Best way to explain my situation on applications?

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Dr. Mindy Lahiri
7+ Year Member
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I did my residency in a community hospital. In intern year I was told that I wasn't performing well from various attendings in my evaluations. I did not "appear interested", I made mistakes when presenting patients, I did not answer questions correctly, I "did not show initiative" and so on. I also did not update my duty hours on time. With such evaluations I tried to change in the best way I thought I had to but I found that the first impressions some had of me were just stuck. The same attendings who had given me poor evals continued to do so in following evals even though they had zero to minimal interaction with me in subsequent rotations. They did not reevaluate me and acknowledge the growth I had made.

Three months before the end of my first year I was asked to come to my PD's office and I was told that I would not be getting a contract for the following year. He asked me to look for a first year or second year spot for the following year at a different institution. It came as a surprise to me because although I did not get good evaluations from some of my attendings I had never failed a remediation or probationary status or even been placed in a remediation/probationary status to expect a jump to such a decision.

I didn't know what I should do so I went a head and found an open spot for a second year spot at a different institution and interviewed there. Meanwhile I sought the help of my academic affairs department and was advised to appeal this decision. I won the appeal. I was also looking forward to start at a new program the following year with new attendings and a fresh start.

I won the appeal because the program did not notify me on time of their decision in writing. When my PD learned of the appeal and that I had won, he told me that he would not promote me to second year and that I had to do 6 months of remediation of my first year. Since the other program was a second year spot I couldn't accept the other spot.
This remediation of 6 months resulted in my residency to be 3.5 years instead of 3 years.

In my last year of residency, being friends with the chiefs I find out about the status of other residents. Residents who have made specific medical errors, who have put patients at jeopardy are in remediation. However they were told it would not be documented if they complete the remediation process. It makes sense as residents are being trained; they have to be given a chance to grow.

I feel that I was not given proper or fair treatment. The extra 6 months looks horrible on applications. Some assume that I had been put through and failed previous remediation or probation which is not the case.
 
Uoure
I did my residency in a community hospital. In intern year I was told that I wasn't performing well from various attendings in my evaluations. I did not "appear interested", I made mistakes when presenting patients, I did not answer questions correctly, I "did not show initiative" and so on. I also did not update my duty hours on time. With such evaluations I tried to change in the best way I thought I had to but I found that the first impressions some had of me were just stuck. The same attendings who had given me poor evals continued to do so in following evals even though they had zero to minimal interaction with me in subsequent rotations. They did not reevaluate me and acknowledge the growth I had made.

Three months before the end of my first year I was asked to come to my PD's office and I was told that I would not be getting a contract for the following year. He asked me to look for a first year or second year spot for the following year at a different institution. It came as a surprise to me because although I did not get good evaluations from some of my attendings I had never failed a remediation or probationary status or even been placed in a remediation/probationary status to expect a jump to such a decision.

I didn't know what I should do so I went a head and found an open spot for a second year spot at a different institution and interviewed there. Meanwhile I sought the help of my academic affairs department and was advised to appeal this decision. I won the appeal. I was also looking forward to start at a new program the following year with new attendings and a fresh start.

I won the appeal because the program did not notify me on time of their decision in writing. When my PD learned of the appeal and that I had won, he told me that he would not promote me to second year and that I had to do 6 months of remediation of my first year. Since the other program was a second year spot I couldn't accept the other spot.
This remediation of 6 months resulted in my residency to be 3.5 years instead of 3 years.

In my last year of residency, being friends with the chiefs I find out about the status of other residents. Residents who have made specific medical errors, who have put patients at jeopardy are in remediation. However they were told it would not be documented if they complete the remediation process. It makes sense as residents are being trained; they have to be given a chance to grow.

I feel that I was not given proper or fair treatment. The extra 6 months looks horrible on applications. Some assume that I had been put through and failed previous remediation or probation which is not the case.

You're going to need to clarify a few things:
1) what type of applications are we talking about: state medical licensure? Fellowship? Jobs?

2) have you passed the boards?

3) how bad were these evaluations?

4) how were your evaluations after the remediation

5) how do you assume you weren't given fair treatment? They required you to remediate, you did and you were allowed to finish your residency. Seems pretty reasonable.

I'm assuming you are an fmg. Your explanation is simple if you passed the boards on your first try: you were unprepared to practice medicine when you came to this country and required remediation. After remediation you were up to speed as evidenced by your ability to pass the boards.

However if you failed the boards it doesn't look all that good
 
You're going to need to clarify a few things:
1) what type of applications are we talking about: state medical licensure? Fellowship? Jobs?
Job and licensure at this time. I want to be consistent with my explanation in any case
2) have you passed the boards?
I recently graduated so the boards are coming up later (I am not in internal medicine but did not feel safe to post in my residency forum). I have good scores on all licensing exams.
3) how bad were these evaluations?
They were vague and they are as I described above. Not pointing to anything specific that I did wrong. Not all evals were bad. Some of my attendings gave great evals.
4) how were your evaluations after the remediation
The evaluations all suddenly were great after I started my second year. In my program second year and third year make decsions/ run the show. As a first year it is difficult to show what you know and your skills because the attendings don't interact with you as much as they do with your seniors. (Unless you are the talkative/ aggressive / loud type). Once I started my second year I was (had to be) in charge, make decisions, interact more closely with my supervisors.
5) how do you assume you weren't given fair treatment? They required you to remediate, you did and you were allowed to finish your residency. Seems pretty reasonable.
I don't see how the remediation helped me. They didn't say you are doing x wrong you should do y. The feedback was vague and I was left feeling alone and struggling on my own for most of my first year. If they had problems with me why not start the remediation process in my 3rd month of intern year and give me some direction. I understood later that programs have steps in place that must be followed in addressing issues with residents. They should be put through remediation first, then if they fail put on probation, if they fail that they should be given the notice of dismissal. I had not gone through such a process.
I'm assuming you are an fmg. Your explanation is simple if you passed the boards on your first try: you were unprepared to practice medicine when you came to this country and required remediation. After remediation you were up to speed as evidenced by your ability to pass the boards.
I am an FMG but I am Canadian. I did my clinical rotations in the United States. I do believe the problem is my personality. I am soft spoken. An attending once told me in my last few months that she was previously under the impression that I was a weak resident because of the way I presented myself until we worked together a research project where she could see that I actually knew my stuff.


Uoure


You're going to need to clarify a few things:
1) what type of applications are we talking about: state medical licensure? Fellowship? Jobs?
Job and licensure at this time. I want to be consistent with my explanation in any case

2) have you passed the boards?
I recently graduated so the boards are coming up later (I am not in internal medicine but did not feel safe to post in my residency forum). I have good scores on all licensing exams.
3) how bad were these evaluations?
They were vague and they are as I described above. Not pointing to anything specific that I did wrong. Not all evals were bad. Some of my attendings gave great evals.
4) how were your evaluations after the remediation
The evaluations all suddenly were great after I started my second year. In my program second year and third year make decsions/ run the show. As a first year it is difficult to show what you know and your skills because the attendings don't interact with you as much as they do with your seniors. (Unless you are the talkative/ aggressive / loud type). Once I started my second year I was (had to be) in charge, make decisions, interact more closely with my supervisors.

5) how do you assume you weren't given fair treatment? They required you to remediate, you did and you were allowed to finish your residency. Seems pretty reasonable.
I don't see how the remediation helped me. They didn't say you are doing x wrong you should do y. The feedback was vague and I was left feeling alone and struggling on my own for most of my first year. If they had problems with me why not start the remediation process in my 3rd month of intern year and give me some direction. I understood later that programs have steps in place that must be followed in addressing issues with residents. They should be put through remediation first, then if they fail put on probation, if they fail that they should be given the notice of dismissal. I had not gone through such a process.

I'm assuming you are an fmg. Your explanation is simple if you passed the boards on your first try: you were unprepared to practice medicine when you came to this country and required remediation. After remediation you were up to speed as evidenced by your ability to pass the boards.
I am an FMG but I am Canadian. I did my clinical rotations in the United States. I do believe the problem is my personality. I am soft spoken. An attending once told me in my last few months that she was previously under the impression that I was a weak resident because of the way I presented myself until we worked together a research project where she could see that I actually knew my stuff.


However if you failed the boards it doesn't look all that good
 
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Your PD wants to remediate you for six months, likely because you did poorly on six months of rotations. I don't see how that is unreasonable. Should you be able to move on to PGY2 without fulfilling the requirements of PGY1? I say no.

It sucks...but it probably is what it is. Finish your PGY1 strong and prove that you are going to be killing people with your increased autonomy in PGY2.
OP has finished residency and is applying for jobs and licensure.
 
You're main issue is going to be getting licensed by the state which may want some paperwork explaining the situation. You will also need to address remediation when applying for hospital privileges. I don't know your field, but most jobs are going to be looking for people with a pulse, a valid medical license, and a level of competence that isn't going to create headaches in terms of quality issues or interpersonal issues. The last is going to be optional at a lot of places depending on the fullness of the call schedule.
 
You're main issue is going to be getting licensed by the state which may want some paperwork explaining the situation. You will also need to address remediation when applying for hospital privileges. I don't know your field, but most jobs are going to be looking for people with a pulse, a valid medical license, and a level of competence that isn't going to create headaches in terms of quality issues or interpersonal issues. The last is going to be optional at a lot of places depending on the fullness of the call schedule.
I sent in my application to the state licensing board giving my explanation just simply remediation for "improving clinical skills" . I had to apply for FCVS..so hopefully FCVS will contact my program to get whatever paperwork that needs to be provided...
 
In verbal discussions "I got off to a slow start but have grown into a strong performer."
 
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