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Your friend. Punched. Your program director.

And... is now "concerned". Hospital board? Kicked out of the program? STFU. Oops. Me so sorry.

I got 5 on jail time. Wasn't this on Gray's Anatomy last night? I love it.

Well, whatever the outcome, I bet neither of the two of them will act like this ever again. Please keep us updated. I love this kind of stuff.
 
Recently one of my colleagues who is an Surgical Intern, was in a physical altercation with his Program Director. It was not intentional, and the two do not have a history of bad blood. It is a long, complicated story, but basically, my colleague needed off in order to see his friend, who is very sick in the hospital. The program director took his time with getting back to my colleague..almost a month! My colleague ended up confronting his director as to what was taking so long and if he had any idea of possible dates. My colleague has been "dicked around" by his director before, and during the confrontation my colleague got very frustrated, and ended up punching his director. There has never been any ill will between the two, nor was there any malintent in terms of the confrontation.

I'm a bit confused about how you can unintentionally punch someone... and what on earth do you mean about there being no "malintent"?

This has to be a joke trying to reinforce all our negative stereotypes about surgeons, right?
 
^ He didn't have the intention of punching him when he went and spoke with him him. He intended to try and sort of what exactly was going on in terms of being able to get the days off. He got frustrated, and in turn lost his cool and punched his director.
 
I'm just seeking opinions as to what anyone thinks may happen. Nothing more, nothing less.
 
I'm just seeking opinions as to what anyone thinks may happen. Nothing more, nothing less.

Probably be up to the PD, maybe the PD will feel that he did get into a fight with the intern, and although physical violence is never excusable, realizes that he was part to blame for getting into a fight.

But I doubt it if the PD decided to bring it to the hospital board. The hospital board probably will now revoke privileges for the intern and he won't be allowed on hospital grounds.

If the intern decked the PD, i.e. clench fist and fell to the floor then I guess he would be fired that day. But what about a light slap to the face without a closed fist?? Both unexcusable, but different I guess. I have been hit by an attending and was shocked even though I wasn't decked, but attendings can get away with more than interns . . .
 
Do you think it is possible that he may just be put on probation, or even perhaps just suspended for a few days?
 
Just when I thought I'd seen it all here...

...I'm proven wrong.
 
Yeah... likewise. Dude, he freaking punched his program director in the face. Somehow "it's OK, they're surgeons" doesn't compute.

A diagnosis of Alien Hands Syndrome is his only shot.
 
I have been hit by an attending and was shocked even though I wasn't decked, but attendings can get away with more than interns . . .

Really? Were they joking - like a light slap, and have you all joked in such a manner before?

I mean it is assault AND battery in EVERY state. It is a felony in EVERY state. It is at the least aggravated assault, unless plea bargained down if you have witnesses. If you had witnesses or if there were hospital surveillance cameras - a police report should have resulted in an arrest.

Did you have witnesses?
 
Really? Were they joking - like a light slap, and have you all joked in such a manner before?

I mean it is assault AND battery in EVERY state. It is a felony in EVERY state. It is at the least aggravated assault, unless plea bargained down if you have witnesses. If you had witnesses or if there were hospital surveillance cameras - a police report should have resulted in an arrest.

Did you have witnesses?

I doubt there was footage, it was a hallway, it was mean when I was being yelled at, hurt some, actually later I was like "oh yeah, that was harder than I thought". Much more than a slap, more like a punch. I don't think there were witnesses, but only fellow students who probably wouldn't want to stick their neck out if there was. It wasn't so much the physical discomfort, but realizing that some attendings don't value you as a human being on the service. Impossible to prove unfortunately. I told another faculty member, and it was like no big deal, i.e. "he does that." ??? I thought it was wrong, but to them it was just high school locker room high jinx I guess? Made me feel stupid for bringing it up. It never plays to complain, especially up the chain of command . . . I have seen this before too, at another hospital, between a senior resident and intern. Point being, while I wouldn't do it, it is more or less OK to punch/twist arms of a subordinate according to some attendings. This is what "laying on the hands" really means . . . anybody in medicine a long time realizes this.
 
Probably be up to the PD, maybe the PD will feel that he did get into a fight with the intern, and although physical violence is never excusable, realizes that he was part to blame for getting into a fight.

But I doubt it if the PD decided to bring it to the hospital board. The hospital board probably will now revoke privileges for the intern and he won't be allowed on hospital grounds.

If the intern decked the PD, i.e. clench fist and fell to the floor then I guess he would be fired that day. But what about a light slap to the face without a closed fist?? Both unexcusable, but different I guess. I have been hit by an attending and was shocked even though I wasn't decked, but attendings can get away with more than interns . . .

I am still a bit surprised at this. I have heard of various different abuses in residency - push ups etc. But am surprised at physical assault --- simply because it is so dumb. Dumb in the sense that it can land you in prison - not jail - since it can be a felony.

Residency is not like normal work environments - but seriously folks, do not assault people in a work environment. With a felony you will lose your license and you can end up living with guys for whom assault is a daily routine - guys who are real good at it, and who certainly won't respect your attending status. Guys who don't feel submissive because they are only residents. Guys who will tell you to shove your attending status up you a** - and while you are busy shoving things up your a**, they can give you some other tall orders to shove too.

Felony assault charges are serious business
 
I agree with Doowai (what! law of probability means it has to happen sometime, right?).

Darth, that is seriously weird and unfortunate. I can't believe an attending doctor was so angry at a medical student he bawled you out in a hallway and then socked you. And then you complained about it to other academic staff responsible for your clerkship and they brushed it off? Seriously beyond the pale.

At the very least, you could mention it to the clerkship director at your medical school, so that they avoid sending med students to that site for that specialty. Losing rotating students = losing dollars, and that will wake up the other staff at the hospital if they remain unmoved by things like ethics, the law and human decency.
 
Do you think it is possible that he may just be put on probation, or even perhaps just suspended for a few days?

If an attending surgeon did this, they at worst would be put on "probation" like in the case of a surgeon in the OR, punching an "incompetent intern" in the back later. The hospital figure the surgeon knows what they are doing and the intern deserved it and shouldn't probably be in medicine and they wouldn't want to lose such a great surgeon and the "punch" wasn't as bad as what the intern says.

If an intern punches a surgeon who happens to be the Program Director that is an automatic firing if brought to the hospital board as nobody wants to have a surgeon quit if they feel "unsafe" in the hospital. If a janitor punches a surgeon they would be fired that day. The hospital review board will have to fire the intern . . . by bringing it to the hospital review board the program director is saying go ahead and fire him.
 
I am still a bit surprised at this. I have heard of various different abuses in residency - push ups etc. But am surprised at physical assault --- simply because it is so dumb. Dumb in the sense that it can land you in prison - not jail - since it can be a felony.

Residency is not like normal work environments - but seriously folks, do not assault people in a work environment. With a felony you will lose your license and you can end up living with guys for whom assault is a daily routine - guys who are real good at it, and who certainly won't respect your attending status. Guys who don't feel submissive because they are only residents. Guys who will tell you to shove your attending status up you a** - and while you are busy shoving things up your a**, they can give you some other tall orders to shove too.

Felony assault charges are serious business

People physically assault subordinates *all the time* in medicine. You have to decide if you want to destroy your career as a student or resident by reporting someone above you for a "felony" or whatever it is for punching people. Seriously.

My arm will feel better in a day, but boy will you be in a world of pain if you try to get an attending in trouble. I would never, ever inflict physical pain on someone, it is immoral and unjustifiable. But many punk ***** attendings apparently grew up on the wrong side of town and are physically aggressive and hurt people. I had a nurse yank my arm and twist my wrist once too, but I felt confident enough to verbally reprimand her, twist my wrist out, and walk away. Not so easy when you are low on the totem pole.

The attending who hit me made open complaints before this incident about how the institution was going to fire him, so he knew it was wrong, but didn't care. Today, even if an attending punch me in the face I wouldn't report it unless I was really roughed up, i.e. blood and broken nose and there were half a dozen witnesses. Period.
 
I doubt I would have mentioned to the PD. And at the time I don't think its a good idea to make threats like "I will sue you", or "I will call the police". I would simply later go to security with the time it happened and see if they had footage. If so I would get a copy, call the police and make an arrest. As a medical student there is not much retribution you would face.

Or get a copy of the film and hold it over them - see whose doing push ups then hahahaha

Ok just kidding.

I would simply say - thank you sir may I have another sir
 
If an intern punches a surgeon who happens to be the Program Director that is an automatic firing if brought to the hospital board .

Only an automatic firing if there were witnesses or if everyone involved tells the truth about the matter. If the intern lied about the matter, said he was shoved by the PD first, he might get away with it, especially if the intern is an underrepresented minority and the PD is a white male (in which case discrimination could be alleged).

There is no honorable way out of this for the intern, but there are ways out (not that I am recommending them).
 
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I think the intern will be fired.
Agree with drrack somewhat, though.

As far as Darth's situation, I am actually pretty shocked...well, at least a little. I was at one hospital where people were pretty malignant, and I have been publicly dressed down, and yelled at, even cussed at on occasion, and seen it happen to others, and seen surgeons scream at interns and throw surgical instruments, but never seen anyone hit someone else. Unfortunate that this behavior would be tolerated...I honestly don't think attendings or senior residents should be able to swear AT people either, but physical assault should definitely be stopped. That's something objective that you can say is off limits. With yelling, etc. you can always have one person saying they had a slightly raised voice, the other one saying "You were screaming and yelling at me!" and some of it may be perception. Hitting is hitting, though.
 
RE: physical altercations

We had a resident strike a medical student. She was placed on probation and sent for anger management counseling; unfortunately, most of her co-residents thought she should be fired because this really was the culmination of a rather obvious personality disorder. From the PD's POV, it can be difficult to fire a resident. If the OP's friend had other issues during the year which were documented (which it sounded as if this was the case, if you read between the OP's lines), it may not be that difficult to let him go. At the very least probation with anger management seems to be in his future if he is contrite and the PD forgiving.
 
Darth, that's completely crazy! 😱 I'm so sorry you had to go through that, but I honestly cannot imagine a scenario where an attending (or anyone for that matter) would touch me at all in any kind of harmful way and I didn't do something about it...(big scary guy meeting them in a back ally for a can of whoopass:laugh:) I know you might feel scared but I just couldn't let that go.
I would at least bring it to your school's attention, either an advisor, the clerkship director or your dean. Someone has to listen because that could really be big problems for them legally if they refuse to do something about a technically unsafe working/learning environment.
I don't know where you go to school and how supportive you feel your administration is, but at my school I could think of several people who would back the students up in a situtation like that.
 
People could go nuts on me and puts and kick all they want and I wouldn't respond. Defensive gestures at best to protect the eyes/face and the testes... but that's about it. Fortunately, it takes a lot to do any damage to me.

It is a lose-lose situation if an average (or larger) male strikes another person (male or female) in our profession. Especially if it is obvious that the person being attacked has other options. Unfortunately, if an average male connects with a punch or kick on another, it is going to cause damage. Thus DarthNeurology made the right choice.
 
so for all you mensches, he was NOT kicked out of his program, and is just on a "probation period", which entails him to be watched more frequently then what he used to. basically his work is triple checked, etc. he has to be on his A game at all time. he has always been on his A game before, so I have no worries. thank you for all your input though, as it was much appreciated.
 
basically his work is triple checked, etc. he has to be on his A game at all time.

Great plan. Monitoring his progress notes for clues of impending attacks on the attending...?
 
so for all you mensches, he was NOT kicked out of his program, and is just on a "probation period", which entails him to be watched more frequently then what he used to. basically his work is triple checked, etc. he has to be on his A game at all time. he has always been on his A game before, so I have no worries. thank you for all your input though, as it was much appreciated.

Except for the time he physically assaulted his program director, right?
 
Wow, I can't believe he wasn't kicked. I wouldn't want someone with that little control over their emotions/actions to be my doctor.

*shrug* Wish him well I guess. Everyone gets one free ticket/mulligan...he just got his.
 
Some of you guys are so rude. I've known this guy for a long time, and his control over his emotions have always been unwavering. He was upset for what I believe is a legitimate reason; the fact that his friend is dying in the hospital, and his program director does not care to try and rearrange my friends schedule so that he can visit his dying friend in the hospital. I do not approve of the way the situation was handled on his part, and I told him that. He does feel great remorse for what he did, and he is obviously not proud of it. It was just a reaction to tension that had been building up over time. He made a mistake, as ALL of you have done during your lifetime. I'm sure MOST, if not ALL of you have felt the emotion of wanting to strike someone because of something they had said or done. I give my friend A LOT of credit for what he's done in his career, and I think that anyone (interns, residents, dr's) who have accomplished what my friend has, deserves an exuberant amount of respect.
 
Except for the time he physically assaulted his program director, right?

yes, this is correct. it's not like he doesn't think that what he did isn't wrong. he is very regretful for his actions and the shame he brought upon himself.
 
so for all you mensches, he was NOT kicked out of his program, and is just on a "probation period", which entails him to be watched more frequently then what he used to. basically his work is triple checked, etc. he has to be on his A game at all time. he has always been on his A game before, so I have no worries. thank you for all your input though, as it was much appreciated.

I'm glad he wasn't kicked out of the program and I suspect it has more to do with the fact that he's a Preliminary Surgery resident and not someone they were thinking about keeping around for 5-7 years. They keep him on probation until June 30th and then he's gone anyway (I'm not sure where you got the idea that he was done in May, that would be a full 2 months before the end of internship).

As a pre-med, you probably don't understand residency training, especially surgical training. I suspect your friend wasn't being truthful when he told you he was "always on his A game before", or perhaps his "A game" wasn't good enough. After all, you told us that he has had run-ins with the PD prior to the physical assault (ie, he had been "dicked around" by the PD).

Secondly, what surgical resident asks for a day off to go to the doctor? Unless he had an acute problem (where he belongs in the ED), doctor's appointments are to be done on your post-call days, vacation, weekends, etc. Its one thing to ask for a weekend off to go visit a very sick friend, but to ask for a middle of the week day off for personal activites is beyond the pale in most surgical training programs. I sense that your friend did not recognize this and tried to take advantage of it. Many surgical programs do not allow personal days - whatever you need to do outside of work is done on your own time, no special days off allowed.

Although you've deleted your original message, I recall enough of it to wonder about how much of a team player your friend was. This is not uncommon with Prelim residents on General Surgery, especially those going into non-surgical fields. They get the impression that the schedule is much more flexible than it really is or that they have some control over it.

Not letting him off for personal things is not about how much coverage they have or whether or not the hospital can afford it (costs are fixed regardless of how many days per year your friend works) but rather I suspect he wasn't well liked by the PD and perhaps by his colleagues (who generally are the first to step up and cover the call schedule for any fellow resident who has a dire need to be off) so no one had any impetus to help him out. Residents who work hard and are well liked are almost always treated well when they need a favor.

The story your friend told you just doesn't add up. As much as we like to paint a picture of evil faculty who are looking for every possible angle to screw residents, most of the time when they do screw residents (and I know that happens) its for a reason..not for the sheer joy of f'ing with someone. Is it not possible that the PD forgot about your friend's request? Or perhaps your friend had a history of trying to get extra days off and the PD simply saw this request as yet another excuse to get out of work. As crass as that sounds, people who cry wolf a lot don't tend to be believed when an honest excuse comes up.

Finally, your friend has at least 1 day off each week and in some programs you get a full weekend. Why couldn't he had used that time to see the dying friend? I'm not saying that the program shouldn't have given him time off, but his first choice should have been to ask them to rearrange the call schedule so that he could use a weekend to see the friend.

Physically assaulting someone is NEVER ok. Have I felt like it? Not at work and believe me, I have a very high maintenance patient population. I've felt like yelling at them, but hitting someone, especially someone in a supervisory position is beyond the pale. He should thank his lucky stars he has a job today.

IMHO, he's lucky he wasn't fired or sent to anger management and was just put on probation.
 
Some of you guys are so rude. I've known this guy for a long time, and his control over his emotions have always been unwavering. He was upset for what I believe is a legitimate reason; the fact that his friend is dying in the hospital, and his program director does not care to try and rearrange my friends schedule so that he can visit his dying friend in the hospital. I do not approve of the way the situation was handled on his part, and I told him that. He does feel great remorse for what he did, and he is obviously not proud of it. It was just a reaction to tension that had been building up over time. He made a mistake, as ALL of you have done during your lifetime. I'm sure MOST, if not ALL of you have felt the emotion of wanting to strike someone because of something they had said or done. I give my friend A LOT of credit for what he's done in his career, and I think that anyone (interns, residents, dr's) who have accomplished what my friend has, deserves an exuberant amount of respect.

I'm glad your friend isn't kicked out. If everything you've said about him is true, then I'm sure he'll put this incident behind him and have a fine career.

But have some perspective here. You brought this story to a message board full of people that are either about to, are going through, or have gone through the exact same type of training and stress that your friend is going through. Every single one of us has personal or family issues that go on during internship and residency, but not a single one of us has ever dealt with those issues by striking our program director.

I imagine you posted this story because you wanted advice from other folks in medicine about how he should handle it, because if you posted it looking for sympathy then you're in the wrong place.
 
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You can't assume you'll be granted ANY personal time off as an intern.

There was an IM intern whose sister was sick in the hospital, on pressors (sepsis) and it was touch and go whether she'd survive vs. not, and our program director wouldn't let her off to go see her sister, even though another member of the IM house staff had offered to cover for her. She was on an MICU rotation, but still...her sister seriously could have died, apparently was close to death at one point. And by the way, this intern was the nicest woman out of all the interns in my class, so it wasn't a matter of "not being liked". Some programs are just that old school that they pretty much won't let someone off for ANY reason. Perhaps the PD truly didn't understand the gravity of her sister's illness, but to me this was just cruel...he is a pretty insensitive person though, IMHO (though well intentioned) so it didn't particularly surprise me.
 
You can't assume you'll be granted ANY personal time off as an intern.

Exactly.

There was an IM intern whose sister was sick in the hospital, on pressors (sepsis) and it was touch and go whether she'd survive vs. not, and our program director wouldn't let her off to go see her sister, even though another member of the IM house staff had offered to cover for her. She was on an MICU rotation, but still...her sister seriously could have died, apparently was close to death at one point. And by the way, this intern was the nicest woman out of all the interns in my class, so it wasn't a matter of "not being liked". Some programs are just that old school that they pretty much won't let someone off for ANY reason. Perhaps the PD truly didn't understand the gravity of her sister's illness, but to me this was just cruel...he is a pretty insensitive person though, IMHO (though well intentioned) so it didn't particularly surprise me.

That's very unfortunate. My experience has been that well liked residents are usually given the benefit of the doubt, but obviously there are restrictions on what can be done. It sounds as this PD was pretty insensitive, because most PDs recognize that making their residents happy goes a long way towards a stable program.
 
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