Stanford resident taking questions

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STMD08

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Happy to take any questions. We have our strengths. Some of my colleagues have loved it. But I have not been happy here and would choose to train elsewhere if I could try again. Our new program leadership and culture feel very different now than what it used to be under Dr. Skeff.

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Hmm.. what chaos, disruption and disorganization are you referring to? Can you describe specifics?

Also, what exactly do you feel underprepared for?

Sorry, it feels like general frustration and blasting without details... If it makes you feel better, my friends at multiple other top academic programs have all expressed moments of frustration with their programs and leadership. I'm guessing no program is perfect...
 
Would like to hear more details from OP as well
 
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Could you please furthur expand on why the new program leadership, is not as you had hoped? Also, could you speak about the ability to obtain fellowships and fellowship interviews on the east coast, as it appears a lot of people from Stanford stay there for fellowship? I was also hoping you might touch on the rumor that Stanford is a fellow run hospital, and limits resident autonomy? thanks
 
im betting it is an applicant who is hoping to deter others from ranking it #1 so he/she can secure a spot.
 
im betting it is an applicant who is hoping to deter others from ranking it #1 so he/she can secure a spot.

Quite possibly. Let's see what they back it up with.
 
If this person is really a resident, I assure she or he is likely one of the rare ones (probably been on probation or reprimanded - there's always one bad egg in a basket...) The overwhelming majority of residents are happy, collegial well-trained physicians. If you any have doubts about the program, feel free to request the match lists for fellowship going several years back. You'll find that many of residents match into programs such as UCSF, BWH, MGH, Duke, etc for competitive specialties.
 
Happy to take any questions. We have our strengths. Some of my colleagues have loved it. But I have not been happy here and would choose to train elsewhere if I could try again. Our new program leadership and culture feel very different now than what it used to be under Dr. Skeff. The Department of Medicine is also in chaos and undergoing much disruption. With all the high IQs here I'm blown away every day by the level of sheer disorganization and clinical incompetence. If you're considering coming here make sure that you are set on research and being a subspecialist working in suburbia. You will be underprepared for anything else. This program and hospital still have a long way to go.

While I think the OP is a troll, I do think he/she hits on some things that are accurate based on my interview day and the opinions of friends of mine in the program.

A couple of friends of mine in the program have stated that they feel that the clinical training is "sub-par" compared to a lot of programs they could have gone too. I'm not sure how they have made this assessment (having obviously not done residency elsewhere), but I think it's based on their fellows who trained at Stanford for IM vs. stanford fellows who trained elsewhere. Additionally, I was also told by one friend in the program that the program seems to attract "quite a few unjustifiably inflated egos." Again, who knows if this is true or not...these opinions may be of the minority. One definitely stated that he/she wishes they had gone elsewhere and was quite disappointed with the training.

On the flip side, lots of residents short-track and do incredible research. Stanford truly is innovative/a step ahead in that sense and if you are chasing a research heavy career, I can't envision you going wrong here.

Dr. Verghese is the PD, and despite his fame as an author, I couldn't help but be turned off by him on interview day. He came off as pretty arrogant. He talked about himself a lot more than what he hoped to do with the program (hilariously enough, his talk to us was a paraphrased version of a a NYtimes article that profiled him and was included in our folders). Then again, Dr Witteles (sp?) is the associate PD who seems like he REALLY runs the show, and he seemed like an incredible guy (one of my favorites on the interview trail).

I will say that based on my friends in the program, the schedule is incredibly more chill compared to ALOT of other "more hardcore" places. They really do fill in with hospitalist services to ensure that residents are not overworked.

In summary, take what people say on this forum with a grain of salt. If you think you are ranking Stanford highly, I would try to contact residents in the program (or friends you have in the program) directly and really grill them on some of these things so you get the info from credible sources. My impression is, when pressed, residents aren't really going to lie for the sake of lying.
 
I'm not sure how they have made this assessment (having obviously not done residency elsewhere), but I think it's based on their fellows who trained at Stanford for IM vs. stanford fellows who trained elsewhere.

I will just point out that this attitude is everywhere. If I had a dollar for every fellow/junior attending who started a sentence with "when I was at (insert fancy program name here), we did X, Y and Z, not A, B and C like you do here...I just can't understand why you would do it that way," my student loans would have been paid off by the end of intern year.

It's called being a pretentious name-dropping d-bag. You get used to it and hopefully over it soon enough.
 
While I think the OP is a troll, I do think he/she hits on some things that are accurate based on my interview day and the opinions of friends of mine in the program.

A couple of friends of mine in the program have stated that they feel that the clinical training is "sub-par" compared to a lot of programs they could have gone too. I'm not sure how they have made this assessment (having obviously not done residency elsewhere), but I think it's based on their fellows who trained at Stanford for IM vs. stanford fellows who trained elsewhere. Additionally, I was also told by one friend in the program that the program seems to attract "quite a few unjustifiably inflated egos." Again, who knows if this is true or not...these opinions may be of the minority. One definitely stated that he/she wishes they had gone elsewhere and was quite disappointed with the training.

On the flip side, lots of residents short-track and do incredible research. Stanford truly is innovative/a step ahead in that sense and if you are chasing a research heavy career, I can't envision you going wrong here.

Dr. Verghese is the PD, and despite his fame as an author, I couldn't help but be turned off by him on interview day. He came off as pretty arrogant. He talked about himself a lot more than what he hoped to do with the program (hilariously enough, his talk to us was a paraphrased version of a a NYtimes article that profiled him and was included in our folders). Then again, Dr Witteles (sp?) is the associate PD who seems like he REALLY runs the show, and he seemed like an incredible guy (one of my favorites on the interview trail).

I will say that based on my friends in the program, the schedule is incredibly more chill compared to ALOT of other "more hardcore" places. They really do fill in with hospitalist services to ensure that residents are not overworked.

In summary, take what people say on this forum with a grain of salt. If you think you are ranking Stanford highly, I would try to contact residents in the program (or friends you have in the program) directly and really grill them on some of these things so you get the info from credible sources. My impression is, when pressed, residents aren't really going to lie for the sake of lying.



On -my- interview day, I found Dr. Verghese to be incredibly eloquent. His talk about his work and the "Stanford 25" seemed completely appropriate and was a great "talking point." (Every program I have been to has had a talking point, some better than others... they need to differentiate themselves from all of the other programs we interview at in some way…). I also felt like it was clear that Dr Witteles was the acting PD and very in touch with the residents and, yes, an incredible guy.
 
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STMD, for those of us looking forward to also doing research and staying in academics, would you deem Stanford a good fit? I'm looking for a program that has strong teaching, will allow me to stay involved with research, and help me match into a fellowship...thoughts?
 
As for the Department of Medicine I'll just say an unfortunate scandal made our Chairman step down. Now there's lots of angling to be the next Chairman. The sad thing is it'll probably be more of the same

Stanford must have really managed to keep this under lock and key. While Googling around, I could only find the briefest mention of Horwitz' departure buried deep in the dean's newsletter from last year. Horwitz doesn't even get his own section: the sub heading is "Transitions and Searches", and his notice comes last, grouped together with snippets about the departures of 3 other chairs at Stanford. Interesting to note that the departing psychiatry chair gets his own section sub heading ("Thanks to Dr. Alan Schatzberg").

Pray tell. This story must be much juicier than his departure from the deanship at Case.

-AT.
 
I'm also a Stanford Medicine resident and usually like to avoid posting on these sites because I think it's useful for applicants to have a forum that's a safe space for them to share their experiences and thoughts on the residency application trail. A friend of mine (a current applicant) mentioned this thread's discussion of Stanford's program and I felt compelled to add my perspective simply because I think the thoughts outlined in other posts are NOT the feelings of the majority. Like any posts in this listerv, their posts (and certainly mine also) should be taken with a grain of salt (or perhaps a pound!).

In specific,

(1) There certainly are a few general medicine attendings from the community on the wards although I think these are the exception rather than the rule and they usually have a long history with Stanford. I've had good experiences with the ONE that I worked with during 3 years of residency and felt that they brought a unique perspective to our inpatient team.
(2) I do feel strongly that the breadth of disease that we see is more than adequate. The patient population for tertiary and quaternary care draws from a huge swath of California and beyond and is more than ample to provide for the few major hospitals in the Bay Area. To speak to HIV in particular, I agree that we don't see much inpatient HIV at Stanford. That being said, during my residency I've been able to expand my HIV experience both through a six week elective abroad working in inpatient and outpatient settings in a Ugandan hospital with a very high HIV rates and an outpatient HIV elective here at Stanford which has a great reputation amongst residents for teaching.
(3) It's true that our departmental leadership has changed recently (Summer 2010) and that we have an acting chair (Linda Boxer) while a replacement is found.
(4) Finally, I just wanted to emphasize that I personally and also many of my colleagues have not had difficulty obtaining competitive interviews at academic institutions. This has been my goal all along and I've found it relatively easy to obtain the interviews I was hoping for. What's more, I feel prepared to dive into fellowship.

I know that everyone is trying to manage the pro's and con's of every program and create their perfect match list and I certainly wish you luck. It's complicated. I hope you'll take ALL of the perspectives that you've been able to come into obtain. If you have more questions in those dwindling hours before the match lists are due, get in touch with us!
 
(3) It's true that our departmental leadership has changed recently (Summer 2010) and that we have an acting chair (Linda Boxer) while a replacement is found.

So what's the story there? Has Horwitz left Stanford medicine in as much of a mess as when he left Case's medical school abruptly in 2006?

-AT.
 
I'm also an SUH resident, and as STMD08 indicates, the best way to get a holistic view of the program is to listen to a number of voices, to that end:

1) Patient diversity: it is true that you will not see as many of certain demographics here as you will at other hospitals. For instance, the number of urban folks is much lower since Stanford is not in an urban area. Having said that, and having done med school at one of the hospitals STMD08 refers to as a model school, I can say that the level of diversity here is substantial and compares well with that other school. We see patients from a whole range of ethnic, cultural, economic, and other demographic areas. Further, as the other previous poster mentioned, SUH has arguably one of the most complete GH programs available and so, for instance, a good number of residents rotate in South Africa at a clinic where every patient has HIV and usually a number of comorbidities. Along the same lines, the breadth of illness at SUH is remarkable; interestingly, a complaint I have heard more commonly is that we see such interesting and esoteric illness that some people wonder if we see enough bread and butter (I think we do, but, in any case...).

2) Attending strength: I honestly have no idea what STMD08 is talking about. It is certainly true that there are a number of super-researchers at SUH. My experience, however, has actually been that the attendings on the wards are often stronger for their clinical skills that for their esoteric research acumen. Every attending differs, of course, and that will be true no matter where you train, but I have found the clinical teaching here first rate. And, whatever else you think about Dr. Verghese, he was my attending on the wards last year and is a fabulous teacher of clinical medicine.

3) I guess I just don't understand the knocks against "community docs." Some of my attendings have been from the community--and so what? Some community docs have great things to teach that might not be as obvious to more academically-minded folks.

4) To my knowledge, those who wish to can spend at least 3 months at the Valley, sometimes more. It is true, however, that you will not spend 1/3 of your time there.

5) It is true, the chairman stepped down in something of a very subdued scandal. If anyone knows details about this, it is not me.

6) Overall, as stated above, I attended one of the "reputable" schools STMD08 mentions in his post for med school, and I loved it. I thought it gave me fabulous preparation for residency and left me with well-honed skills to apply as a doctor. The change in chair and PD at SUH did, indeed, make last year a bit rocky, but, I have to say: on the whole, my experience here has been a very positive continuation of the one I started on the East Coast. No program is perfect, of course, and attendings will vary at every institution, but I think most residents here are quite pleased with their training and their lives. Further, while the program administration is new, I think it speaks highly to their goals that, when the new work-hour restrictions were announced, they literally gathered all residents who were interested in a room for eight hours one saturday and said "this is our chance to redesign the program to emphasize education over scut, let's figure out how to do it best." And then the residents and PDs together figured out, from the ground up, how to design the program to best benefit residents.
 
from west coast med school with fantastic clinical training which is what I am providing comparisons to.

here are my two cents. While all current Stanford residents will have own opinions there are a few indisputable facts.

i came to stan b/c of kelley skeff (prob the most memorable PD on the interview trail). he really cared about this residents and the residency programs and this was his first and foremost priority. Our now dethroned former chairman essentially fired Skeff since he always put the priorities of the housestaff OVER the needs/wants of the chairman. The best part is, apparently this tiff had been going on when i was interviewing but there was no mention of it. and then on the first few days of orientation it was like "psych, we've replaced the entire residency administration" and kelley skeff was no longer in charge.

In place, where appointed Varghase and Witeles.

1. Varghase is NOT our PD. He himself will admit this. He is a placeholder for Witeles until he has enough years under his belt before he can qualify for the job (as ACGME requires certain number of years as associate PD or faculty before one can be appointed full PD) as he only graduated from fellowship ~ 4-5 yrs ago (2007 i believe). All of the current housestaff will agree that we hardly see Varghase. He was not around for most of last year as he was touring the country promoting his book….good for him…bad for us. Why was he given a PD job if he is not even going to be around?!? He is extremely eloquent, charming, and great speaker. but PD of Stanford residency he is not. His stanford 25 is an interesting idea but R2 and R3 got very little exposure to it. i've been to ~ 5 sessions since start of internship and two of them where repeats. one applicant last month made a joke last month which i thought was interesting: Varghase says his goal is to bring the physical exam "back" into medicine...this applicant said "where the hell did it go, its still present at my med school and many of the other places i interviewed."

2. Witeles is our sen assoc PD by paper but he truly is the guy running the program. Great educator (on the CCU and in morning reports), great clinician (very smart), very young (he is only ~ 4-5 yrs from finishing fellowship). But a PD he is not. Last year was painful as he was learning on the fly and this affected many housestaff. changes where made to QI/research blocks, ward structure, caps, rotations, without any notice or resident input. It was essentially “my way or the highway” type of approach. This year is better, but it in no way makes up for last year.

His approachability is also far less than that of kelley skeff. skeff door always open. witeles door never open. I guess there is valid reason that ACGME requires a certain # of years being on faculty or certain # of years as associate/assistant PD before one can be full PD, and we clearly have not obeyed this rule and the front put on during interview season was a farce. With new ACGME hour restrictions coming up, perhaps it would be a good thing to have someone preparing for it who has not PD experience as a way of "thinking outside of the box." applicants should decide for themselves if this is good/bad and something they want to be a part of.

3. Departure of our former chairman is quite scandalous, but that is for another thread/website.

4. Ward Experience.
true that many ward attednings are former stanford grads. i also agree (IMHO) that our clinical breath and depth are lacking of not only the patient population but also some (not all) of the attendings, but this is probably universal.

We get tons of trainwreck transfer from far away hospitals that where denied from other instituions. Then these trainwrecks end up becoming dispo nightmares.

I can count on one hand the number of DKA’s I have taken care of. Other than clicking on the order set of DKA I could not take care of it blindly nor would I know what to do with any complications that arise. We are a giant community hospital for a community that is financially well off, with insurance, and well educated. We do not get much neuro as we have a separate neuro residency (but this is true for most academic institutions). Very little HIV and very little TB. True that we have GH electives but residents who take part are in the minority. Our 2 week HIV block is interesting but we only see outpatient HIV, no inpatient cases.

ICU experience here is awesome when it comes to the medical cases. My only problem is that ~ 50% of your time is taken up dealing with MICU consults to neurosurg pt’s admitted to ICU. And yes, we consult on ALL neurosurg pt’s admitted to MICU even without them asking and even if they don’t have ANY medical problems. Most of these pt’s end up getting downgraded the follwing day. Each of these consults takes up time as you have to go see them, physical, write H+p, etc. I think this takes away valuable time when you could be going down to ED to perform the initial assessment and plan of a sick medical pt coming up to ICU. Since we are so busy with neurosug pt’s often the fellows do this alone and we often don’t see the sick medical icu pt’s until they are already on the unit, lined up, and orders already in place. So you end up being a clerk pretty much writing restraint orders, K replacement scales, and putting in a H+P.

5. Educational Diversity of Housestaff.
Kelley Skeff spent a significant amt of time evaluating the character and clinical ability of an applicant in addition to the traditional “name of medical school” and board scores. For this reason, those classes that came here under him are very diverse. With the new “regime” the applcant roster reads Harvard, UCSF, Stanford, Yale, Columbia, etc. I went to one of these institutions for medical school but the diversity of individuals coming from other not-so-well-known instituions is now lacking and this results in a very “stereotypical” class that I did not sign up for. It is up to the current round of applicants to decide if this is for them.

6. Fellowships.
Can’t speak towards the competitive ones (GI, cards). But for non competitive fellowships (rheum, endo, renal) most stay in house or go to nearby UCSF. However, we interview at all top locations around the country but I suspect (your truly included) there are other issues limiting our departure (family, weather, lifestyle, etc). maybe one of the other residents on the threads can comment on fellowship matches for the more competitive programs.

7. Future of Stanford Residency.
I think this is up in the air. Mostly b/c we have an interim chair. The current search committee is still a while away from making final decision (latest rumor puts it at ~ 1 yr). The residency will change depending on the vision of the new chair….and so may the PD (or associate PDs who essentially are the real PD). If the new chairman is anything like Horowitz, than you are in for major changes. …for the better? …for the worst?

This is just my thoughts of our residency. And as you can see you will receive a whole spectrum of thoughts. Its up to you guys to decide what you would want to be a part off. In all, I think we HAD a great program, and currently our program has the potential to be great again. But the one thing I did not agree with was the façade of who the real PD is in our program. I think it was unfair and unethical to the current group of applicants. They should be aware that they will be training under someone who does not have prior PD experience. Some people want that, but others may not.

If you have any other questions, post a thread or PM any one of the other residents on this thread. I’m sure we would be more than happy to post our thoughts.
 
from west coast med school with fantastic clinical training which is what I am providing comparisons to.

here are my two cents. While all current Stanford residents will have own opinions there are a few indisputable facts.

i came to stan b/c of kelley skeff (prob the most memorable PD on the interview trail). he really cared about this residents and the residency programs and this was his first and foremost priority. Our now dethroned former chairman essentially fired Skeff since he always put the priorities of the housestaff OVER the needs/wants of the chairman. The best part is, apparently this tiff had been going on when i was interviewing but there was no mention of it. and then on the first few days of orientation it was like "psych, we've replaced the entire residency administration" and kelley skeff was no longer in charge.

In place, where appointed Varghase and Witeles.

1. Varghase is NOT our PD. He himself will admit this. He is a placeholder for Witeles until he has enough years under his belt before he can qualify for the job (as ACGME requires certain number of years as associate PD or faculty before one can be appointed full PD) as he only graduated from fellowship ~ 4-5 yrs ago (2007 i believe). All of the current housestaff will agree that we hardly see Varghase. He was not around for most of last year as he was touring the country promoting his book….good for him…bad for us. Why was he given a PD job if he is not even going to be around?!? He is extremely eloquent, charming, and great speaker. but PD of Stanford residency he is not. His stanford 25 is an interesting idea but R2 and R3 got very little exposure to it. i've been to ~ 5 sessions since start of internship and two of them where repeats. one applicant last month made a joke last month which i thought was interesting: Varghase says his goal is to bring the physical exam "back" into medicine...this applicant said "where the hell did it go, its still present at my med school and many of the other places i interviewed."

2. Witeles is our sen assoc PD by paper but he truly is the guy running the program. Great educator (on the CCU and in morning reports), great clinician (very smart), very young (he is only ~ 4-5 yrs from finishing fellowship). But a PD he is not. Last year was painful as he was learning on the fly and this affected many housestaff. changes where made to QI/research blocks, ward structure, caps, rotations, without any notice or resident input. It was essentially "my way or the highway" type of approach. This year is better, but it in no way makes up for last year.

His approachability is also far less than that of kelley skeff. skeff door always open. witeles door never open. I guess there is valid reason that ACGME requires a certain # of years being on faculty or certain # of years as associate/assistant PD before one can be full PD, and we clearly have not obeyed this rule and the front put on during interview season was a farce. With new ACGME hour restrictions coming up, perhaps it would be a good thing to have someone preparing for it who has not PD experience as a way of "thinking outside of the box." applicants should decide for themselves if this is good/bad and something they want to be a part of.

3. Departure of our former chairman is quite scandalous, but that is for another thread/website.

4. Ward Experience.
true that many ward attednings are former stanford grads. i also agree (IMHO) that our clinical breath and depth are lacking of not only the patient population but also some (not all) of the attendings, but this is probably universal.

We get tons of trainwreck transfer from far away hospitals that where denied from other instituions. Then these trainwrecks end up becoming dispo nightmares.

I can count on one hand the number of DKA's I have taken care of. Other than clicking on the order set of DKA I could not take care of it blindly nor would I know what to do with any complications that arise. We are a giant community hospital for a community that is financially well off, with insurance, and well educated. We do not get much neuro as we have a separate neuro residency (but this is true for most academic institutions). Very little HIV and very little TB. True that we have GH electives but residents who take part are in the minority. Our 2 week HIV block is interesting but we only see outpatient HIV, no inpatient cases.

ICU experience here is awesome when it comes to the medical cases. My only problem is that ~ 50% of your time is taken up dealing with MICU consults to neurosurg pt's admitted to ICU. And yes, we consult on ALL neurosurg pt's admitted to MICU even without them asking and even if they don't have ANY medical problems. Most of these pt's end up getting downgraded the follwing day. Each of these consults takes up time as you have to go see them, physical, write H+p, etc. I think this takes away valuable time when you could be going down to ED to perform the initial assessment and plan of a sick medical pt coming up to ICU. Since we are so busy with neurosug pt's often the fellows do this alone and we often don't see the sick medical icu pt's until they are already on the unit, lined up, and orders already in place. So you end up being a clerk pretty much writing restraint orders, K replacement scales, and putting in a H+P.

5. Educational Diversity of Housestaff.
Kelley Skeff spent a significant amt of time evaluating the character and clinical ability of an applicant in addition to the traditional "name of medical school" and board scores. For this reason, those classes that came here under him are very diverse. With the new "regime" the applcant roster reads Harvard, UCSF, Stanford, Yale, Columbia, etc. I went to one of these institutions for medical school but the diversity of individuals coming from other not-so-well-known instituions is now lacking and this results in a very "stereotypical" class that I did not sign up for. It is up to the current round of applicants to decide if this is for them.

6. Fellowships.
Can't speak towards the competitive ones (GI, cards). But for non competitive fellowships (rheum, endo, renal) most stay in house or go to nearby UCSF. However, we interview at all top locations around the country but I suspect (your truly included) there are other issues limiting our departure (family, weather, lifestyle, etc). maybe one of the other residents on the threads can comment on fellowship matches for the more competitive programs.

7. Future of Stanford Residency.
I think this is up in the air. Mostly b/c we have an interim chair. The current search committee is still a while away from making final decision (latest rumor puts it at ~ 1 yr). The residency will change depending on the vision of the new chair….and so may the PD (or associate PDs who essentially are the real PD). If the new chairman is anything like Horowitz, than you are in for major changes. …for the better? …for the worst?

This is just my thoughts of our residency. And as you can see you will receive a whole spectrum of thoughts. Its up to you guys to decide what you would want to be a part off. In all, I think we HAD a great program, and currently our program has the potential to be great again. But the one thing I did not agree with was the façade of who the real PD is in our program. I think it was unfair and unethical to the current group of applicants. They should be aware that they will be training under someone who does not have prior PD experience. Some people want that, but others may not.

If you have any other questions, post a thread or PM any one of the other residents on this thread. I'm sure we would be more than happy to post our thoughts.



I have heard that a few residents have dropped out Stanford's IM program within the last 2 years or so. Was this part of the problem? I also heard that Stanford has been making ACTIVE attempts to increase its board score averages by recruiting folks from bigger name schools, hence losing a bit on the diversity of the institutions were applicants come from.

It seems like the program still has ALOT of personality issues that it needs to flush out.
 
Thanks to all the current residents that have responded! I'm currently an MD/PhD student in Texas and will be applying for IM this upcoming fall. Stanford is clearly at the top of my list of places I would love to train at.

For those of us who still have some time before applying, could any of the current residents comment on what Stanford really looks at in selecting its residents? ie. is it known if board scores are heavily weighed v letters v research?

From everything i've read/heard about Stanford I've always thought it would be a good fit for me...my focus now is on getting in!

Thanks in advance!
 
also, can someone comment on the oncology fellowship program/exposure to various malignancies as a resident at Stanford? Thanks!
 
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Alright, we're all dying to know. What did he do? My guess is "misappropriation" of money. But who knows, maybe there's an inappropriate relationship as well?
 
wow

the plot does thicken, does it not?

Count DKAs on one hand?! :eek: It seemed like on call I'd admit at least one per call . . . I'm sure that's a bit of hyperbole, but damn . . .

until things settle out a bit, I may rethink how strongly I push folks to go there, which is not saying it's bad, but everything else being equal . . .
 
Alright, we're all dying to know. What did he do? My guess is "misappropriation" of money. But who knows, maybe there's an inappropriate relationship as well?

Who knows? Either the Stanford residents know and aren't telling, or Stanford has managed to keep this tightly under wraps.

-AT.
 
One more point of reference from another Stanford resident. I just heard about this conversation today and wanted to put in my 2 cents.

I am a PGY-3, so have a frame of reference before and after the program leadership change. I liked Kelley Skeff a lot as well when I was interviewing, and he was one of the main reasons I ranked Stanford #1. He's a great person who you can't help but like, and I imagine he was once a great PD, but once I got here he seemed burnt out to me. Everything seemed disorganized, from the office to the schedules to the conferences. I still liked being a resident here, because my co-residents were great and I had fantastic experiences with my attendings (and contrary to what some have said I felt I saw great diversity of cases and was receiving overall superb clinical training.)

When the leadership changed, things were clearly quite different. I felt some sympathy for the new guard, as they were taking over from someone who was personally beloved, and they had to deal with the organizational side of the program which those of us who were here knew was quite a mess. Right away, changes started. I disagree with the person who said that Dr. Skeff advocated for the residents and the new leadership didn't. My take was that while Dr. Skeff was friendly and well-liked by the residents, nothing ever got done and the residents got walked on. With the new regime, for example, residents were given their weekends off when they were on consult rotations. (Previously they had to come in for what was often a very low education:service yield.) From what I heard, the specialty services were anything but happy about this, but the new leadership was strong and fought through it. That never would have happened before. The new leadership held attendings accountable if they were rounding right through morning report. That never would have happened before. They completely turned over the office staff, and those of us who have been here for a while know that it is night and day fro before. The current staff is both friendly and extremely efficient and organized. It may seem silly, but this can make a big difference in the life of a resident.

I think that the biggest mistake of the new leadership their first year was that they seemed to not be including the residents enough in the changes. Clearly that message came through loud and clear to them, because it couldn't be any more different this year. They started having monthly meetings with the residents where all changes to the program are discussed and that is where the decisions get made. When the work-hour changes were announced, as someone else mentioned, they held a retreat and specifically did not allow any attendings to come, because they wanted the solution to be resident-driven (and educationally-driven). I was at that retreat and what we came up with that day is basically exactly what is being put in place. Show me one other program where the process was anything like this, anything approaching where we as residents got to redesign the program purely from what made sense from an educational perspective.

Change is always difficult, particularly when some residents came here largely for the program director. I'm not surprised that some people who came here with one expectation and got another were upset. That will always be the case. But if you talk to this year's interns, I think you will find they are universally happy and thrilled they came here. I personally feel the same, and have found the leadership (especially Dr. Witteles) extremely supportive. They helped me from a career perspective, helped me with my fellowship application, and I got interviews everywhere I applied, including the big programs out east. I would absolutely come here again if I had it to do over.

Anyway those are my thoughts for whatever they are worth. Good luck to everyone in this year's match.
 
Five, six Stanford residents and no one wants to cough up the story about the department chair?

-AT.
 
The only thing I'd add is that with the new administration, there is much more accountability. Residents are held to a higher standard, which is definitely a good thing. At the end of the Skeff era, there were residents skating by doing the minimum as they knew there would be no repercussions. As a result, there were some recruits who came to Stanford exactly for that reason, to the detriment of the program.

This is no longer the case. Don't get me wrong; this isn't Yale where residents get dismissed for no reason. But if you underperform, you will be called on it, and I suspect that's the real reason some of the complainers above are unhappy with the current system. You can't skate by anymore. I would trade competency for touchy-feely any day.


p diddy
 
The only thing I'd add is that with the new administration, there is much more accountability. Residents are held to a higher standard, which is definitely a good thing. At the end of the Skeff era, there were residents skating by doing the minimum as they knew there would be no repercussions. As a result, there were some recruits who came to Stanford exactly for that reason, to the detriment of the program.

This is no longer the case. Don't get me wrong; this isn't Yale where residents get dismissed for no reason. But if you underperform, you will be called on it, and I suspect that's the real reason some of the complainers above are unhappy with the current system. You can't skate by anymore. I would trade competency for touchy-feely any day.


p diddy

really? was that necessary??:laugh:
 
This thread is becoming more interesting than a good thrilling Hollywood blockbuster.

I hope some more juicy scoops keeps coming........:smuggrin:
 
I hope some more juicy scoops keeps coming........:smuggrin:

Probably not. Five or six SUH residents have come and gone and none have commented on the chief of medicine scandal. I'm impressed by the discipline.

-AT.
 
Impressive discipline. Im sure we'll find out sooner than later. Academic gossip is the best sometimes.
 
Does Stanford take D.O.'s for their IM categorical residency?
 
I know the Stanford program extremely well. Well enough that I can identify each person from Stanford on this thread. That includes you ATsai, although it's quite bold to be fomenting rumors about us as a fellow from somewhere else--granted, you do have a connection to this place---ERRRRRRR I digress.

Let's not beat around the bush. The OP and others obviously did not have a good time here. There are others on this thread who sound like robots defending this program. The truth lies somewhere in between.

1. There's no real way to directly compare your experience in a residency program to some other place. Keep this in mind whenever someone has a strong opinion about their program.

2. That being said, the number one problem at Stanford is that Stanford is disorganized. This is Stanford in general. Same goes with the residency program. It's gotten better, but not by much. Registration, orientation, paperwork, expect to have hassles setting any of this up.

3. Diversity of patients. Surprisingly, we do get a diverse group of patients. There's definitely the rich b*tch clientele who demand everything, but there's also a large population of migrant workers, uninsured, etc who are referred to Stanford. I don't want to discuss this ad nauseam, but suffice it to say the only big deficiency is the lack of HIV patients.

4. Biggest gap in training. Our ICU training sucks. Whoever tries to sell you that it's good, don't listen to them. When we are on unit months we take care of a lot of postop surgical patients, which gets old after about 2 patients and frankly is a waste of our time. Both at the VA and at Stanford, residents are basically interns and rarely get to run the show. You get the point.

5. Team morale. This one is harder to assess, but there definitely was a time when most of the residents were pissed off and disgruntled about the leadership change. Also, there were too many changes at one time, some good, some really bad. The residents--and a lot of faculty actually--felt slighted by all the unilateral changes. Also, it's true, the person touted as the program director is not the real program director. But you'd rather have the other person running the show anyway. It is an unnecessary facade though. It seems like the morale has gotten better, but time will tell.

6. Yea, our former dept chair was dishonorably discharged. I won't go into details either, because it's all hearsay and could lead to slander.

7. We still do pretty well in the fellowship match. A lot of people want to stay at Stanford for fellowship, which explains the disproportionate number of Stanford matches for GI/Cards/Heme-Onc. Most want to stay because of family, comfort, etc. A lot of the people who matched for GI/Cards, for instance, could've matched elsewhere if they chose to. Some of them at the top places (MGH, UCLA, Brigham, etc.) if they wanted. The Stanford name carries weight when applying--whether deservedly so, that's another story. The faculty is also pretty supportive when it comes to applying. Our fellowship matching is one of our greatest strengths--don't ignore this if you want to specialize!

I'll post more later, if this thread continues...




Probably not. Five or six SUH residents have come and gone and none have commented on the chief of medicine scandal. I'm impressed by the discipline.

-AT.
 
Just curious- If you come in the IM program already knowing what fellowship you want to do, how open is Stanford to letting you fast-track to fellowship in 2 years?
 
Just curious- If you come in the IM program already knowing what fellowship you want to do, how open is Stanford to letting you fast-track to fellowship in 2 years?

Stanford's probably no different than other places. In general, fast tracking is reserved mainly (although some exceptions) for people pursuing basic science research. These are people who will likely join as faculty afterward. A large percentage of people who fast track are MD/PhDs, although anyone technically can do it. Just knowing what fellowship you want to do probably won't be enough. A lot of people who go into IM have a good idea about what fellowship they want to pursue.
 
Fast track is handled under the Clinical Investigator Pathway (CIP) at Stanford. Most members of CIP indicated their interest during the residency interview process, but CIP welcomes residents who decide shortly after starting internship. The chief residents make a good effort to arrange relevant clinical rotations that allow CIP candidates to make connections with faculty and develop rapport for letters of recommendation before the Oct-Nov deadline of fast track review. I have seen several CIP candidates switch from cards to heme-onc, and vice-versa, during the initial few months of internship, who are now in fellowship.

CIP is not exclusively MD/PhD, with several MD's who have fast tracked into cards and GI at MGH, UCLA and BWH during my residency at Stanford. The MD/PhDs tend to stay at Stanford because they already have a desired lab here, have started a project with the Biodesign/Bio-X group, or are attached to local geography.
 
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Stop the teasing. Give us the dirt.

Seriously.

It's weird-- even the people who know, or partially know, or think they know, haven't been willing to provide even vague details. Gotta wonder why.

-AT.
 
So I found out what happened.

It wasn't criminal or as bad as I thought. But it showed questionable judgment from someone who is supposed to be a role model.
 
To the current residents on the thread:

Do you have any insight into what factors weigh most heavily into choosing incoming residents? Are there board score/grade cutoffs?

And historically speaking, have they been partial to students that have done ms4 elective rotations at their institution or does it not really help w/ residency admission?

Thanks!
 
So I found out what happened.

It wasn't criminal or as bad as I thought. But it showed questionable judgment from someone who is supposed to be a role model.

Stop the teasing. Give us the dirt.
 
This is really interesting. I've never been at Stanford, but the basic assessments I've heard of their program include:
1) good fellowship matches
2) they have a fair number of residents from "big name" med schools, which contributes to #1, and likely also draws more residency applications from MSIV students at such schools (along with the nice weather, safe neighborhood, etc.).
3) the rigor of the clinical training may be lacking versus what one would obtain by doing residency at some of the other "top" IM programs
4) I too have heard rumors about disorganization at Stanford (perhaps not limited to the IM program, though) but I'm not sure how accurate they are...one would think that a place like Stanford that has $$ would be able to fix the organizational stuff
 
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