Did not get offered position as staff

[Athina]

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I just finished fellowship in an IM subspecialty.
I did my IM training at a hybrid community/academic hospital ("hospital A") where I really enjoyed my training. I really liked most of the attendings at that hospital: I felt that we got along and we were quite friendly at work. I went on to do my fellowship at a big academic center where I also got along with the staff but hoped to return to hospital A to work. Hospital A has 3-4 openings to fill over the next couple of years so I happily applied and even went to do a rotation during fellowship in order to demonstrate interest.

During my rotation, I found out that the head of the department for hospital A had just changed and the new head of department, "Dr X", was not someone I particularly appreciated even though she had always been mostly positive towards me. Dr X is a bit of a hothead and has a reputation in the hospital for yelling at nurses, having explosive fits of anger, and generally not being easy to talk to. Over 3-4 years, she and I had only had one negative interaction and I didn't make much of it.

During my rotation, I worked with different staff. Everyone said that they were very happy to see me and found it very pleasant to work with me. A couple of people suggested I apply for a position. I worked with Dr X one day during which I maybe saw her for 10 minutes. At the end of the day, I tried to have a discussion with her about the upcoming positions and asked to meet to discuss what they are looking for. Dr X was very cold and said that there will be an application process and that the positions will only be discussed with candidates that will be hired. I found this strange because at big academic centre, everyone is free to meet with the head of the department to discuss upcoming opportunities.

A month later, I received instructions via email about how to apply for a position and was again told that only applicants who will be hired will be contacted. I submit the required documents and 2 months later, I got an email stating that they cannot offer me a position. My evaluation for my rotation was glowing but I found out they didn't want to hire me because they thought I would not be easy to get along with and that I was not a good fit. They also felt that I was too friendly with the nurses and that this was inappropriate.

I took this quite personally. I have known these people for 5 years and they were always friendly to me. I even had lunch with a few of them quite regularly. It feels like I was betrayed: that they pretended to like me to my face but that, in reality, they didn't and I was nothing to them. My friends tell me that it's for the best and that I do not want to work with people who are not transparent and who do not appreciate me. I am having a hard time getting over the rejection partly because it feels very hypocritical, partly because I blame myself for having valued these people so much, and partly because I find it unfair to be turned down for a job because Dr X decided she doesn't like me.

I would appreciate some advice about how to move on or if anyone has any similar stories.
Are the people at hospital A just not my kind of people?

 

[rokshana]

I just finished fellowship in an IM subspecialty.
I did my IM training at a hybrid community/academic hospital ("hospital A") where I really enjoyed my training. I really liked most of the attendings at that hospital: I felt that we got along and we were quite friendly at work. I went on to do my fellowship at a big academic center where I also got along with the staff but hoped to return to hospital A to work. Hospital A has 3-4 openings to fill over the next couple of years so I happily applied and even went to do a rotation during fellowship in order to demonstrate interest.

During my rotation, I found out that the head of the department for hospital A had just changed and the new head of department, "Dr X", was not someone I particularly appreciated even though she had always been mostly positive towards me. Dr X is a bit of a hothead and has a reputation in the hospital for yelling at nurses, having explosive fits of anger, and generally not being easy to talk to. Over 3-4 years, she and I had only had one negative interaction and I didn't make much of it.

During my rotation, I worked with different staff. Everyone said that they were very happy to see me and found it very pleasant to work with me. A couple of people suggested I apply for a position. I worked with Dr X one day during which I maybe saw her for 10 minutes. At the end of the day, I tried to have a discussion with her about the upcoming positions and asked to meet to discuss what they are looking for. Dr X was very cold and said that there will be an application process and that the positions will only be discussed with candidates that will be hired. I found this strange because at big academic centre, everyone is free to meet with the head of the department to discuss upcoming opportunities.

A month later, I received instructions via email about how to apply for a position and was again told that only applicants who will be hired will be contacted. I submit the required documents and 2 months later, I got an email stating that they cannot offer me a position. My evaluation for my rotation was glowing but I found out they didn't want to hire me because they thought I would not be easy to get along with and that I was not a good fit. They also felt that I was too friendly with the nurses and that this was inappropriate.

I took this quite personally. I have known these people for 5 years and they were always friendly to me. I even had lunch with a few of them quite regularly. It feels like I was betrayed: that they pretended to like me to my face but that, in reality, they didn't and I was nothing to them. My friends tell me that it's for the best and that I do not want to work with people who are not transparent and who do not appreciate me. I am having a hard time getting over the rejection partly because it feels very hypocritical, partly because I blame myself for having valued these people so much, and partly because I find it unfair to be turned down for a job because Dr X decided she doesn't like me.

I would appreciate some advice about how to move on or if anyone has any similar stories.
Are the people at hospital A just not my kind of people?

Be happy that you dodged a bullet...realize that you would not be happy there.

 

[anonperson]

I just finished fellowship in an IM subspecialty.
I did my IM training at a hybrid community/academic hospital ("hospital A") where I really enjoyed my training. I really liked most of the attendings at that hospital: I felt that we got along and we were quite friendly at work. I went on to do my fellowship at a big academic center where I also got along with the staff but hoped to return to hospital A to work. Hospital A has 3-4 openings to fill over the next couple of years so I happily applied and even went to do a rotation during fellowship in order to demonstrate interest.

During my rotation, I found out that the head of the department for hospital A had just changed and the new head of department, "Dr X", was not someone I particularly appreciated even though she had always been mostly positive towards me. Dr X is a bit of a hothead and has a reputation in the hospital for yelling at nurses, having explosive fits of anger, and generally not being easy to talk to. Over 3-4 years, she and I had only had one negative interaction and I didn't make much of it.

During my rotation, I worked with different staff. Everyone said that they were very happy to see me and found it very pleasant to work with me. A couple of people suggested I apply for a position. I worked with Dr X one day during which I maybe saw her for 10 minutes. At the end of the day, I tried to have a discussion with her about the upcoming positions and asked to meet to discuss what they are looking for. Dr X was very cold and said that there will be an application process and that the positions will only be discussed with candidates that will be hired. I found this strange because at big academic centre, everyone is free to meet with the head of the department to discuss upcoming opportunities.

A month later, I received instructions via email about how to apply for a position and was again told that only applicants who will be hired will be contacted. I submit the required documents and 2 months later, I got an email stating that they cannot offer me a position. My evaluation for my rotation was glowing but I found out they didn't want to hire me because they thought I would not be easy to get along with and that I was not a good fit. They also felt that I was too friendly with the nurses and that this was inappropriate.

I took this quite personally. I have known these people for 5 years and they were always friendly to me. I even had lunch with a few of them quite regularly. It feels like I was betrayed: that they pretended to like me to my face but that, in reality, they didn't and I was nothing to them. My friends tell me that it's for the best and that I do not want to work with people who are not transparent and who do not appreciate me. I am having a hard time getting over the rejection partly because it feels very hypocritical, partly because I blame myself for having valued these people so much, and partly because I find it unfair to be turned down for a job because Dr X decided she doesn't like me.

I would appreciate some advice about how to move on or if anyone has any similar stories.
Are the people at hospital A just not my kind of people?

It's unfortunate but part of the game, especially in academics.

Personal connections play a large role and if you aren't connected with the right people, it's not going to happen.

Personal anecdotes:

A buddy of mine was in the last year of fellowship (2 fellows per year). The department chair offered his co fellow a job in the department. Did not offer him anything. She ended up turning them down and they still did not offer him anything.

He is hardworking, good clinically and easy to get along with. It's just one of those things.

For myself, my program director had hired the past 2 fellows. The department went out of their way to keep them.

When it came time for myself, crickets were chirping. Even though I had more publications and had reasonable skills in the OR( equivalent to the other fellows for sure). I wasn't apart of the inner circle.

Go to a place that wants and values you.

 

[Redpancreas]

I just finished fellowship in an IM subspecialty.
I did my IM training at a hybrid community/academic hospital ("hospital A") where I really enjoyed my training. I really liked most of the attendings at that hospital: I felt that we got along and we were quite friendly at work. I went on to do my fellowship at a big academic center where I also got along with the staff but hoped to return to hospital A to work. Hospital A has 3-4 openings to fill over the next couple of years so I happily applied and even went to do a rotation during fellowship in order to demonstrate interest.

During my rotation, I found out that the head of the department for hospital A had just changed and the new head of department, "Dr X", was not someone I particularly appreciated even though she had always been mostly positive towards me. Dr X is a bit of a hothead and has a reputation in the hospital for yelling at nurses, having explosive fits of anger, and generally not being easy to talk to. Over 3-4 years, she and I had only had one negative interaction and I didn't make much of it.

During my rotation, I worked with different staff. Everyone said that they were very happy to see me and found it very pleasant to work with me. A couple of people suggested I apply for a position. I worked with Dr X one day during which I maybe saw her for 10 minutes. At the end of the day, I tried to have a discussion with her about the upcoming positions and asked to meet to discuss what they are looking for. Dr X was very cold and said that there will be an application process and that the positions will only be discussed with candidates that will be hired. I found this strange because at big academic centre, everyone is free to meet with the head of the department to discuss upcoming opportunities.

A month later, I received instructions via email about how to apply for a position and was again told that only applicants who will be hired will be contacted. I submit the required documents and 2 months later, I got an email stating that they cannot offer me a position. My evaluation for my rotation was glowing but I found out they didn't want to hire me because they thought I would not be easy to get along with and that I was not a good fit. They also felt that I was too friendly with the nurses and that this was inappropriate.

I took this quite personally. I have known these people for 5 years and they were always friendly to me. I even had lunch with a few of them quite regularly. It feels like I was betrayed: that they pretended to like me to my face but that, in reality, they didn't and I was nothing to them. My friends tell me that it's for the best and that I do not want to work with people who are not transparent and who do not appreciate me. I am having a hard time getting over the rejection partly because it feels very hypocritical, partly because I blame myself for having valued these people so much, and partly because I find it unfair to be turned down for a job because Dr X decided she doesn't like me.

I would appreciate some advice about how to move on or if anyone has any similar stories.
Are the people at hospital A just not my kind of people?

In medicine I truthfully think we're insulated from work place subjectivity. When I was learning about random proteins, my friends were complaining about the drama at their workplaces and what was required/not required. I thought, "boy, am I lucky to be in a field that values aptitude and merit"...low and behold I was wrong. That reality was just delayed.

Back to your case, it seems like Dr. X did not like you and that was wrong on her part. Some people can hold grudges for a long time. Who knows if it's because they hate how you come across to people, or if they hold some secret prejudice against you for another reason. Unhappy people in power like Dr. X tend to exaggerate their preferences to validate their views.

I think as you seem to have some insight on this and know you're dwelling on this too much so I won't drill that in further. Just realize that the relationships you developed over those 5 years in IM/Fellowship are still there. It wasn't a joint decision in the department to exclude you but likely someone vocal in the group and usually when there's not much dirt on anyone being selected, even that one vocal critic gets your name taken off the list. People call this politics, but I don't think it's the right word because I don't think people have any hidden motive or voter base they're appealing to. I just think when it comes to people who are chosen to be chiefs, program directors, etc. people in groups choose the "safe" candidate who seems the most neutral/professional over the ones who wear their heart on their sleeve or whatever because we don’t know what else to do.

Go elsewhere. It will be the best thing for you. You don't want to be at the same institution you trained in IM, Fellowship, and now staff in. You'll only know that world. Learn what in medicine is different elsewhere, but as importantly what is the same. Develop new relationships. You already have some references/connections here and keep those in your back pocket. I'm sorry that it feels this way but it seems like you'll succeed just as much if not more elsewhere.

 

[GoSpursGo]

This sucks, and academics can indeed be cruel. But your friends are right--it actually would have been worse to have to work with people who don't value you. You will find a good landing spot.

 

[Sushirolls]

Congratulations! This is good news. Celebrate. You are looking at this all completely wrong. You were just spared a crappy life experience of working at a place that would have made you miserable.

Re-calibrate, open up your eyes to new opportunities and go interview at other places and locations in the country. A better opportunity awaits.

 

[Bobblehead]

Dr X would have been your boss and that would not have been a good thing. The first few years of attending life you're going to need some hand-holding and some/a lot of that will come from your department head who will grease the wheels for you.

Decide where you'd like to apply to next then consider asking a few highly selected individuals if they have connections in that area. Realize that most IM subspecialties are relatively small fields and a lot of people know other people. Your description of what happened with Dr X and your job search thus far should reflect that.

Also realize that in the future someone may give Dr X a call even if you do not list her as a references if they see where you've trained and know Dr X. As such unfortunately it will be best to maintain a gracious attitude indefinitely.

 

[Gastrapathy]

They never wanted you but saying that to your face incurs legal risk. So you were told to apply and get rejected by HR. Maybe it’s them, maybe it’s you. Who cares. On to the next opportunity. Just be sure you get letters you can trust. F em.

 

[Athina]

Thanks everyone for the responses. They are very helpful.
I'm lucky to have been offered a position at the big academic center I did fellowship at.
I am honestly just surprised at how things played out with Hospital A. I am trying to get over it and I know I'm overthinking it: it is, after all, just a job, and it really is becoming clear that it was a poor fit. It irritates me though that the onus of "fit" is on the applicant and the group hiring has no responsibility in ensuring that they are being fair. I guess I was being naive when I thought that in medicine being a good physician, having good research productivity, and teaching evaluations would trump whether someone likes you especially when it's someone that is universally considered "problematic"...
Oh well, life goes on. Time to make the most out of the opportunities I have.

 

[Dave1980]

I took this quite personally. I have known these people for 5 years and they were always friendly to me. I even had lunch with a few of them quite regularly. It feels like I was betrayed: that they pretended to like me to my face but that, in reality, they didn't and I was nothing to them.

Tough lesson to learn but that's how most training programs treat their residents and fellows. You are there to make the program work. You aren't friends.

 

[robellis]

I just finished fellowship in an IM subspecialty.
I did my IM training at a hybrid community/academic hospital ("hospital A") where I really enjoyed my training. I really liked most of the attendings at that hospital: I felt that we got along and we were quite friendly at work. I went on to do my fellowship at a big academic center where I also got along with the staff but hoped to return to hospital A to work. Hospital A has 3-4 openings to fill over the next couple of years so I happily applied and even went to do a rotation during fellowship in order to demonstrate interest.

During my rotation, I found out that the head of the department for hospital A had just changed and the new head of department, "Dr X", was not someone I particularly appreciated even though she had always been mostly positive towards me. Dr X is a bit of a hothead and has a reputation in the hospital for yelling at nurses, having explosive fits of anger, and generally not being easy to talk to. Over 3-4 years, she and I had only had one negative interaction and I didn't make much of it.

During my rotation, I worked with different staff. Everyone said that they were very happy to see me and found it very pleasant to work with me. A couple of people suggested I apply for a position. I worked with Dr X one day during which I maybe saw her for 10 minutes. At the end of the day, I tried to have a discussion with her about the upcoming positions and asked to meet to discuss what they are looking for. Dr X was very cold and said that there will be an application process and that the positions will only be discussed with candidates that will be hired. I found this strange because at big academic centre, everyone is free to meet with the head of the department to discuss upcoming opportunities.

A month later, I received instructions via email about how to apply for a position and was again told that only applicants who will be hired will be contacted. I submit the required documents and 2 months later, I got an email stating that they cannot offer me a position. My evaluation for my rotation was glowing but I found out they didn't want to hire me because they thought I would not be easy to get along with and that I was not a good fit. They also felt that I was too friendly with the nurses and that this was inappropriate.

I took this quite personally. I have known these people for 5 years and they were always friendly to me. I even had lunch with a few of them quite regularly. It feels like I was betrayed: that they pretended to like me to my face but that, in reality, they didn't and I was nothing to them. My friends tell me that it's for the best and that I do not want to work with people who are not transparent and who do not appreciate me. I am having a hard time getting over the rejection partly because it feels very hypocritical, partly because I blame myself for having valued these people so much, and partly because I find it unfair to be turned down for a job because Dr X decided she doesn't like me.

I would appreciate some advice about how to move on or if anyone has any similar stories.
Are the people at hospital A just not my kind of people?

Would you have rather them hire you and treat you badly then you’re forced to quit? They obviously don’t like you..that’s life, there’s people you don’t like and vice versa..go find somewhere you are appreciated and think about their criticisms seriously, it’s possible they are unfounded but the opposite is also possible so recalibrate if needed and move forward, good luck!

 

[Athina]

Would you have rather them hire you and treat you badly then you’re forced to quit? They obviously don’t like you..that’s life, there’s people you don’t like and vice versa..go find somewhere you are appreciated and think about their criticisms seriously, it’s possible they are unfounded but the opposite is also possible so recalibrate if needed and move forward, good luck!

I guess I would have wanted them to give me a chance: to accept me for who I am (a hardworking individual with flaws who is always looking to improve) and to give me the benefit of the doubt just as a do to people. No one is perfect, there is no perfect fit but if people are open and willing to listen to each other and work hard, it shouldn't be an issue. Am I being naive again?

 

[emergentmd]

It’s business. You have learned a valuable lesson in life. You are a worker bee/high paid widget with the sole purpose of making the company more money. No more, no less. Better to learn early and make informed decisions than learn later on.

If you happened to get the job, worked your butt off, took pay cuts, picked up more calls, and essentially bend over backwards you would feel worse when they find the next attending that is either prettier, nicer, more maleable, or willing to work for less.

Many docs think they bring something special to the company and would never get fired only to realize there are always someone that is more "special" to the company. Your idealistic views may have been more reasonable a generation ago when docs actually owned alot of the practices. But currently with all the hospitals/CMGs/VCs/Cut throat docs owning practices, you are defined by metrics.

"It irritates me though that the onus of "fit" is on the applicant and the group hiring has no responsibility in ensuring that they are being fair." - This is wrong on so many level. Business sole purpose is to make money. Fair is great if it happens to achieve more profits.

 

[rokshana]

I guess I would have wanted them to give me a chance: to accept me for who I am (a hardworking individual with flaws who is always looking to improve) and to give me the benefit of the doubt just as a do to people. No one is perfect, there is no perfect fit but if people are open and willing to listen to each other and work hard, it shouldn't be an issue. Am I being naive again?

I have stayed at places much longer than maybe I should have because I liked the people I worked with...don’t underestimate the influence and importance of a good work environment...and again... you lucked out... if going in they didn’t think you were a good fit... your life would have been miserable there, no question.

 

[anonperson]

I guess I would have wanted them to give me a chance: to accept me for who I am (a hardworking individual with flaws who is always looking to improve) and to give me the benefit of the doubt just as a do to people. No one is perfect, there is no perfect fit but if people are open and willing to listen to each other and work hard, it shouldn't be an issue. Am I being naive again?

Yes.

Dr. X, for whatever reason doesn't like you. If the chair doesn't want/ like you, doesn't matter how good you are, it's not going to happen.

This is the politics of academic medicine.

 

[IonClaws]

I just finished fellowship in an IM subspecialty.
I did my IM training at a hybrid community/academic hospital ("hospital A") where I really enjoyed my training. I really liked most of the attendings at that hospital: I felt that we got along and we were quite friendly at work. I went on to do my fellowship at a big academic center where I also got along with the staff but hoped to return to hospital A to work. Hospital A has 3-4 openings to fill over the next couple of years so I happily applied and even went to do a rotation during fellowship in order to demonstrate interest.

During my rotation, I found out that the head of the department for hospital A had just changed and the new head of department, "Dr X", was not someone I particularly appreciated even though she had always been mostly positive towards me. Dr X is a bit of a hothead and has a reputation in the hospital for yelling at nurses, having explosive fits of anger, and generally not being easy to talk to. Over 3-4 years, she and I had only had one negative interaction and I didn't make much of it.

During my rotation, I worked with different staff. Everyone said that they were very happy to see me and found it very pleasant to work with me. A couple of people suggested I apply for a position. I worked with Dr X one day during which I maybe saw her for 10 minutes. At the end of the day, I tried to have a discussion with her about the upcoming positions and asked to meet to discuss what they are looking for. Dr X was very cold and said that there will be an application process and that the positions will only be discussed with candidates that will be hired. I found this strange because at big academic centre, everyone is free to meet with the head of the department to discuss upcoming opportunities.

A month later, I received instructions via email about how to apply for a position and was again told that only applicants who will be hired will be contacted. I submit the required documents and 2 months later, I got an email stating that they cannot offer me a position. My evaluation for my rotation was glowing but I found out they didn't want to hire me because they thought I would not be easy to get along with and that I was not a good fit. They also felt that I was too friendly with the nurses and that this was inappropriate.

I took this quite personally. I have known these people for 5 years and they were always friendly to me. I even had lunch with a few of them quite regularly. It feels like I was betrayed: that they pretended to like me to my face but that, in reality, they didn't and I was nothing to them. My friends tell me that it's for the best and that I do not want to work with people who are not transparent and who do not appreciate me. I am having a hard time getting over the rejection partly because it feels very hypocritical, partly because I blame myself for having valued these people so much, and partly because I find it unfair to be turned down for a job because Dr X decided she doesn't like me.

I would appreciate some advice about how to move on or if anyone has any similar stories.
Are the people at hospital A just not my kind of people?

Lol, sounds like a group of a ss holes calling you an a sshole and not being one is apparently "inappropriate." I don't get why people are like this. Let's follow Dr. X and be a di ckhead to everyone because maybe we'll be popular like Dr. X? I guess that's the thought process? Seems quite cliquely.

Anyway, OP, as an old friend of mine said about when things don't go the way we'd like....."Eh...fuc k 'em."

 

[90sportsfan]

I just finished fellowship in an IM subspecialty.
I did my IM training at a hybrid community/academic hospital ("hospital A") where I really enjoyed my training. I really liked most of the attendings at that hospital: I felt that we got along and we were quite friendly at work. I went on to do my fellowship at a big academic center where I also got along with the staff but hoped to return to hospital A to work. Hospital A has 3-4 openings to fill over the next couple of years so I happily applied and even went to do a rotation during fellowship in order to demonstrate interest.

During my rotation, I found out that the head of the department for hospital A had just changed and the new head of department, "Dr X", was not someone I particularly appreciated even though she had always been mostly positive towards me. Dr X is a bit of a hothead and has a reputation in the hospital for yelling at nurses, having explosive fits of anger, and generally not being easy to talk to. Over 3-4 years, she and I had only had one negative interaction and I didn't make much of it.

During my rotation, I worked with different staff. Everyone said that they were very happy to see me and found it very pleasant to work with me. A couple of people suggested I apply for a position. I worked with Dr X one day during which I maybe saw her for 10 minutes. At the end of the day, I tried to have a discussion with her about the upcoming positions and asked to meet to discuss what they are looking for. Dr X was very cold and said that there will be an application process and that the positions will only be discussed with candidates that will be hired. I found this strange because at big academic centre, everyone is free to meet with the head of the department to discuss upcoming opportunities.

A month later, I received instructions via email about how to apply for a position and was again told that only applicants who will be hired will be contacted. I submit the required documents and 2 months later, I got an email stating that they cannot offer me a position. My evaluation for my rotation was glowing but I found out they didn't want to hire me because they thought I would not be easy to get along with and that I was not a good fit. They also felt that I was too friendly with the nurses and that this was inappropriate.

I took this quite personally. I have known these people for 5 years and they were always friendly to me. I even had lunch with a few of them quite regularly. It feels like I was betrayed: that they pretended to like me to my face but that, in reality, they didn't and I was nothing to them. My friends tell me that it's for the best and that I do not want to work with people who are not transparent and who do not appreciate me. I am having a hard time getting over the rejection partly because it feels very hypocritical, partly because I blame myself for having valued these people so much, and partly because I find it unfair to be turned down for a job because Dr X decided she doesn't like me.

I would appreciate some advice about how to move on or if anyone has any similar stories.
Are the people at hospital A just not my kind of people?

It's a little hard to determine whether or not there is more to the story than what's being presented. It seems like you dodged a huge bullet in not having to work with someone like Dr. X, so it's a little curious why you wanted to even apply given all the red flags, and why you are upset about it now (given that you dodged a bullet).

The other thing that's a little confusing, is that you keep referring to "these people" at hospital A that you feel betrayed by, but it seems like the issue was only with one "person," Dr. A, unless there is more to the story (and other people were involved).

 

[Athina]

It's a little hard to determine whether or not there is more to the story than what's being presented. It seems like you dodged a huge bullet in not having to work with someone like Dr. X, so it's a little curious why you wanted to even apply given all the red flags, and why you are upset about it now (given that you dodged a bullet).

The other thing that's a little confusing, is that you keep referring to "these people" at hospital A that you feel betrayed by, but it seems like the issue was only with one "person," Dr. A, unless there is more to the story (and other people were involved).

There are roughly four years of interactions that can be included as background in this story so there is definitely more to this story that is being presented. I tried to give an objective summary but this is personal so objectivity is likely limited. I would love to hear Hospital A's version!

As to why I applied to this hospital, I think you will realize when it's your turn to be an attending that opportunities in academic centers in a niche field aren't endless and compromises have to be made especially if one is limiting themselves to a particular location. I like the type of practice my subspecialty has at this hospital, I like the schedule, and I like the nurses. I also liked most of the team and was hopeful that, with the people I liked less, we would be collegial and things would be fine. I would have been more than ok with that as I do not need to be friends with everyone at work but I need to have a good professional relationship with everyone.

Dr X clearly is not looking to have a good work relationship with me and I found out that she spent quite a bit of time going to see other staff trying to convince them that I am not a good fit. I am disappointed that the rest of the group played along especially since we were friendly over the years.

 

[IRattending2021]

I don’t want to sound like a huge ass especially because I was in a very similar situation as you as didn’t get my ideal location because residency hospital wouldn’t offer.

I actually lost my first marriage because I couldn’t return to do IR in my relatively small town where my ex was doing their long residency training. Ultimately, it was the best thing to happen to me, because I actually hated that small town and would only go back because of ex. Now I am living in my dream location doing my dream job.

The second thing is that unfortunately it’s one side of your story. Having not had personally interacted with you, I wouldn’t know how the other hospital viewed you. However, being in the other side of the fence now, there are trainees that want to return but those trainees would have a repeated history of poor care.

I know someone who keep trying to bump cases I want to book because she doesn’t feel like coming in at night. She would tell other teams that “this abscess can wait” while I made it clear in writing to her that I want to go in and get cases done.

While I don’t want to raise a big deal about this particular issue since in reality attending preference for timing of cases can vary and I think her approach can be reasonable, you can absolutely be sure that I will present multiple documented instances where this resident went against my plan and resulted in compromise in care due to miscoordination if she came back looking for a job. Key word is “multiple” here as despite repeated coaching this trainee simply doesn’t understand that while draining an abscess in 3 hrs or 12 hrs are both reasonable in a hemodynamically stable and afebrile patient and most staff would do it in 12 hours, if I wanted it done in 3 for my own reason, she is operating under my license and should coordinate it to do so. In one of the worse offending situation, I actually offered to come in myself and just do everything on my own because evidently she has some family emergency (we are both on call) and kept telling the clinical team a procedure can wait when I explicitly asked for this case to go. I really felt like a resident again basically begging this trainee to allow me to do my own case under my own name.

I can totally see this result in a post a few years down the line where she says “hey Dr.X doesn’t like me”. The thing is that I am at this game longer than trainees do and it’s quite probable that there are documented issues against you (real or not) that would bump you off this train.

It’s sad because reputation takes year to build yet two incidences of the same problem is considered a “pattern” and will probably disqualify you from a job.

This is another reason why many people choose to not work in the center they did residency. It’s better to start anew and not to let people remember you as the resident.

 

[Athina]

I don’t want to sound like a huge ass especially because I was in a very similar situation as you as didn’t get my ideal location because residency hospital wouldn’t offer.

I actually lost my first marriage because I couldn’t return to do IR in my relatively small town where my ex was doing their long residency training. Ultimately, it was the best thing to happen to me, because I actually hated that small town and would only go back because of ex. Now I am living in my dream location doing my dream job.

The second thing is that unfortunately it’s one side of your story. Having not had personally interacted with you, I wouldn’t know how the other hospital viewed you. However, being in the other side of the fence now, there are trainees that want to return but those trainees would have a repeated history of poor care.

I know someone who keep trying to bump cases I want to book because she doesn’t feel like coming in at night. She would tell other teams that “this abscess can wait” while I made it clear in writing to her that I want to go in and get cases done.

While I don’t want to raise a big deal about this particular issue since in reality attending preference for timing of cases can vary and I think her approach can be reasonable, you can absolutely be sure that I will present multiple documented instances where this resident went against my plan and resulted in compromise in care due to miscoordination if she came back looking for a job. Key word is “multiple” here as despite repeated coaching this trainee simply doesn’t understand that while draining an abscess in 3 hrs or 12 hrs are both reasonable in a hemodynamically stable and afebrile patient and most staff would do it in 12 hours, if I wanted it done in 3 for my own reason, she is operating under my license and should coordinate it to do so. In one of the worse offending situation, I actually offered to come in myself and just do everything on my own because evidently she has some family emergency (we are both on call) and kept telling the clinical team a procedure can wait when I explicitly asked for this case to go. I really felt like a resident again basically begging this trainee to allow me to do my own case under my own name.

I can totally see this result in a post a few years down the line where she says “hey Dr.X doesn’t like me”. The thing is that I am at this game longer than trainees do and it’s quite probable that there are documented issues against you (real or not) that would bump you off this train.

It’s sad because reputation takes year to build yet two incidences of the same problem is considered a “pattern” and will probably disqualify you from a job.

This is another reason why many people choose to not work in the center they did residency. It’s better to start anew and not to let people remember you as the resident.

I see your point. I feel though that in the example you gave above, if the trainee were to post that that you didn't like her, she should know why and she should also take into account that she was given specific instructions that she ignored. She chose to do that and I think it's fair that there are consequences when you ignore your superior's instructions.

In my case, the only feedback I ever received over 3 years was to be less friendly with nursing because that was not the culture at this institution. It was noted on my part and I even downplayed my personal relationships in front of staff but, honestly, I found that awkward and unnecessary. It is no one's business who I choose to be friends with outside of work. If this group had to provide documented instances where I hindered patient care, they would not be able to and that's why the rejection feels overly personal. I am having a hard time not seeing it as "we simply do not like you" and maybe that's ok but it stings when it comes with so many consequences on my end and none on theirs.

 

[IRattending2021]

I see your point. I feel though that in the example you gave above, if the trainee were to post that that you didn't like her, she should know why and she should also take into account that she was given specific instructions that she ignored. She chose to do that and I think it's fair that there are consequences when you ignore your superior's instructions.

In my case, the only feedback I ever received over 3 years was to be less friendly with nursing because that was not the culture at this institution. It was noted on my part and I even downplayed my personal relationships in front of staff but, honestly, I found that awkward and unnecessary. It is no one's business who I choose to be friends with outside of work. If this group had to provide documented instances where I hindered patient care, they would not be able to and that's why the rejection feels overly personal. I am having a hard time not seeing it as "we simply do not like you" and maybe that's ok but it stings when it comes with so many consequences on my end and none on theirs.

if you are in a procedural specialty, excessive banter with nursing or other staff can lead to issues as patients may feel that they are being ignored. There could even be reports against you that you are not aware of.

 

[Athina]

if you are in a procedural specialty, excessive banter with nursing or other staff can lead to issues as patients may feel that they are being ignored. There could even be reports against you that you are not aware of.

Not a procedural specialty and I don't ever talk about anything apart from the patient in front of a patient. In front of any patient, nursing addresses me as "Dr" and we keep it 100% professional; that has always been my policy.

 

[Iamnew2]

I just finished fellowship in an IM subspecialty.
I did my IM training at a hybrid community/academic hospital ("hospital A") where I really enjoyed my training. I really liked most of the attendings at that hospital: I felt that we got along and we were quite friendly at work. I went on to do my fellowship at a big academic center where I also got along with the staff but hoped to return to hospital A to work. Hospital A has 3-4 openings to fill over the next couple of years so I happily applied and even went to do a rotation during fellowship in order to demonstrate interest.

During my rotation, I found out that the head of the department for hospital A had just changed and the new head of department, "Dr X", was not someone I particularly appreciated even though she had always been mostly positive towards me. Dr X is a bit of a hothead and has a reputation in the hospital for yelling at nurses, having explosive fits of anger, and generally not being easy to talk to. Over 3-4 years, she and I had only had one negative interaction and I didn't make much of it.

During my rotation, I worked with different staff. Everyone said that they were very happy to see me and found it very pleasant to work with me. A couple of people suggested I apply for a position. I worked with Dr X one day during which I maybe saw her for 10 minutes. At the end of the day, I tried to have a discussion with her about the upcoming positions and asked to meet to discuss what they are looking for. Dr X was very cold and said that there will be an application process and that the positions will only be discussed with candidates that will be hired. I found this strange because at big academic centre, everyone is free to meet with the head of the department to discuss upcoming opportunities.

A month later, I received instructions via email about how to apply for a position and was again told that only applicants who will be hired will be contacted. I submit the required documents and 2 months later, I got an email stating that they cannot offer me a position. My evaluation for my rotation was glowing but I found out they didn't want to hire me because they thought I would not be easy to get along with and that I was not a good fit. They also felt that I was too friendly with the nurses and that this was inappropriate.

I took this quite personally. I have known these people for 5 years and they were always friendly to me. I even had lunch with a few of them quite regularly. It feels like I was betrayed: that they pretended to like me to my face but that, in reality, they didn't and I was nothing to them. My friends tell me that it's for the best and that I do not want to work with people who are not transparent and who do not appreciate me. I am having a hard time getting over the rejection partly because it feels very hypocritical, partly because I blame myself for having valued these people so much, and partly because I find it unfair to be turned down for a job because Dr X decided she doesn't like me.

I would appreciate some advice about how to move on or if anyone has any similar stories.
Are the people at hospital A just not my kind of people?

Rejection is part of life and part of medicine. We have all been rejected - from med schools, from residency places, from fellowships, etc. Would have figured you'd be used to it by now. If they don't like you and don't want to hire you, then it is what it is - their job, their rules. Whether you'd be easy to get along with or not is subjective but if they feel that way, they have every right to choose a candidate they feel they might get along with better. At the end of the day we all spend long hours with colleagues so it's important to have a collegial team. I have a business. If I feel someone is not a good fit or not someone I can get along with or not a good employee, I won't hire them. Doesn't make me or them bad. It's my business and my rules and feelings - whether right or not. Same here. Be glad that you have a different position and for all you know it might be for the best. Enjoy!

 

[dpmd]

You taking a business decision personally is pointless. Just be glad you do fit in with the place you got an offer at. Wouldn't be fun to work someplace where the boss dislikes you.

 

[teddy_tu]

You taking a business decision personally is pointless. Just be glad you do fit in with the place you got an offer at. Wouldn't be fun to work someplace where the boss dislikes you.

Wishing OP luck in their new job.

 

[SurfingDoctor]

Why would you want a person who doesn't like you to be your boss? That is just setting oneself up for misery (and a lack of forward mobility).

 

[Iamnew2]

Why would you want a person who doesn't like you to be your boss? That is just setting oneself up for misery (and a lack of forward mobility).

Particularly the misery!

 

[Dral]

People there may think you don't fit in with their personality/workplace. They could have just been being professional when you were there before.

We're seeing your side and not the other here. To sort of play devil's advocate, it may be that most of the staff there may not want you there either and it's you who don't fit in (opposed to it being the new head who just doesn't seem to want you there).

It seems unlikely that's the case based on what the new head did (going out and convincing people you weren't a good fit there). However, it's possible.

Either way, for whatever reason, you are not wanted there for a position. Try your best to not take it personally and instead move on with your career. Kick butt at your new job and make them see they are the ones who made the mistake of not hiring you.

 

[FlowRate]

All the appropriate advice about people potentially being two-faced aside, I wouldn't cut off relationships with the people you liked there if they were more or less friends (people you might hang out with outside of work). The Dept Head has a lot of power and it could have been solely her decision to block you.

 

[clausewitz2]

The hospital will never love you back.

 

[Apollyon]

The hospital will never love you back.

I've said it for years - "business is sociopathic". The hospital doesn't care if you worked on Christmas or Yom Kippur or Eid-al-Adha. In fact, I recall an attending from my residency who said that "institutional memory is about 4 years" - after that, you, individually, are forgotten. The hospital doesn't care about YOUR kids, even if you are a pediatrician.

Recall another truism: "Who is underpaid? You and your spouse. Who is overpaid? Everyone else." It's all about the dollars and cents, and ends right there. "Physician well being" only matters when it makes $$ sense.

 

[SurfingDoctor]

I've said it for years - "business is sociopathic". The hospital doesn't care if you worked on Christmas or Yom Kippur or Eid-al-Adha. In fact, I recall an attending from my residency who said that "institutional memory is about 4 years" - after that, you, individually, are forgotten. The hospital doesn't care about YOUR kids, even if you are a pediatrician.

Recall another truism: "Who is underpaid? You and your spouse. Who is overpaid? Everyone else." It's all about the dollars and cents, and ends right there. "Physician well being" only matters when it makes $$ sense.

Can confirm…

 

[Dawkter]

Is it worth it for the OP to re-apply for this position once there are leadership changes in the department?

 

[FlowRate]

Is it worth it for the OP to re-apply for this position once there are leadership changes in the department?

Great question. I don't feel seasoned enough to have a strong answer. I will say I've talked to much older attendings about various level of regime changes and sometimes a leadership change is just a new figurehead (with the same underlying players and institutional culture) while other times a leadership change is a complete reworking of the department. In OP's case I think it would depend on how strongly connected they felt they were to the old players / how confident they were it was just the dept head blocking him.

 

[Iamnew2]

Is it worth it for the OP to re-apply for this position once there are leadership changes in the department?

Why woud OP do that? I cannot imagine not getting this position can be that crushing! Op has another position. this is not residency where someone might only have a few options. This is attending hood - for goodness sake move on OP! perhaps count your blessings and know that sometimes things don't work out for a reason!

 

[ortnakas]

Are you sure you didn’t actually dodge a bullet? Dr. X doesn’t sound like a pleasant boss/coworker.

 

[TableMD]

The Red Flag of the place you applied is this so called culture of not being too friendly with the nurses. That means that there is some sort of screwy, adversarial dynamic at play that explains why you are a threat to whatever Dr X +\- her cronies have as goals for the endgame.

My biggest issue with your shock at this situation is that you have worked with these people and are unaware of why that dynamic is there and why YOU and YOuR STYLE are incompatible with it. Dr X taught you a valuable lesson on work culture/dynamics that you can learn from if you can take the evidence available to you and put it together. As a trainee you are too used to being the problem and you instead need to realize that you are a likely very strong/great clinician, but are not compatible with where you applied.

Being surprised at this situation is concerning regarding your ability to read the situation.

I run a very casual clinic with my coworkers, hell I dropped off flowers today for my office manager despite being on vacation because having a relationship beyond being compatible cogs is important to me.

You need to be able to see people like Dr X coming and know in advance what they will likely do as much as possible. This is part of your wellness.

 

[chitown2012]

Lots of good advice here but just my own 2 cents...

sometimes these hiring decisions have nothing to do with factors in your control.

I have personally heard of a competitive fellowship program looking for female fellows and not wanting to match another male. I have also personally heard of academic centers wanting to hire “diverse” Faculty and turning down applicants because they are not diverse enough, whatever that means.

dr X may be looking for someone who fits in with their culture of not being friendly with nurses. It likely has nothing to do with your clinical skills, expertise, or CV.