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October 11, 1985

The Harvard Way

Author Affiliations

Thomas Jefferson University Philadelphia

JAMA. 1985;254(14):1904. doi:10.1001/jama.1985.03360140055019

To the Editor.—  "The Harvard Way" is a telling description of how surgical residency programs are conducted at some "big-name" institutions. There are probably many other bright young men and women who bitterly drop out of surgical residencies because of the sort of inexcusable treatment Dr Walker experienced.One year ago, I was a medical student traveling around the country in search of a surgical residency. It appeared that the more prestigious the program, the more dissatisfied were the residents. The high-powered programs characteristically have steep pyramids, every-other-night on-call schedules, and top-heavy hands-on experience such that only the more senior residents are allowed to operate.After reading Dr Walker's essay, I became even more confident that I had made the right choice in selecting my surgical residency program. Thomas Jefferson University's program is well respected; at the same time, it is strictly nonpyramidal, the on-call schedule is, at most, every