Dealing with a malignant program director

[calvnandhobbs68]

The situations above are pretty hairy for the residents but not exactly that crazy when you think about how many community hospitals are set up. There's been a recent trend towards 24/7 intensivist staffing but typically there's no dedicated ICU in house coverage at most hospitals. It's just you and the nurses until the attending on call shows up.

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[Dral]

We always had either the hospitalist or ccu intensivist available over night at the VA.

Academic center though.

 

[link2swim06]

I am at a large tertiary care center and there are zero fellows or ICU attendings in house overnight (for our MICU...SICU is a different story). Although you can call them (and should if a patient dies, or needs something crazy like ECMO). I certainly wouldn't call them for intubations...if you feel like the pt needs intubated you call anesthesia and they do it.

I don't think it's the norm to have an attending in house.

 

[Arcan57]

I am at a large tertiary care center and there are zero fellows or ICU attendings in house overnight (for our MICU...SICU is a different story). Although you can call them (and should if a patient dies, or needs something crazy like ECMO). I certainly wouldn't call them for intubations...if you feel like the pt needs intubated you call anesthesia and they do it.

I don't think it's the norm to have an attending in house.

In order to financially justify having an in-house MICU attending you would need to have an intense non-elective procedural volume. A couple of central lines or an intubation overnight isn't going to pay enough to entice someone to stay overnight, especially if there are over in-house docs that can perform those procedures.

 

[rokshana]

At our rather small VA, where we cover the floors (~30-40 patients) and the MICU (which only has 6 beds, but still usually has a couple intubated patients who may or may not be on pressors), the only attending in house in the entire hospital is in the ER. And they aren't allowed to leave the ER by policy. There are no fellows in house. There is no anesthesia in house. There is literally no one above a PGY2-3 in the entire hospital outside of the ER itself between 5pm and 7am. The attendings are available by phone and it's always perfectly clear who to call if necessary.

At our 650+ bed main hospital, with not infrequently >40 patients on the MICU services (and pretty much never has <30), we have a PGY3 and a PGY2 in house to cover the ICU. The only academic IM attending in the hospital is one covering their own non-teaching service and has nothing to do with any of the ICU patients. The fellow and the attending for ICU are available by phone.

realize that her experience is being an ED intern...in the ED the ED residents always have an attending with them...

 

[hamstergang]

one reason my posts are so long is having to pre-qualify anything I ever say with either a citation or apparently even if I all have to offer is personal experience anecdote or just outright opinion that is a problem with you people

And yet, most everyone else doesn't have this issue. That should make you strongly consider that the problem is you and not the rest of us.

 

[Crayola227]

I am at a large tertiary care center and there are zero fellows or ICU attendings in house overnight (for our MICU...SICU is a different story). Although you can call them (and should if a patient dies, or needs something crazy like ECMO). I certainly wouldn't call them for intubations...if you feel like the pt needs intubated you call anesthesia and they do it.

I don't think it's the norm to have an attending in house.

I think it's come up that not all places have anesthesia in house overnight, but good point.

 

[Crayola227]

And yet, most everyone else doesn't have this issue. That should make you strongly consider that the problem is you and not the rest of us.

Actually I have quite a few coworkers read along with me, just cuz I was starting to let it get to me. Maybe you guys should strongly consider that you're too hard on people.

 

[rokshana]

Actually I have quite a few coworkers read along with me, just cuz I was starting to let it get to me. Maybe you guys should strongly consider that you're too hard on people.

or we have learned to say what we need in a concise matter...and generally comment on that which we have some knowledge and/or experience...

 

[Raryn]

Actually I have quite a few coworkers read along with me, just cuz I was starting to let it get to me. Maybe you guys should strongly consider that you're too hard on people.

I write long posts periodically. Some of them are probably >1 page printed out. Not that uncommon if you get me started.

That said, I have never had anyone complain that I'm rambling and incoherent. People are welcome to quibble with content, I know I've gotten in my fair share of arguments on this site... but with you it's not just a content issue: the style of writing just makes it so much worse.

That's the last I'll comment on it though, this sort of discussion about another poster isn't conducive to the environment on the site and is probably bordering on a TOS violation to boot.

 

[j4pac]

Law2doc is spot on. The ability to take a test doesn't make you a good resident or physician. It says that you have a decent knowledge base and can take a test. Don't hang your hat on that. If your PD thinks that you are a crap resident...they have probably come to that conclusion for a reason. I would ask what specifically makes you a crap resident so that you can work on it. Ask your other faculty as well. You have 6 months to work out the kinks before you are in the real world, where your deficiencies can lead to poor patient outcomes.

 

[dozitgetchahi]

Program dependent. My program the PGY3 is the seniormost person inhouse overnight in our ICU. At the VA, sometimes it's even a PGY2. We can self-initiate intubations at the main hospital and just do them with RT for backup (and anesthesia available in-house via page if we ask since they're in-house for trauma call). Have to call them in from home at the VA for intubations per policy, but we've had a couple people intubate there without backup just b/c the situation was that urgent. At both hospitals there is a fellow and attending available via phone that are always quite responsive, but rarely called.

Bingo.

Except in most situations here, anesthesia has to intubate. All decision-making is otherwise done by the senior IM resident (and when yours truly did VA ICU, he was a 3rd month PGY2!)

 

[NontradICUdoc]

The most dangerous intern I have come across is the one that doesn't know what they don't know. This is especially true in fellowship as I review M&M's in the ICU.

Where I did my residency, the only inhouse attending was in the ED and they never left. The intensivist was always available by phone. However, there were three senior IM residents (ICU, Admissions, and Floor). So if you really needed help you can rely on your colleagues.

As a critical care fellow, in our program there is a fellow in house 24/7, we encourage the residents and interns to do things, but they must notify us immediately of any intentions. Sure there are a couple of cowboys (yes they were men) who just did things on their own without alerting us and this was squashed quickly. The nurses in the ICU are quick to ask the resident to get the fellow or they will call us on their own to come to the ICU. While a resident, we made all of the decisions regarding the management of the patient in the ICU. However, depending on the procedure, we can either do it ourselves or get someone else. the nurses had the list of residents that were cleared to do lines. But intubation was not allowed unless you asked the CRNA and they were in the room.

 

[Siggy]

maybe it would be more helpful to point out in the case of the story Law2Doc had, which is that no matter what level of resident you are or what is going on, you should orient yourself at the start of your shift to what attending you would both call or try to reach out and physically grab to help you should you really need it, because I'm still not hearing from anyone that there are zero attendings on site, maybe there is depending on site or speciality I wouldn't know, again, that would be a good thing for the resident to know before initiating an elective intubation, and something I would want to be aware of at the start of any shift any where is how to get a hold of an attending before I need one

Granted, I'm at a small community program, but overnight there's no IM attending in house. We have access to an IM attending at a sister hospital over the phone (who we check in with on admissions), an ICU attending available by phone (a couple are close enough to come in if need be), and an EM attending (who is supposed to come supervise any emergent procedures and codes overnight... but it can be painful with a couple of them), but no IM program.

When I was a medical student, the 450 bed county hospital I spent half of my rotations at was the same way. No IM attending overnight in house.

 

[chocomorsel]

There are residency unions? Why is this not universal? Sounds like you were incredibly lucky.

Yup. CIR-SIEU. They are all over the East and West Coast. Always looking to expand but I am sure there are some legal state specific rules that prevent them from being universal.

 

[Doctor4Life1769]

Yup. CIR-SIEU. They are all over the East and West Coast. Always looking to expand but I am sure there are some legal state specific rules that prevent them from being universal.

I was at a similar type malignant program with the crap you described in the same specialty as you. We didn't have a union or ombudsman type thing so I was pretty much screwed. I peaced out and switched specialties. I knew fighting it wasn't gonna do much for me. I was able to land on elsewhere and here I am on my way to finishing up. Pending contract stuff, have a job lined up. I came to fortunately enjoy what I do. Things would probably had been different though if I had a union or ombudsman, but I'm genuinely happy with that I'm doing so it all worked out and I'm not bothered by it anymore.

 

[chocomorsel]

I was at a similar type malignant program with the crap you described in the same specialty as you. We didn't have a union or ombudsman type thing so I was pretty much screwed. I peaced out and switched specialties. I knew fighting it wasn't gonna do much for me. I was able to land on elsewhere and here I am on my way to finishing up. Pending contract stuff, have a job lined up. I came to fortunately enjoy what I do. Things would probably had been different though if I had a union or ombudsman, but I'm genuinely happy with that I'm doing so it all worked out and I'm not bothered by it anymore.

That is unfortunate. Sorry to hear that. Glad you are finishing up and liking your new choice.
Mine was a small program like people here have stated where it was 7 of us per class and just like the OP they picked on someone every year. And I stood out like a sore thumb due to my looks and personality. I made mistakes yes, but was treated beyond unfairly and constantly scrutinized. It was horrible.
The Union was a Godsend and I gladly paid the 72 bucks a month all four years I was there. They were voluntary dues.
I swear If I run into that bitch again, I would easily, reflexively clock her skinny ass in the face and break some teeth. I fantasize about it.
Anyway, no issues at all in practice since I left, no problems with boards, the nurses and I get along, surgeons and I get along unlike all that crap that happened in residency. So much better in Private practice.

 

[RadOncDoc21]

That is unfortunate. Sorry to hear that. Glad you are finishing up and liking your new choice.
Mine was a small program like people here have stated where it was 7 of us per class and just like the OP they picked on someone every year. And I stood out like a sore thumb due to my looks and personality. I made mistakes yes, but was treated beyond unfairly and constantly scrutinized. It was horrible.
The Union was a Godsend and I gladly paid the 72 bucks a month all four years I was there. It was voluntary dues.
I swear If I run into that bitch again, I would easily, reflexively clock her skinny ass in the face and break some teeth. I fantasize about it.
Anyway, no issues at all in practice since I left, no problems with boards, the nurses and I get along, surgeons and I get along unlike all that crap that happened in residency. So much better in Private practice.

I feel you, like others had a similar experience during my training. I've witnessed targeting due to either race, religion or cultural differences and no matter how hard you try, nothing is ever good enough. These people should never be in a position of power.

My experience has been a whole lot better since completing residency, but I would never want to go through that again and hope things improve for those who follow.

 

[Doctor4Life1769]

That is unfortunate. Sorry to hear that. Glad you are finishing up and liking your new choice.
Mine was a small program like people here have stated where it was 7 of us per class and just like the OP they picked on someone every year. And I stood out like a sore thumb due to my looks and personality. I made mistakes yes, but was treated beyond unfairly and constantly scrutinized. It was horrible.
The Union was a Godsend and I gladly paid the 72 bucks a month all four years I was there. They were voluntary dues.
I swear If I run into that bitch again, I would easily, reflexively clock her skinny ass in the face and break some teeth. I fantasize about it.
Anyway, no issues at all in practice since I left, no problems with boards, the nurses and I get along, surgeons and I get along unlike all that crap that happened in residency. So much better in Private practice.

I would have gladly paid $200 per month for something like that. There were 8 in my class each year, one was fired so my year had 7. We all make mistakes but they certainly targeted me for similar reasons. I initially was in a bad place but I fortunately had some folks help me land on my feet in another program and it's worked out. Sure, I lost out 300K+ per year (never mind I would have been selected as a pain fellow at my home program bc the fellowship program loved me so much), but nonetheless it all worked out and I'll still be a doctor.

 

[chudat]

I would have gladly paid $200 per month for something like that. There were 8 in my class each year, one was fired so my year had 7. We all make mistakes but they certainly targeted me for similar reasons. I initially was in a bad place but I fortunately had some folks help me land on my feet in another program and it's worked out. Sure, I lost out 300K+ per year (never mind I would have been selected as a pain fellow at my home program bc the fellowship program loved me so much), but nonetheless it all worked out and I'll still be a doctor.

Anesthesia would NOT land you 300k+ per yr over family medicine.

 

[Doctor4Life1769]

Anesthesia would NOT land you 300k+ per yr over family medicine.

No...
For the extra year in training, I lose out $300k where I could have been an attending. Now, it probably was moot since I was pursuing a pain fellowship. I'd be a fellow currently and on my way to an interventional pain career. The switch has me doing 5 years total of training, fortunately my intern year was credited.

 

[pulmoblast]

of residents that were cleared to do lines. But intubation was not allowed unless you asked the CRNA and they were in the room.

Wow...ICU residents being supervised by nurses for intubation ? Why not the fellow? Were the fellows also supervised by CRNA for intubation ??

 

[chocomorsel]

Wow...ICU residents being supervised by nurses for intubation ? Why not the fellow? Were the fellows also supervised by CRNA for intubation ??

I can pretty much guarantee that the CRNAs have done lots more intubations than the fellows or attending ICU doc. That is of course unless the ICU doc is an anesthesiologist. Yea you can actually learn a few things from nurses.

 

[pulmoblast]

Well then I am glad I didn't train where you guys trained...

 

[johndoe44]

Created a throwaway account just because my other one could easily identify me. Also going to be vague on details for the same reason. Anyway, I need some advice on what to do. My PD and I have not had the world's best relationship for quite some time--probably since toward the end of my PGY-1 year and I'm now a PGY-3. I just found out that sometime around a year ago, another faculty told some other residents (who are now done and out in the real world) about what she had been telling them about me. I guess she said she wanted to fire me, but was afraid of getting sued. Instead, she told them that I was close to quitting (true, mostly because I was/am sick of being targeted by her), so they needed to keep riding me so that I would quit. Not much has changed in that time, I get told all the time that I'm a terrible person and terrible doctor even though my testing scores are higher than all of my classmates and I've done way more in the way of academic endeavors. This program has a history of choosing one person to pick on, and two of the last three of those people have quit. How do I deal with this news? I feel completely blindsided and don't even know what to say. For someone who is supposed to be my adviser and my advocate, this behavior is unacceptable.

Thanks for your thoughts.

As someone who has been through this all the way to resignation, I feel I can give some quick thoughts.

3 years and still working means more than likely you will finish. Too much work to justify termination so I would recommend you just push through and not quit. When you have the target on your back (regardless whether it is warranted) it will always be there. People will always look you over twice and everyone else may get a glimpse; unfortunately this leads to more evidence to throw at you because we all have things that can be used against us.

Another thing that I think is a great strategy is avoiding those who you know don't like you; avoid them like the plague. Don't argue or disagree with attendings, if someone asks for questions let others ask and definitely don't reveal to much to others in your program. Bottom line, lay low and ride it out.

 

[Doctor4Life1769]

As someone who has been through this all the way to resignation, I feel I can give some quick thoughts.

3 years and still working means more than likely you will finish. Too much work to justify termination so I would recommend you just push through and not quit. When you have the target on your back (regardless whether it is warranted) it will always be there. People will always look you over twice and everyone else may get a glimpse; unfortunately this leads to more evidence to throw at you because we all have things that can be used against us.

Another thing that I think is a great strategy is avoiding those who you know don't like you; avoid them like the plague. Don't argue or disagree with attendings, if someone asks for questions let others ask and definitely don't reveal to much to others in your program. Bottom line, lay low and ride it out.

Depends on how long the training is, but I agree with everything you said otherwise.

 

[cbrons]

But intubation was not allowed unless you asked the CRNA and they were in the room.

Huh

 

[chocomorsel]

I am not a huge fan of CRNAs but I think you need to get over your ego and realize that you might even learn something from a nursing assistant.

Well then I am glad I didn't train where you guys trained...[/QUOTE

 

[Doctor4Life1769]

Well then I am glad I didn't train where you guys trained...

I'd rather a CRNA intubate over you.

 

[pulmoblast]

It's not about ego my friend. There are a lot of things in medicine you can learn from nurses, MAs, radiology techs and hey even lay people at times. In an academic institution learning a skill as crucial as intubation should not be from CRNAs, especially in critical care settings.

There are many nuances in instituting mechanical ventilation in the critically ill that require in depth knowledge of physiology that nurses just don't have. A monkey can be trained to use the DL and stuff a tube in.

Just a side question ... Who is medically liable for bad outcomes during intubation ? The resident/fellow or CRNA? Or is it the anesthesia attending who is not there ?

 

[chocomorsel]

It's not about ego my friend. There are a lot of things in medicine you can learn from nurses, MAs, radiology techs and hey even lay people at times. In an academic institution learning a skill as crucial as intubation should not be from CRNAs, especially in critical care settings.

There are many nuances in instituting mechanical ventilation in the critically ill that require in depth knowledge of physiology that nurses just don't have. A monkey can be trained to use the DL and stuff a tube in.

Just a side question ... Who is medically liable for bad outcomes during intubation ? The resident/fellow or CRNA? Or is it the anesthesia attending who is not there ?

The attending anesthesiologists are responsible for the CRNAs.
No one stated that they were gonna be running your ventilators. They are just strictly there to assist with the intubation. As a senior resident I went to ICU intubations with the junior and the attending was a phone call away. Any potential problems and call for backup.

So which is it? Is intubation a "crucial skill"? Or one that "a monkey can be trained to do?"

If it makes you feel better, think of it as a monkey see, monkey do 1000times and monkey teaches next monkey. Now, that will stroke your ego and make you feel special as the Doctor.

It is about your ego. You feel like a CRNA can't possibly have anything to teach residents. No one said that the pulmonologists or fellows weren't around when all this is going down and manage the patients once the tube is in.

At my last job the pulmonologist hadn't tubed a patient in years.

 

[pulmoblast]

I am sure you are a very smart but nevertheless ... Please read my post again. Carefully

1. Instituting mechanical ventilation in the critically ill is not the same as running a ventilator

2. The mechanical act of intubation is what a monkey can do. Deciding when, how, what agent and what dose to use in a critically ill patient is something crucial and something an intensivist or attending anesthesiologist should do

3. No one is saying pulmonologists are better than CRNA in intubations. The point is that critical care fellow or ICU resident should learn from an experienced intensivist or anesthesiologist and not be supervised by a CRNA

4. Actually this exchange feels a lot like your ego is being hurt for some reason. Anyway since this has nothing to do with the OP, it's my last post on this topic. Feel free to argue/troll in this matter...

Peace to all

 

[ThoracicGuy]

I can see why you are frustrated. Having a union for housestaff is amazing (though I am biased). It allows for better communication with administration in regards to housestaff issues and enforces the contract you sign. If your hospital isn't one of the 50+ represented by CIR, feel free to contact CIR by phone: (212) 356-8100 or email: [email protected] to get more information

So do residents have the right to strike? If so, would you recommend that?

 

[ThoracicGuy]

CIR residents do have the right to strike in certain situations but IMO it would be morally and ethically wrong. We have not had a resident strike in the past 20+ years and we hope not to have any strikes in the future.

In lieu of striking, CIR would work with you/your co-residents to enable shows of solidarity, picketing, involving other key unions at your hospital, press conferences and other tactics to pressure administration to hear our issues and respond appropriately. If administration does not respond appropriately, CIR lawyers put in a formal complaint and take the administration to Arbitration.

So basically a union takes fees and then uses other employee unions to do the picketing or even potentially striking? And without residents striking, you don't really have much in the way of retaliation if you don't like what is offered. If a resident strikes then they can potentially run afoul of their ACGME requirements for board eligibility and prolong their training because of this.

So basically unions get this:

 

[Crayola227]

I think it's fair to say a resident union can represent residents and give them voice in other ways. The strike is the ultimate "**** you I aint taking this," but it doesn't mean there's no other point to a union or ways it can pressure employers. Granted, the most effective way is to strike, but in certain fields that is fraught with ethical issues (teachers, police, for example).

 

[Raryn]

I think it's fair to say a resident union can represent residents and give them voice in other ways. The strike is the ultimate "**** you I aint taking this," but it doesn't mean there's no other point to a union or ways it can pressure employers. Granted, the most effective way is to strike, but in certain fields that is fraught with ethical issues (teachers, police, for example).

There's zero evidence I've ever come across that residencies with unions have any better treatment of their residents than residencies without them. The pay is about the same, the hours are about the same, the benefits are about the same, etc. The only objective difference that I've come across is that one group of residents has to pay union dues...

All residencies in every institution across the country have representatives on the GME committee at an institutional level. Those representatives have equal power whether or not the residencies are unionized (that power is minimal of course).

 

[Crayola227]

There's zero evidence I've ever come across that residencies with unions have any better treatment of their residents than residencies without them. The pay is about the same, the hours are about the same, the benefits are about the same, etc. The only objective difference that I've come across is that one group of residents has to pay union dues...

All residencies in every institution across the country have representatives on the GME committee at an institutional level. Those representatives have equal power whether or not the residencies are unionized (that power is minimal of course).

fair enough, I agree.

I think it's just more the notion that if a union doesn't strike, it's good for nothing. That's sort of a fallacy, unions are about more than just striking. As far as how helpful they are.... I don't know, I imagine that depends on a lot of things.

 

[Light at end of tunnel]

So basically a union takes fees and then uses other employee unions to do the picketing or even potentially striking? And without residents striking, you don't really have much in the way of retaliation if you don't like what is offered. If a resident strikes then they can potentially run afoul of their ACGME requirements for board eligibility and prolong their training because of this.

So basically unions get this:

Having unions isn't about striking at all.

It's about the prospect of striking; a power that gets people's attention real fast.

Was it Teddy Roosevelt that said "speak softly, and carry a big union stick"?

 

[ThoracicGuy]

fair enough, I agree.

I think it's just more the notion that if a union doesn't strike, it's good for nothing. That's sort of a fallacy, unions are about more than just striking. As far as how helpful they are.... I don't know, I imagine that depends on a lot of things.

Personally, I think current unions are basically good for nothing.

 

[ThoracicGuy]

Having unions isn't about striking at all.

It's about the prospect of striking; a power that gets people's attention real fast.

Was it Teddy Roosevelt that said "speak softly, and carry a big union stick"?

And you risk your graduation and board eligibility for a few bucks salary? You are only in training a set amount of time. Why risk it when you'll have an attending salary shortly. Residency unions just don't seem worth the cost.

 

[Crayola227]

Personally, I think current unions are basically good for nothing.

I know a few guys in some blue collar fields that really believe in them. One of them works in a wood mill processing raw lumber, the other is a professional welder, does the insulation ducts in big buildings, the kind you see crawl through on TV. The one guy, he's gone on strike with the union. Makes 6 figures, gets a nice base pay when construction is slow. So I dunno, maybe the union isn't doing much for him, he thinks it does. Before he got the union job he made like 1/5 as much.

 

[ThoracicGuy]

I know a few guys in some blue collar fields that really believe in them. One of them works in a wood mill processing raw lumber, the other is a professional welder, does the insulation ducts in big buildings, the kind you see crawl through on TV. The one guy, he's gone on strike with the union. Makes 6 figures, gets a nice base pay when construction is slow. So I dunno, maybe the union isn't doing much for him, he thinks it does. Before he got the union job he made like 1/5 as much.

I think unions had their place in the early 20th century. Now? They are a big reason for spiralling costs with their pensions. Look at the teacher unions in NYC. They have it so you can't hardly fire bad teachers. They get reassigned and sit in a room making their salary for nothing.

 

[AdmiralChz]

I know a few guys in some blue collar fields that really believe in them. One of them works in a wood mill processing raw lumber, the other is a professional welder, does the insulation ducts in big buildings, the kind you see crawl through on TV. The one guy, he's gone on strike with the union. Makes 6 figures, gets a nice base pay when construction is slow. So I dunno, maybe the union isn't doing much for him, he thinks it does. Before he got the union job he made like 1/5 as much.

As ThoracicGuy said above, this doesn't apply for residency since, by definition, it only lasts for a limited amount of time and the prospects of much higher (typically anywhere from 4-5 to >10) salary is on the other side. This isn't the same as a blue collar union where one can be more readily replaced by "scabs" - this prospect is part of why people just swallow their complaints and just deal with residency. A union totally isn't needed, and I would be furious to pay a union anything without tangible evidence of the benefits (and it better be more than free crappy food).

 

[ThoracicGuy]

As ThoracicGuy said above, this doesn't apply for residency since, by definition, it only lasts for a limited amount of time and the prospects of much higher (typically anywhere from 4-5 to >10) salary is on the other side. This isn't the same as a blue collar union where one can be more readily replaced by "scabs" - this prospect is part of why people just swallow their complaints and just deal with residency. A union totally isn't needed, and I would be furious to pay a union anything without tangible evidence of the benefits (and it better be more than free crappy food).

I think the union at Michigan managed to get birthdays as a day off for residents!!! Yay!

 

[Winged Scapula]

I think the union at Michigan managed to get birthdays as a day off for residents!!! Yay!

The union at my fellowship (not in Michigan) got us our birthdays off as well. Yay! (I still worked that day).

It was about the only thing I saw them do.

 

[ThoracicGuy]

The union at my fellowship (not in Michigan) got us our birthdays off as well. Yay! (I still worked that day).

It was about the only thing I saw them do.

Did they pay you overtime for that day?

 

[sazerac]

Did they pay you overtime for that day?

That should count as moonlighting.

 

[NotAProgDirector]

Having your birthday off seems a silly benefit to me. What if your birthday falls on a weekend? What if you were born on Christmas -- is it fair that you get it off every year? What if you were born on Feb 29th?

We offer personal days. Everyone gets them. Want your birthday off? Fine. Want some paid paternity leave? Also fine. You choose.

 

[Raryn]

Having your birthday off seems a silly benefit to me. What if your birthday falls on a weekend? What if you were born on Christmas -- is it fair that you get it off every year? What if you were born on Feb 29th?

We offer personal days. Everyone gets them. Want your birthday off? Fine. Want some paid paternity leave? Also fine. You choose.

I'd love a personal day I could take in addition to vacation, to get dental appointments and such taken care of if nothing else.

 

[NotAProgDirector]

I'd love a personal day I could take in addition to vacation, to get dental appointments and such taken care of if nothing else.

That's exactly what they are for. Doc appointments. Day after t-giving if you're on elective. Etc. They also are sick days, so you can't use them all up. Seems like the fairest way of letting residents have some flexibility.