. On an average day there is about 3 hours of grossing. That leaves, on average, > 3 working days to preview/enter reports/sign-out cases with the attending. Grossing is not done on Saturday or Sunday. If you want to go the extra mile and come in on a weekend to look at cases, you can have significantly more than 3 full days to look at cases and generate reports.

Speaking with residents from other programs I get the sense that our ratio of preview/report generation/signout time with attending to time spent grossing is on par with or better than most. And I COMPLETELY disagree with the statement that residents don't write reports with the exception of gross descriptions. First year residents during the first few months may struggle to get all of the reports generated, but once they get their bearings in the grossing room and with the dictation system they should generate nearly all of the reports for cases that came down on their grossing day before sitting with the attending to sign them out.

 

[member0007]

It seems reasonable. I guess as long as you are not working with malignant personalities who sabotage your work and make stuff about you, this sounds like a vacation compared to Mount Sinai Hospital!

 

[Substance]

An anonymous report has been sent to me:

UMDNJ-RWJMS in New Brunswick, NJ. You gross, dictate the gross, then watch the attending dictate the final diagnosis the next day. The system is arranged such that no resident has the chance to do the final diagnosis in the report or dictation. You may or may not be able to preview some cases and write your own notes or diagnoses down, but it is separate from the actual report that is dictated by the attending. This was on surg path. Other rotations had variably more responsibility.

Sounds like a fail program to me.

<!-- / message --><!-- SDNCODE: one sig per thread -->

 

[mlw03]

If true, yeah, would agree. Sounds like a bad way to learn pathology.

 

[Q1Q2]

First year residents during the first few months may struggle to get all of the reports generated, but once they get their bearings in the grossing room and with the dictation system they should generate nearly all of the reports for cases that came down on their grossing day before sitting with the attending to sign them out.

may I have some numbers, please? on what % of the cases that the attending signs out do you contribute to the final diagnosis in the actual report (even if it's wrong or replaced)? please average over the whole PGY, so please incorporate this "getting used to the system and not producing (any or as many) results" time and don't just report your "best week's or day's %." ranges and broad estimates are fine. if your numbers aren't zero or near zero, then what are they for you? thank you. this is helpful. even the absence of an answer is helpful.

PGY1:
PGY2:
PGY3:
PGY4:

 

[gbwillner]

may i have some numbers, please? On what % of the cases that the attending signs out do you contribute to the final diagnosis in the actual report (even if it's wrong or replaced)? Please average over the whole pgy, so please incorporate this "getting used to the system and not producing (any or as many) results" time and don't just report your "best week's or day's %." ranges and broad estimates are fine. if your numbers aren't zero or near zero, then what are they for you? Thank you. This is helpful. Even the absence of an answer is helpful.

Pgy1:
Pgy2:
Pgy3:
Pgy4:

pgy1:100%
pgy2:100%
pgy3:100%
pgy4:100%

Theoretically, every case that comes though the door is seen by a resident. We dictate/write all the reports. The attending just reviews it and pushes the "sign-out" button.

 

[Q1Q2]

pgy1:100%
pgy2:100%
pgy3:100%
pgy4:100%

Theoretically, every case that comes though the door is seen by a resident. We dictate/write all the reports. The attending just reviews it and pushes the "sign-out" button.

just to clarify, i'm asking this question of the people who posted earlier claiming to be stony brook residents. are/were you a stony brook resident? if you are from SB, i'm asking for what actually happens (not what theoretically should happen) specifically on surg path *in each post graduate year.* an earlier post said your program's pgy3 was all CP, so that's why i'm clarifying. thank you.

 

[gbwillner]

just to clarify, i'm asking this question of the people who posted earlier claiming to be stony brook residents. are/were you a stony brook resident? if you are from SB, i'm asking for what actually happens (not what theoretically should happen) specifically on surg path *in each post graduate year.* an earlier post said your program's pgy3 was all CP, so that's why i'm clarifying. thank you.

No sorry, I don't got there and I misunderstood your post.

 

[Alteran]

An anonymous report has been sent to me:



Sounds like a fail program to me.

<!-- / message --><!-- SDNCODE: one sig per thread -->

Well, something is going on at that program. Looking at their residents, doesn't look like many of them are making it to the finish line.

 

[oldfatman]

"Hard pathology training programs create hard pathologists, and hard pathologists rule the world"

Grossing like a mule builds mental toughness. Fluffy programs at big academic centers create soft weak academic pathologists.

 

[mlw03]

"Hard pathology training programs create hard pathologists, and hard pathologists rule the world"

Grossing like a mule builds mental toughness. Fluffy programs at big academic centers create soft weak academic pathologists.

What? Are you serious? So grossing 30 hours a week and never seeing a slide is going to make one ready to go out in practice where PAs will do your grossing and your main job is to look at glass? Or is this why everyone has to do 2-3 fellowships before getting a private practice job, because residency is now about gross scut work and actually learning how to be a diagnostician is for fellowship?

 

[Substance]

"Hard pathology training programs create hard pathologists, and hard pathologists rule the world"

Grossing like a mule builds mental toughness. Fluffy programs at big academic centers create soft weak academic pathologists.

Your kind of attitude is common in people who came from such programs. I suppose its a way for you to justify to yourself how much time you wasted doing worthless work.

Residency is a limited amount of time, and taking part in low-yield non-value-added work like grossing and autopsies is a disservice to your future patients.

On that note, surgery residents should do the floor nursing work and never go to the OR. Radiology residents should be positioning all of the patients but never dictate films. When their residencies are finished they can do years of fellowships to learn how to operate or read a film.

And last I heard, no pathologists rule the world. In fact, they are themselves ruled by urologists, who hire them and pay them peanuts, and dermatologists, who stole their most lucrative organ system. Pathologists are fail.

 

[DoctrAwesome]

Rough estimates here at SB...

July-Sept PGY1: 60-100%. This early period I think is pretty resident specific with some picking things up quicker than others.

Oct-Dec PGY1: 80-100%.

Jan-Jun PGY1 and PGY2-4: 90-100%.

 

[2121115]

last I heard, no pathologists rule the world. In fact, they are themselves ruled by urologists, who hire them and pay them peanuts, and dermatologists, who stole their most lucrative organ system. Pathologists are fail.

Epic smackdown.

 

[Myelofibrosis]

"Hard pathology training programs create hard pathologists, and hard pathologists rule the world"

Grossing like a mule builds mental toughness. Fluffy programs at big academic centers create soft weak academic pathologists.

If oldfatman is an attending at a program and in any position of authority, that program must be Crappy Gross-hArse program, not to mention the one that he got trained at. No offense.

 

[Substance]

We are all in agreement that programs that force their residents to be the PAs at half-salary are bad programs.

What we need is a good list of said programs so that they can be avoided by good applicants, and looked upon with scorn by all pathology groups. One could correctly assume that those who come from these programs are diagnostically weaker than those that are from good programs.

If the urologists are going to be hiring slave paths, they might as well get them from these crap programs that will have horrible reputations if we keep outing them.

So far the list on the front page is pretty long, and four have been specifically named as poor programs. One has had a few new accounts give it fervent support, so there is some dissonance with those accounts (Stony Brook). But the other three (albany, SLR, UMDNJ - R) seem to be pretty bad and should be avoided at all costs.

We need a longer list. If anyone can chime in about any of the programs listed as "with reservations", we'd like to hear it. Some of these are bound to end up on the definitely avoid list.

 

[Alteran]

"Hard pathology training programs create hard pathologists, and hard pathologists rule the world"

Grossing like a mule builds mental toughness. Fluffy programs at big academic centers create soft weak academic pathologists.

Wow, don't know if you're serious or just sarcastically trolling for a response. I'm just going to toss out some numbers and let them mostly speak for themselves.

Number of US Medical graduates/yr: ~16,000
Number of US Medical graduates interested in pathology (~1-2%): ~160-200
Number of total training spots in pathology (PGY1-4): ~2,400
Number of openings per year: ~600

These numbers are taken off the NRMP and ACGME websites. I could quote exact figures, but anyone can go to those websites and see the numbers for themselves. Pathology is right behind family medicine in the percentage of FMG occupancy (about 2/3). Assuming only 1-2% of every graduating medical school class is interested in pathology, then they really do have 2-3 openings on average...assuming none are take out of the match (which never happens). *But the bottom line is that as a medical student applying to pathology, you have TONS of choice. The only real power a program has in the whole match process basically is to not rank terrible applicants. So if you're applying to pathology, sample liberally because you can infer from the numbers there is a lot of junk out there and you stand a very good chance of getting into a good program...provided you bother looking.*

 

[Myelofibrosis]

Number of US Medical graduates/yr: ~16,000
Number of US Medical graduates interested in pathology (~1-2%): ~160-200
Number of openings per year: ~600
*

You kinda make me feel bad for getting into pathology. I knew it going in, but still, it hurts to see not enough US graduates care for it.

 

[mlw03]

You kinda make me feel bad for getting into pathology. I knew it going in, but still, it hurts to see not enough US graduates care for it.

Why? Who cares what others do? If you had a wife you loved and thought was beautiful would it hurt if someone else called her ugly?

 

[Substance]

Why? Who cares what others do? If you had a wife you loved and thought was beautiful would it hurt if someone else called her ugly?

I think it would. It's human nature to want to be the one who is envied; to be the one who has what others covet. Pathology is coveted by no-one but the weakest of IMGs.

 

[Alteran]

I think it would. It's human nature to want to be the one who is envied; to be the one who has what others covet. Pathology is coveted by no-one but the weakest of IMGs.

I wouldn't go so far as to say that pathology is the universal wastebasket of medical residencies, but I think the numbers do show that 2/3 of the spots can be dispensed with and still pretty much meet US medical student interest 1:1 (medical student to opening). How much of that 2/3's portion is there to actually be trained as a competent pathologist vs hired just to be a gross monkey at virtually no cost to a pathology program I really can't say...but I'm guessing more than I'd like to think so.

 

[Substance]

I wouldn't go so far as to say that pathology is the universal wastebasket of medical residencies, but I think the numbers do show that 2/3 of the spots can be dispensed with and still pretty much meet US medical student interest 1:1 (medical student to opening). How much of that 2/3's portion is there to actually be trained as a competent pathologist vs hired just to be a gross monkey at virtually no cost to a pathology program I really can't say...but I'm guessing more than I'd like to think so.

There are too many programs, and potentially more than half exist to use residents as PAs without giving them training in diagnosis. Given this fact, these programs probably have the bar set very low for applicants - human, no criminal record, subservient - since all they need are warm bodies. The caliber of applicant is therefore, on average, lower, which makes pathology somewhat of a wastebasket of medical fields.

Passing a board exam is only one step in being a competent pracitioner; the other is experience. Without the experience necessary to be skilled in diagnosis, these graduates are likely less competent than those who went to good programs. Combined with the high likelihood of them being generally lower-quality as I stated above, their competence is probably questionable.

Nonetheless, they are out there and any enterprising urologist or dermatologist can use them to diagnose biopsies risk-free and make cash. If the incompetent pathologist screws up (which they probably do given the scandals), its on them, not on their urologist or dermatologist master.

It is up to you to name these bad programs so that:
1. applicants avoid them
2. graduates from those programs are seen as less competent and are not hired by good groups, which would result in point #1.

I know if I had a pathology practice, if you came from SLR or Albany or whatever, your resume would go straight into the bin, multiple fellowships or not.

 

[Ombret]

As a surg path fellow I see lots of consult cases from community pathology practices. Most of the time their diagnoses are pretty good. If such a large fraction of graduates were disasters, we would be reversing cancer diagnoses every day.

There are a few practices whose cases ARE often total disasters. Their pathologists are all old white guys. Not FMGs.

 

[tco]

I've found that "the weakest of FMGs" are often better than our average students. They work harder, complain less, and end up better diagnosticians.

 

[MirkoCrocop]

I've found that "the weakest of FMGs" are often better than our average students. They work harder, complain less, and end up better diagnosticians.

As a former chief residents, I would concur with that - the AMGs are the primadonna complainers; the FMGs are thankful for what they have and less likely to complain that they had to gross one more day on surg path than the other guy.

 

[KCShaw]

Eh. My experience was a mixture. There were complainers and those who struggled, as well as sharp get'r'done types, among both AMG's and FMG/IMG's. Similar goes for attendings as well as residents. It's possible it depends on the individual person.

 

[Pathwrath]

As a former chief residents, I would concur with that - the AMGs are the primadonna complainers; the FMGs are thankful for what they have and less likely to complain that they had to gross one more day on surg path than the other guy.

I think this is true. However, I don't think that gratitude and lack of complaining is conducive to improving the kind of poor programs this thread meant to expose. Quite the opposite, in fact. Lousy programs and desperate grateful residents afraid to make waves go hand in hand. The two perpetuate each other.

 

[mlw03]

As a former chief residents, I would concur with that - the AMGs are the primadonna complainers; the FMGs are thankful for what they have and less likely to complain that they had to gross one more day on surg path than the other guy.

I hate to say this as an AMG, but in my limited experience, I too saw this sort of thing. The AMGs where I trained were far more prone to complain about things than the FMGs.

 

[Euchromatin]

We don't have a ton of FMGs at our program, usually only a quarter or so of our residents at any one time, but I have NOT noticed any particular pattern in the attitudes/work habits of FMGs vs. AMGs overall. I completely agree with KCShaw that these attributes are more likely due to a resident's individual personality.

We have some residents (both FMG and AMG) that are great, work hard, don't whine and are quite bright. We also have had a rare resident or two (again, both FMG AND AMG) who avoid teaching junior residents, won't answer their pagers, show up obnoxiously late to lectures and have flat out, absolutely refused to perform service duties that they thought were non-educational/beneath them.

I suppose this seems obvious, but I would say that FMGs overall are probably more likely to have (English) language-barrier issues vs. AMGs, so, there is that.

 

[deleted314957]

We don't have a ton of FMGs at our program, usually only a quarter or so of our residents at any one time, but I have NOT noticed any particular pattern in the attitudes/work habits of FMGs vs. AMGs overall. I completely agree with KCShaw that these attributes are more likely due to a resident's individual personality.

We have some residents (both FMG and AMG) that are great, work hard, don't whine and are quite bright. We also have had a rare resident or two (again, both FMG AND AMG) who avoid teaching junior residents, won't answer their pagers, show up obnoxiously late to lectures and have flat out, absolutely refused to perform service duties that they thought were non-educational/beneath them.

I suppose this seems obvious, but I would say that FMGs overall are probably more likely to have (English) language-barrier issues vs. AMGs, so, there is that.

Agree---I think it is very largely the language/communication barrier and nothing to do with skills, ability or ethic.

 

[malchik]

I've found that "the weakest of FMGs" are often better than our average students. They work harder, complain less, and end up better diagnosticians.

At my program I see exactly the opposite. The FMGs almost uniformly have an inaccurate notion of what it means to be a pathology resident and complain when they are asked to do work. This is probably not universally true; I am simply stating what our experience is to counter observations to the contrary such as the above. I suspect on the whole that pathology resident quality and work ethic has nothing to do with AMG or FMG, ignoring language issues.