Dealing with a malignant program director

[Raryn]

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.

Sounds almost like you're treating your residents like regular old employees. You shouldn't say it too loudly, the rest of us might get ideas.

---

Members don't see this ad.

 

[RadOncDoc21]

Sounds almost like you're treating your residents like regular old employees. You shouldn't say it too loudly, the rest of us might get ideas.

Except a sick days means you need to provide a note claiming you had sepsis and needed to be admitted vs well just being "sick."

 

[Siggy]

Except a sick days means you need to provide a note claiming you had sepsis and needed to be admitted vs well just being "sick."

Just include your pulse and temperature and remind them that Medicare still uses SIRS instead of SOFA.

 

[BoardingDoc]

Just include your pulse and temperature and remind them that Medicare still uses SIRS instead of SOFA.

Thank God. If I had to justify every sepsis admission from the ED by using that asinine formula I'd shoot myself.

Thankfully, I have yet to meet an accepting inpatient doc who has been so pedantic as to ask for one.

 

[Winged Scapula]

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.

Plus adults just actually work on their birthday. It seemed sort of childish to me (at the time and still does).

 

[Siggy]

Thank God. If I had to justify every sepsis admission from the ED by using that asinine formula I'd shoot myself.

Thankfully, I have yet to meet an accepting inpatient doc who has been so pedantic as to ask for one.

I know, right. Proving that there's something actually wrong when admitting that "septic" CAP patient with a CURB-65 of 0 is hard work. It completely screws over that 2 hours throughput window when you try to provide appropriate care. Next the inpatient team will actually expect useful numbers instead of the iSTAT lactate that always provides a high lactate levels. Accurate lab work messes with the door to dispo time too much.

 

[BoardingDoc]

I know, right. Proving that there's something actually wrong when admitting that "septic" CAP patient with a CURB-65 of 0 is hard work. It completely screws over that 2 hours throughput window when you try to provide appropriate care. Next the inpatient team will actually expect useful numbers instead of the iSTAT lactate that always provides a high lactate levels. Accurate lab work messes with the door to dispo time too much.

The implication that I provide inappropriate care for my patients because I don't use a SOFA score for admissions is absurd.

I'm sorry you feel maligned by your emergency department. If you have frequent admissions that you feel are unnecessary or avoidable at your hospital, you may find speaking with those physicians more fruitful than ranting on the internet.

 

[Siggy]

The implication that I provide inappropriate care for my patients because I don't use a SOFA score for admissions is absurd.

I'm sorry you feel maligned by your emergency department. If you have frequent admissions that you feel are unnecessary or avoidable at your hospital, you may find speaking with those physicians more fruitful than ranting on the internet.

You mean the implication that you made that it was easier to admit patients by abusing an antiquated criteria that essentially means "patient has infection"? You made that implication all by yourself. My question is "Why are you getting push back for admitting a septic patient?" The easiest answer is that the patient doesn't actually have organ dysfunction due to an overacting immune system instead of just an infection.

By the way, I find your implication that providing evidence based medicine based on the most current consensus from a broad spectrum of specialties absurd. I agree that SOFA has implication issues, but those issues pale in comparison to "SIRS+Source=admission."

 

[bannie22]

It is understandable to want to stand up and fight for justice and equality.

However, it is also important to recognize that residency is not any other occupation.
I think it would be wiser to keep a low profile.

 

[Light at end of tunnel]

It is understandable to want to stand up and fight for justice and equality.

However, it is also important to recognize that residency is not any other occupation.
I think it would be wiser to keep a low profile.

What exactly do you mean by 'not any other occupation'?

 

[cbrons]

What exactly do you mean by 'not any other occupation'?

He means the nails that stick out get hammered.

Sent from my SM-N910P using SDN mobile

 

[BoardingDoc]

You mean the implication that you made that it was easier to admit patients by abusing an antiquated criteria that essentially means "patient has infection"? You made that implication all by yourself. My question is "Why are you getting push back for admitting a septic patient?" The easiest answer is that the patient doesn't actually have organ dysfunction due to an overacting immune system instead of just an infection.

By the way, I find your implication that providing evidence based medicine based on the most current consensus from a broad spectrum of specialties absurd. I agree that SOFA has implication issues, but those issues pale in comparison to "SIRS+Source=admission."

What? You're reading a lot into my response. I wasn't implying anything. Thanks for playing though.

 

[Siggy]

What exactly do you mean by 'not any other occupation'?

Residency is a time limited experience where if you get fired your entire career is gone.

 

[bannie22]

The above posters speak my mind. The fine thread that residents balance on.
Compared to other jobs, the risks and costs are higher, the benefits are much lower.

 

[chocomorsel]

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).

Check out UNM. I am a former resident and the CIR increased wages, paid meals, paternity leave, capped insurance fees. And of course help me fight the program too.

 

[FamilyDO86]

I'm not even an intern yet so take the following with a grain of salt...

Are you doing a 3 year residency? If so, you're a 3rd year with ~7 months left out of 3 grueling years, correct?

Unless you hate medicine, ride it out, you've already proven to be tough enough. No need to let others dictate the course of the rest of your life, you're at the finish line of this particularly significant hurdle. Board cert or bust!

Just my .02

Hey, guys. I'm here to provide hope for anyone unjustly terminated from a residency program. I was terminated from an ABSOULTELY AWFUL family residency program run by a literal demon. This woman had NO BUSINESS being in a leadership position in the first place. Wrote me up for anything and everything she could - including "saying a curse word" in the residents' lounge, using my meal stipend to buy a nurse lunch who was short on change, calling an attending "too many times" when the attending themselves did not even complain, and giving me horrible marks on my quarterly evals even though I had stellar reviews from all of my attendings. If it's true injustice, people will see it. That was true in my case. I found another program that worked really well, and although the wicked witch of the East wrote two pages of stupid **** I did on my FCVS (no lie) and I have to explain it EVERY TIME I APPLY FOR A LICENSE, it's pretty obvious to people that she was petty and 100% out to get me. I haven't had an issue with licensure yet, and I didn't have an issue finding and excelling in a new program. I'm holding off on taking any formal action until I'm well enough established in my career. Then I intend to fight people like that with every inch of my being.

 

[Obnoxious Dad]

Hey, guys. I'm here to provide hope for anyone unjustly terminated from a residency program. I was terminated from an ABSOULTELY AWFUL family residency program run by a literal demon. This woman had NO BUSINESS being in a leadership position in the first place. Wrote me up for anything and everything she could - including "saying a curse word" in the residents' lounge, using my meal stipend to buy a nurse lunch who was short on change, calling an attending "too many times" when the attending themselves did not even complain, and giving me horrible marks on my quarterly evals even though I had stellar reviews from all of my attendings. If it's true injustice, people will see it. That was true in my case. I found another program that worked really well, and although the wicked witch of the East wrote two pages of stupid **** I did on my FCVS (no lie) and I have to explain it EVERY TIME I APPLY FOR A LICENSE, it's pretty obvious to people that she was petty and 100% out to get me. I haven't had an issue with licensure yet, and I didn't have an issue finding and excelling in a new program. I'm holding off on taking any formal action until I'm well enough established in my career. Then I intend to fight people like that with every inch of my being.

You can't wait forever to take legal action. If you hold off too long, the statute of limitations will run and you will get kicked out of court for that reason alone. As soon as you finish residency and get settled in a permanent job, I would start looking for an attorney. I would also try to find out if this witch did this to anyone else. She needs to be out of her administrative misery and the best way to do it is to sue her.

 

[shiftingmirage]

Except a sick days means you need to provide a note claiming you had sepsis and needed to be admitted vs well just being "sick."

My program started doing this because it was always the same people calling in "sick". When people abuse the system, it's predictable they are going to become strict about it.

 

[newbie04]

Check out UNM. I am a former resident and the CIR increased wages, paid meals, paternity leave, capped insurance fees. And of course help me fight the program too.

UNM is a POS. Don’t listen to this nonsense. Go East or West coast to well-established institutions. UNM is amateur hour.


Sent from my iPad using SDN mobile

 

[chocomorsel]

UNM is a POS. Don’t listen to this nonsense. Go East or West coast to well-established institutions. UNM is amateur hour.


Sent from my iPad using SDN mobile

Ehh, I hated my program and PD.
However, our amateur hour did do us plenty of good.

 

[Crayola227]

Ehh, I hated my program and PD.
However, our amateur hour did do us plenty of good.

I'm confused. You're recommending UNM or you're not? and isn't it specialty dependent?

 

[chocomorsel]

Was recommending it for their Union. Not necessarily recommending their anesthesia program but every specialty program is different.