I would greatly appreciate any help I can get from anesthesia residents, pds and other experts on here! I found myself in a very hard situation. I am an AMG MD with decent stats: step 1 226, step 2 244 and passed step 3. I matched into a university general surgery categorical program but had a really tough time adjusting into intern year due to several factors: being far away from home, not fitting with the program, not really liking any of the type a personality residents/faculty and just not feeling that surgery was the right choice for me. I struggled for the first couple months and thought things were getting better until I was put on a remediation for some "communication" problems by my PD. Unfortunately I feel that no matter what I would have done to improve he had already made up his mind to not really help me fix some of these problems much. Come March this year I was told that I should resign because my contract would most probably not be renewed. Since I hated being here anyway, I resigned without much persuasion,almost breathing a sigh of relief that I might get to go back home. My PD agreed to cooperate and help me find a position in anesthesia since that's what I have been really wanting to do anyway. I had been debating between that and surgery during medical school. Problem is,I agreed to work until the end of the contract and now he tells me he's not giving me credit for intern year. Says I can only receive 9 months of credit because I did badly the other three months. I had an amazing pgy 2 offer from an anesthesia program close to home. The PDs talked to each other, and that PD was actually really interested in me but when my final evaluation form was submitted saying I didn't receive full credit for the year, he refused to offer me the position. I've been in a lot of discussions with my PD and my GME about this but to no avail. what do I do. I have a research position I somehow secured at a great institution for anesthesia but its on volunteer basis. I just hate to have to repeat intern year. am I ever going to be able to find an anesthesia spot or is this situation going to keep repeating itself. I considered getting a lawyer but I also need a letter from my PD. Im at this point going to try applying to 2016 pgy 1 anesthesia spots but do I have another way of resolving this and am I still an attractive candidate? Please help!!
Need advice asap! Gen surg switching to anesthesia
- Thread starter odissidoc
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deleted171991
Get a lawyer. Your PD obviously won't help (and might be the problem). Actually you should have gotten a lawyer before signing your resignation. That was just dumb. Now your PD has another "proof" that you have "problems". You can bet he had a nice paper trail already, before suggesting that you should resign.
You need to fix this, because otherwise you'll have to explain it for years. You might not get into any good program, regardless of specialty. Amicable resignation is one thing; being denied credit suggests bigger problems that another PD might not want.
You need to fix this, because otherwise you'll have to explain it for years. You might not get into any good program, regardless of specialty. Amicable resignation is one thing; being denied credit suggests bigger problems that another PD might not want.
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deleted171991
It's tough, I know. This is why nobody will give you advice, because we have no idea what to do in this type of situations. You are between a rock and a hard place.
I still think it would be worth consulting a lawyer, especially one who specializes in labor issues. The problem is that a big university has an entire department of them, so they won't be scared by you lawyering up, on the contrary. You don't have to "use" your lawyer, or even mention him/her to the department, but at least you will get better advice than on a forum.
I don't know about that letter of recommendation; these people are not your friends. A lawyer might get them to agree in writing about what will go in that letter and what won't, or at least you would know exactly what they plan to write.
If the PD was initially helping you get a position in anesthesia, how did that get to the point that he wouldn't give you credit? What kind of "communication" issues can an American grad have?
Anyway, repeating the intern year, as part of a categorical anesthesia residency, might be the least bad thing that you could walk away with here.
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He said he would help by writing a letter of recommendation and answer phone calls and try to be supportive. I have multiple attendings from here who are writing me great letters. However, if I just walk away from here without creating a mess, do research in this other more prestigious anesthesia department for year and get support from them as a volunteer and then apply for a pgy 1 categorical position, would I need my program director's letter? Or could I go without it. Obviously, since I have letters from this surgery program faculty, I would be asked about it for interviews. What I don't understand is how my PD had a conversation with the other anesthesia PD and even after that conversation, the anesthesia PD was still interested in me! Which leads me to believe my PD may not have been that abrasive on the phone.
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deleted171991
That means that something has happened since. He wouldn't have recommended you had he thought you would not graduate.
If you don't want to piss off your PD, then you should just roll over and hope for the best. What's done is done. I would still try to find a lawyer who knows about labor and medical residency issues, and invest some money in an hour's worth of advice, just to know that I did my best, when I look back in years.
Truth is that, if your whatever residency committee decided not to give you credit for the last 3 months, I don't think there is much you can change.
Maybe somebody has been through this before and can help odissidoc privately, please?
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First, relax and breathe! Seeing a labor lawyer is good advice. Secondly your statements of not liking any of your fellow residents or faculty is very odd and suggests some underlying personality disorder not on their part. I do believe in Grace in that you can overcome whatever communication problem you are having with others. I would continue with your intern year even if you cannot get credit for those three months. It looks good that you honored your contract even if the credentialing committee is not honoring theirs. Even in anesthesia we have to communicate with angry surgeons, OR nurses, PACU nurses, and CRNA's even without the captain of the ship hat as surgeons. You need to truly reflect what are the communication issues? Why did this not work out? What about General Surgery did not work for me? You may have to finish your internship and do another intern year somewhere else. I wish you luck and success in medicine, deeper I wish you reflect and become a better person because of this. Good luck.
Thank you very much FFP! Even my surgery letter writers and individual members of the surgery committee who decided to not renew me have suggested the lawyer route but I can't expect them to back me up when the time comes. And I like I said earlier, I don't know if even applying for a PGY 1 position this september would need me to get a letter from him.
I really appreciate this advice! Everyone else, please chime in! Give me advice, whatever little you have will be much appreciated! in response to narcusprince, I didn't fit in with the rest of the residents because I am much younger than everyone. I went to a shortened MD program and the residents here were actually even older than the average surgery resident. Do not feel comfortable elaborating more, especially not on a public forum because I don't want to give away where I am and the location and stuff which also played a big part in me not doing as well as I would have here.
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Can you elaborate on what you mean by communication problem so that new surgery intern can avoid such pitfalls...and im sorry that you find yourself in this dilemma....i knew a resident who had similar occurence and the key point he drove home was getting a lawyer. If it makes you feel any better he recovered and he is about to finish residency
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The thing that is being missed here is that your last six months were on probation. In order to remediate a 6 month probation and receive credit, you must complete six months immediately after that and get an acceptable evaluation. When that occurs, you then get credit for the previous six months. So, if what you stated is true, you only have six months credit and, by not continuing on in the same program, you have lost the ability to get credit for the previous six months. So, the way it has played out, the PD could not give you full credit, even if they wanted. If the Clinical Comepetency Committee determined that you were on probation, then your fate was sealed when you resigned because you forfeited the ability to remediate those six months.
Those are ACGME rules as I understand them, like them or not.
Best of luck to you.
Those are ACGME rules as I understand them, like them or not.
Best of luck to you.
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First off - you have made the right choice to leave surgery. That - regardless of the situation, is ALWAYS the right decision.
I can't say if anesthesia is right for you - but it looks like you have to repeat internship regardless of what you decide. I would accept this fate and move on. It may be a good time to decide if you even want to stay in clinical medicine. Many would say you were given a gift - that is - a hiccup in the road so that you could get your head on straight, get some strength to leave this profession all together.
I can't say if anesthesia is right for you - but it looks like you have to repeat internship regardless of what you decide. I would accept this fate and move on. It may be a good time to decide if you even want to stay in clinical medicine. Many would say you were given a gift - that is - a hiccup in the road so that you could get your head on straight, get some strength to leave this profession all together.
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Regardless of what specialty you're doing here's my take on the situation. NOw, You've told us bits and pieces but outside of any details no one on this forum knows what's going on beside you, the PD, and maybe a few residents/fellows at your program. I agree with another post, "What does communication problems mean?" and also, "Problems with fellow residents?" I did a surgical intern year. Guess what? I sucked. HARD. The problem I have and what some anesthesiology PDs might have is that you quit. I don't care if the work resigned is used....you quit on you colleagues and the program. This is something that you seniors didn't tell you, it is very very very hard to FIRE a resident. You have to damn near kill someone (or actually murder someone). If you would have told your PD that you had problems with,"Hey. We have our differences and maybe I can't continue here, but I'll finish theses 3 months and then be gone" then that would look infinitely better on your part, but as I said earlier, in medicine, no one likes someone that quits.
Sure get the lawyer and see what you can do, but honestly, your best bet at this point is probably to cut you loses and do a medicine PGY1 and show them you can finish intern year with no problems. Seriously, a "being force to resign" line on your record is a red flag.
Sure get the lawyer and see what you can do, but honestly, your best bet at this point is probably to cut you loses and do a medicine PGY1 and show them you can finish intern year with no problems. Seriously, a "being force to resign" line on your record is a red flag.
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The first time I read it, I thought he just quit with 3 months to go. The second time I read it, I wasn't sure. If he quite 3 months shy, no need to explore further or get a lawyer. It's done.
If he quit after completing the full year with the last six months being on probation, no need to explore further. He does not get credit by ACGME rules. It's done.
Repeat your first year if you can find a program to take you or explore non clinical medicine options if you are better suited for that.
Everyone, I'm still currently working with 4 days to go until the end of my contract. My resignation is effective on the end of the contract date. I'm currently still taking q 3 call and killing myself here working over 90 hours a week.....And to not get credit for overworking??? I don't think so.
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How would you not get credit?? Now THAT could be worth fighting for. If you do 365 days of an intern year that should count and should be recognized. If you finish PGY 1 dont leave the building until you get your certificate
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As I mentioned before, if he is receiving an unsatisfactory (I have inferred from his comments that this is the case, though he never used those words) for the last 6 months, there is no credit received if it is not followed immediately by a six month period of "Satisfactory" evaluation.
These are the rules for the Anesthesiology ACGME and I suspect it is the same across most specialties.
I sympathize with the OP, but the ACGME does not bend the rules on this issue. I suspect that, since they were told that their contract would not be renewed, the matter was completely out of their hands since they had no ability or recourse with which to accomplish a six month period of satisfactory work to follow their unsatisfactory 6 month evaluation.
We need to also keep in mind that we are only hearing one side of the story here as well. The OP said they had "communication issues" which may have been that they felt he was too timid or quiet, or it may have been that he verbally assaulted the nursing staff and fellow residents. There are some issues that can be re-mediated and others that likely cannot. It seems clear that this PD felt that there was not a lot of hope that his situation could be fixed and that his odds of success in that program were very low, thus the request for his resignation, which is essentially getting fired but in a nicer way. There are also many PD's that are complete jerks and who do not try very hard to make situations work out. All I'm saying is that we don't know the whole story. He might be able to leave there with a certificate if he causes enough of a stir. The thing he really needs, though, is for the ACGME to recognize the final six months as "satisfactory" performance, as noted by the Clinical Competency Committee so that his next program will be able to start him at the PGY-II level instead of the PGY-I level. My gut feeling is that this will be much harder to accomplish. The next program they attend will have the burden of tracking down all of the GME training and showing that he received full credit. I think that will be the main issue. The ACGME takes this issue very seriously and that is why it is such a big part of the old site reviews to view the files of all residents who transferred in from another program. They don't want programs bouncing bad doctors around from one program to the next without remediation and, eventually, graduating a resident that was clearly unsatisfactory.
I have a feeling that his fate has been determined and that he will need to repeat the PGY-1 year in order to receive full credit. Again, I don't know the whole story, but the above situation is my best guess about the OP's circumstances.
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The OP needs to forget the lawyer route and try for a Categorical Program with an open spot in Anesthesiology. The lawyer route is a waste of money IMHO.
Instead, focus on a Transitional PGY-1 year or an Internal Med PGY-1 year if you can't secure a Categorical anesthesia position. Consider the past 12 months a lesson on the hard road of life.
Instead, focus on a Transitional PGY-1 year or an Internal Med PGY-1 year if you can't secure a Categorical anesthesia position. Consider the past 12 months a lesson on the hard road of life.
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Or....I hate the be the bearer of what is possibly the truth....if you couldn't make it through intern year (which is sort of like the class in college that everyone passes as long as you show up) maybe you should really consider another field. PGY 1 is basically
1: Show up (hell, if you're on time even better)
2: Complete your task (again, one time even better)
3: Say yes sir/no sir
Check you ego at the door. Don't argue. Do what you're told. Basically that's all anyone wants out of an intern, at least in surgery (that's what i did). Medicine is probably the same, just with longer rounds and longer notes.
1: Show up (hell, if you're on time even better)
2: Complete your task (again, one time even better)
3: Say yes sir/no sir
Check you ego at the door. Don't argue. Do what you're told. Basically that's all anyone wants out of an intern, at least in surgery (that's what i did). Medicine is probably the same, just with longer rounds and longer notes.
