As a current resident, I would like to add some additional perspective. Generally, I think I am in between the various positive and negative posts above. I will try to be as objective as possible and reconcile the various differing opinions here.
First off, I just want to defend our new head of breast. I think she is a welcome addition to our faculty and highly emphasizes patient education and wellbeing. She has brought a breath of fresh air and stability to the breast department, which did see a big exodus recently. If she had a reputation for being difficult to work with in the past, she is certainly not the case now. We have hired a lot of new faculty members to replace those that have left for private practice and other academic institutions, so I think we are still feeling everyone out and these attendings are getting their bearings.
I do think the facts of what radresident7 are true. Our shifts have been a moving target over the course of the past year or two (mainly because of COVID and to keep up with volume). Some things have gotten better (attending coverage to 9 and 11 for body and neuro, which greatly improves AM readout on night float) but other things have gotten worse (increased volumes because we are acquiring new hospitals throughout the area). As an aside, I think having attendings on overnight slows things down greatly but we pay the benefits in the morning. An increase in volume across all departments does not seem to be unique but our issue seems to be hiring more attendings to match the increased volume. Recruiting someone to the Midwest, who may not have any real ties, is tough to swallow, especially if the pay is not great. Prestige can only do so much. The lack of manpower spills over to the residents because we have to dictate more, stay later, have less time to think during the day, etc. Additionally, attendings, who historically did not need to dictate much, now dictate more on their own because of volume or privileges at these new hospitals. What this means is that everyone gets busy and attendings forget to explicitly tell you to leave for conference (probably unintentionally). Of course, leaving without telling anyone is frowned upon, so we are left in limbo if we don't speak up. If I was told to pick up a new study right before noon conference, I think the vast majority of attendings would be ok if I said I couldn't because of noon conference. Holding onto a dictation over the noon hour is not preferred, so wanting to read out and delaying going to noon conference probably happens more than it should.
Our benefits are not that great to begin with (I blame BJH for spending money on the hospital fountains and the clash between employed by the hospital and not technically being an employee of the university) but we did get a billion (?) dollar new pacs, recently upgrade our EMR, and revamped our reading rooms (so maybe that's where our money is going). Shout out to Dr. Narra, who honestly has done so much for us and deserves praise from every single person in the institution. However, I do wonder where all the money we saved on not interviewing applicants live went and how much money we get as the largest radiology program in the country but it's probably tied up in administrative budgeting that is not worth getting into and is honestly something I can overlook for the time being.
Regarding our training, specifically night float, and the stresses that come with it, I may be in the minority but I get the feeling that we are actually middle of the road. We have recently changed our night float system to acidometer covid guidelines and streamlined live readout, so these numbers are based on the night float system described by Kaputt and mmityul. To put our numbers in perspective, one night float resident will read approximately 50 body and neuro CTs overnight, a handful of ultrasounds (max 10), and the rare nuclear medicine study. A "busy" night may mean up to 70 and is especially painful if the number of body CTs reaches more than 30. No MRs, which are read by the neuro fellow or body fellow. The other night float resident covered the peds hospital (plain film, CT, non-neuro MRs, fluoro, ultrasound) and was responsible for adult plain films (mainly ED and inpatient questions). In total, an average night means 130 or so plain films with 10 or so CTs/US/etc. After talking to a few fellows and residents elsewhere, frankly, I think these numbers are comparable if not slightly lower than other places. We do issue full reports and have to undergo live readout in the AM, which did increase the fatigue aspect of night float. On top of that, we have a system of overreads often requiring us to call in our errors and make sure everything is well documented. Great for patient care and accountability but not the most fun thing to do at the end of your shift. All in all, I think our night float experience is tough but doable. Worse still, we've gone through a lot of changes (with night float, daily rotations, faculty hiring, new PACS, increasing volume), in the setting of covid, in a city that may not be for everyone, so I can see why the original poster is not happy. In summary, night float is tough and I was very tired after my round of night float but it was doable and I do feel faster/smarter having done it.
Regarding the original poster's comments on being made fun of, by techs, nurses, and MDs, I do think that happens but not way beyond what is pervasive through medicine. Maybe it's a little bad for a radiology program but compared to medical school, I at least explain my thoughts without fear of getting yelled at. I sympathize with the original poster because they have grievances which I can totally see and feel like I have experienced but to a much smaller degree. However, if you are a bad apple in the program (for being lazy, rubbing people the wrong way, etc.), you may not get favorable treatment from people. Also, you just might not get along with someone, which is not good if that person happens to work with you very frequently. I think this is not specific to MIR but human nature, especially in a high stress environment. LadyRads, our culture can be a little stale/old-fashioned and does have a lot of sticks without much carrots so to speak. Naturally, this does tend to bring the worse out of people (especially attendings who have been here a while and walked up hills both ways). The culture can be a little hard to get used to, especially when residents and medical students are less and less tolerant of "malignant" behavior of any sense. Therefore, when we are corrected on errors, it is easy to take it very poorly depending on how the feedback is delivered. I have gotten very bad feedback and glowing reviews the next rotation. Par for the course for anyone who struggled with subjective reviews on limited interactions over the course of a month (sounds like 3rd year of med school to me). On top of that, the department is huge and everyone does things differently so it's hard to be 100% right about every situation.
That being said, I think the overall day to day anxiety level is going down because we are slowly hiring more attendings (especially in neuro where business is booming). On top of that, I personally think the vast majority of our new hires have been very nice, efficient, like teaching. There were times on neuro where the list would be in the 50s around noon and residents would have to read out 10 studies at 5PM because things were so backed up. Now, we have many more attendings on service for readout, so the list is way, way more manageable. Our CT service regularly scans 100+ patients a day, so residents will read 20+ CTs each, but fortunately, our body/chest attendings are very efficient, fast, and help each other out, so there are times where people leave an hour or so early. When there is reduced staffing, especially of the attendings, then we run into trouble.
Addressing our board reviews, yes, we do not get dedicated time off. Residents are let of service at 4 and have two hours of review over the course of three months or so. There were times where you worked a full day, then stayed for two hours afterwards for boards review. Obviously, other residents have it better than us in that regards but given how busy we are at times, I can see why attendings are loathe to lose manpower at the end of the day (especially in the past where lists stayed big towards the end of the day). While many attendings do write for the boards, not all the attendings who give boards review do write for the boards. Furthermore, we are not told the questions ahead of time (as much as we would like) but I do think the board reviews are more focused on what could appear on the boards. The reason we do not get dedicated time off is probably exactly for the reason Cognovi stated. On top of that, our PD is very by the books, probably because wrangling 70+ residents, each with their own unique issues, is no easy task. Having spoken to the R4s who took the test, I'm not sure our board reviews or studying made a big difference (crazy I know). It seemed like the vast majority of the test was focused on nucs, physics, and non-interpretive skills, which makes sense given the structure of the test, and is a known weakness for all residents. That being said, I can see that studying for boards is very stressful and having time off at the end of the day to decompress is very welcome. As far as needing board reviews for studying, it is very helpful but my sense is that the residents could not study the other sections (maybe with passable overall scores) because of the good day to day training, although I doubt any resident would trust this advice. Perhaps the alumni here will disagree.
All in all, is MIR a perfect program? Clearly not. We are a little old-fashioned in a lot of ways and it shows in certain ways as described by the original poster. It is busy and there are daily stresses that make it feel even busier than it probably is. We do have many exceptional teachers and great education but the fellows that come here seem pretty good too. I do think people can be difficult to work with if personalities clash but I attribute that to human nature. Overall, I am slightly positive regarding my time here so far. The training has been very good and I think I will be in a good position once I graduate but I can't say that I didn't leave here with some scars (not to surprising since residency isn't supposed to be a walk in the park). I agree with GadRads above, there are favorites/golden children and other residents who fly under the radar. I think there are faculty who are very well regarded and well connected so if you are liked by them, you can benefit greatly. No one is purposefully treated poorly I don't think but I do think a bad working relationship with even one attending can make your time here not fun.
