I failed to obtain a spot in the SOAP and need some advice. I am an US IMG graduated from a Caribbean med school in 2018 and started FM residency in 2018. However after 6 months, i had to resign due to medical issues. It was too late to apply for this year's match so i only did the SOAP and obviously failed to get a spot. I do not want to give up my dream of becoming a doctor and desperately want to reenter residency. Do I have any chance of matching into any residency next year? What are some things I can do to strengthen my application to increase my chances? Is quitting one residency a huge red flag that simply cannot be overcome? How do I explain why I quit to program directors? How does funding work for residents who quit halfway; does it count as a year of funding lost?
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Does your previous PD support your application? Did you get LORs from your prior attendings?
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Sorry but your story doesn't make much sense. You started residency in July of 2018, had to resign due to medical issues in December of 2018, and now 3 months later in March of 2019 you are all better and trying to get a new spot??!
I can't think of (m)any medical issues that fit that timeline. Maybe acute psychosis?
I can't think of (m)any medical issues that fit that timeline. Maybe acute psychosis?
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What did your prior PD say about your situation? Now is the time to ask bluntly if he supports you finding another FM spot. Would he consider taking you back if the medical issues are cleared? While the letters are waived, you should be talking to your letter writers and at least get a feeling if they can write you a GOOD letter.
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Then why did you resign and not just take FMLA for a medical leave?
As said above, you are
Not giving us the full story...and as thoracic guy had asked twice, is your PD supportive of you? That will make a big difference.
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So here's the thing. I remember your post from the PHP thread. You may have resigned due to the medical issues, but it was also because your PD wanted to seek help from the PHP. Frankly, without knowing the whole story, I probably shouldn't say this, but I don't blame you. I wouldn't want to go to PHP either as many have been alleged to be corrupt, to the point that lawsuits are filed and news stories are done about them. That said, you're going to have to explain this and you likely weren't able to do so in the SOAP. You need to talk to your former PD and see if there's any chance he/she will support your application. If not, it's going to be tough because it just looks bad that you resigned instead of going to the PHP, so you'll have to have a good reason, maybe even make it the center point of your personal statement, OR find a PD who understands the news circulating about PHPs.
Thanks for everyone's advice. I failed to obtain a spot in the SOAP and need some advice. I am an US IMG graduated from a Caribbean med school in 2018 and started FM residency in 2018. However after 6 months, i had to resign due to medical issues. It was too late to apply for this year's match so i only did the SOAP and obviously failed to get a spot. I do not want to give up my dream of becoming a doctor and desperately want to reenter residency. Do I have any chance of matching into any residency next year? What are some things I can do to strengthen my application to increase my chances? Is quitting one residency a huge red flag that simply cannot be overcome? How do I explain why I quit to program directors? How does funding work for residents who quit halfway; does it count as a year of funding lost?
Here is what happened to me: I greatly apppreciate any advice. thanks
We all know that suicide rates are increasing every year among medicine residents, especially interns. The new challenges, long hours, and drastic increase in responsibilities can overwhelm many interns, even those without any psychiatric history. This is why program directors, psychiatrists, and other healthcare providers do not take even passive suicidal thoughts lightly and strongly encourage residents to seek help and to be proactive in preventing suicide. However, the terrible consequences of seeking help are unspoken. Suicide rates are so high because we all know there are dire consequences of admitting we need help, admitting we are vulnerable, admitting that we might be suffering from depression. We are expected to be perfect and even if we are not, to pretend nothing is wrong and most importantly to “hide” our weaknesses. Thus, most residents burry these negative feelings, pretend nothing is wrong until its too late. These suicides could have been prevented if help was encouraged without consequences, without violation of one’s privacy, without holding interns to such high standards that one tiny mistaken cannot be forgiven.
Unfortunately, I have first-hand experience of the severe consequences of admitting to be vulnerable, of being proactive in seeking help, trying to improve my performance, and than suffering the horrible effects. This “nightmare” all started when I when to my program director and advisor, asking for academic help because I “thought” I was not performing up to the standards I was “expected” to. I was told that I was wrong, that my academic performance was on par with other interns. No academic deficiencies were bought to my attention. Instead, they said I was depressed, which is why my judgment is colored; why I had such negative views of myself. They are not wrong and I am not disagreeing. However, my personality is simply that I tend to have low self esteem and lack confidence in myself. It does not mean I have a mental impairment, or that I suffer from MDD. But because the field of medicine tends to attract highly confident individuals, they jumped to the conclusion that I must be “depressed.” Not all interns are the same, I know I am an abnormally among the masses of overconfident people that flock to the field of medicine.
They convinced me that I must be depressed and pressured me into seeing a psychiatrist. I was told that my “issues” would remain private between my psychiatrist and I and that the program would fully support me. I was never told that I would be penalized; not be allowed to return to work if I was ever hospitalized for a psychiatric issue. Naively, I agreed and started seeing a psychiatrist and was started on medications, which I admit did help me. I did feel like I was performing better in residency. However, unfortunately, due to a lapse in judgment, I made the horrible mistake of telling my psychiatrist I had passive suicidal ideations. This was during time clinic in which I was “bored” because we had no patients and I was a bit tired/stressed because I had not had an off day in over a week. Immediately, I realized my mistake; my thoughts were passive, transient and fleeting and I was never going to act on them. Subsequently, I tried to retract my statement, tried to convince her that I was 110% not going to harm myself or anyone else. And I never did. My “crime” was that I stated once that I had suicidal thoughts.
The consequence of this was that my psychiatrist called my program director and they both convinced me to meet the psychiatrist in her office, even after I repeatedly stated that I was fine, I had no suicidal thoughts anymore. Those thoughts happened hours ago, and I had shown no signs of harming myself. (side note- I had one suicidal thought at around 2pm and by 530pm, I was still sitting in clinic and was completely fine. If I had truly wanted to hurt myself, wouldn’t I have attempted already? ) Regardless, I was forced to go to the psychiatrist office. Perhaps due to a terrible misunderstanding, my psychiatrist “believed” that I was going to hurt myself and called 911. I do not blame her, she was simply “doing her job,” but this unfortunate situation should have been avoided. I was unrightfully and wrongfully hospitalized; I did not receive a proper psychiatric evaluation in the ED. One ought not be hospitalized just base on one psychiatrist’s opinion. Psychiatry is an extremely subjective field which requires multiple evaluations before something as serious as admitting someone to a psychiatric unit.
This was when my “nightmare” began. Two police officers arrived armed with guns and bulletproof vests. They treated me like I was a criminal, acted as if I had just committed a horrendous crime. Of course, I am not proud to admit that I started crying which definitely did not help the situation. Maybe if I had acted cool, calm, and collected, things would have turned out differently? I was forced into the ambulance, strapped down and bought to the hospital ER against my will. Once in the ED, I was treated like a criminal. I was stripped of my clothes and of my belongings. Someone was assigned to watch me at all times. I was not provided with the standard of care that all patients deserve.
No one even asked me “what was wrong? Why was I bought to the ED? How they can help me?” Aren’t those the first questions, we are taught to ask a patient, to ask open-ended patient centered questions to help the patient? No one was willing to listen to my side of the story. Instead, no one listened to what I had to say, they assumed I was “crazy” because I was labeled as a psychiatric patient. I did not even receive a proper psychiatric evaluation. All patients deserve a second opinion, especially if they were bought to the hospital against their will. Instead, I was forced to sit in the ED for hours and no one told me what was going on. Finally the night on call psychiatrist came to talk to me. He told me he was not here to evaluate me, not here to determine whether I deserved to be admitted or discharged. He said my psychiatrist had called the head of the department and he was told to not discharge me. However, he did not admit me to the psychiatric unit. Instead he told me that I would have to wait until the morning when a team of psychiatrists would come to evaluate me to determine whether I meet the criteria for admission. The next morning, no team came. Instead I was forced to sit in the ED where no one updated me on what was going on. My psychiatrist finally came and gave me no option but to either be involuntary or voluntary admitted. Without any way out, I dumbly agreed to be voluntary admitted to the psychiatric unit. Retrospectively, I should have stood up for my rights, demand a proper psychiatric evaluation and not give in so easily. Adding to the inappropriateness of my admission, by this time, I had spent greater than 24 hours in the ED and I had display no signs of hurting myself or others and I had no suicidal thoughts or statements. Clinically, I did not meet the criteria for psychiatric admission. My dumb transient suicidal thought was obviously long gone.
Long story short, I was sent to the psychiatric unit, where I was treated like a “criminal” It was by far the worst experience of my life. Nothing in residency compared to the level of anxiety that I experienced, to how overwhelmed and stressed I was. However, I was able to handle it. Throughout my admission, I had no suicidal thoughts or statements and displayed no signs of suicide. It was obvious that I did not need to be hospitalized. Hospitalization did not benefit me and simply made things worse for me. The decision to hospitalized me was made too hasty, without evaluation by multiple professions and unethical and without consideration for my wellbeing.
After discharge, my psychiatrist told me that she would write me a note to clear me to return to work the following week. I convinced myself to forget all the negatives of this terrible experience and to try to see the “silver lining in the dark cloud.” Surviving psychiatric hospitalization did make me realize that I can overcome difficult situations. I won’t break down under stress. I will be able to handle anything that comes my way during residency, because nothing can be as difficult, as overwhelming, and as anxiety provoking as this.
Sadly, my tragic story does not end here. I was told that I was not allowed to come back to work without participating in one specific lengthy and costly program (PHP programs, which are alleged to be corrupt and have had several lawsuits against them) that required me to sign an unreasonable lifelong contract with them that involved indefinite monitoring, which would undeniably taint my career forever. This seemed irrational given my actions and this program was more fit for people who committed actual crimes, who harmed a patient, who endanger the lives of others, etc. They refused to allow me to get evaluated by any other psychiatrist even after I saw another different psychiatrist and agreed to continue “treatment.” The administration did not take into the circumstances of my hospitalization. I did not commit a horrendous crime. All I did was made ONE statement that I had passive suicidal thoughts. I do not deserve to endure such a lengthy process to be able to return to work. I do not deserve to be treated as if I have an impairment that would hinder my ability to perform my duties. To add to the unfairness of all this, before my hospitalization, there were never any complaints against me. I was never told that I was incompetent or unable to perform my duties. I was performing on par with the rest of my class. This is a case of employee discrimination. I was mistreated and with all those involved being “physicians who never admit any wrong”, no one was willing to admit that this whole thing was a mistake that should have been avoided.
I sincerely regret my mistake. I wish I could take back my words. But I cannot change the past; I can only look towards the future. It is too late of me. One dumb mistake ruined my career. I can only hope my story will enlighten future/current residents on how costly admitting to weakness can be and how tenuous one’s place in residency is. I also hope that in the future, the administration will consider supporting and protecting the privacy of residents who seek help, instead of making life more difficult and challenging. I believe this will encourage more residents to seek mental health help and will result in a decrease in suicidal rates among medical residents. Unfortunately, it is difficult to change the culture of medicine, but I hope slowly, with time, some changes can be made to benefit the wellbeing of residents.
Here is what happened to me: I greatly apppreciate any advice. thanks
We all know that suicide rates are increasing every year among medicine residents, especially interns. The new challenges, long hours, and drastic increase in responsibilities can overwhelm many interns, even those without any psychiatric history. This is why program directors, psychiatrists, and other healthcare providers do not take even passive suicidal thoughts lightly and strongly encourage residents to seek help and to be proactive in preventing suicide. However, the terrible consequences of seeking help are unspoken. Suicide rates are so high because we all know there are dire consequences of admitting we need help, admitting we are vulnerable, admitting that we might be suffering from depression. We are expected to be perfect and even if we are not, to pretend nothing is wrong and most importantly to “hide” our weaknesses. Thus, most residents burry these negative feelings, pretend nothing is wrong until its too late. These suicides could have been prevented if help was encouraged without consequences, without violation of one’s privacy, without holding interns to such high standards that one tiny mistaken cannot be forgiven.
Unfortunately, I have first-hand experience of the severe consequences of admitting to be vulnerable, of being proactive in seeking help, trying to improve my performance, and than suffering the horrible effects. This “nightmare” all started when I when to my program director and advisor, asking for academic help because I “thought” I was not performing up to the standards I was “expected” to. I was told that I was wrong, that my academic performance was on par with other interns. No academic deficiencies were bought to my attention. Instead, they said I was depressed, which is why my judgment is colored; why I had such negative views of myself. They are not wrong and I am not disagreeing. However, my personality is simply that I tend to have low self esteem and lack confidence in myself. It does not mean I have a mental impairment, or that I suffer from MDD. But because the field of medicine tends to attract highly confident individuals, they jumped to the conclusion that I must be “depressed.” Not all interns are the same, I know I am an abnormally among the masses of overconfident people that flock to the field of medicine.
They convinced me that I must be depressed and pressured me into seeing a psychiatrist. I was told that my “issues” would remain private between my psychiatrist and I and that the program would fully support me. I was never told that I would be penalized; not be allowed to return to work if I was ever hospitalized for a psychiatric issue. Naively, I agreed and started seeing a psychiatrist and was started on medications, which I admit did help me. I did feel like I was performing better in residency. However, unfortunately, due to a lapse in judgment, I made the horrible mistake of telling my psychiatrist I had passive suicidal ideations. This was during time clinic in which I was “bored” because we had no patients and I was a bit tired/stressed because I had not had an off day in over a week. Immediately, I realized my mistake; my thoughts were passive, transient and fleeting and I was never going to act on them. Subsequently, I tried to retract my statement, tried to convince her that I was 110% not going to harm myself or anyone else. And I never did. My “crime” was that I stated once that I had suicidal thoughts.
The consequence of this was that my psychiatrist called my program director and they both convinced me to meet the psychiatrist in her office, even after I repeatedly stated that I was fine, I had no suicidal thoughts anymore. Those thoughts happened hours ago, and I had shown no signs of harming myself. (side note- I had one suicidal thought at around 2pm and by 530pm, I was still sitting in clinic and was completely fine. If I had truly wanted to hurt myself, wouldn’t I have attempted already? ) Regardless, I was forced to go to the psychiatrist office. Perhaps due to a terrible misunderstanding, my psychiatrist “believed” that I was going to hurt myself and called 911. I do not blame her, she was simply “doing her job,” but this unfortunate situation should have been avoided. I was unrightfully and wrongfully hospitalized; I did not receive a proper psychiatric evaluation in the ED. One ought not be hospitalized just base on one psychiatrist’s opinion. Psychiatry is an extremely subjective field which requires multiple evaluations before something as serious as admitting someone to a psychiatric unit.
This was when my “nightmare” began. Two police officers arrived armed with guns and bulletproof vests. They treated me like I was a criminal, acted as if I had just committed a horrendous crime. Of course, I am not proud to admit that I started crying which definitely did not help the situation. Maybe if I had acted cool, calm, and collected, things would have turned out differently? I was forced into the ambulance, strapped down and bought to the hospital ER against my will. Once in the ED, I was treated like a criminal. I was stripped of my clothes and of my belongings. Someone was assigned to watch me at all times. I was not provided with the standard of care that all patients deserve.
No one even asked me “what was wrong? Why was I bought to the ED? How they can help me?” Aren’t those the first questions, we are taught to ask a patient, to ask open-ended patient centered questions to help the patient? No one was willing to listen to my side of the story. Instead, no one listened to what I had to say, they assumed I was “crazy” because I was labeled as a psychiatric patient. I did not even receive a proper psychiatric evaluation. All patients deserve a second opinion, especially if they were bought to the hospital against their will. Instead, I was forced to sit in the ED for hours and no one told me what was going on. Finally the night on call psychiatrist came to talk to me. He told me he was not here to evaluate me, not here to determine whether I deserved to be admitted or discharged. He said my psychiatrist had called the head of the department and he was told to not discharge me. However, he did not admit me to the psychiatric unit. Instead he told me that I would have to wait until the morning when a team of psychiatrists would come to evaluate me to determine whether I meet the criteria for admission. The next morning, no team came. Instead I was forced to sit in the ED where no one updated me on what was going on. My psychiatrist finally came and gave me no option but to either be involuntary or voluntary admitted. Without any way out, I dumbly agreed to be voluntary admitted to the psychiatric unit. Retrospectively, I should have stood up for my rights, demand a proper psychiatric evaluation and not give in so easily. Adding to the inappropriateness of my admission, by this time, I had spent greater than 24 hours in the ED and I had display no signs of hurting myself or others and I had no suicidal thoughts or statements. Clinically, I did not meet the criteria for psychiatric admission. My dumb transient suicidal thought was obviously long gone.
Long story short, I was sent to the psychiatric unit, where I was treated like a “criminal” It was by far the worst experience of my life. Nothing in residency compared to the level of anxiety that I experienced, to how overwhelmed and stressed I was. However, I was able to handle it. Throughout my admission, I had no suicidal thoughts or statements and displayed no signs of suicide. It was obvious that I did not need to be hospitalized. Hospitalization did not benefit me and simply made things worse for me. The decision to hospitalized me was made too hasty, without evaluation by multiple professions and unethical and without consideration for my wellbeing.
After discharge, my psychiatrist told me that she would write me a note to clear me to return to work the following week. I convinced myself to forget all the negatives of this terrible experience and to try to see the “silver lining in the dark cloud.” Surviving psychiatric hospitalization did make me realize that I can overcome difficult situations. I won’t break down under stress. I will be able to handle anything that comes my way during residency, because nothing can be as difficult, as overwhelming, and as anxiety provoking as this.
Sadly, my tragic story does not end here. I was told that I was not allowed to come back to work without participating in one specific lengthy and costly program (PHP programs, which are alleged to be corrupt and have had several lawsuits against them) that required me to sign an unreasonable lifelong contract with them that involved indefinite monitoring, which would undeniably taint my career forever. This seemed irrational given my actions and this program was more fit for people who committed actual crimes, who harmed a patient, who endanger the lives of others, etc. They refused to allow me to get evaluated by any other psychiatrist even after I saw another different psychiatrist and agreed to continue “treatment.” The administration did not take into the circumstances of my hospitalization. I did not commit a horrendous crime. All I did was made ONE statement that I had passive suicidal thoughts. I do not deserve to endure such a lengthy process to be able to return to work. I do not deserve to be treated as if I have an impairment that would hinder my ability to perform my duties. To add to the unfairness of all this, before my hospitalization, there were never any complaints against me. I was never told that I was incompetent or unable to perform my duties. I was performing on par with the rest of my class. This is a case of employee discrimination. I was mistreated and with all those involved being “physicians who never admit any wrong”, no one was willing to admit that this whole thing was a mistake that should have been avoided.
I sincerely regret my mistake. I wish I could take back my words. But I cannot change the past; I can only look towards the future. It is too late of me. One dumb mistake ruined my career. I can only hope my story will enlighten future/current residents on how costly admitting to weakness can be and how tenuous one’s place in residency is. I also hope that in the future, the administration will consider supporting and protecting the privacy of residents who seek help, instead of making life more difficult and challenging. I believe this will encourage more residents to seek mental health help and will result in a decrease in suicidal rates among medical residents. Unfortunately, it is difficult to change the culture of medicine, but I hope slowly, with time, some changes can be made to benefit the wellbeing of residents.
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So basically you called your psychiatrist while in clinic and told her that you were suicidal??
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Off track a bit, but at most institutions (all?) you aren't technically eligible for FMLA until you've been employed for > 12 months. My wife had to take ~ 1 month unpaid leave when she had our child because she had only been there 7 months at the time (not a doctor, but employed at a university).
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I was sadly thinking the same thing.
Residents should be able to seek psychiatric care if they need it and ideally without significant risks to their career. That said, I would hesitate to suggest seeking it within their healthcare system. I'd probably call somewhere outside of the system (if possible) and ideally find a way to self-pay. I doubt that it would be a big deal to even use your own insurance, but if you have the means paying out of pocket will be best.
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I don't get how this isn't a blatant HIPAA violation? What right did this psychiatrist have in calling the program director?
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If there is concern for suicide or homicide the psychiatrist has an obligation to intervene. Since the PD sent the OP to the psychiatrist it makes sense that that would be the contact person to help intervene and save the OP's life.
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I'm a psychiatrist and don't know that I can agree with this. If the psychiatrist was concerned that OP was imminently suicidal to the point that privacy needed to be breeched, then the psychiatrist has an obligation to call the police to go get OP. You don't waste time calling someone else who can't immediately intervene to make the person safe. The only justification I could see is if the psychiatrist didn't know where OP was, but even then I'm not sure.
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Tarasoff requires that if a psychiatrist feels that the pt is a danger to others then they are require to notify those potentially in danger...it could be argued that by notifyingthe Pd, they are protecting/notifying those in danger
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OP expressed SI, not any threat towards others (that we're told of). I don't see how this argument would hold up.
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You mean it could wrongly be argued...
This isn't a Tarasoff thing and would get thrown out of court in a heartbeat if anyone argued that. That said, I think the psychiatrist should have called police, not the PD.
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Yeah, I thought the Tarasoff was for HI only, with a specific threat, not SI. (I am EM, not a psychiatrist.)
And, I see, another of our psychiatry friends said the same.
