Getting on bad side of the program

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
U

unknown22

New Member
10+ Year Member
Joined
Oct 25, 2008
Messages
9
Reaction score
0
Members don't see this ad.
Hmmm, I never thought I would find myself here but I need help.
My wife is a hardworking, kind young mother and beloved spouse and she ended up landing in a wrong program. Half of the residents did not like her and also some nurses made problems for her couple of times. well I know that everybody else in the word likes her i.e prior colleagues, co-students, friends and family of course.
She graduated magna cum laude with a BS and finished med school on time with honors but strugled with the usmle grades to some extent. Since I am an academic attending myself my own evaluation from her is that she has the mental and physical ability to do this - of course I love her - and also I know she has the knowledge to get her by as a junior attending in a bit at least.
The bad mouthing of the people spread out in the program and she was isolated and singled out. These things eventually got to the program director. I think he is a good guy and tries to help but the negative reports keep coming - mostly from his chief residents - mainly because she is marked and under microscope and people think that they are supposed not to like her and she is unfit. this is getting to a level that eventhough now she has only 8 more months to go - by design - I am not sure if she can finish at all. She loves this and can not settle with idea of another career. The PD keep getting reports that are distorted and frankly I think this whole thing is rediculous but she keep having to deal with lies and mispresentation of the reality or loneliness and condoscending attitude of other residents and now even some attendings and she can not defend herself. All the positive evals that she got does not count but if somebody says a bad thing, - no matter how unbelievable is this no matter how absurd, - it is true and against her. Like somebody said she was sitting doing nothing when a patient was coding as a senior resident she even did not recognize the cardiorespiratory arrest "total rediculous lie" and they say you know we have other things on file as well. It is probably true!!!! Thanks god no probation yet or major patient care gaffe.

any body have any experience like this? any recommendation? this is not termination but it can very well be in few months. we are extremely worried and need to save her career. but now out of ideas.🙁🙁
 
Such a shame....I can imagine the frustration with this. As an attending, I wonder if you could have a meeting with the PD along with your wife and the chief resident to really hash-out the problem. It seems as though the facts of what is going on need to be brought out in the light. No serious decision could be made based on hearsay alone...at least not by any professional with a shred of integrity. Have you sat down with your wife and empathetically asked her how this all started? Once you have the honest truth from your wife..it would be worthwhile to investigate this situation and get to the bottom of it. If you can't, or the PD won't arrange a meeting, I would suggest your wife go to the PD and ask that she be allowed to present her concerns with all those accusing her together in the same room with the PD. If this is truly a possible termination then your wife certainly deserves the chance to defend herself. It's not fair or professional that residents are running around saying negative things then getting them back to the PD. He/She should've come to your wife and arranged a meeting a long time ago. I would want a meeting with any accusing resident, the chief resident, head nurse and the PD. That at least would give your wife a chance to hear what people are saying and lay it all out for her to defend. I would consider any refusal to do this rather unbecoming of the program and might consider going to the Chief Hospital Administrator if necessary. I sure wish you the best of luck and am sorry to hear this is happening.
 
Medicine fellow here,
OK, I think there are a couple of possible approaches.
1) Just put her head down, try to work really hard, ignore the gossip, be super, super nice to all her interns and help them with their work, get everything done on time (like the discharge summaries, etc.). Be very nice to the other residents and all attendings and fellows, and just try to get through the next 8 months (I'm assuming she is PGY3 in medine, peds or family practice). If she's not officially on probation yet, then I doubt she's about to be fired (unless the prog. director has been talking of firing her?). What she needs is to avoid being officially put on probation. Be especially careful when working in the MICU, because that's where the most sick patients are. She needs to honestly think about what actions she has personally taken that have contributed to this, and how she can change to make things better. I don't doubt that she might have been unfairly targeted, and you are right that she is most likely being put under the microscope now. This happens in a lot of residency programs and she is not the only person this has happened to.
2) Try to meet with the program director and try to discuss what some of the concerns are, and make a plan to make these better. I suggest she NOT have you along with her, as that just makes her look weak and like she can't handle herself, and there's not going to be much you can do for her anyway. In general, the guidelines for residencies (put out by the AMA and other groups) say that whenever a resident is having this type of meeting with the program director, then he/she should be able to have an advocate with her. I think the best way to do it is to have an attending or fellow who likes her in there in the room with her, acting as her advocate and to help her. Your wife should take notes/write down what the concerns are, then send an email after the meeting back to the program director (for example: "You mentioned that my knowledge base was a concern - I have plans to read about my patients 1 hour every night and am bringing in research articles for my team."). I don't know...this is just hard to deal with, particularly the rumors/accusations like not helping out enough in a "code". The only way to deal with that particular accusation is to make sure she is one of the first ones in the room for any stat/code on her ward, and to act like she knows what she is doing - in reality I think most all residents are scared in this situation, and it's a team effort anyway, so who is "running" the code, though everyone pays a lot of attention to it, a lot of time is a moot point (almost all the medicine patients who code die anyway....).
3) I think it would be quite hard to be a mom and a resident at the same time. Is there some way that you are another family member could give her lots of help with the kid(s) in the next 8 months, just so she has less to stress out about? She needs to show that she can outwork any other resident - it sucks but sometimes women are held to different standards.
4) If she has not passed any of the USMLE steps, now is the time to do so in the next few months. She needs to make sure she passed any remaining ones on the first try. Just get those study books and tear in to them...
 
Are you an attending in this country? Is your wife training here? I ask because your written English was not quite up to snuff, which made me curious-- our advice is very USA-centric.

It is quite possible that your wife handled being a "kind young mother and beloved spouse" when she was a medical student, but the additional demands and responsibilities of residency were too much to add to an already-full plate of her home life. Are you sure the things they're saying about her are *completely* unfounded, or are you viewing this through the lens of a concerned, supportive husband?

I ask because her strategy will therefore be completely different. If her work is suffering because she's trying to do too much at home, because she never stays late to help out, she isn't reading at night, etc then you as her husband have a responsibility to take on much of the domestic workload (i.e. arrange for childcare later at night, hire a housekeeper) so she can concentrate on medicine and become a reliable, dedicated resident again.

If not-- if you genuinely believe she has been capriciously and unfairly targeted (as a senior resident no less!), then follow dragonfly's advice above.
 
Hey Unknown 22

I have complete emapthy for your wife, being in the same boat, but further downstream. From what I've realized is that the program is really not lying. Its a matter of the perspective the program takes. i.e. they view your wife as "half empty" where as another resident who makes the same mistake as "half full" if you get my drift. Perceptions can also be distorted, twisted an exaggerated.

Got to go, finish this later.

PM me
 
Thanks for everybody responses. These are really good and somehow help I organize my mind and help her come up with a plan. from this page I can not see the screen names but:

1) yes all these are happening in US. and it is right we are originally not from US but all her training was here and I did my residency and fellowship here. nice catch though, also we live like any other modern couple that you can see in the upper westside ... BUT ... maybe the cultural roots are there. she insists on preparing meal and even for my next day to bring to office that I think it is always too much and hurts her also motherhood does not go with residency well so that causes alot of problems but helping more certainly can decrease her fatigue which to me is culprit of lots of problems.

2) a residency is an employment so the general workplace regulations should apply ... I do not understand why not as it was implied in the "termination" thread were they spoke about the role of lawyers.

3) I think it is good to find residents like this to see what was their experiences. I was even before this very frustrated with the residency system here and as somebody with experience in education and educational course design ... like to see if a systematic non threatening grievance or even prior to grievance mechanism can be added somehow to this system. like in our case I predict a situation might come up that she might request for grievance. there should be a mechanism that people can get proactive and activate a procedure to prevent unwanted situations to come up. As it was mentioned we are not alone and so many residents are in her shoes. last year in my program I helped a resident with spending hours with him to avoid pitfalls that could augment his problems successfully. he had no real official source to go to because chief residents made fun of him on his back and the program director has certain amount of time to spend with one person. I agree most of them have good intentions but they are one person in a system get reports and have to act on that or they are not doing their job.

4) how about RRC violation in her program. it is a constant on going issue and it seems nothing happened .. I experienced it for years now. of course a resident is supposed not bring it up or even complain let alone a resident "with prior issues" ... when placed 3 saturdays on call back to back with 3 other calls on the last week of rotation if she says a thing she is just complaining/incapable/unlikable/problem person. . ... who did not come all those saturdays? the one who was very popular with chiefs. this is disgusting and common. The funny thing is that when I did my residency I was on the popular side both by program and among the peer so trhese things are new experiences ... of course from the "concerned husband's lans"

to lighten up: hey blondedocteur sorry for my English mistakes I can not go over to correct 'em since I have to run for a crying baby ... she is studying. 🙂

ps: I have a friend with 2 kids who used to say it is not fair there should be a requirement for all PGY3s to atleast have one kid.
 
unknown22 said:
My wife is a hardworking, kind young mother and beloved spouse and she ended up landing in a wrong program. Half of the residents did not like her and also some nurses made problems for her couple of times. well I know that everybody else in the word likes her i.e prior colleagues, co-students, friends and family of course.
She graduated magna cum laude with a BS and finished med school on time with honors but strugled with the usmle grades to some extent. Since I am an academic attending myself my own evaluation from her is that she has the mental and physical ability to do this - of course I love her - and also I know she has the knowledge to get her by as a junior attending in a bit at least.
The bad mouthing of the people spread out in the program and she was isolated and singled out. These things eventually got to the program director. I think he is a good guy and tries to help but the negative reports keep coming - mostly from his chief residents - mainly because she is marked and under microscope and people think that they are supposed not to like her and she is unfit. this is getting to a level that eventhough now she has only 8 more months to go - by design - I am not sure if she can finish at all. She loves this and can not settle with idea of another career. The PD keep getting reports that are distorted and frankly I think this whole thing is rediculous but she keep having to deal with lies and mispresentation of the reality or loneliness and condoscending attitude of other residents and now even some attendings and she can not defend herself. All the positive evals that she got does not count but if somebody says a bad thing, - no matter how unbelievable is this no matter how absurd, - it is true and against her. Like somebody said she was sitting doing nothing when a patient was coding as a senior resident she even did not recognize the cardiorespiratory arrest "total rediculous lie" and they say you know we have other things on file as well. It is probably true!!!! Thanks god no probation yet or major patient care gaffe.

any body have any experience like this? any recommendation? this is not termination but it can very well be in few months. we are extremely worried and need to save her career. but now out of ideas.🙁🙁
Click to expand...

Remember that in the U.S. medical system how you present yourself means a lot. For example, when U.S. med students are "pimped" by attendings, i.e. asked multiple questions we must keep a smile on our face although the facts being taught may be presented wrong or something that a student wouldn't know.

Even more so, when you are criticized about something you did on the wards, even if it was something that was not your fault and you would do it the same way the second time, you must be profusely sorry about it and say how much you learned how to do it differently next time, etc.

I have seen students who on rotations didn't jump quick enough to get a lab result or help with a patient get branded as being lazy or incompetent. Learning to grease the wheels is important in US hospitals. Nurses like to poke and prode residents to see if they are "nice" or not, and if you talk back to a nurse or show some spine then they will take it out on you later such as in bad evals or talking trash about you behind your back to the residents. Most people who work in U.S. hospitals are pretty vindictive as they have been workng in the same job for ten years or more and basically don't have much of a life outside of work and their hobby is fighting with people. Sad but true.

Physicians from other countries such as India are much nicer to work with as perhaps in their country there is more emphasis on being nice at work. Regardless, if your wife is "being tough" and being mean back to people who are mean to her then yes, they will make her life hell. As a resident you are expected to be nice all the time to everybody including nurses or they will attack you.

Her only recourse is to talk the PD about how some residents/nurses are acting towards her, without naming names, and say that she wants to have better work relations with people and that she will work on this. And then she needs to figure out specifically what she did wrong and make it clear that she wants to change.

A couple codes I have seen students/residents who just talk/laugh and observe without helping, and yeah, everybody pretty much hates them for the rest of the rotation/block.
 
unknown22 said:
1) yes all these are happening in US. and it is right we are originally not from US but all her training was here and I did my residency and fellowship here. nice catch though, also we live like any other modern couple that you can see in the upper westside ... BUT ... maybe the cultural roots are there. she insists on preparing meal and even for my next day to bring to office that I think it is always too much and hurts her also motherhood does not go with residency well so that causes alot of problems but helping more certainly can decrease her fatigue which to me is culprit of lots of problems.
Click to expand...

So, Unknown, your wife is a senior resident somewhere in New York City; she is home every day in time to prepare dinner for her family; she brings food to your private office during the day; she is fatigued, causing her "lots of problems"-- and you think that it's all unfair and malicious hatemongering that causes her to be smeared in her hospital as less than dedicated to her job?

While I think it's perfectly nice that she cooks for you and the kid(s), surely you can understand that saying-- just once-- "I can't stay, I need to be home to make dinner" will *definitely* not go over well?
 
blondedocteur:
No the way you put this is far far from the reality and no it is not NYC I lived there when I was a resident in 2003ish and the upper west side comment was addressing your institutional reference. it does not matter any way a resident no where can bring food to husbands office. even though she "insisted - no cultural implications attached" to make a sandwitch for me to bring to work when she was in some light electives we are not crazy enough to think she can/or would want to bring me food in general. may be it is some kind of bias on your side to through lots of negativity on somebody that you have no idea who he is except he is a minority doctor and already finished his training and teaches medicine. What would you do if you saw your significant other is suffering from unfair and unsubstantiated chatter?


... but I very much appreciated your first comments.

also please lets not continue this because I think this will get the thread away from what I started it for.

others:
this person lived 20 of her 29 years in the US and I lived here for long time. I do not think this is about not knowing the system or regular IMG/FMG stuff that goes on all the time. also I do not think this is about being lazy or incompetent ... fatigued yes. Also no I am sure there are things here and there that every body has but goes under magnifying glass only for some people and causes harm only for some people.

I think this is as nsap102 said about a system that allows seeing the full half of the glass for some people and the empty half of the glass for some other people and how this can change the life of some medical graduates, in an unfair manner. This goes on under our nose all the time ... why we let it go? a good student that I worked with few years ago went to general surgery and the PD hated him ... he did not get a PGY2 and now he is handling surgical procedures for animals for a few years now. These events usually start with a resident who start bad mouthing you and expands exponentially specially in small programs.
 
dragonfly99 said:
Medicine fellow here,
OK, I think there are a couple of possible approaches.
1) Just put her head down, try to work really hard, ignore the gossip, be super, super nice to all her interns and help them with their work, get everything done on time (like the discharge summaries, etc.). Be very nice to the other residents and all attendings and fellows, and just try to get through the next 8 months (I'm assuming she is PGY3 in medine, peds or family practice). If she's not officially on probation yet, then I doubt she's about to be fired (unless the prog. director has been talking of firing her?). What she needs is to avoid being officially put on probation. Be especially careful when working in the MICU, because that's where the most sick patients are. She needs to honestly think about what actions she has personally taken that have contributed to this, and how she can change to make things better. I don't doubt that she might have been unfairly targeted, and you are right that she is most likely being put under the microscope now. This happens in a lot of residency programs and she is not the only person this has happened to.
2) Try to meet with the program director and try to discuss what some of the concerns are, and make a plan to make these better. I suggest she NOT have you along with her, as that just makes her look weak and like she can't handle herself, and there's not going to be much you can do for her anyway. In general, the guidelines for residencies (put out by the AMA and other groups) say that whenever a resident is having this type of meeting with the program director, then he/she should be able to have an advocate with her. I think the best way to do it is to have an attending or fellow who likes her in there in the room with her, acting as her advocate and to help her. Your wife should take notes/write down what the concerns are, then send an email after the meeting back to the program director (for example: "You mentioned that my knowledge base was a concern - I have plans to read about my patients 1 hour every night and am bringing in research articles for my team."). I don't know...this is just hard to deal with, particularly the rumors/accusations like not helping out enough in a "code". The only way to deal with that particular accusation is to make sure she is one of the first ones in the room for any stat/code on her ward, and to act like she knows what she is doing - in reality I think most all residents are scared in this situation, and it's a team effort anyway, so who is "running" the code, though everyone pays a lot of attention to it, a lot of time is a moot point (almost all the medicine patients who code die anyway....).
3) I think it would be quite hard to be a mom and a resident at the same time. Is there some way that you are another family member could give her lots of help with the kid(s) in the next 8 months, just so she has less to stress out about? She needs to show that she can outwork any other resident - it sucks but sometimes women are held to different standards.
4) If she has not passed any of the USMLE steps, now is the time to do so in the next few months. She needs to make sure she passed any remaining ones on the first try. Just get those study books and tear in to them...
Click to expand...

How can she be a senior resident if she hasn't passed any USMLE exams?
 
I usually don't comment but this thread hits home for me because I'm very familiar with this situation.
Let me give you some pointers from my own personal experience.

You can have a talk individually with the PD in private to express your concern about what's going on but if he has a negative impression of her already, there's not much good that can come of that.

Don't NOT try to defend her publicly. It will make her seem weak. She has to stand up for herself otherwise she will be further labeled as a someone who can't hack it in this profession without her husband babying her along. She must demonstrate inner strength and you can help her with that by talking to her at home with her family or other signficant people in her life present to generate support for her in private and build her confidence.

I know very well that once a person, especially a woman, is targeted in a program, the outcome is not generally positive. If her chiefs are targeting her and constantly feeding negative news through the PDs door, it would be hard to fight that. Chief residents have a lot of power, more in some programs than others, but specially in surgery, they're opinion matters a lot and can make a huge difference in whether a resident gets fired.

I can absolutely believe you that many of the accusations against her are unfair and unfounded. Everyone makes a mistake, but when someone who's targeted makes an error, it is blown out of proportion. Living constantly in this negative enviorment generates drop in self confidence, and that alone can cause productivity to drop. Hence, it's like a revolving door and it's not really that person's fault.

The suggest that she should try to generate as much support for her at work from third party individuals (attendings that are respected and still are neutral; other residents; attendings from other departments who have worked with her). You can do the same to some extent but only in private in a one to one basis and very judiciously without appearing overbearing.

She has to work hard, be PLEASANT but aggressive in patient care, constantly in contact with attendings to let them know that she is concerned about the care of their patients. She should not get into arguments, should not get angry and cry, but defend herself logically and thoughtfully if someone picks on her unfairly. She should not allow even senior residents or chiefs to humiliate her in public. She should be polite but defend herself PUBLICLY if ridiculed. She should talk to th PD HERSELF and without emotion or crying, calmly defending her position and her concern about the way she is being treated.

Unfortunately, all this might not work and she make have to change programs. Sometimes, that's how things work out. If that were to happen, she should embrace the change and be happy that she doesn't have to work in a hostile enviornment anymore. It's new change and new beginning.

But absoutley, she should not quit or give up her career because of some douche bags.
 
bluealiendoctor said:
Such a shame....I can imagine the frustration with this. As an attending, I wonder if you could have a meeting with the PD along with your wife and the chief resident to really hash-out the problem. It seems as though the facts of what is going on need to be brought out in the light. No serious decision could be made based on hearsay alone...at least not by......

Bluealiendoctor: I guess this was the main thing that I was unable to decide for 1.5 years I stayed on the side thinking like the other contributors to this thread like if I get involved in any way it is just worse for her ..... I have no affliation with that healthcare system but they know me from social events .... don't you think if I talk to him in anyway it is just way worse for her and project the incompetence that they are talking about? .... since you were the only person who said go and talk to this PD can you elaborate on your reasoning? or may be now you also agree with other people? .... also if "AProgDirector" happens to come here it is good to here his comments as well. I am sure as soon as we/she start talking about how so many subtle things are hurting her it will make who ever is sitting on the other side of the desk angry .... how can she convey this message in a way that they hear it ???
Click to expand...
 
bluealiendoctor,
in regards to your question above
I meant if the resident hasn't yet passed all 3 of the steps, she should do so. I was really talking about Step 3 specifically. Of course she has passed Step 1 and 2, or she wouldn't be a senior resident. But a person can totally be a senior resident (i.e. PGY3) in many programs without ever having taken or passed Step 3. My point about taking Step 3 was based on the fact that if she passes Step 3 and does OK, then it would be another point in her favor and against any/all who try to say that she doesn't have an adequate knowledge base. She needs to set herself up to succeed in the future, regardless of what her program does to her. If they want to put her on probation or fire her, then having passed all of the USMLE will be important.

I think she should also work on getting her medical license, if it's possible for her to do so at this point. If she has passed Step 1 2 and 3 she should be able to get a license in most states. If her husband is an attending then paying the license fees shouldn't be too expensive for her. I'm just thinking of worst case scenarios...in case they try to fire her, etc. then to have a license is good. It proves that she doesn't have black marks on her record, etc. (i.e. never been in trouble with the law, used drugs, etc.). But I have had my license for a while, and can't remember if one needs the overt written recommendation of the program director to get a license while in training. I think you don't...I think you just need them to certify that you completed a certain number of years of training.

I disagree with the husband meeting with the program director, or overtly intervening in any way. And I think blonddocteur was being overly harsh with the original poster, who it doesn't seem has a condescending attitude toward his wife. On the contrary, it seems he is trying to be supportive.

I think as a husband there isn't much you can do. Just be supportive, try to take as much of the household/baby care responsibilities off her as you can for the next few months (even if it means getting a cleaning lady and/or relatives to help). Usually as a resident there are things we/she did to get in the situation, but at the same time people become unfairly targeted (i.e. someone sees one or two mistakes or just doesn't like the way someone comes across, and then EVERYTHING become blown out of proportion). I agree with the surgeon's comments above...best for her to continue to work very hard, frequent contact with the attendings so they KNOW she is taking good care of her patients (i.e. it's not just the interns, nurses, other people doing the work, but that she gets credit for the management decisions she participated in and the work she does), be VERY NICE to everyone, ignore the gossip but to defend herself and her decisions in the nicest way possible but without overtly arguing with people (this last one is HARD HARD HARD sometimes).

To the original poster - I agree with you that the evaluation and promotion system in US residencies needs to be improved. I actually think this is true for med school as well. What you have is an evaluation system that is primarily subjective...some of that is unavoidable but it seems that this system could be improved upon. What we have is just too open to bias and all kinds of prejudice and decisions that often just aren't based on facts at all, and that just seems unjust. I know that the AMA resident/fellow section has been working on a report on what they think should be the ideal practices for residency programs, and they are about to publish this. Perhaps it could be a jumping-off point to explore this program. I think most trainees (be they med students or house staff) want to do well and want to improve on whatever deficiencies they have. The problem is that I don't believe that residency programs, or medical schools for that matter, are necessarily well set up to do teaching and/or help trainees with accurately evaluating their strengths/weaknesses or with fixing the latter. It's just easy for them to throw out people rather than trying very hard to actually teach/train people.
 
I agree with you Dragonfly..as usual. I only suggested the husband be present so as to have someone in her corner to verify what is being said in the meeting. Nothing can be more frustrating than sitting in a room with everyone there to slay you only to hear later that NEW rumors are being started as to what was said in the actual meeting. I thought maybe if the PD could see the impact this is having on her family, he/she might realize it's time to start solving this issue. I'm thinking this could possibly be a cultural problem and could be addressed with a meeting of all those involved and maybe this woman could better represent herself if she had some familial support. Now to the OP, I don't mean to be harsh, but it is still possible that your wife hasn't filled you in completely on what is going on, or maybe she truly doesn't see the whole picture. The 'code' for example..she either responded or she didn't....but, maybe she reluctantly shuffled over to the code but didn't really get her hands dirty. A collegue might have viewed that as 'not doing anything' while your wife was thinking...hey, I came to the code. These petty accusations are merely symptoms of what the real problem is. Is your wife shy, quiet? In many countries this is viewed as respectful behavior...and is some..expected..especially for women. In the USA, it is appreciated at times, but woman are expected to take control and handle situations just as well as men..and they do just that. Being assertive and confident is a favorable personality here and it requires some sacrificing on foreign citizens...just as Americans who travel abroad need to mind their p's and q's when in another country. I don't mean for you to take control of the meeting..that would be detrimental. I only advised you be present if it will give your wife the ability to defend herself better. However, I must say I agree with Dragonfly on everything else.
 
Less is more. The less that you try to "manage" the situation, the better it'll be. Take care of your patients, smile, and just do your job.

That said, you do need advocates. One of which should be your faculty advisor. Rather than saying/thinking everyone is a liar, best thing to do is to reflect on whether or not there might be some truth to any of this, ask the advisor if they have the same perception, but more importantly, work on a solution.

Your faculty want to graduate her. And unless there's something really bad going on, they won't. You don't make it to senior resident if there is something really bad, so that's the good news. Just try to survive. The gossip may not go away, but it'll die down.
 
yes it is quite possible that I do not know the very exact truth that happened but look at this:
on a post call day after the usual 28-9 hour she put the note for A Smith in the chart for B. Smith who went home yesterday but the chart was still in the rack. both were her patient. the PGY2 on the team sees there is no note on the A. Smith and sees the chart of B.. smith in the chart rack and looks into it and sees the note is there. normally you would put it in the right chart and go. probably you even do not mention it to your co-resident. She goes to the team attending and says this but never tells this to my wife. at the end of rotation a statement comes from attending that she signs out a patient who was discharged 2 days ago and just because another resident was very good a clinical mistake was not done. when she asks around what is this the truth come out but the chief and PD do not want to hear it and the ex-attending just says oh I did not realize .... I thought it was a sign out. this probably happens because of being tired, not liked and people are looking to find something bad to say. if in one evaluation 3 things like this goes ... then you feel real badly subject of unfairness ....
 
I'm not doubting that there is some unfair behavior occuring. Obviously that small error should have passed without incident. That only supports my opinion that there is a root cause as to why she is being treated in such a way. Residents don't often just pick names from a hat and decide who their not going to like...leave that for the nurses who have nothing better to do. Something has caused the other residents and perhaps the PD as well to feel negative towards your wife. All residents make mistakes but when you are liked by your peers, nit-picking doesn't usually become so prominent...we all do things we regret when we're tired...we get over it and our friends forgive us. Having such a short time left, I do like the idea of your wife giving it her best shot to suck it up and be as friendly as possible and do her work diligently and effeciently. Unless there seriously is a chance of termination..she will finish and put all this behind her soon. Again, I wish the best of luck for you and your wife. It is nice to see you supporting her. Some spouses get into the ole' "you think YOU have it rough?" notion....so I admire you taking the time to look for solutions.
 
Hey Unknown22

Sometimes the program is right in its comments. Medicine is a field which is easy to make small mistakes in. And I agree that people should be notified about thier mistakes. The only problem I have is when the other resident is not chastised for making a mistake similar to the one your wife made. I don't understand that. But it seems that sometimes, a witch hunt starts and we all know what the end is.

There's not much I can add on to what is already said. You've got plenty of good advice. But here's what I would I advise your wife do inorder to avoid being burned stake. Use the info as it best suits you.

1. What is the problem?

a. Obviously the program has some merit in what it is saying about your wife. Rectify deficiencies immediately. It will take a lot of work, and quite frankly on a 30 hour work day, its so easy to goof. But shes gonna have to sweat it out.

b. Furthermore, based on what you're saying, even little things are being twisted. This points to a larger problem. Not that your wife is not an adept physician, but rather someone labeled her as a witch. Is it something she said? Did she make a comment about a faculty member? Was there an altercation between her and someone else? Has she ever expressed a negative opinion about the program? Look into it and see what you can come up with.

2. Meet with the PD
Your wife should do this alone. You shouldn't be present unless your wife has nothing else to loose. Her goals with the PD:

a. Find out what academic problems the program sees her having. Work with the PD to develope a clear cut plan of how she will rectify those deficiencies in performance. It is important that she understand exactly what she must do to move forward. Furthermore, if she has any say in the matter, she should try to set up key rotations where her evaluator is someone will most likely give her the best evaluation and maybe even down the line defend her in front of a comittee. She can justify her choice in certain faculty members to the PD by saying that she learns the most from these people.

b. Remind the PD that she really likes the program and loves to work with everyone there and that she feels priviledged to be there. This is especially important if you found something in 1b. It may well be a misunderstanding that someone misconstrued something your wife said once.

c. You definitely feel that there is something else going on besides incompetence on your wife's behalf which has placed in her this situation. In that case, this is your chance to find out from the PD what it is. However, this must be done VERY tactfully... If can't be done that way, then don't do it. Otherwise the program will see your wife as someone who is making excuses.

d. Are there any problems in her private life? Is there marital conflict. Is she worried about her little one(s)? If there is something in her life which is placing an extra burden on her which other residents do not have then she may choose to let the PD know. Most PD's are sympathetic and understanding. If she's having rough time in her life outside of medicine, maybe the PD has experienced this him/herself. Share that information and let the PD know that she is working on overcomming that bump. But also be careful, because from what you're saying the PD is out to get her. In that case I would share little and just say that things a little tough, but its going to be over.

Well, that's my 2 cents, hope it helps.

GL
 
I work with ADULTS and find this kind of behavior "high schoolish". In fact it is hard to believe but feel sorry for you and your wife.
 
You've already had some excellent advice here. This is what I would add and echo:

- Try not to get personally involved in the politics of this, especially if you work at a completely different hospital.

- If you work in the same hospital, well, you'll have to use your wisdom and good judgement. Meeting directly with those involved specially about your wife's situation will not be considered acceptable. On the other hand, I think you are allowed to judiciously talk about your personal problems and concerns with friends. Remember that gossip does go around (this can either be good or bad depending on what is said).

- Your wife needs to know who her friends are. Who are the attendings who have said positive things? She needs to talk to them, especially those who are good mentors, and ask them for help. Not only can her friends help her correct any true deficits she may have in her performance, they can also go to bat for her in a committee review or meeting.

- She should not meet with only the program director, but with other faculty who can go to bat for her and ask them for help.
 
strongly agree with the husband NOT meeting with the program director. I can't think of any situation under which this strategy would be helpful. At best, he'll make his wife look weak. At worst, he will anger the program director at make things worse.

I agree with her meeting with a faculty member(s) who are sympathetic and think she is a decent resident. I found it helpful to get constructive feedback from these types when I was a resident, and I also blatantly asked one of them what I should do when I was in a situation where the PD was not happy with me. He really helped me see how to handle the situation...not that there was much to do but soldier on. I doubt the resident (original poster's wife) is going to get much help from the program director - if she has been this negative thus far, it will probably be hard to get her to change her opinion, and any discussions may be taken as the resident being "argumentative". It may be best not to stir things up by having more meetings with the program director.

I kind of favor the strategy of trying to work very hard, harder than anyone else, smile a lot and be VERY friendly to everyone from now until she finished. I think she can get through with no major damages (at least external ones) if she isn't officially on probation yet and is already a senior resident.
 
since lots of people are reading this it is good to put my summary on this as I see it ... probably it can help someody else as well ...
but before that ... have to say that I changed a lot of details in a way that it still represents the situation but protect the personal identifiable information but dragonfly is right if somebody is in this situation has to rush to pass step 3 (in case it is still pending and get that license - it means they agreed with lots of your training and you are not in risk of not being a doctor. in fact they have to send the info about you to AMA each year so when you are in year n it mean at least AMA have year n-2 on file and if it is the second half of the year probably even year n-1 they can not take those back so it is a matter of months that you loose not years.

1. I AM NOT GOING TO HAVE ANY KIND OF CONTACT WITH THE PROGRAM UNLESS THE DISCUSSION POPS UP IN AN UNOFFICIAL FRIENDS CIRCLE and I can use the chatter to my benefit ... which is highly unlikely anyway.

2. Fatigue management is so important ... I guess I have to strongly encourage her to leave the kids in the daycare on post call day (which she is not doing!!!) and get sleep. also I agree with 2-3 people who said get some more domestic help ....

3. She has to show with tact her operational and academic presence in the program also she has to show ability to lead the team .... i.e patient management, being nice, being assertive, using EBM, teaching the medical students and interns , being extra nice ....

4. I love the idea of regular meetings with the PD and write down issues and send a follow up email with plans for all of them to the PD and asking feedback .... this is the cornerstone of a possible defend later I think. many people said have an advocate with you in these meeting but this is hard because as soon as you want to have that advocate things get/look much worse - any feed back on this?

5. Ideally try to rotate with the attendings that are likely to defend her later ... but my observation is that as soon as a resident goes toward these kinds of issues the program puts him/her with puppet or inner circle attendings not to have these kinds of problems later.... maybe getting as much as recommendation letters help. FYI: when ever the main program people knew she spoke with somebody they got extremely angry with her over the last 1.5 years that these things going on ... I guess this is a part of liability management on their part. they appointed people that she is allowed "kinda" to talk to about her problems in the program and they come every time with an agenda and impose the meeting agenda and say we are not going to talk about anything else or ... maybe you have problem with authority or ... blah. 😱

6. I totally agree that probably .... may be she contributes to the fact that people are reacting like this and now its out of control .... the question is what the hell it is. your friends usually do not see it and are not willing to tell what they hear ... though it is worthy to try to figure it out from the friends

7. also reading these posts and the termination post, I am convienced that she has to shut up about all the unfairness and less than truthful reports and instead keep being nice and hardworking and in general do a good job in patient management and team management instead. this way her chances of graduation is much higher than telling the truth unless she is about to be terminated then she she no thing else to loose.

by the way since couple of people asked I think her program director is an honest good person who is doing his job within a system that has a lot of problems that takes time to improve one step at a time ... his attitude is ... shoot again there is something else that is very destructive (and probably it is true so do not even go toward saying no it happened this way not that way); but we will team up and get through this and I want to graduate you ... just do not mess up; I can not defend you much more ... well this does not add up with the chief saying why don't you quit .... so there is a big question mark there
 
Last edited:
Agree with your plan.
It sounds like your wife is trying to do too much...I can't really imagine going through residency with a couple of kids...it would have kicked my butt totally. I think women have a lot more "mommy guilt" also...
i.e. a man doesn't feel bad leaving the kids in daycare for a few more hours, but the mom would.

I agree from past experience that sleep is key. If she is tired then it's easier to make mistakes and also to sound annoyed with people.

Agree she should stop trying to point out any problems she sees in the program. Nobody cares what a resident has to say and she'll only get herself into trouble. And stay out of the sights of the chief resident because it sounds like he has it in for her.

It doesn't sound like the prog. director wants her out so I think she can make it if she just tries to stay out of any and all conflicts at work!
 
You've already received a bunch of good advice here. My thoughts are really the same as others. I'm going to be a bit direct here, so either hold on or stop reading:

First, let's be 100% clear. If the story you tell is accurate, then your wife is failing out of her residency program. Don't kid yourself about the seriousness of the situation.

The timeline here is unclear. You mention that this has been going on for 1.5 years, and that she has 8 months left. This doesn't quite add up, as the shortest residencies in the US are 3 years. It's not clear to me if she is a PGY-2 or PGY-3. It's also not clear if she had completely smooth sailing in her PGY-1, or ran into some difficulties / had her training extended, etc. Doesn't really matter for this discussion.

One other very important point: You only know 1/3 of the story. My rule of thumb is there are always three sides to the story -- the resident's side, the "other guy's side", and what really happened. You're only hearing what your wife tells you. Maybe she is truly incompetent. Maybe she really did leave a patient on her signout who went home 2 days ago. I don't know, and neither do you.

Thoughts:
  1. This is your wife's problem, not yours. Yes, I know that any problem my wife has is really mine too, and I'd want to try and fix it. But there are some problems that only my wife can fix, no matter how much I want to help her. This is one of those things. The fact that you are here getting this advice, and she is somewhere else, is a bad sign overall. If she isn't taking this seriously enough to deal with this, then it's over before it started.
  2. But you want to help, right? So what can you do? Well:
    1. Picking up kids post call is absolutely forbidden. No discussion -- she sleeps post call. This is your responsibility to address -- and that means she sleeps without kid noise / interruption. It might mean you picking up the kids after school on her post call days. That might mean cutting back your hours, or otherwise being very flexible with your time. Can you do that? If not, what's more important: your job / career or hers?
    2. Her making dinner, essentially ever, is forbidden in the short term. So is housework, grocery shopping, laundry, etc. This includes getting the kids ready for and to school / day care, and making your lunch. This is now all your responsibility. Do it yourself, or hire someone to do it. Either way, you point out to her that her career is the #1 issue for your household now, and you're willing to make the sacrifices to prove it.
    3. You do this by being 100% clear about this. Anything you can get off her plate comes off, and onto yours. You're clear that you're doing this because you love her and want her to succeed.
    4. Any time this frees up for her is for sleeping or studying. She gets a certain amount of time with the kids every day. Play with them for 30-60 minutes, no more. Sounds tough, and it is, but her whole career is at stake here.
  3. You started this thread with the notion that your wife's performance was fine, but that people were singling her out and blowing things out of proportion. Most likely her performance is actually poor. You hinted that she had trouble with her USMLE's. Although people argue that USMLE performance might reflect test taking abilities, anxiety, etc, my experience suggests that poor USMLE scores are usually represent poor medical knowledge. So, what I "see" here is a resident with low USMLE scores and now multiple poor evaluations from multiple evaluators. Thus, I expect the reason she is getting poor evaluations is not primarily because someone is "out to get her" or that there is something unfair, but in fact is because her performance is poor. The sooner you and she face that, the better.
  4. As others have mentioned, most programs do not make a sport out of firing residents -- it's a huge pain, creates big problems with the schedule, etc. All residents make mistakes. However, your wife is probably making more mistakes, not improving her performance, etc. Then what happens is that someone starts reporting some of those mistakes. Others may make the exact same mistake, but on a background of otherwise doing well. That's why she gets reported, and they don't. This then triggers closer scrutiny of your wife -- it has to, for patient safety. Then, all errors start getting reported. So yes, it's somewhat unfair, but that's life and it's not isolated to medicine -- it happens in every field. If you work at Walmart and your boss finds you goofing off, you're more likely to be inspected in the future.
  5. You do not get involved with her PD. Her PD is her boss. You have no standing here. This can only make things worse. Would you want your wife coming in to talk to your boss about some problems at work? I doubt it.
  6. Regular meetings with the PD are important. She needs to show progress -- making these problems go away.
  7. Many residents who struggle find that some faculty give them horrible reviews, and others seem to give them satisfactory reviews. They wonder how this can be. The answer is usually: 1) some residents perform well in some venues, but not others; 2) some faculty are afraid to give residents a poor grade, despite a poor performance; 3) some faculty are very direct with their feedback (ie. "You did a terrible job with that admission") and some are subtle ("I think you could have had a better differential on that last admission which might have changed your admission plan"). Understand that the second statement, in the right context, could be a serious concern, but many residents will hear that and simply say "OK".
  8. Because of this, many residency programs will try to steer struggling residents to teams with faculty in the "inner circle" -- those who are more critical evaluators who will give honest feedback. This can seem like the resident is being "picked on", and in some ways it's true, but the main purpose is to get clear feedback as quickly as possible which really is in everyone's best interest.
  9. Remember that the PGY-1 to PGY-2 transition is the hardest. The two jobs are very dissimilar -- as a PGY-1 you are usually highly supervised, whereas as a PGY-2 you are much more on your own (and often supervising PGY-1's). The PGY-2 to PGY-3 transition is usually much easier, although PGY-3's end up with even more autonomy. This could explain a satisfactory performance in her PGY-1, with now struggles in the PGY-2+.
  10. Complaining that the system is unfair will only make things worse. The system is what it is. Evaluation of any complex skill will always be subjective -- there will never be a truly objective test for this. She needs to accept this criticism for what it is worth, and improve her performance.
 
aProgDirector said:

First, let's be 100% clear. If the story you tell is accurate, then your wife is failing out of her residency program. Don't kid yourself about the seriousness of the situation.

The timeline here is unclear. You mention that this has been going on for 1.5 years, and that she has 8 months left. This doesn't quite add up, as the shortest residencies in the US are 3 years. It's not clear to me if she is a PGY-2 or PGY-3. It's also not clear if she had completely smooth sailing in her PGY-1, or ran into some difficulties / had her training extended, etc. Doesn't really matter for this discussion.

One other very important point: You only know 1/3 of the story. My rule of thumb is there are always three sides to the story -- the resident's side, the "other guy's side", and what really happened. You're only hearing what your wife tells you. Maybe she is truly incompetent. Maybe she really did leave a patient on her signout who went home 2 days ago. I don't know, and neither do you.

Thoughts:
  1. This is your wife's problem, not yours. Yes, I know that any problem my wife has is really mine too, and I'd want to try and fix it. But there are some problems that only my wife can fix, no matter how much I want to help her. This is one of those things. The fact that you are here getting this advice, and she is somewhere else, is a bad sign overall. If she isn't taking this seriously enough to deal with this, then it's over before it started.
  2. But you want to help, right? So what can you do? Well:
    1. Picking up kids post call is absolutely forbidden. No discussion -- she sleeps post call. This is your responsibility to address -- and that means she sleeps without kid noise / interruption. It might mean you picking up the kids after school on her post call days. That might mean cutting back your hours, or otherwise being very flexible with your time. Can you do that? If not, what's more important: your job / career or hers?
    2. Her making dinner, essentially ever, is forbidden in the short term. So is housework, grocery shopping, laundry, etc. This includes getting the kids ready for and to school / day care, and making your lunch. This is now all your responsibility. Do it yourself, or hire someone to do it. Either way, you point out to her that her career is the #1 issue for your household now, and you're willing to make the sacrifices to prove it.
    3. You do this by being 100% clear about this. Anything you can get off her plate comes off, and onto yours. You're clear that you're doing this because you love her and want her to succeed.
    4. Any time this frees up for her is for sleeping or studying. She gets a certain amount of time with the kids every day. Play with them for 30-60 minutes, no more. Sounds tough, and it is, but her whole career is at stake here.
  3. You started this thread with the notion that your wife's performance was fine, but that people were singling her out and blowing things out of proportion. Most likely her performance is actually poor. You hinted that she had trouble with her USMLE's. Although people argue that USMLE performance might reflect test taking abilities, anxiety, etc, my experience suggests that poor USMLE scores are usually represent poor medical knowledge. So, what I "see" here is a resident with low USMLE scores and now multiple poor evaluations from multiple evaluators. Thus, I expect the reason she is getting poor evaluations is not primarily because someone is "out to get her" or that there is something unfair, but in fact is because her performance is poor. The sooner you and she face that, the better.
  4. As others have mentioned, most programs do not make a sport out of firing residents -- it's a huge pain, creates big problems with the schedule, etc. All residents make mistakes. However, your wife is probably making more mistakes, not improving her performance, etc. Then what happens is that someone starts reporting some of those mistakes. Others may make the exact same mistake, but on a background of otherwise doing well. That's why she gets reported, and they don't. This then triggers closer scrutiny of your wife -- it has to, for patient safety. Then, all errors start getting reported. So yes, it's somewhat unfair, but that's life and it's not isolated to medicine -- it happens in every field. If you work at Walmart and your boss finds you goofing off, you're more likely to be inspected in the future.
  5. You do not get involved with her PD. Her PD is her boss. You have no standing here. This can only make things worse. Would you want your wife coming in to talk to your boss about some problems at work? I doubt it.
  6. Regular meetings with the PD are important. She needs to show progress -- making these problems go away.
  7. Many residents who struggle find that some faculty give them horrible reviews, and others seem to give them satisfactory reviews. They wonder how this can be. The answer is usually: 1) some residents perform well in some venues, but not others; 2) some faculty are afraid to give residents a poor grade, despite a poor performance; 3) some faculty are very direct with their feedback (ie. "You did a terrible job with that admission") and some are subtle ("I think you could have had a better differential on that last admission which might have changed your admission plan"). Understand that the second statement, in the right context, could be a serious concern, but many residents will hear that and simply say "OK".
  8. Because of this, many residency programs will try to steer struggling residents to teams with faculty in the "inner circle" -- those who are more critical evaluators who will give honest feedback. This can seem like the resident is being "picked on", and in some ways it's true, but the main purpose is to get clear feedback as quickly as possible which really is in everyone's best interest.
  9. Remember that the PGY-1 to PGY-2 transition is the hardest. The two jobs are very dissimilar -- as a PGY-1 you are usually highly supervised, whereas as a PGY-2 you are much more on your own (and often supervising PGY-1's). The PGY-2 to PGY-3 transition is usually much easier, although PGY-3's end up with even more autonomy. This could explain a satisfactory performance in her PGY-1, with now struggles in the PGY-2+.
  10. Complaining that the system is unfair will only make things worse. The system is what it is. Evaluation of any complex skill will always be subjective -- there will never be a truly objective test for this. She needs to accept this criticism for what it is worth, and improve her performance.
Click to expand...

This sounds like good advice. I think the most important is to meet with the PD now to figure out what needs to be changed, i.e. do you need to do a better admission note, be more active in patient care? Just the anxiety of not knowing your fate is enough to negatively affect your work performance, I think it reflects poorly on the PD if he/she wants this resident to improve and graduate the residency and be a physician.

HOWEVER, realize that the PD may not be meeting with the resident because he/she feels that your wife will be terminated and that the will put her under "surveillance" not to see if she is incompetent, but to get dirt on her to throw her out.

During a sub-I one resident I knew made up physical examinations without seeing the patient and had a bad approach to doing admission notes, but was golden with the PD and the program and talked in front of residents/students about how excellent she was. Needless to say, if I was "against her" I could have done more than point out that making up physical exams findings is a no-no.

Point being, mistakes are made all the time in medicine and since lives are involved the smallest error could become negligence. I have seen chief residents say and do things that could get them in hot water with the patients and their families. If while on a cardiology elective I filed a complaint against a famous cardiologist for describing his patient as "obese and waiting to die as he/she doesn't care about their health" sure, this could torpedo him/her at the hospital and result in a lawsuit.

In the end, I am sure that the facult can gather enough info to throw just about anyone out of residency, not that difficult. That is why it is important to be nice to everyone you interact with on the floors as people can and will do mean things to you that unjust. Gross incompetence should be addressed, with plan for how to help the resident grow, but realize that being put in a fish bowl likely would lead to exaggeration of small deficiencies.

The residents I have seen who are in trouble have gaping holes in their fund of knowledge, i.e. fundamentals in terms of not knowing the differential and what to do management wise AND also seem to act frivously and nonchalant when commented upon about these things. You must always be hyper and unrealistically responsive to criticism. If somebody says that you have a poor differential diagnosis then you have to really use up-to-date for everything I guess or baby harrison's and make an effort (including the appearance of really sweating the DDx, i.e. don't play it cool).

Nothing pleases an attending more than a student/resident who really squirms after a comment and makes an effort to change, regardless of whether you were 100% successful or not. In the end residency is like an apprenticeship where you have to bow and fawn over the "masters". It helps if you read a lot . . . Knowledge = respect.
 
Last edited:
aProgDirector said:
You've already received a bunch of good advice here. My thoughts are really the same as others. I'm going to be a bit direct here, so either hold on or stop reading:

First, let's be 100% clear. If the story you tell is accurate, then your wife is failing out of her residency program. Don't kid yourself about the seriousness of the situation.


thank you so much APD .... your feedback was like other posts that you place very informative and a shocker to me. Seeing things from the other side of desk is important. I probably will ask some more questions about your comments later. Just wanted to say thanks for now. Also I amy ask couple of things using PM to protect her identity. But I think this thread is very important for who ever have a performance problem. They need to read it early and do what ever is related to their case as early as possible.
Click to expand...
 
This situation sounds FUBAR, as in totally blown. I took the time to actually read your entire wall of text post with the broken English, so you should feel somewhat honored and head my words...

I have seen this exact same thing occur in departments I have been in and my advice is always the same: leave, leave now. I would stage a fighting withdraw for both of you, her to lesser stress 8-5 type residency program and you into an associated (I assume..) internal med dept.

She is not hacking residency, that is apparent. No measure of mental aid & comfort is going to reverse this damage. You need to the load the kids and "get the hell out of Dodge" (look that expression up on google if it is unfamiliar to you..). And dont feel sorry for yourself or her. At this point, this is water under the bridge.

Your only other option is to let her drop out and you support the family for the time it takes her to regroup.
 
surgicalskills said:
Don't try to defend her publicly. It will make her seem weak.
Click to expand...

Hmm, I dont at all agree. I would go out with a bang, maybe knock a mutha f-er out even if it came to that.

I have my own anecdote relating to this, but basically a guy on the other side of the state who I had never met calls me. He said his wife is being torn apart at work (attending level now mind you..) at a place I used to be. He wanted my advice. I said indeed some of my former coworkers were such douche bags that Masengill would call asking for their ad props back..i.e. giant man-sized rubber douches. I told him to tell her to immediately give her 2 weeks notice and go home. Use accumulated sick leave and simple walk the hell off. It wasnt worth it. She found a job shortly after with my help. Problem solved. Giant douche bags deflated and now signing out cases 10+hours a day because they are down 1 person...

The point is many MANY physicians and nurses are douche bags and have no qualms about ripping someone apart, destroying a budding career or simply taking a steaming crap right on a junior colleague (R Kelly premed??). Thats the truth. Eat it up.
 
Last edited:
Tired said:
I'm glad you said this. Seems like every time someone runs into residency difficulties on SDN, it's because they've been "targeted" for no good reason. But based on the little I've seen, residents are usually "targeted" because they suck.
Click to expand...
👎thumbdown👎

Great attitude. You will surely make even a greater doc. Just keep up the same empathy for people who are suffering from different conditions.
 
Realize this: doctor and nurse "empathy" is mostly faux empathy, just like the crocodile..

I keep six honest serving-men
(They taught me all I knew);
Their names are What and Why and When
And How and Where and Who.


Crocodile_Tears.jpg
 
unknown22 said:
Great attitude. You will surely make even a greater doc. Just keep up the same empathy for people who are suffering from different conditions.
Click to expand...

It is important to remember that there are differences between empathy and denial of reality. As others have posted, a lot of what you have said suggests that your wife is performing poorly in residency. I don't think anyone here is taking any glee in the fact that your family is suffering as a result, or that her program is putting excessive pressure on her. But from the residency program's point of view what is the purpose of doing all of this to her without any justification? Programs do not do these things out of spite or out of unnecessary cruelty, or even because they are acting too quickly on misinformation. It is generally because of a pattern of behavior and action (or inaction). Sure, many of the things she is being blamed for may be misunderstandings or unfair, but are all of them?

I have seen a lot of residents in my program who complain about things being unfair, or being railroaded, or whatever. But to be honest, the general reality is that it is the resident who is being inflexible or acting inappropriately. While it is the program's responsibliity to make sure that the resident is progressing and learning and working as a team member, it is also the resident's responsibility to improve and progress. It is a huge responsibility to certify a physician as ready to practice independently. Not everyone can. How much should programs do when what they are doing isn't working for one resident despite it working for others? Part of learning to be a physician is learning how to handle adversity, how to juggle responsibilities, and how to deal when things aren't going well.

To me, from what you have posted, it sounds as though she is having major difficulty in juggling work and homelife. You say a lot of that is because that is how she is, and she wants to do all of this. But if she can't handle it all, what are you doing about it to help her?
 
LADoc00 said:
Realize this: doctor and nurse "empathy" is mostly faux empathy, just like the crocodile..
Click to expand...
LADoc00 said:


Well, it seems you already made it :laugh:

.... eventhough you where rude and sounded empty in your posts, I did not take it personally ...
PS: My lord, I am really honored for your words of wisdom
One thing is sure: we have very different personalities.

So, I guess we had a good brainstorming session here, despite couple of aggitators 🙂 ... I got lots of good ideas .... thanks for the contribution. I do not think if I check back. Trying to leash my tendency to get addicted to the cyberlife.
Click to expand...
 
unknown22 said:
👎thumbdown👎

Great attitude. You will surely make even a greater doc. Just keep up the same empathy for people who are suffering from different conditions.
Click to expand...
Empathy for those who are suffering, while important, isn't what makes a great doctor. Skill and judgment make a great doctor. Kindness isn't what got you through residency, your abilities did - just like they will for Tired, and for me - and hopefully for your wife if she can take the advice offered here and turn it around.
 
I *almost* got booted from med school yr1 for claiming empathy was completely overrated and caring was useless, the only thing that mattered was results.

I actually got sent to the Dean who only pardoned (from double secret probation mind you..) me only once I informed him I was a budding pathologist.
 
Unknown, I feel for you and your wife. While she probably did contribute initially to the problem (perhaps her home responsibilities created a perception that she was not as dedicated as other residents??) it seems as though she is now being scrutinized unfairly. This is the snowball effect of residency, and it cuts both ways. If you are generally well-regarded and you make a mistake, people will stick by you. If you are not well-regarded and you make the same mistake, it will be yet *another* example of how you are a screw-up. Med students and young interns/residents take note: it is crucial that you build a reputation as a hardworking, competent, team-player, b/c when the s*** hits the fan, this is what people will remember. This is the unfortunate truth of how residency works. It is unfair, but you have to play the game. Good luck, Unknown.
 
unknown22 said:
aProgDirector said:
You've already received a bunch of good advice here. My thoughts are really the same as others. I'm going to be a bit direct here, so either hold on or stop reading:

First, let's be 100% clear. If the story you tell is accurate, then your wife is failing out of her residency program. Don't kid yourself about the seriousness of the situation.

How is she doing now? How is your wife? The advises helped?

thank you so much APD .... your feedback was like other posts that you place very informative and a shocker to me. Seeing things from the other side of desk is important. I probably will ask some more questions about your comments later. Just wanted to say thanks for now. Also I amy ask couple of things using PM to protect her identity. But I think this thread is very important for who ever have a performance problem. They need to read it early and do what ever is related to their case as early as possible.
Click to expand...
Click to expand...
 
You must log in or register to reply here.

Similar threads

whatsthepoint
  • Locked
I am in the wrong program. Can I leave?
Replies
1
Views
1K
GoSpursGo
GoSpursGo
Saddleshoes
The WELCOME to your new program???
Replies
8
Views
3K
Top Gun
Top Gun
G
SDN Article: The Importance of Internal Appeal Mechanisms
Replies
1
Views
877
comp1
C
T
What medical specialty has the least amount of "office politics" in residency and attending?
Replies
12
Views
1K
Neuronix
Neuronix
M
Program expansion question
Replies
6
Views
2K
NotAProgDirector
NotAProgDirector
Top