Contract non-renewal/termination

[MedDK]

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I'm PGY-2 in FM program. I've been on academic probation in my residency for over a year and it's not going well. It's been suggested to look for another program or pursue non-clinical path as my contract won't likely be renewed at the end of my second year. They told me I've been very receptive of criticism and have consistently worked hard to improve myself. I did improve, however, not up to the program's standard. I want to continue clinical path and be board certified. Since my program did not allow me to take COMLEX 3 while on probation, I could not take it yet. I am planning on taking it at all cost so I can apply for non-restricted medical license and pay my bills doing something clinical, while applying to vacant PGY-2 spots. I think it will be an uphill battle with abundance of red marks, however, what is my best next move?

 

[NotAProgDirector]

This is a tough situation. COMLEX, unlike the USMLE, requires that your program certify you for the exam. The NBOME requires an "Attestation by a residency program director that the candidate is in good academic and professional standing", so I can see why if you're on probation that they won't / can't do so. I'm not certain what you mean by "taking it at all costs", as without that attestation I don't think you can do so. I would definitely ask your program to do so before you leave.

The ABFM requires that the final 2 years of training be in a single program, and based upon your post it sounds like you have not met their requirements for the PGY-2 year. So you'll need to repeat your PGY-2 year. You'll need to be honest when you apply, explain what happened at your current program, and why a new start in a new program will be more successful.

 

[ThoracicGuy]

I'm PGY-2 in FM program. I've been on academic probation in my residency for over a year and it's not going well. It's been suggested to look for another program or pursue non-clinical path as my contract won't likely be renewed at the end of my second year. They told me I've been very receptive of criticism and have consistently worked hard to improve myself. I did improve, however, not up to the program's standard. I want to continue clinical path and be board certified. Since my program did not allow me to take COMLEX 3 while on probation, I could not take it yet. I am planning on taking it at all cost so I can apply for non-restricted medical license and pay my bills doing something clinical, while applying to vacant PGY-2 spots. I think it will be an uphill battle with abundance of red marks, however, what is my best next move?

Would your program support you applying to other programs? The other programs will want at a minimum, a letter from your current PD. They may even want to talk on the phone, so it would be good to know how the program will approach that.

 

[smq123]

I'm PGY-2 in FM program. I've been on academic probation in my residency for over a year and it's not going well. It's been suggested to look for another program or pursue non-clinical path as my contract won't likely be renewed at the end of my second year. They told me I've been very receptive of criticism and have consistently worked hard to improve myself. I did improve, however, not up to the program's standard. I want to continue clinical path and be board certified. Since my program did not allow me to take COMLEX 3 while on probation, I could not take it yet. I am planning on taking it at all cost so I can apply for non-restricted medical license and pay my bills doing something clinical, while applying to vacant PGY-2 spots. I think it will be an uphill battle with abundance of red marks, however, what is my best next move?

It’s interesting that your program suggested either another program or something completely non-clinical. Did they think that you were fine for the specialty but not a good fit for the program? I’m assuming that they were concerned about your clinical skills….

 

[MedDK]

It’s interesting that your program suggested either another program or something completely non-clinical. Did they think that you were fine for the specialty but not a good fit for the program? I’m assuming that they were concerned about your clinical skills….

One faculty member said to choose a program I may thrive because yeah they are concerned about clinical skills and delayed progress. One of my evaluation said something like "performing at the level of early second year, not on par with peers".

 

[MedDK]

Would your program support you applying to other programs? The other programs will want at a minimum, a letter from your current PD. They may even want to talk on the phone, so it would be good to know how the program will approach that.

We haven't reached that discussion yet but if I were to let go, I do want to be able to take COMLEX 3 and reference. Is there a good way to approach the matter in my situation?

 

[MedDK]

This is a tough situation. COMLEX, unlike the USMLE, requires that your program certify you for the exam. The NBOME requires an "Attestation by a residency program director that the candidate is in good academic and professional standing", so I can see why if you're on probation that they won't / can't do so. I'm not certain what you mean by "taking it at all costs", as without that attestation I don't think you can do so. I would definitely ask your program to do so before you leave.

The ABFM requires that the final 2 years of training be in a single program, and based upon your post it sounds like you have not met their requirements for the PGY-2 year. So you'll need to repeat your PGY-2 year. You'll need to be honest when you apply, explain what happened at your current program, and why a new start in a new program will be more successful.

Clinical pathway is completely blocked without taking COMLEX 3 for DOs. Is there a good way to approach the discussion in my situation?

Of course I will be honest about when I apply to other programs. Program thinks a new start where I have social support may be beneficial (although they did not say whether they'll help with the process).

 

[DJKitty]

I just wanted to reach out and say that I'm sorry that you are going through this. It sucks and is incredibly stressful. Good luck with your situation. I hope that everything works out for you.

 

[Franzd'Epinay]

Perhaps someone with experience in program leadership can chime in (and hopefully correct me), but I just don't see how staying in this specialty is feasible.

If the program is saying "you're a great person, you have a good attitude, you're making visible efforts, but it's just not enough. We don't believe we can bring you up to par at our program, so we're not renewing your contract." I have a hard time believing any other program saying they'll take that chance.

OP, I think you need to start taking concrete steps to switch fields as a backup. With your FM background, you could probably make a good transition to preventive medicine.

 

[MedDK]

Perhaps someone with experience in program leadership can chime in (and hopefully correct me), but I just don't see how staying in this specialty is feasible.

If the program is saying "you're a great person, you have a good attitude, you're making visible efforts, but it's just not enough. We don't believe we can bring you up to par at our program, so we're not renewing your contract." I have a hard time believing any other program saying they'll take that chance.

OP, I think you need to start taking concrete steps to switch fields as a backup. With your FM background, you could probably make a good transition to preventive medicine.

I am at an academic program although it is pretty new. They mentioned I may not be a good fit considering how the program is set up and I may thrive somewhere else. I really put effort although only thing I can say objectively is that my in training exam score surpassed trajectory and it is above passing range for board. However, evaluations are mostly about competency and patient safety issues still. No actual adversary patient issues happened... We lost a resident last year due to an adversary event. She is practicing medicine still because she is MD and passed USMLE 3. I won't have that luxury because I am a DO and cannot take COMLEX 3 without PD attestation.

If any other program isn't going to take a chance... I haven't thought about different paths and will feel too desperate to even think about that. Can anyone advise me on viable non-clinical path that can make a living even with a huge student loan debt...?

 

[Franzd'Epinay]

If any other program isn't going to take a chance... I haven't thought about different paths and will feel too desperate to even think about that. Can anyone advise me on viable non-clinical path that can make a living even with a huge student loan debt...?

I should've been more specific. I'm thinking the same specialty may be a hard sell (FM), but with your PD's support you could transition to another specialty. Preventive medicine is the first one that comes to mind as it is not very clinical.

 

[guytakingboards]

Perhaps someone with experience in program leadership can chime in (and hopefully correct me), but I just don't see how staying in this specialty is feasible.

If the program is saying "you're a great person, you have a good attitude, you're making visible efforts, but it's just not enough. We don't believe we can bring you up to par at our program, so we're not renewing your contract." I have a hard time believing any other program saying they'll take that chance.

OP, I think you need to start taking concrete steps to switch fields as a backup. With your FM background, you could probably make a good transition to preventive medicine.

It is somewhat a caution flag that the program isn't willing to give them a chance to repeat second year but I imagine there have to be some programs out there with an open PGY-2 spot that would take a chance on a repeater; particularly if most of the other comments were decent.