Advice: Disclosure of ITE Scores to Cause Reputational Damage

[greg.house1408]

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During my residency, I did not score well on In-Training Exams. I did, however, pass my boards and matched into a highly competitive fellowship. A member of the clinical competency committee attempted to block my attendance at this fellowship during their tenure at my prior residency program. After they left that program in my senior year, this person moved to another state but continued to communicate with faculty and residents at the prior program. Specifically, they disclosed my poor ITE results to argue that I did not deserve my fellowship, and that the program should no longer give preference in residency applications to people who shared my ethno-geographic characteristics (for the record, they do not do this but they [the discloser] felt that the program did).

I am at a loss of how to proceed. While the validity of FERPA protection for medical trainees is disputed, this was specifically disclosed to cause reputational damage for me and to dissuade hiring anyone like me in the future. Should I seek legal recourse to address this or would this just be tilting at windmills and be a personal vendetta unlikely to succeed?

For context, I have already secured a post-fellowship position; but my goal was to return to my previous program after fellowship to reduce disruption for my family in moving to another city. I feel that, partly due to the above issues, a previous employment offer from my prior training program disappeared over these communications.

 

[operaman]

If I’m reading the situation right, best to let it go. FERPA for residents aside, I think disclosing your ITE results to your residency program that already had access to your results is somewhat redundant. Would be quite a stretch to argue that’s a violation or that it gave them some info they didn’t already know.

Whatever their actual reason for not hiring you, count it a blessing because clearly it wouldn’t have been a good situation.

If you want to stay in that area, just find a private job somewhere and make more money working fewer hours than you would as rando assistant professor at your old program. Get your old ITE scores made into a vanity plate for your new Porsche.

 

[DrMetal]

During my residency, I did not score well on In-Training Exams. I did, however, pass my boards and matched into a highly competitive fellowship.

So what's the problem? ITE scores? We all bombed them . . .

A member of the clinical competency committee attempted to block my attendance at this fellowship during their tenure at my prior residency program. After they left that program in my senior year, this person moved to another state but continued to communicate with faculty and residents at the prior program.

There's something else going on here. Who/how did you piss them off? Agree probably best to just let it go, concentrate on your current fellowship.

There's never been a guarantee (and there's no such thing as a real 'preference', that's not legally binding) that you'll obtain employment at your prior institution. That'll be a function of job availability there in 2-3 years after you complete fellowship, and a function of how you do in that hiring process. Period. Forget the notion of a 'preference'. When the time comes, just apply and see what happens.

 

[DrMetal]

Get your old ITE scores made into a vanity plate for your new Porsche.

Or you're Kia Sorento. Buy a reasonable car . . . not a Porsche (rent one occasionally if you'd like). Read White Coat Investor.

 

[LucidSplash]

This is a really odd post. Residency programs already have access to the ITE scores, and I had to submit my ITE records as part of my fellowship application process.

 

[Smurfette]

Several thoughts:
1. Who cares about the ITEs when you have since passed your boards? Your ITE scores are now completely irrelevant. No one should care.
2. This person could be a problem for you, so avoid working geographically in the same city if possible. Once you're established and doing well, no one will care about what they think.
3. Going back to where you did residency is a double edged sword. They may look at you as less than an equal as you trained there, and you may get dumped on or short changed as a result. So perhaps you dodged a bullet.

 

[Dral]

Agree with others. I'll add this: I would not do anything to address your concerns that they program may not take others from your ethno-geopgraphic group. Just because the person suggested this doesn't mean the program will do it, and you say that they currently don't act in that way.

If you have a good relationship with someone at the program and you have strong concerns, you could maybe keep an eye on who they take. If they seem to be trending in the direction of not taking people from your ethno-geographic group, maybe bring it up to your contact person. However, again, I would not take action on that now since the program isn't doing it currently.

 

[Raryn]

This is almost entirely specialty dependent. General Surgery ITE scores are often public AND explicitly uploaded to ERAS when you apply for fellowship. Ob/Gyn fellowships often require ITE scores be emailed to the program before you can get an interview. There is zero expectation of privacy in those fields.

On the other hand, for the Internal Medicine ITE, the ACP explicitly says the following:

How should the IM-ITE® score reports be used?​

The examination is neither a qualifying nor a certifying instrument. It should not be used for determining who should be promoted, who should be eligible to take the American Board of Internal Medicine certifying examination, or who may be qualified for post residency fellowship training. It is designed only as a self-assessment tool.

However, program directors are encouraged to include IM-ITE results in semiannual reviews of resident performance and reporting on attributes of the Medical Knowledge competency. As part of the Internal Medicine Milestone Project, this activity may contribute to a residency program’s participation in the Next Accreditation System (NAS) to determine the overall progress of residents. The release of any score, either at an individual or aggregate level, to any person or organization outside the residency program, is strictly prohibited.

I don't know what possible penalty the ACP could enact on a program that did share IM-ITE scores, but it's definitely against the rules.

All that said - you matched your fellowship. I would drop it. Nothing good could come of pushing the issue.

 

[dozitgetchahi]

This is a really odd post. Residency programs already have access to the ITE scores, and I had to submit my ITE records as part of my fellowship application process.

In internal medicine, ITE scores cannot be divulged to fellowships and are not supposed to be used for residency promotion decisions.

 

[comp1]

I'm a little concerned that pursuing this may do more reputational harm than anything the original person could do to you.

 

[hallowmann]

During my residency, I did not score well on In-Training Exams. I did, however, pass my boards and matched into a highly competitive fellowship. A member of the clinical competency committee attempted to block my attendance at this fellowship during their tenure at my prior residency program. After they left that program in my senior year, this person moved to another state but continued to communicate with faculty and residents at the prior program. Specifically, they disclosed my poor ITE results to argue that I did not deserve my fellowship, and that the program should no longer give preference in residency applications to people who shared my ethno-geographic characteristics (for the record, they do not do this but they [the discloser] felt that the program did).

I am at a loss of how to proceed. While the validity of FERPA protection for medical trainees is disputed, this was specifically disclosed to cause reputational damage for me and to dissuade hiring anyone like me in the future. Should I seek legal recourse to address this or would this just be tilting at windmills and be a personal vendetta unlikely to succeed?

For context, I have already secured a post-fellowship position; but my goal was to return to my previous program after fellowship to reduce disruption for my family in moving to another city. I feel that, partly due to the above issues, a previous employment offer from my prior training program disappeared over these communications.

Ignore this person. There's a reason they left. You will get nothing but heartache or worsening of your reputation from challenging them. Consider it divine intervention that you are not going to a place that even listens to this person or would theoretically act on their recommendations.