Dismissed from residency in 3rd year

[HaveQuestions1]

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I was dismissed from my pathology residency a few months ago, four months into my 3rd year. It was due to issues with tardiness. I have changed several aspects of my life to prevent this issue from arising again. My academic standing and evaluations have been very positive, and I have already obtained excellent letters of recommendation from three of my former attendings.

Since the dismissal I have been applying to openings on ResidentSwap for any available 3rd year positions, which are few in pathology. I believe there were 5 openings that have been available, all of which I applied to. Thus far I have been unsuccessful in hearing anything back from those programs after sending them requested documentation. I have also used the mass email tool to reach out to several programs that didn't necessarily have current openings. Of the programs that responded, the majority of responses I received were that they'd keep my information on file, and would consider me should a future position arise. I am worried about finding another 3rd year position, so I want to explore other options.

I want to stay in the field of pathology. Am I eligible to go back into the ERAS match program next year for pathology? That is, in effect, start over from scratch at another pathology residency program. As I said, my academic progress and work has been highly regarded, and also I had research that was accepted for a poster at a national meeting. Also, would I be able to participate in the scramble program this March? I'd prefer not to start over, but I am definitely willing to do it to complete a pathology residency.

 

[gutonc]

Yes, you are eligible to re-apply next year. You should also look for any open positions, not just R3.

 

[HaveQuestions1]

So applying to pathology in the match is ok? I had read in some threads here about the program's eligibility with reimbursement or something to that effect. Do I have a serious chance in obtaining a new residency or even interviewing?

And I have been looking for any pathology position; specifically searched for PGY-1 through PGY-3 years. If any of these is a possibility, it's something I would absolutely accept. I did send one email to a program asking about a PGY-3 spot, but also would be willing to do a PGY-2 spot, and he also mentioned PGY-2 would not work due to eligibility issues. Can you explain what this eligibility is, and if programs would move forward with me despite that fact?

 

[Law2Doc]

Apply early, show up to every interview early and so on. Never be tardy again. You don't have to be the best resident but you ought to at least be able to show up on time. Set multiple alarm clocks. Move closer to your program or whatever. that's not something a doctor should ever get fired for.

 

[HaveQuestions1]

I completely understand, and have already made steps in my life to make sure tardiness is not a problem again. I realize the mistakes in my past, and am ready to move on from them. Any suggestions about the eligibility issue, and being able to reapply despite already completing 2 years in a program?

 

[gutonc]

I completely understand, and have already made steps in my life to make sure tardiness is not a problem again. I realize the mistakes in my past, and am ready to move on from them. Any suggestions about the eligibility issue, and being able to reapply despite already completing 2 years in a program?

You're eligible for whatever you want to apply for. There is a small (but largely insignificant) issue with direct vs indirect funding, but any program that uses that as an excuse is trying to let you down easy.

 

[HaveQuestions1]

Ok thank you very much for your help with that. I appreciate it. I am assuming I should include my experience at my previous residency on the new application with ERAS, is that correct? Also, can I attempt to scramble into a program as well during March's post match scramble?

 

[chooks]

You may also want to talk to the attendees that wrote you good LORs to see if they have any advice for where to apply or focus your efforts. In particular, institutions where the letter writers are known would be a good place to look at. If you have been let go, your LOR's may get a lot more mileage at places that may know the letter writers.

Good luck.

- chooks

 

[NotAProgDirector]

Yes, you can apply to any residency spot -- any level PGY position in pathology.

As mentioned above, you will have less funding if you are required to repeat any training (which is virtually certain). But, in general, the decrease in funding is relatively small and most programs won't care. You can search for "residency clock" on SDN and find more information about this.

Some advice:

1. You're not likely to get a PGY-1 path position in the match. Most programs are not going to want to take someone who has already completed 2 PGY years as a PGY-1. Although it may sound "great" from your end (i.e. having someone who is vastly overtrained for the position they are filling), it can be a nightmare for us. It's hard to treat you like a PGY-1 when you act like a PGY-3. Other interns may come to dislike you because you have so much more training than them, it's hard to fit in. If you were a stellar path applicant the first time and washed out of a top program, then perhaps a lower profile program might be willing to take you. Maybe.

2. You were fired for tardiness. You were presumably warned, multiple times, to arrive on time. And despite that you failed to do so, to the point that the program let you go. Now you tell us that you've "made changes". I'm wondering why you didn't make changes before you were fired. I'm wondering whether you've really changed, or will simply have the same problem all over again. So are the PD's you're contacting. The most important things for your application is 1) a letter from your PD describing what happened and why you were fired, and hopefully supporting your application for a new spot; 2) a description from you that matches the explanation from your PD; 3) clear proof that the problem has been fixed.

You haven't put any details here, which is fine. But I'm worried that you have a substance problem. Or a sleep disorder that's not well controlled. Or depression / anxiety / other psych issue. I don't believe you just "slept through your alarm", and neither will any other PD. I write this not to encourage you to explain the situation in detail here -- but you need to convince a program that your problem is fixed. And if your problem is any of the prior, then I don't think it's fixed in 3 months.

3. If I am worried that your problem isn't fixed, then reapplying is a sign of lack of insight / concern. That will get you nowhere.

 

[HaveQuestions1]

Thank you for your response.

I have received a letter from my PD stating his support in starting at a new position, but he didn't specify the reason for my dismissal. Instead he stated in his letter that I would discuss the reasons for dismissal. I have been honest with the PD's that I have contacted for PGY-3 spots who have asked for my reasons for dismissal. Will I need to have him write another letter explaining the situation? One of the attendings has written a brief bit about the situation, not going into much detail.

My issues did have to do with medical issues, including issues with sleep, obsessive compulsive disorder, and tourette's syndrome. I have since, however, developed a solid daily routine, and began taking medications for these problems.

I have considered other options, i.e. research and even PA and lab assistant jobs. If I prove myself in those positions, will I have an improved chance to get a PGY-1 position? Also, isn't it true that the more time I spend out of residency programs, the less likely I will be able to get back in? Or are my best options to keep looking for PGY-3 positions?

I admit that I did handle my situation poorly in my residency, but am willing to take any steps to get back in, so that I can finish pathology, as I was doing well academically.

Would you suggest I explore other career options and forget medicine altogether? I have come far in my career thus far and couldn't imagine leaving medicine now.

 

[Law2Doc]

Thank you for your response.

I have received a letter from my PD stating his support in starting at a new position, but he didn't specify the reason for my dismissal. Instead he stated in his letter that I would discuss the reasons for dismissal. I have been honest with the PD's that I have contacted for PGY-3 spots who have asked for my reasons for dismissal. Will I need to have him write another letter explaining the situation? One of the attendings has written a brief bit about the situation, not going into much detail.

My issues did have to do with medical issues, including issues with sleep, obsessive compulsive disorder, and tourette's syndrome. I have since, however, developed a solid daily routine, and began taking medications for these problems.

I have considered other options, i.e. research and even PA and lab assistant jobs. If I prove myself in those positions, will I have an improved chance to get a PGY-1 position? Also, isn't it true that the more time I spend out of residency programs, the less likely I will be able to get back in? Or are my best options to keep looking for PGY-3 positions?

I admit that I did handle my situation poorly in my residency, but am willing to take any steps to get back in, so that I can finish pathology, as I was doing well academically.

Would you suggest I explore other career options and forget medicine altogether? I have come far in my career thus far and couldn't imagine leaving medicine now.

I think the problem is no one on here can know if you will be able to find that one guy out there with an open spot and a willingness to take a chance on you. All you can do is take your shot. Provide evidence that it was a Medical issue and it has been medically addressed. Line up former attendings who will put in good words, not just hand over a cryptic letter from your PD. Letters won't mean much, they are going to want guys who will pick up the phone. And the unwritten question is surely going to be that if your attendings and PD think you are so good, why wouldn't they take you back now that you've gotten help?

As mentioned on many other threads, jumping from residnt to PA isn't typically a viable course. These are totally separate fields and though you may possess adequate knowledge to be a PA you aren't on a training track that will lead to that position -- they aren't lower rungs on the same ladder.

I don't know that research or lab assistant routes will get you closer to residency. Those paths may buy you more time to look for that needle in a Haystack, and may get you additional references who can say they worked with you and you are solid. But in the end you still need to find that one PD with an open spot who sympathizes with your plight. If he exists. It might pay to wrap you mind around a plan B in case you don't find him.

 

[Gastrapathy]

OP, go back to your old PD and tell him you can't find a spot and, given the reason you were fired, don't think you ever will. Beg to have him take you back. Beg. And go to the attending most likely to help and beg him/her to advocate for you first. Getting fired for tardiness will be interpreted as code for something more sinister. Also, the letter saying that you will explain why you were fired is not helpful (no reason to believe your story). If he won't take you back, ask him to revise the letter to explain why in detail.