Program Review
Staff / Faculty / Chairman
Historically, department chairmen and most faculty have had very little interest in residents or trainee education. In recent years, this is understandably so, given the mass merger that has most merged/merging departments in a state of disarray, leadership wise. New chairman - prolific and well-respected; however, it remains to be seen what she'll mean for the residency. Given how full her hands are/will be, this transition is unlikely to change anything positively for residents in the near future.
The current program director and faculty pride themselves in not even knowing the residents' names, let alone their schedules. Except for a couple notable exceptions, they seem largely unapproachable and entirely disinterested and disconnected from the program. Faculty don't even know when they're on call - and sometimes aren't even available to the residents when they explicitly are on call. Faculty often don't show up for didactics or lectures they're scheduled to give.
Didactics / Teaching
Same old - see prior review. If it's changed, it's only changed for the worse - grown increasingly more malignant and disorganized. The seniors tear into and denigrate the juniors for no good reason except that no one took the time to teach them in prior years. It's pimpfest 24/7 at this program - and there's no constructive baseline education. There's a pervasive culture of trying to humiliate and belittle the juniors to create an inflated sense of self worth. The juniors are so focused on self-preservation and knowing just the right answers to pimp questions, very few of them have any functional foundational understanding and are able to teach even us, the students - except to pass along possible pimpfest answers and cheat sheets. Unfortunately, you can't really blame the residents here - as mentioned previously, they have a historical come back to make and so few faculty care about didactics here; during my month rotation, there was a 50% faculty show rate. We tagged along for intern education as well, which seemed completely useless - watched the sleep deprived interns struggle to stay awake for 3 hours of outdated, disorganized lectures that were less educational than a 30 second orthobullets review. Half of these sessions didn't even have any faculty present or involved.
Operating Experience
Prior review is a bit outdated but the underlying gist persists. A lot of time in ORs from PGY2-PGY4; very little hands on experience. There are select faculty that are better than others, but on the whole pathetic experience relative to similarly located/positioned programs. I watched my resident literally stand in a corner or sometimes place his hands on the drapes for hours at a time. Trauma experience is as a PGY4 at Westchester - sounds ok, but the commute sounds terrible and that's pretty late in the game to get a real trauma experience. They have a 'mini' trauma exposure at Elmhurst a hospital in Queens - went there a couple of times on my rotation since the operating volume at Sinai was too low for me to scrub anything: low volume, terrible commute, very little guidance or organization at this satellite location. Peds experience is all but non existent; the attendings are nice enough, but very low volume: peds junior just mans the pager aside from a day or two a week. Prior review is a bit outdated but the underlying gist persists. A lot of time in ORs from PGY2-PGY4; very little hands on experience. There are select faculty that are better than others, but on the whole pathetic experience relative to similarly located/positioned programs. I watched my resident literally stand in a corner or sometimes place his hands on the drapes for hours at a time. Trauma experience is as a PGY4 at Westchester - sounds ok, but the commute sounds terrible and that's pretty late in the game to get a real trauma experience. They have a 'mini' trauma exposure at Elmhurst a hospital in Queens - went there a couple of times on my rotation since the operating volume at Sinai was too low for me to scrub anything: low volume, terrible commute, very little guidance or organization at this satellite location. Peds experience is all but non existent; the attendings are nice enough, but very low volume: peds junior just mans the pager aside from a day or two a week. Peds senior drinks coffee. It sounds like they're trying to improve this but from a trainee perspective, still suboptimal. Tumor is ok - one day a week in the OR.
Clinic Experience
Low average to average. Clinics are overbooked - residents are overworked. On the positive side, the residents have a ton of autonomy. However, clinic is definitely not safe or educational. Not sure how clinic economics or politics works here but patients flood the waiting room, clinics run hours late, residents have no time to discuss patients, attendings are sometimes around but mostly preoccupied and jaded. It really seems like the residents are overworked to exhaustion and beyond physical handling capacity to manage the enormous medicaid/poorly reimbursing patient population. There doesn't seem to be an efficient vetting process for patients that make orthopedic clinic appointments - I saw fewer primary orthopedic issues in these clinics than I saw during my family medicine rotation. Most of the resident activity is comprised of filling out disability paperwork, prescribing narcotics to demanding patients, and being terrified to do anything differently due to fear of administration.
Research Opportunities
Same as prior review - it seems like the residents try really hard; but aside from a couple attendings in spine and upper extremity that have a handful of projects, research in the department is dead. Unlike other programs, residents are not given elective time to pursue research. And there is little to no funding - I watched residents scramble to even come up with funds to present posters at meetings. Obviously, not a faculty priority here. And the research that does happen tends to be minimal effort/quality and maximum quantity.
Residents
One of my best friends is just finishing residency here - obviously there are normal people and friendships within the department; but overall, the culture is hostile. Seniors pride themselves in not being around as much as possible - and, it's difficult to blame them, given how much they've dealt with culturally in this program as juniors. Unfortunately, this only perpetuates the malignant culture of the program. Unlike programs where there is camaraderie across years, seniors won't budge or show up to teach or help juniors. Juniors tend to teach themselves off of youtube and trial and error. And faculty, aside from the OR, are nonexistent. Overall, everyone tries to emulate the nonexistence as much as possible, given how horrible of a working environment they're in. There's a sense of fear of the attendings that is pervasive - attendings are not to be bothered or contacted unless their VIP patient is actively dying. And there is an unforgiving attending heirarchy - residents will go to any length including turning over patient sheets in the middle of the night for particular attendings out of shear terror of an unhappy attending. As such, there is no resident advocate; residents get yelled at by nurses, other residents, other attendings for departmental deficiencies - and since there is little to no ortho attending back up/presence, the front line residents are stuck taking the brunt of fury from other departments and trying to redirect them from their own attendings and higher ups.
Lifestyle
No post-call system, since in theory there are overnight PAs; however, I watched a lot of sleeping juniors during next day didactics, clinics, or cases, after they'd been up the preceding nights taking call because PAs either didn't show up or couldn't handle nighttime events on their own. Certain services are far overloaded for the number of residents assigned to them - to the point that in some instances, the resident:patient burden is safe for neither party. Particularly the joints, spine, and tumor services typically have far too many patients (and sometimes pretty sick patients) for the resident or residents that are assigned to them. In theory, there are PAs during the days that help with floor work, but in practice, the residents are still run ragged. I watched other services actually submit medical error reports given how thinly spread the residents were on these services. ACGME duty hour violations (especially among the juniors) are rampant but go unreported given that residents don't really have an effective means of reporting them.
Location / Housing
Upper East Side - it sounds like residents are at a severe lack of affordable housing options. The hospital in theory subsidizes housing but the rates are often worse than market rates and the quality is absolutely abysmal - comparable to NYCHA housing at times. Sinai lacks in providing competitive basic benefits like health, dental, vision insurance with affordable and desirable options. It sounds like the west side residents have better housing options and live in more conveniently located places.
Limitations
There probably doesn't need to be a separate section for limitations for this program - see above and prior review.
Overall Rotation Experience / Conclusion
If you're hell bent on being in NYC, this is an option to be eligible for orthopedic surgery boards. But like the prior commentator, I don't envy this program's residents.
