Curious to get others' thoughts on this...

I searched thoroughly (using the less-than-stellar advanced search function) for a similar thread(s) but the only ones that popped up regarding this issue pertained to residency or licensing applications.

I wanted to see if there are others here who are aware of similar cases and, if so, what their outcome/disposition was. Has anyone here ever known or heard of a resident who's been arrested (all while a resident) for multiple DUIs and other charges related to their substance-abuse, admitted multiple times for inpatient rehab, relapsed following each and every admission, had their medical license revoked indefinitely due to the failure to comply with the medical board requirements for reinstatement after each offense, AND still been allowed to remain in the program? By "in the program", I mean a position has been reserved until if/when their license is reinstated even if that may be several years down the road.

Despite the fact the resident's struggles with substance-dependence were already known to the program, they were promoted to the next level without any requirement for remediation, and allowed to continue practicing (and supervising junior residents) even though it was already becoming apparent to others in the program that their ability to practice was impaired.

Just wanted to gather other thoughts on the matter.

 

Wow, that may be even stranger than the scenario I mentioned. If the guy had no diagnosed substance-dependence or psychiatric conditions, what exactly were they rehabbing? Better yet, what kind of rehab center does one go to for a personality disorder? I wasn't aware there were rehab centers for that. That sounds super sketchy on the part of your program.

I defintely agree that this resident has been cut some major slack. I don't know what's gone on behind the scenes with the program administration but I've never heard of someone being given that many chances. Not only that, they were promoted with what I can only assume was some pretty lax supervision since their impairment was noted by other residents (who weren't even on the same rotations) long before the program.

I was not aware that FMLA afforded individuals that protection. Though, this isn't simply an issue of someone with a history of substance-dependence and abuse with a single arrest or charge who has entered inpatient treatment and complied with the conditions set forth by the board. We're talking multiple inpatient admissions, multiple relapses, and multiple arrests within a single year.

Certainly, these individuals deserve second chances and an opportunity to have their licenses restored, but how many chances is too many? How many people in medicine, especially in residency, get second chances let alone four or five? How many residents do you know or have heard of who were terminated or let go by their program for infractions which were much less serious and did not involve legal, licensure, or even clinical competence or academic issues without being given second chances? The bias here is glaring and, to me, represents a clear abuse of power. The program was clearly negligent in this case and, if a malpractice case were to have ever been brought against the institution, I cannot imagine what their defense would have been.

 

Dudes, I'm always up for having good fun, but if you're going to hijack the thread please make your "witty" banter at least mildly entertaining. I wasn't aware it was amateur night.

I can see your point if the program were to accept up to their cap for each incoming intern class then eventually that position would no longer be available. However, some programs (such as the one I'm talking about) usually have openings for the particular PGY level of the resident and the program director can choose not to fill that position--even if there are qualified residents to fill that position--to "reserve" a position for whomever they desire. Effectively, that is equivalent to "holding" a position.

In this case, the resident had been out of training for almost a year before the decision to revoke was made (it was previously suspended). Yet, the program director has still chosen not to fill the position. That, though, is not why I say the resident's position has been reserved. I say that because the resident is still listed on updated resident lists (meaning they are still considered to be part of the program) for that PGY level but is not scheduled for any rotations since they have no license.So, it's not a simple clerical error.

I tried to clarify that in my original post when I defined "in the program" to mean that their position seems to have been safeguarded until if/when their license is reinstated which will not be for at least a couple of years.

I don't know exactly how you would define "bad" but, at least in my experience thus far in medicine, there seems to be quite a low threshold for that definition. This resident self-reported to the board initially, and, subsequently, was required to submit to inpatient treatment. If you define "bad" as arriving hours late or not at all for rounds and unexplained absences, then, no, they did not go out on leave prior to their impairment affecting patient care. I did not work personally with the resident so I can not say whether the resident was completely sober or hungover at any time they were actively providing patient care. That part, though, is based on hearsay. The sequence of events tends to support their assertions though.

Several posters have mentioned FMLA as a possible reason. I very much doubt what was a deterrent to termination since, in this particular case, they were willing to wait >7 months and the resident was--before the last relapse where the license was revoked indefinitely--scheduled to commence rotations after that period.

 

Admittedly, my knowledge of this is rather indirect but I have explained my reasoning in the previous post for why I have reason to believe the resident's position has been reserved. The new resident schedule and updated list of residents was made well after the resident's license was revoked. The program, therefore, knew that the resident would not be able to rejoin the program for that year and yet they remain on the schedule. I cannot at this point say that it's been reserved indefinitely but certainly this resident has been accomodated quite nicely; more so than many other residents have. I would think that we can all agree on that.

Not quite sure what you mean by this, but it's pretty self-explanatory really. The resident was PGY-X and was promoted at the same time along with their class to PGY-Y despite the fact that they were noted by other residents to likely be impaired and not able to safely and competently provide patient care and, shortly thereafter, re-entered treatment.

As I mentioned previously, these weren't personality quirks. Regardless of whether the resident was impaired because they were under-the-influence of some substance or because they were going through some sort of withdrawal doesn't matter; if it limits or, in any way, affects their ability to function and provide safe patient care, it represents an "impairment" and must be addressed by the program. Finally, if the resident wasn't impaired, they wouldn't have had to re-enter inpatient treatment for relapsing. That much is not in doubt.

I can't say for sure that there was no remediation. However, if they were being remediated prior to their promotion--and I can only imagine that successful remediation would have been a requirement for them to be promoted--I cannot imagine how they could've been promoted seeing as how there were clear problems which were known to others in the program prior to the new academic year.

Also, I can't imagine there was no supervision, but obviously it had to have been lax for their problems to have been made aware to so many before the resident had to re-enter inpatient treatment.