Can I terminate PGY-1 now

Why burn a bridge like that? Aren't you in the home stretch anyway? Is your current experience substantially more hellish than average?

I guess technically if your PGY1 year and the successful completion of it is not required for your new training program, then yes, you could leave.

However, as noted above, why burn bridges? Medicine is a small field. We had a Prelim resident who did the same - basically got a position in the scramble and called and said she would not be coming in again. Not only did that upset everyone (adding to their call schedule), it was unprofessional...our PD made sure her new PD knew about what he was getting.

Seriously, I realize that you must be dead tempted to quit... I wouldnt do it. There are a million "What if" scenarios that can happen that can make you glad you finished the 1 year in IM.

No. Don't quit. Period. You have 3 months left - ride it out. Do whatever you need to get by, but don't put that mark on your record...

Panda Bear said:

Yeah, but so what? ....Your resident was probably laughing all the way to her new program at the impotent fury of your program director. .

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I have been surprised by how tight the medical community is, how clique-sih. Its worse than fraternity life in college. Last year (2006) I applied to 5 local FP programs, got 4 interviews. At one of the interviews I realized it was not the program for me, I did not feel at home there - and excused myself and went home in the middle of the interview. I then had to drop out of last years match because of failing step 2 ck by one point, but fully expected to have a repeat of last year - aftr I had dropped out of the match I got a handwritten note from one of the FP PD's that he was impressed and wanted me to either try and scramble or apply again the next year (2007) and an email from one of the other PD's saying he looked forward to me applying again in 2007. This year neither program invited me back for an interview - after taking the time last year to write personal mails telling me they thought highly of me.

One of the PGY3 residents I know from one of the programs told me that the PD of the program I excused myself from during the interview, called all the other FP PD's in town to black ball me - which apparently was effective.

So I would not dismiss the fury of a PD as "impotent" until you have 100% signed a contract with another program, and even then once they find out you walked out of a program they may keep a strict eye on you and be ready to dismiss you quickly as a prima donna.

Programs are like snooty fraternities in many ways, and do not do well with anything less than a full ego stroking from residents. Brown nosing is a large part of the game, and the MD's in charge of programs have very sensitive egos/// be careful

Doowai said:

Programs are like snooty fraternities in many ways, and do not do well with anything less than a full ego stroking from residents. Brown nosing is a large part of the game, and the MD's in charge of programs have very sensitive egos/// be careful

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Brown nosing is one thing, being professional and courteous is another. Leaving in the middle of an interview is rude, period. Regardless of what you think of the program, when you agree to an interview, it is expected that you will behave professionally and complete the interview day. Unless they were being rude or unprofessional to you, I can't think of a reason why your actions would be considered within the realm of professional behavior.

PDs want people who are going to show up, be professional, and complete the job. Finding out you left in the middle of an interview would be a big red flag. To people who don't know you, and for whom this is their first (and lasting) impression of you, it sends a very negative message about you and I can't say I'm surprised you were blackballed, whether you deserved it or not.

It has nothing to do with being clique-ish. It's about sharing red-flag information between PDs, and I imagine it happens all the time.

While I do not entirely disagree with Panda's vitriolic, if not tiresome, discourse on residency, I supported my former PD's actions on the part of our former intern. The actions had little to do with the impotent ravings of a angery PD because he knew that while the residents grumbled about having to take more call after her departure, everyone else breathed a sign of relief because it meant that we would have to deal with the problems anymore.

Truth was, it wasn't the first time we had problems with her and that was the reason she wasn't asked to stay on as a categorical. The problems started as a medical student..it wasn't residency that made her want to leave, but perhaps her realization that what barely cut it as a student, wasn't even adequate as a resident.

But that wasn't the point. The point was that as her PD he had been required to support her application at other programs and had done so, allowing her to secure another position. However, when her actions became so unprofessional and contrary to the presumed teamwork which *any* job is about (not just medicine), it was HIS reputation on the line as well. There is something to be said about knowing that when you get a letter of rec from a colleague that its truthful without being cruel or dishonest.

sophiejane said:

Brown nosing is one thing, being professional and courteous is another. Leaving in the middle of an interview is rude, period. Regardless of what you think of the program, when you agree to an interview, it is expected that you will behave professionally and complete the interview day. Unless they were being rude or unprofessional to you, I can't think of a reason why your actions would be considered within the realm of professional behavior.

PDs want people who are going to show up, be professional, and complete the job. Finding out you left in the middle of an interview would be a big red flag. To people who don't know you, and for whom this is their first (and lasting) impression of you, it sends a very negative message about you and I can't say I'm surprised you were blackballed, whether you deserved it or not.

It has nothing to do with being clique-ish. It's about sharing red-flag information between PDs, and I imagine it happens all the time.

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Well you certainly are right. I would not say they were rude, but I felt they were unfriendly, knew at the time I would not rank them , and had spent very very very little time with my family and just did not want to kill a day being polite - so I went home and hung out with my children, something rare at the time. I was doing a cardiology rotation at the time and the SOB who was my attending really had me busting the hours, plus I was trying to study for boards. So it seemed more important to do spend the day doing something that mattered instead of spending it smiling, nodding, and eating their brownies.

In retrospect I would smile, nod and eat their brownies. I just had no idea at the time that the programs were that connected. Nor that other PD's would value another PD's input more than their own experience, observation and thinking. Having owned businesses for almost 2 decades prior to returning to medical school I have hired and fired more people probably than most PD's have hired interns- if some former employer had bad things to say I would have discussed it with the person I was planning on hiring to see why , trusted my own judgement and observation more than heresay, and made my own decision instead of imitating (although being alone is a very insecure position, and imitating others means never having to be alone)

Anyway the point for qlin is, to not underestimate the wrath of a woman or PD scorned

=================

Actually I had to come back and edit it, because their unfriendliness I did consider to be rude. Yesterday I felt like I would do anything to please a program to let me in, but at the time I interviewed with them I wanted some place I felt at home - and certainly did not with them. THe other 3 programs I interviewed with were friendly. I love medicine, but also want to enjoy my life - for me, no long term job position (and 3 years is a considerable part of your life) is worth being miserable the whole time - but then again I may have been too spoiled in life by being able to construct my own work environment (is nice to be the boss)

I have been surprised by how tight the medical community is, how clique-sih. ...At one of the interviews I realized it was not the program for me, I did not feel at home there - and excused myself and went home in the middle of the interview. ...One of the PGY3 residents I know from one of the programs told me that the PD of the program I excused myself from during the interview, called all the other FP PD's in town to black ball me - which apparently was effective.

Programs are like snooty fraternities in many ways, and do not do well with anything less than a full ego stroking from residents. Brown nosing is a large part of the game, and the MD's in charge of programs have very sensitive egos/// be careful

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I have to agree with sophiejane here. Unless there was some frighteningly unprofessional behavior on the part of the interviewer, I can see no excuse to leave in the middle of an interview. It is childish and grossly inappropriate, not to mention rude.

Being expected to behave professionally is not brown-nosing but it what is expected in our polite society, especially in formal business situations. Your behavior reflected poorly on you and your potential for being a valuable team-member and you paid the price for it, in a manner I do not find suprising.

Since we don't know you, we must presume that this was an isolated incident in an otherwise mature, kind person. If there truly was something more to your actions rather than just "not feeling right" (ie, the interviewer made racist comments, etc.) then you owe it to yourself to explain this. But it really should require outrageous behavior on the part of the faculty to have warranted your actions.

NB: I posted as you were leaving the post above. While your actions seem understandable - wanting to spend more time with your family - you obviously now know that it was a mistake, and hopefully would realize that even if you did get the job. Medicine is a fairly small field, and people DO talk. You have now been fair warned. Sorry you had to learn it the hard way.

Kimberli Cox said:

If there truly was something more to your actions rather than just "not feeling right" (ie, the interviewer made racist comments, etc.) then you owe it to yourself to explain this. .

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It would be hard for me to explain in writing, but - I think it was obvious it was not a good fit for either of us. I think they sent pretty clear messages that they too were just killing time and being polite by interviewing me. My natural talent is not in writing. I do seem to have a natural skill with people, and have an innate sense of social interaction - always won the popularity contests in public school etc, although was certainly not liked by everyone - and like some sort of social idiot savant - seem to have a knack for counting the toothpicks (reference to the movie RAINMAN - obviously I like movies) in soial situations and knew the program and I thought little of each other - and realized I was wasting my time.

I value money and time, and of the two I value time much much much more - as I have less of that each year, and have always realized that what I spend of time I can never get back. I also treasure my time with my children (coach my children's sports etc) - so when I realized this interview was a wash for both of us I figured it was more valuable to go do something valuable.

I do not have the skills to put into writing the slights, or the way the rudeness was conveyed, but it was clear it was a complete waste of my time.

Doowai,

I have heard of others who walked out of their interviews too because of various reasons. So, you are not the first.

FP may not be too competitive for AMGs. But, there is always an FMG who is willing to do about anything to get a spot in FP.

Scramble is going to be difficult for the AMGs who did not match in FP. There are going to be a whole ton of FMGs who are going to inundate the system during scramble for FP. I met some cocky FMGs during the FP interview trail who were boasting USMLE scores in the upper 90's. Some of them were attendings in a different field in their own country and just wanted to come to the US to make the big money.

I wish you luck in the scramble!

fp

This is why residents are America's most abused employees. Even something as basic as switching jobs(which every other mammal on the face of the planet does with ease) can be construed as unprofessional behavior. Yet you guys wonder why physicians are getting steamrolled by everyone in society(lawyers, politicians, insurance Co etc). Well the "sheep herd" training our Academia is running is not exactly going to produce bravehearts.

Kimberly, I was just getting ready to go to the gym when I thought of one specific regarding the interview I walked away from - the overall tone of the program when I got there was unfriendly, PLUS I did not get invited to the dinner they had the night before.I took the lack of invitation as a very clear sign they were not really interested in me.

They sent it by mail, and when I got home from leaving the interview it was in my mailbox. Perhaps they took my lack of response to their invitation (which was late) personally and that resulted in their cold-shoulder to me. In any event --- too keep this on topic for qlin, do not underestimate the ability of one PD to influence another PD...... it is very much like dating women (except the inverse)..

Anyway, that is all for now. The scramble starts in one hour

fpforever said:

Doowai,

I have heard of others who walked out of their interviews too because of various reasons. So, you are not the first.

FP may not be too competitive for AMGs. But, there is always an FMG who is willing to do about anything to get a spot in FP.

Scramble is going to be difficult for the AMGs who did not match in FP. There are going to be a whole ton of FMGs who are going to inundate the system during scramble for FP. I met some cocky FMGs during the FP interview trail who were boasting USMLE scores in the upper 90's. Some of them were attendings in a different field in their own country and just wanted to come to the US to make the big money.

I wish you luck in the scramble!

fp

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Thank you for the wishes. I hope I am not one of the cocky FMG's - I am a FMG, am confident in my business abilities and people abilities, but know I am not the brightest scholar - not like some of you. I skipped so much school in high school I know the only reason I graduated is because NOBODY wanted to see me come back - I am just not much of a book person. Perhaps not the best qualifications for a doctor - perhaps not me not matching is best for everyone...I may save more lives by NOT being a doctor...LOL

Doowai said:

Kimberly, I was just getting ready to go to the gym when I thought of one specific regarding the interview I walked away from - the overall tone of the program when I got there was unfriendly, PLUS I did not get invited to the dinner they had the night before.I took the lack of invitation as a very clear sign they were not really interested in me.

They sent it by mail, and when I got home from leaving the interview it was in my mailbox. Perhaps they took my lack of response to their invitation (which was late) personally and that resulted in their cold-shoulder to me. In any event --- too keep this on topic for qlin, do not underestimate the ability of one PD to influence another PD...... it is very much like dating women (except the inverse)..

Anyway, that is all for now. The scramble starts in one hour

Click to expand...

It does sound like they were less than welcoming and I don't blame you for sizing up the situation and having your priorities (your family) straight. That said, I would have stuck it out, ate their brownies and then hated myself, complaining about the waste of time. Too bad that there wasn't a better way to salvage yourself and your reputation rather than walking out...if you had known earlier, some "white lie" about having to catch a plane at noon, etc.

Anyway, best of luck with the scramble.

Thanks Dr.Cox, I am sure it looks different to you then me, being on the residency side of the fence - so I appreciate your empathy.

I could not white lie as they knew I lived there (here) in town.

While I agree with pandabear that professionalism is a two way street, why is it the program's responsibility only? There is something to be said for agreeing to a commitment and following through with it. If it isn't working out and the career obviously isn't meant for you, then fine, quit, go do something else. But does anyone really think a program is going to force you to stay if you don't want to be there (let alone be in that field)?

If you really want to change fields, it is going to be a process which involves negotiation and compromise. You will have to find a new program willing to take you and get out of your current one. It becomes a lot easier if you go about it in a planned, professional fashion. I would never recommend to anyone that they jump ship and tell the current program to fend for themselves. Medicine is a small field, yes, and it may come back and bite you. But that should that be your primary reason for not doing it? Hell no. Does professionalism matter to anyone? Why should anyone treat you professionally if you don't deserve it? For those who say that programs deserve this treatment, that may be well and good, but what about personal pride?

I keep hearing about how my generation is the most narcissistic and selfish ever, and I tend to agree with it more every year.

Doowai said:

Thanks Dr.Cox, I am sure it looks different to you then me, being on the residency side of the fence - so I appreciate your empathy.

I could not white lie as they knew I lived there (here) in town.

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Obviously things change when you change vantage points.

I suppose the white lie about leaving for a flight out of town would have raised some questions. The dead grandma comes to mind but that would require some acting.

Kimberli Cox said:

our PD made sure her new PD knew about what he was getting.

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aProgDirector said:

When you apply for state licenses / privileges, you will need a letter from each training program with which you were associated. A letter stating unprofessional behavior can cause you great harm in the future.

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NinerNiner999 said:

Do whatever you need to get by, but don't put that mark on your record...

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Panda Bear said:

Can you imagine any other job where you could get blacklisted for quitting a job you didn't like? The residency contract is not as tight as you folks think, by the way, and you don't sign yourself into indentured servitude by signing it.

Most residency programs will sell you up the river at the first sign of trouble, without regrets, and with no thought of being loyal to you. It is the proverbial dog-eat-dog world. And if your program makes you pull extra call because somebody quits, thats the programs fault and their lack of leadership, not the person who left's fault.

In other words, the whole residency system is unprofessional as it relies, no, depends, on sleep deprivations and sweat-shop wages.

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This is what is boils down to in the end: Government licensing is being used to control residents.

You don't like your employer? Tough, because if you quit (as you could at almost any other job) you will be blacklisted and won't have a future in the profession. I think it is simply medieval and belongs in the museum right next to Torquemada's torture devices.

Remember kids, whatever you do, don't piss off the guild.

Panda Bear said:

Leadership is protecting your subordinates, especially from unfair treatment. Making them do extra call is unfair. It is punishing them for things out of their control. The whole philosophy of the residency system makes me sick.

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Amen! But have you ever heard of a PD stepping in to pull shifts when a resident is down? No, they pull people off of a pull list, which is fair. But after that they pull people from slow services, or research blocks that are supposed to be protected (depending on the program). Of course, if a faculty member is out for a day a Chief Resident can sometimes step in, which may or may not be fair. "Medical leadership" is almost an oxymoron.

Adam_K said:

You don't like your employer? Tough, because if you quit (as you could at almost any other job) you will be blacklisted and won't have a future in the profession. I think it is simply medieval and belongs in the museum right next to Torquemada's torture devices.

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You don't get blacklisted for leaving the job, you get blacklisted for unprofessional behaviour.

Today, another one of my techs handed in his notice. He stuck to the period in his contract, he continues to do the excellent work he has allways done. I will gladly give him a reference if one of his future employers calls.

And while there are residency directors that just turn vindictive after residents decide to leave, the majority (if given enough time to recruit a replacement for the beginning of the academic year) will be either neutral or helpful.

as to the original post, what are the terms of your current contract for the intern IM position?

Dropping out of the program in March? Wouldn't do it, unless it is physically killing you. It can only help to stick it out and finish the year.

yaah said:

While I agree with pandabear that professionalism is a two way street, why is it the program's responsibility only? There is something to be said for agreeing to a commitment and following through with it. If it isn't working out and the career obviously isn't meant for you, then fine, quit, go do something else. But does anyone really think a program is going to force you to stay if you don't want to be there (let alone be in that field)?

If you really want to change fields, it is going to be a process which involves negotiation and compromise. You will have to find a new program willing to take you and get out of your current one. It becomes a lot easier if you go about it in a planned, professional fashion. I would never recommend to anyone that they jump ship and tell the current program to fend for themselves. Medicine is a small field, yes, and it may come back and bite you. But that should that be your primary reason for not doing it? Hell no. Does professionalism matter to anyone? Why should anyone treat you professionally if you don't deserve it? For those who say that programs deserve this treatment, that may be well and good, but what about personal pride?

I keep hearing about how my generation is the most narcissistic and selfish ever, and I tend to agree with it more every year.

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Exactly how I feel about it.

Maybe your wife/husband can do the house searching while you finish up the next couple of months.

f_w said:

You don't get blacklisted for leaving the job, you get blacklisted for unprofessional behaviour.

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f_w,

I (like Panda) have the advantage of having worked in the private non-healthcare sector prior to med school. Apart from the arguments we have about the system (such the match, the effect of the government GME subsidy, and the use of professional licensing to limit residents options), I have a different perspective having hired and fired employees in the private sector.

While I agree that not giving notice reflects poorly on the employee, I think that what is really unprofessional is the following. First and foremost is overworking the prelim surgery resident. Had I tried to have my employees work anything even resembling that kind of schedule, they would have walked off the job and across the street into the waiting arms of the competition. One of the greatest problems with the current system is that there is effectively no competition for residents once they are employed. This is partly why I believe it is a form of indentured servitude. One of the many ways any employee is able to improve his lot is to try and make it on the open marketplace.

I had an employee who accepted a job from a competitor almost literally across the street (down it actually in the neighboring business park) and quit on the spot after I could not match the offer he received (increased pay, responsibility, signing bonus and a promotion). The competitor knew that my employee was quiting on the spot and didn't care (why should they? after all, they are not getting paid to make my job easier). I pled with the employee to give two weeks notice, as corporate policy was that someone leaving without minimum notice would never be considered for rehire. He decided to burn his bridges. Did I like it? No. Did it cause my department problems? Yes. Were we able to overcome these? Sure.

Now, as far as references go. My corporation had a very strict policy. Unless there was documented gross misconduct or criminal wrongdoing on the former employee's part, the only information we released were dates of employment upon a signed/written waiver from the former employee. In the case of gross misconduct or criminal wrongdoing, our legal department would handle it with one of the lawyers calling their counterpart at the other firm. If I had done what Kimberli Cox's PD had, I would have been disciplined. Why? Because the company would needlessly have been exposed to threat of a lawsuit from the departed employee. (Thanks to our current system of licensing and specialization, PDs are effectively shielded from these. Power corrupts and absolute power corrupts absolutely.)

The system that exists for residents today, puts them at the mercy of their PDs. While many are decent folks who put in extra hours for the sake of their residents, we all know that not all do. As there is no real competition between programs once the resident has matched, there is no way for the resident to improve their lot without falling out as "unprofessional behavior" can be very, very broadly interpreted (you even admit this below).

f_w said:

And while there are residency directors that just turn vindictive after residents decide to leave, the majority (if given enough time to recruit a replacement for the beginning of the academic year) will be either neutral or helpful.

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Again, the fact that there is little or no competition for the residents once signed is the problem. The market is not fully able to function to act as a restraint on malignant PDs.

f_w said:

Today, another one of my techs handed in his notice. He stuck to the period in his contract, he continues to do the excellent work he has allways done. I will gladly give him a reference if one of his future employers calls.

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Forgive me for pointing this out, but you are obscuring the argument. Comparing indentured servants to those who enjoy the advantages of a free market for their services is I think, very misleading.

Your tech probably has the following advantages over a resident.

Better pay per hour and probably per annum.
Far better working conditions (certainly when it comes to hours worked).
The ability to walk across the street to the competition after giving adequate notice. In other words, the market works for him.

aProgDirector said:

This discussion is getting a bit one sided.

I have personally taken call to deal with a resident shortfall.

When my program is down a resident, I try to uncover services rather than pull residents off other rotations, whenever possible.

My point above was simply this: if a resident were to walk into my office tomorrow and quit, I would have no choice but to pull someone to cover. If someone gives me a reasonable amount of notice, I can usually rearrange the schedule to address it. Part of being professional is weighing the effect your actions will have on others.

If the OP is miserable enough that they cannot do their job safely, then patient safety comes first and they should quit or be removed from their position (on leave). I would hope that they would have discussed this with their PD already -- presumably they have been unhappy for quite awhile.

Perhaps I'm in the minority. Perhaps I'm an idealist. Perhaps the poor behaving programs get most of the press. But in any case, the picture being painted is not representative of all programs.

Click to expand...

Let me put it this way. A couple hours from now, when I find out where I matched I really hope to match at a program whose PD is as dedicated to their residents (and a bunch of strangers on this forum -- your posts are a great source of information and very helpful) as you are.

I hope that you do not take my arguments personally. As you and Panda agreed, there are problems with the system. My point is that these stem from the anti-competitive nature of the current arrangement which specifically acts to restrain market forces. Until these are changed, we are stuck with hoping that the program we match with will be as benevolent as yours.

Adam_K said:

My corporation had a very strict policy. Unless there was documented gross misconduct or criminal wrongdoing on the former employee's part, the only information we released were dates of employment upon a signed/written waiver from the former employee... If I had done what Kimberli Cox's PD had, I would have been disciplined.

Click to expand...

But he essentially did nothing different than what you are suggesting is ok...which is releasing the dates of employment. All he had to say (and since I wasn't there I have no idea what was actually said but the following is my understanding) was that she left on March 15 (or whatever the actual date was)--which is 3.5 months early. Its the truth...so I can't see why anyone would be disciplined.

qlin said:

Thank you for all the responses. I am matched to one of the pathology programs. The reason that I like to leave the IM earlier is to prepare the move which involves selling the old house, buying a new house,finding a new school for my two children and etc. I agree with plan that I should give PD some grace period, like 30 days?. I am not sure that how the PD will response. How should I tell him? The truth?

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Yes, the truth.

But frankly, your situation is no different than anyone else moving between intern and residency years or residency and fellowship.

Lots of residents have to sell their house, buy a new one, find schools for their children, and many have to use their vacation to do so, and have days to move. An attending of mine finished residency on June 30th and had to be ready to start his fellowship (in another part of the country) on July 2. Not much time to do the above. So since everyone else figures it out, why can't you? Why can't you go out to your new area, using vacation time, find some living arrangements, or even rent until you're been there awhile and then buy,etc. Getting your kids into school shouldn't take a month,

But talk with your current PD and see what he/she says. IMHO, you're asking for special favors for things that other residents and fellows have to do everyday without any more time off.

Adam_K said:

f_w,

I (like Panda) have the advantage of having worked in the private non-healthcare sector prior to med school.

Click to expand...

Well, medicine is just not the private sector or the military.

First and foremost is overworking the prelim surgery resident.

Click to expand...

You know what you get if you sign up for a surgery prelim. If you don't want to do it, don't sign that 1 year contract.

Had I tried to have my employees work anything even resembling that kind of schedule, they would have walked off the job and across the street into the waiting arms of the competition.

Click to expand...

Not if they knew that at the end of that limited period will be a six-figure salary for life.
Young corporate attorneys do the same thing. They work 100+ hours for a measly 70k because they know that times will get better.

I had an employee who accepted a job from a competitor almost literally across the street

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Did you have a contract with him, did you have a non-compete ?

As there is no real competition between programs once the resident has matched, there is no way for the resident to improve their lot without falling out as "unprofessional behavior" can be very, very broadly interpreted (you even admit this below).

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Residents change programs, they can improve their lot. Your contracts are for one year at a time, if you want to change, you let your PD know and don't sign a new contract for the next year. No harm no foul.
This is different from just not showing up after you found a new job.

Forgive me for pointing this out, but you are obscuring the argument. Comparing indentured servants to those who enjoy the advantages of a free market for their services is I think, very misleading.

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I compared professional behaviour in one area with professional behaviour in another. The tech gave the notice that was agreed upon and we will be able to get a locums or possibly a permanent replacement so our patient care mission won't be affected.

Better pay per hour and probably per annum.
Far better working conditions (certainly when it comes to hours worked).

Click to expand...

Actually, he works a 1:2 call schedule, more than I ever did.

Panda Bear said:

I swear, there is no other job where the employees are such slaves and ******* that they can't even quit without people accusing them of unprofessional behavior.

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We had a few "quitters" this year in my program - (surgery pre-lim). I admired them for moving on with their life and not subjecting themselves to being miserable. All of our residents said the same **** "how un-proffesional, how could they do that us, etc etc". I think a bigger tradgedy is sticking out a residency, or anything else in life, for the sake of someone else rather worrying about your own happiness. I was happy to see the miserable POSs leave they brought us all down with their constant whinning and bitching.

Guess what happened to them? They all landed on their feet. Two path and FP. And our PD was wicked hateful and not very helpful. They still got jobs. I still talk to two of them on the regular and much better dudes these days - actually fun again.

aProgDirector said:

If you want to quit, talk to your PD and give them reasonable (i.e. 60 day) notice.

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60 days? When I worked in corporate America, two weeks was the standard. Some investment banks don't take any notice (as soon as you tell them you accepted another position they escort you from the building). My buddies and I used to joke about how hypocritical it is to expect two weeks notice because it doesn't go both ways. If they fire you, you get about 10 minutes notice before they throw you out on the street. Man, two weeks is bad enough but you guys expect 60 days?!? Why stop there? I mean, it's pretty unprofessional to give any less then 3 years notice, right?

Doowai said:

I have been surprised by how tight the medical community is, how clique-sih. Its worse than fraternity life in college. Last year (2006) I applied to 5 local FP programs, got 4 interviews. At one of the interviews I realized it was not the program for me, I did not feel at home there - and excused myself and went home in the middle of the interview. I then had to drop out of last years match because of failing step 2 ck by one point, but fully expected to have a repeat of last year - aftr I had dropped out of the match I got a handwritten note from one of the FP PD's that he was impressed and wanted me to either try and scramble or apply again the next year (2007) and an email from one of the other PD's saying he looked forward to me applying again in 2007. This year neither program invited me back for an interview - after taking the time last year to write personal mails telling me they thought highly of me.

One of the PGY3 residents I know from one of the programs told me that the PD of the program I excused myself from during the interview, called all the other FP PD's in town to black ball me - which apparently was effective.

So I would not dismiss the fury of a PD as "impotent" until you have 100% signed a contract with another program, and even then once they find out you walked out of a program they may keep a strict eye on you and be ready to dismiss you quickly as a prima donna.

Programs are like snooty fraternities in many ways, and do not do well with anything less than a full ego stroking from residents. Brown nosing is a large part of the game, and the MD's in charge of programs have very sensitive egos/// be careful

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There are some things that residencies really REALLY try to prevent for valid reasons.

1. Quitting - hey, if a resident quits, just quits, then call is left to his or her peers. This REALLY sucks and can cause a lot of problems. Before you think "Hey, I don't have to put up with this bull**** any longer, why should I care?" You are not the only one in the world. How would you feel picking up the slack. In the Marines, when a recruit or Marine fell out of a hump (a really long march with heavy gear) that person got to ride in the truck, but their gear, M-16, heaven forbid their 50 cal, is left to be carried by the remainder of the platoon. Don't be that guy riding in the truck watching your peers who have personal lives just as important as yours, carrying your crap. Also, someone who quits, is likely to quit again. This poses a serious risk to the next program, hence, the heads up call to the PD. How is the next PD to know that if they get under your skin that you won't just quit again?!?!? That's life. I have seen plenty of resident transitions (plastics to neurosurg, surg to rads, psych to peds) and fortunately, all of them were carried out at the end of the year and done so without much difficulty or animosity from their peers.

As far as bowing out of an interview in the middle of it. ARE YOU FREAKING NUTS!! Good grief, if you have a shaky app as it is, why do something to potentially put you further on the negative side. For crying out loud, how much trouble would have it been to sit through a free lunch, get a tour, smile and say thank you for their time, and leave. In the end, you don't rank them if you feel that strongly. I hate to say it, but that was sheer stupidity and you had to have left them scratching their heads and becoming a immortalized as an "interview story." Yes, their are some interviewees who by their own hands, become a story of what not to do in an interview. They had to be asking the same questions and regretting ever giving you a chance. This isn't cliquish, although by calling it such somehow vindicates your poor, poor choice.

2. Failure - board exams are very important for the resident and the program. When a resident fails, incoming prospects learn of it, and question the strength of the program. One bad crop of senior residents can ruin the program for years by repelling superior candidates. That is why failing course or USMLE is a red flag. It tells them, you may fail while at their program, thus taking yourself and the program down.

I also thought that it was very very hard to switch residencies because you signed a contract with your program and then you anger everyone in the program by leaving.
But after reading the responses it sounds like it's possible for people to switch residencies without being blackballed if they 1.) do it at the end of the training year and 2.) give the PD plenty of notice about switching.
but what happens to their contract that they signed? i thought that when you sign the contract you cant join another program. so if you have a horrible PD who wont let you get out the contract, are you basically screwed???

The contracts usually run for a year at a time July1st-june30th.

Kimberli Cox said:

But he essentially did nothing different than what you are suggesting is ok...which is releasing the dates of employment. All he had to say (and since I wasn't there I have no idea what was actually said but the following is my understanding) was that she left on March 15 (or whatever the actual date was)--which is 3.5 months early. Its the truth...so I can't see why anyone would be disciplined.

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I just got a very different impression reading your post and him telling her new PD what he was getting.

f_w said:

Well, medicine is just not the private sector or the military.

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The military is different, because upon entry its members are subject to the Uniform Code of Military Justice, not civilian law. However, when I enter my residency my employment is subject to the employment laws of the state as any other private sector employee.

You know what you get if you sign up for a surgery prelim. If you don't want to do it, don't sign that 1 year contract.

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Well, thanks to the match, her options might have been limited. She may well have listed it as a backup and not matched elsewhere. I do not need to remind you of the anti-competitive nature of the match, right?

Not if they knew that at the end of that limited period will be a six-figure salary for life.

Young corporate attorneys do the same thing. They work 100+ hours for a measly 70k because they know that times will get better.

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I'll take that 70k right now, as I'm stuck with the mythical 80 hours.

Did you have a contract with him, did you have a non-compete ?

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Non-compete clauses have no legal standing in my state for employees, only business ownership.

Residents change programs, they can improve their lot. Your contracts are for one year at a time, if you want to change, you let your PD know and don't sign a new contract for the next year. No harm no foul.
This is different from just not showing up after you found a new job.

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I just read the contract I'm going to sign for my residency. The contract is subject to the employment laws of the state. Though it is nominally for one year, it requests 30 days notice and allows the employer to terminate at any time for any reason. Why should the employer enjoy this lopsided advantage?

No, like any other employee, residents should have the ability to leave and get a better job at any time during their employment without having to fear reprisals.

Besides, according to state law, employment is at will.

I compared professional behaviour in one area with professional behaviour in another. The tech gave the notice that was agreed upon and we will be able to get a locums or possibly a permanent replacement so our patient care mission won't be affected.

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Every business faces these issues. Patient care is just an excuse.

Actually, he works a 1:2 call schedule, more than I ever did.

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No wonder he left. Was he hourly?

Adam_K said:

Well, thanks to the match, her options might have been limited. She may well have listed it as a backup and not matched elsewhere.

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Don't list a program if you don't want to go there.

Why should this restriction only be enforced at the employee's expense?

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Because you signed it.

No wonder he left. Was he hourly?

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Hourly at a very competitive rate. For a 2 year degree, he was making more than some pediatricians.

f_w said:

Don't list a program if you don't want to go there.

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Good advice, but it doesn't change the nature of the match.

Because you signed it.

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This provision is meaningless and void, as employment is at will. There is no statutory requirement to give any amount of notice on either party. In other words, either the employer or employee can terminate their relationship at any time.

Hourly at a very competitive rate. For a 2 year degree, he was making more than some pediatricians.

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Obviously, as he was making time and a half after 40 and maybe more depending on hours above that and the state laws.

More evidence that residents are underpaid.