Can I terminate PGY-1 now

[bigtimesmally]

PB has argued his views on the subject of resident "indentured servitude" many times here and makes some good points. However, I think the argument falls down for 2 reasons: 1. medicine is not "just a job", and 2. we all knew the situation when we applied for medical school.

Yeah, it is a job. All you have to do is work with attendings for a sufficent amount of time to realize that, yes, it is just a job. I specially love it when the attending covering a service asks me if the patient has insurance or not. And, of course, if he/she doesn't, then the attending replies, "it's really not a big deal. Just give em some pain meds and fluids."

And, no, we all didn't know the situation before applying. That's a crock of ****. All we knew is that it was difficult. All the little interesting details that surface about this profession are learned later as we progress through the years.

Man, once again, this thing about professionalism. I give up.

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[8744]

...Be honest and negotiate with the PD, but if you leave early just for housing reasons I think you're satisfying only yourself at the expense of the free time of people in your program....

There is nothing to negotiate. Negotiation implies that each party has something the other part wants and for which they are willing to barter. The program has nothing the OP wants, certainly not money or better hours so I can't see how the negotiation could be anything more than, "If you leave we're going to screw over your collegues big time."

I'm about ready to give up explaining to people that the decision to assign uncovered call to the remaining residents is the sole responsibility of the program to whom all blame should be directed.

...I don't have kids, and I don't have a big house... the hours are not ideal but my life is at a point right now where I can deal with it and no one else is affected by my choice..

This is another subject I'm going to address in my blog at a future date, namely how medical schools tend to select against people with family obligations which is a lot different than other professions where family stability and responsibility is viewed as an asset.

 

[8744]

By the way, medicine, like every other thing in life, is all about money.

Don't kid yourselves.

 

[DocBrown]

I don't understand what the problem is here.

If a person wants to leave a job, then the person can leave the job. Who's holding a gun to his/her head? Who cares? To the folks rabidly defending residency programs: have you ever worked in the real world, aside from medicine?

I worked as an engineer. I didn't like my employer, so I secured a position with a better employer, THEN gave my current employer 30 days notice. Then I left.

I'd do the same thing in residency if I felt it was best for ME. I'm not going to lose even one minute of sleep worrying about other residents (i.e. employees). Are they going to pay my mortgage? Are they going to take my kids to school or help pay my bills?

Welcome to the real world. If you don't like your job, you have every right to pick up and leave, whenever you damn well feel like it.

 

[3dtp]

DocBrown,

The problem is, it is not that simple. The program directors have not just a gun held to the head of the would be departee, but a bazooka in the form of a program letter that will be required in the future for credentialling and licensing purposes. If you are in a program with a malicious/malignant program director you will spend a small fortune in time and money dealing with credentialling issues arising from this. If you can prove a program director was malignant and/or dishonest with these credentialling documents with a state licensing board, (difficult, but not impossible) you may be able to get a state to take a licensing action, but absent that, who's going to take your word against a program? This is why PB, correctly, in my opinion, equates the situation to the Stockholm Syndrome.

And fang, I'm sorry, but if the details of medical education, especially that beyond medical school were far and widely known I think that the medical school application rate would plummet. There was a drop in medical school applications when Congress was debating the proposed legislation to mandate the 80 hour rules which the ACGME largely gives lip service to except in certain high profile situations. Was this related to the publicity surrounding it on the national TV news? I don't know, but I think if every prospective medical student had to spend two months on an internal medicine or surgical rotation at a Q3/unrestricted or even 80/30 program to see the life, and are told they must do this for the next 3-7 years, I suspect a great many would excercise the appropriate extensors and flexors of their right hand and second digit at the collective medical educational establishment and those who profit by it and do something else.

And there is no (none, not even a little bit) job security in medicine. You have no legal protections that are usual and customary in other fields, you can be "peer reviewed" into oblivion and nationally blacklisted for economic, political or even just plain personal bad feelings by hospital administration. The situation in medicine is such that today, Joseph McCarthy would be quite proud. And there is no Margaret Chase Smith to give a Declaration of Conscience speech. Blow the whistle on improper behavior, and you are finished. Don't and when Medicare audits your billing, you are finished. Any doubt, see last August's Time magazine where this was reported. I have a friend whom I knew long before medical school. He owned property on a lake near his practice. His neighbor was a friend of the hospital administration. There was a property boundary dispute where his neighbor was totally in the wrong. My hospital administrator told him that if he didn't drop the dispute (which cost him 40 foot of lakefrontage), his charts would be reviewed and he would lose his credentials at that hospital. This is the kiss of death and he had no recourse. He sold the property, left town and moved somewhere else. The subsequent owner sued the neighbor for encroachment and was handed full rights to the land in question. This is just about as bad as it gets.

Ms. Kimberli, you are rapidly becoming someone I respect very much along with Panda. I am pleased that you regard a limit as something one should not exceed, rather than a mandate to reach. That is an important and impressive distinction. I was caught in between the "old" and "new" as well. Ultimately, what we do is indeed "shift" work. It's just a question of how long the "shifts" are. Medical "education" fails repeatedly to adhere to its own science and bases itself on purely financial motivations. The present "guild" mentality arises from the AMA takeover of medicine and the Osler mentality of the 19th and 20th centuries. Perhaps this was necessary then, but it has now grown to the point where the present medical provider/funding establishment has, for the reasons given above, gained a death grip on individuals who would work in this system and are capable of silencing anyone who would propose reasonable reforms. Got many more thoughts, but gotta run.

 

[f_w]

Welcome to the real world. If you don't like your job, you have every right to pick up and leave, whenever you damn well feel like it.

Well, medicine is not 'just another job'. As a resident, you expect to be treated as a physician, so you will be held to the professional standards of a physician. Later in your career, at the attending stage, you will have 3 and 6 month notice periods for 'termination without cause'. If you just pack up and leave, you will incur a significant liability for patient abandonment.

(actually, having a bazooka held in front of your head is not so bad. It'll take the rocket a fraction of a second to ignite and you have time to duck, the thing will explode 100yards behind you)

 

[8744]

Well, medicine is not 'just another job'. As a resident, you expect to be treated as a physician, so you will be held to the professional standards of a physician. Later in your career, at the attending stage, you will have 3 and 6 month notice periods for 'termination without cause'. If you just pack up and leave, you will incur a significant liability for patient abandonment.
(actually, having a bazooka held in front of your head is not so bad. It'll take the rocket a fraction of a second to ignite and you have time to duck, the thing will explode 100yards behind you)

Depends on your specialty.

And that old saw about "Residents Being Treated as Physicians" irks me almost as much as "Patient Care." If that's the case, how about paying me as a physician? In truth, what The Man means when he throws that at you is "We expect you to work like a physician but will pay you like a burger-flipper."

I hate hearing residency being compared to being an attending because for 140 bucks an hour (what they pay hospitalists around here) I'll pull Q4 call and work 80 hours a week (for a while, anyways). It's the combination of low pay and long hours which make this such a crappy job. Not to mention that no matter who you are, if you only make ten bucks an hour the presumption on everybody's part is that you are a chump.

Hell, you are a chump which is why hospitals treat residents so carelessly.

 

[Obedeli]

If a person wants to leave a job, then the person can leave the job. Who's holding a gun to his/her head? Who cares? To the folks rabidly defending residency programs: have you ever worked in the real world, aside from medicine?

Um no.... Give me a break.

 

[8744]

Highlighting one of the more glaring hypocrisies of medical training, the flexible standards. That is, the hospital treats you like a physician, a contractor, an employee, salaried, hourly, a taco jockey, somebody, nobody, useful, useless, or whatever depending on the circumstances and when or when it is not convenient.

 

[fang]

DocBrown,
And fang, I'm sorry, but if the details of medical education, especially that beyond medical school were far and widely known I think that the medical school application rate would plummet.

My point is we should all accept some responsibility for this decision. Out of a million possible careers, we *chose* medicine. You have to read the fine print when you buy car insurance, and you have to investigate a profession before you choose it. If you don't and it turns out you don't like working 80 hrs a week for a year with crappy pay, then by all means complain about it, but don't compare it to being kidnapped. We're adults who can make informed choices, and even now we have other options if 80 hrs a week for 30K a year x1 yr is unacceptable.

 

[f_w]

Depends on your specialty.

Try walking out of a pathology, ER or other non-primary gig without giving notice. If you are lucky, you'll keep your license and you have to part with just a fraction of your money.

 

[8744]

Try walking out of a pathology, ER or other non-primary gig without giving notice. If you are lucky, you'll keep your license and you have to part with just a fraction of your money.

Whoa. Because of the nature of Emergency Medicine, we have no long-term patients and abandonment is not an issue. It might make your group angry and you may owe damages (which your group might have to sue to collect) but your license would be safe as you have done nothing, in quitting after only a short notice, that is in the purvue (sp) of your state medical board. Telling you boss, "Hey, I'm tired and I can't work this job any more" is not the same as walking out on your shift which, in EM, would certainly be unprofessional and subject you to sanctions from your state board.

If this were not the case, you could also not be fired by your group without three to six months of notice because they would be abandoning the patients, not you.

On the other hand, you can agree to whatever terms in your contract you want and if they meet the test of legality and mutual understanding, you are legally bound by them. The point being that the only choice we have as residents is to train or not to train and, since abuse of residents is widespread and impossible to predict secondary to a code of Omerta among programs, there is not necessarily a good understanding of working conditions when we match.

In fact, if I worked for any other firm and I was promised that my hours would not exceed 320 per month (although what fool would work for a company like that unless they paid really well) and I was later expected to work 325 hours a month, this would be a material breach of the contract and I could terminate it with impunity. When a program attests in their contract that they abide by the ACGME rules, it's a legally binding agreement that they will abide by the ACGME rules. Anything less is the typical two-faced pusillanimity that is typical of many residency programs and wouldn't fly in the so-called real world and wouldn't in medical training except through a combination of residents being a big bunch of ******* and the program having our gonads in a vice.

 

[8744]

My point is we should all accept some responsibility for this decision. Out of a million possible careers, we *chose* medicine. You have to read the fine print when you buy car insurance, and you have to investigate a profession before you choose it. If you don't and it turns out you don't like working 80 hrs a week for a year with crappy pay, then by all means complain about it, but don't compare it to being kidnapped. We're adults who can make informed choices, and even now we have other options if 80 hrs a week for 30K a year x1 yr is unacceptable.

What if, and this is common, your program makes you work 90 hours a week and violates other ACGME guidelines? You did your research, you interviewed, the program director assured you that that they abided by all ACGME guidelines, and you show up and find you have been lied to. Is this now your fault under the well-known legal precedent of "Har Har, You Fell For it!"

Abuse is not part of the "fine print."

As for being kidnapped, you're not. But a lot of you are saying that the resident who started this thread not just shouldn't quit but can't quit. If that's not being kidnapped, I don't know what is. And I think we've shot to pieces the conventional wisdom that the resident who quits is to blame for his program stepping up the abuse of the remaining resdidents to compensate for his absence.

 

[f_w]

Whoa. Because of the nature of Emergency Medicine, we have no long-term patients and abandonment is not an issue.

Well, our ER has plenty of long-term patients, but that is a failure of the healthcare system and not (allways) the individuals fault.
If you don't show up for an ER shift you where posted for on the hospital schedule, you derelicted your duty to the patients who will undoubtedly show up that day (because of that shiny 'emergency services' sign outside).

It might make your group angry and you may owe damages (which your group might have to sue to collect)

Or they just take it out of your share in the pension plan. They rather leave it up to you to sue.

but your license would be safe as you have done nothing, in quitting after only a short notice, that is in the purvue (sp) of your state medical board.

As long as you give enough notice to allow your group to hire a locums (usually a couple of weeks due to credentialing & background check requirements) you should be fine.

If this were not the case, you could also not be fired by your group without three to six months of notice because they would be abandoning the patients, not you.

Most physician contracts have a bilateral 3 month 'termination without cause' (you quitting, they firing you) period. For anything shorter there has to be one of the 'for cause' scenarios which usually involve billing fraud or risk to patients.

 

[fang]

What if, and this is common, your program makes you work 90 hours a week and violates other ACGME guidelines? You did your research, you interviewed, the program director assured you that that they abided by all ACGME guidelines, and you show up and find you have been lied to. Is this now your fault under the well-known legal precedent of "Har Har, You Fell For it!"

Abuse is not part of the "fine print."

As for being kidnapped, you're not. But a lot of you are saying that the resident who started this thread not just shouldn't quit but can't quit. If that's not being kidnapped, I don't know what is. And I think we've shot to pieces the conventional wisdom that the resident who quits is to blame for his program stepping up the abuse of the remaining resdidents to compensate for his absence.

No, I agree abuse and making people work >80 hrs/wk are not part of the fine print. However, the ACGME is cracking down on violations (U. Washington, Hopkins are the 2 places that come to mind most recently), and it seemed to me during interviews that the residents were satisfied with their work hours (you'll argue stockholm syndrome again I suppose). The residents at my med school rarely go over 80 hrs per week. So bottom line is that abuse is the exception in what I've seen, not the rule.

I'm not saying the OP can't quit. What many people here are arguing is that he/she should give plenty of notice and leave in a way that minimizes disruption to the program, especially if the only reason for leaving early is to sell and buy a house.

 

[8744]

No, I agree abuse and making people work >80 hrs/wk are not part of the fine print. However, the ACGME is cracking down on violations (U. Washington, Hopkins are the 2 places that come to mind most recently), and it seemed to me during interviews that the residents were satisfied with their work hours (you'll argue stockholm syndrome again I suppose). The residents at my med school rarely go over 80 hrs per week. So bottom line is that abuse is the exception in what I've seen, not the rule.

I'm not saying the OP can't quit. What many people here are arguing is that he/she should give plenty of notice and leave in a way that minimizes disruption to the program, especially if the only reason for leaving early is to sell and buy a house.

The thing is, 80 hours is abusive. And as far as being satisfied with their work hours, what are the residents going to say? One of my attendings actually got mad at me and gave me a bad evaluation because after asking me why I didn't seem enthusiastic about the rotation, I replied that I hated losing sleep, the Q3 call I was pulling for the last three weeks of the rotations (with the first week on night float, get it?) was wearing me out, and I was exceedingly glad to be done with her specialty and call forever.

Which was the truth, of course, but she was expecting some kind of apology or pledge to be more enthusiastic which is what she would get from the typical kiss ass resident.

"I don't think you understood the purpose of this rotation," she said.

"The purpose was for me to work like a dog every third night until I was sick with fatigue admitting your patients," I said, which was also the truth, but earned me no points.

Then she got all patronizing with me and started calling me "Doctor" and saying, "We expect a lot from our residents, Doctor."

Well, yeah, but nowhere in my contract does it say I have to pretend to be enthusiastic. The fact that a guy like me who is almost universally known to be the most level-headed, unflappable, and cheerful resident at the hospital is not exactly gung ho should say something. Another admission at 4AM. Forgive me if I don't clap my hands in joy.

She also pulled that "When I was a resident" crap but the key fact about me is that I don't care what they did back in the day.

By the way, the ACGME is not cracking down at all. For various reasons, it is almost impossible for a resident to blow the whistle on his program.

I thank the Lord every day that I am an Emergency Medicine resident. I think we have the ideal training environment (shift work with a protected didactic block every week), relatively reasonable hours (About 60 per week) and as little chicken**** as is humanely possible. If the pay were a little better it would be perfect. We still have to suffer through the usual off-service stuff and I have done two intern years but the first one was my fault.

 

[fang]

The thing is, 80 hours is abusive.
...Well, yeah, but nowhere in my contract does it say I have to pretend to be enthusiastic. The fact that a guy like me who is almost universally known to be the most level-headed, unflappable, and cheerful resident at the hospital is not exactly gung ho should say something. Another admission at 4AM. Forgive me if I don't clap my hands in joy.

Well, I like your style, although I doubt I could pull it off (I probably would have told that attending I should have been more enthusiasic, if only for the purpose of satisfying her fragile ego and escaping unscathed).

I'm about to start an internship in medicine, so I expect I'll be hating life at times next year. In med school a few rotations were 90 hrs+, but only for 4 weeks at a stretch, so we'll see if I agree about 80 hrs being abusive next year this time.

 

[NotAProgDirector]

I think we have the ideal training environment (shift work with a protected didactic block every week), relatively reasonable hours (About 60 per week) and as little chicken**** as is humanely possible. If the pay were a little better it would be perfect. We still have to suffer through the usual off-service stuff and I have done two intern years but the first one was my fault.

It's going to hurt, but I'm going to agree with PB here. EM has created a training system with no overnight call, shift based work, direct faculty oversight of residents at all times, and about a 60 hour work week, and seems to train residents to be competent docs.

So, can other programs match this? Well:

1. EM has the benefit of having no continuity with patients, hence it is more amenable to shift based care. However, I think with adequate hand off routines, all fields should be able to match this.

2. As the work hours are decreased, overall training time is decreased. One can easily argue that the educational quality of an overnight 24 hour shift is poor, and hence a reasonable 60 hour week could have as much learning as an unreasonable 90 hour work week. Still, at some point training years get extended. EM seems to have already done so -- it's 4 years long compared with 3 for IM and FP. Would IM residents be willing to trade a 60 hour work week with no overnight call for an extension of residency to 4 years?

3. Direct oversight of residents by faculty at night by IM docs would require a major shift in most programs, one that is long overdue IMHO.

 

[3dtp]

No, I agree abuse and making people work >80 hrs/wk are not part of the fine print.

The residents at my med school rarely go over 80 hrs per week. So bottom line is that abuse is the exception in what I've seen, not the rule.

I'm not saying the OP can't quit. What many people here are arguing is that he/she should give plenty of notice and leave in a way that minimizes disruption to the program, especially if the only reason for leaving early is to sell and buy a house.

The abuse may becoming less routine, but it is still very widespread. The ACGME does not arbitrate this where an individual is concerned. It may sanction a program but JHU and Yale got zinged primarily for telling the ACGME to sit on it and spin. If they had simply said "we will comply" and carried on business as usual which at that time was closer to 110-120 hours a week like many other programs did, no one would have batted an eye. Don't forget these rules have been on the books in New York for decades and been nearly totally ignored prior to the threat of legislation and the class action lawsuit. My PGY1 program routinely worked residents well over 100 and generally closer to the 109-115 hour range with 36-40 hours on duty. This is just plain wrong. 80 Hours and 30 hours is less wrong, but wrong is still wrong.

The business of any business administrator, including a program director is to solve problems, and someone leaving with 2 weeks notice is just one more problem to solve. If someone decides to leave, and as I recall the OP was miserable at the program, and suggested that they were using the house hunting as an excuse to bail, That in and of itself is mildly untruthful, but given the tenor of the post, understandible. I have seen the wrath of a PD who would not hesitate to fire a resident because of candor about the program on zero notice. So, it is a two way street. The difference is as AProgDirector said above, the PD holds all the cards. The departing resident holds few, unless they want to see their shining face on TV so the world will know about these darker secrets.

And Panda Bear is absolutely right. Programs will LIE to applicants. They lie on paper, they lie to Freida, and they lie to your face concerning working conditions and you find out the day after you've appeared for orientation. What motivation? I don't know, ego, financial, a streak of sadism, a desire to get top applicants who, knowing the truth wouldn't consider those working conditions? The reason is irrelevant. If they told the truth, they would get applicants who agreed with them and those who didn't would not rank them and go elsewhere.

As for the idea that reducing the sleep deprivation is going to necessarily lengthen training times, I'm not certain this is supported by evidence. Time will tell, but there have been many, many well published studies that clearly have demonstrated that sleep deprivation deprives the mind of the ability to learn and of civility, the popular press having cited 24 hours without sleep as the equivalent capability of an intoxicated person. I don't think 80 hours a week is a magic number. I worked 80+ hours a week in most of the jobs I've had prior to medical school. Sometimes for extended times, sometimes for shorter project deadline times. But, I also got between 6 and 9 hours of sleep every single night. And I was very well paid for those positions.

So, if the gain in learning productivity by eliminating draconian shifts exceeds that lost by "being there" 30 hours straight, I cannot see that this is a problem. In fact, I have a probably naive and simple way to manage this. Make the hospitals pay the residents time and a half after 40 hours in a week and double time for any shift time past 16 hours in a 24 hour period. Then it becomes somewhat less economical to force this issue and we would see residents getting compensated either the same as now or their wages approaching that of an NP or PA. And, as soon as the effective hourly wages reached that of the floor nurses, there would be strong incentive to stop using residents as gofers to get lab results and x-ray films.

Slave level labor is rarely economically advantageous. As soon as the true cost of labor becomes apparent, then and only then will there be investment in infrastructure to make medicine highly efficient. Slave level labor merely permits inefficient and ineffective systems to continue to be inefficient because the true cost is hidden.

 

[Apollyon]

EM seems to have already done so -- it's 4 years long compared with 3 for IM and FP.

The vast majority of EM programs are three years, with about 35 of about 140 EM programs being either 2,3,4, or 1-4 programs, and those disproportionately located in NYC.

 

[Winged Scapula]

If someone decides to leave, and as I recall the OP was miserable at the program, and suggested that they were using the house hunting as an excuse to bail...

I recall it differently. I don't remember the OP saying she was miserable at the program, but rather the other users where the ones who assumed she was and was simply using the housing issue as an excuse to leave early. I think perhaps she simply sees the fact that since she is switching specialties, this year doesn't "count" for her and she might as well quit,not that she is particularly unhappy doing it.

And while I remain absolutely convinced that sleep deprivation does no one any good, early studies are coming out that seem to indicate that surgical residents, at least, are less skilled than their predecessors, when it comes to technique. Blame it on the hour restrictions (which of course they are trying to do) or on lack of efficient teaching (which is my argument) but I would not be suprised to hear the trumpet call for longer training in procedural based fields...again, if these results keep up.

 

[3dtp]

I recall it differently. I don't remember the OP saying she was miserable at the program, but rather the other users where the ones who assumed she was and was simply using the housing issue as an excuse to leave early. I think perhaps she simply sees the fact that since she is switching specialties, this year doesn't "count" for her and she might as well quit,not that she is particularly unhappy doing it.

And while I remain absolutely convinced that sleep deprivation does no one any good, early studies are coming out that seem to indicate that surgical residents, at least, are less skilled than their predecessors, when it comes to technique. Blame it on the hour restrictions (which of course they are trying to do) or on lack of efficient teaching (which is my argument) but I would not be suprised to hear the trumpet call for longer training in procedural based fields...again, if these results keep up.

Went back and reviewed and have come to the conclusion you are right and I am wrong. I stand corrected.

And blame it they will. At my institution, this was made up with "virtual surgery" suites where we could get practice OR time in LSC surgical techniques and on our fine and dandy new da Vinchi system. Simulation systems help, but it is not the real thing. I'm not sure that there will be nearly as much pressure for longer trainging as there is not much, if any financial incentives. In the late 1980s/early 1990s there was a push by the big academic institutions to move rad-onc from 3 years to 4 years. The big boys were candid: They wanted residents to do research for free for a year on the government ticket. It passed and soon other specialties were eyeing the same plan when the government instituted the DGME funding caps. They would like to find ways out of the 80 hour week, though.

 

[fang]

And Panda Bear is absolutely right. Programs will LIE to applicants. They lie on paper, they lie to Freida, and they lie to your face concerning working conditions and you find out the day after you've appeared for orientation.

Now you're just encouraging my paranoia.

 

[8744]

Now you're just encouraging my paranoia.

I don't mean to. But why should we be skeptical of car dealers, siding salesmen, stockbrokers, and five-dollar hookers but be completely credulous when it comes to residency programs? Salesmen, stockbrokers, car dealers, and economical prostitutes are not inherently bad people and have a legitimate service to offer but when they tell me some variation of "I love you" I don't necessarily either believe it or become despondant when it turns out not to be true.

You need residency training to practice medicine. You can only get it at a residency program. The hospital needs cheap, cheap, physician labor and they can only get it from you. Love, trust, mutual orgasms, and comforting hugs have nothing to do with it.

 

[Winged Scapula]

They would like to find ways out of the 80 hour week, though.

No doubt they would. I firmly believe that if programs and specialties had made the move to reduce work hours on their own they would have been approved for longer hours. For example, if surgery programs had worked to reduce hours to say, 90/week, they probably would have gotten that approved. But being stubborn and assuming that they were "above the law", the programs were forced into the same restrictions as all others (with the exception of those, mostly Nsg, who were approved for 88 hrs).

 

[f_w]

I don't mean to. But why should we be skeptical of car dealers, siding salesmen, stockbrokers, and five-dollar hookers

Who said I am skeptical of $5 hookers ?

 

[Winged Scapula]

Now you're just encouraging my paranoia.

I won't let Panda be the only one to fuel your paranoia - because he is right. I expect it from THE MAN, but was appalled when I found out that some of our residents were lying to interviewees...one who matched there later was so angry and upset, turned out that he had made his decision about his ROL based on the lies he was told by one of the Chief residents. As someone who tried to be honest when interviewing, it really angered me...but you can't control what others say.

While FREIDA may lie, in most cases I think its more a case of someone not making changes from year to year.