Does the punishment fit the crime?

[Beachlife]

I am on the latter half of finishing my residency in the Miami area. Close to home, last January 2016 a neurology resident at University of Miami Anjali Ramkissoon made national headlines for a notorious incident with an uber driver. This was caught on camera, uploaded and went viral. She was in the final year of her neurology residency and was subsequently terminated in April 2016 just prior to what I would presume would have been a June 2016 graduation.
http://www.nydailynews.com/news/nat...er-driver-viral-video-fired-article-1.2611674

I am in no way condoning her actions but I cannot help but wonder, does the punishment fit the crime? To think back to my own experiences which many others who read this may share, I have been planning out how to become a physician since I was in high school 12 years ago; shadowing doctors, identifying colleges with high medical school acceptance rates, completing all the pre-med courses, unpaid research, thousands of hours of time preparing for tests, hundreds of thousands of dollars invested awaiting repayment. I am very optimistic now that I am almost at the end of the journey of becoming an attending physician and to imagine having that taken away in one sudden swoop is a devastating thought. To this end, I am deeply sympathetic with Dr. Ramkissoon. I do not know her personally, but I know personally the hours of time, and efforts she had to have invested to be in the position she was professionally.

After some consideration and thought, I am of the opinion that her punishment of losing her residency, and thus probably her career as a budding neurologist does not fit the 'crime' of belligerently berating and perhaps physically injuring an innocent person while in an altered [intoxicated] state of mind one night of her life. We all have bad nights, and I am of the opinion that if she wasn't a physician, she would be one of many people who lost their cool and acted inappropriately on a drunken weekend night out and would not have made national headlines. I think the bottom line is that physicians, resident physicians, medical students and anyone on this journey need to be also recognized as human beings vulnerable to stressors, that we do indeed make mistakes in our private lives and have bad days. I am in agreement perhaps that physicians need to be held to higher standards due to an oath taken to act out of the benefit for others first and that we are never really "off duty" as our personal and professional identities are sometimes deeply interwoven. With regard to this resident though, I can guess if she has matriculated this far in her program, she has the knowledge required and bedside manner to treat patients with neurological illness. She should be reprimanded for her inappropriate behavior, but perhaps with a leave of absence where she can undergo mental health counseling, community service and other sorts of punishment that do not erase the years and efforts of progress she has made.

I have read a lot of things in the media, but none from the medical community, moreso from outraged individuals who do not have a good conception of this journey of becoming an attending physician. I am intrigued in the opinions of other residents and those in the medical community and just putting this out there to see how people feel. Thank you for reading.

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[gutonc]

Welcome to SDN Dr. Ramkissoon. I can't believe it took you this long to get here.

 

[Psai]

Sounds like the story is very close to home. We've already discussed your case extensively, in multiple threads.

 

[QofQuimica]

I have a hard time feeling "sympathetic" for anyone who gets drunk and uses that as an excuse to assault another person (whether with fists or from behind the wheel of a car). Whether her/your punishment fit the crime is tough to say, as none of us here knows the whole story. Maybe this was just the very public final straw in a long list of private infractions, as opposed to a one-time event. Or maybe the university just decided to make an example of someone because of the bad luck that the video went viral and hit the national media. Either way, it's not our decision to make. The university was within their right to terminate an employee whom they felt represented them badly, and the employee has the right to appeal that termination. I don't see how any of that is "unfair."

I would also add that, as an attending employed at one of our state universities, if I behaved similarly to what is shown in that video, I would not be at all surprised if my department chose to terminate my employment. Nor would I feel that my termination was in any way unjustified.

 

[bashwell]

I am on the latter half of finishing my residency in the Miami area. Close to home, last January 2016 a neurology resident at University of Miami Anjali Ramkissoon made national headlines for a notorious incident with an uber driver. This was caught on camera, uploaded and went viral. She was in the final year of her neurology residency and was subsequently terminated in April 2016 just prior to what I would presume would have been a June 2016 graduation.
http://www.nydailynews.com/news/nat...er-driver-viral-video-fired-article-1.2611674

I am in no way condoning her actions but I cannot help but wonder, does the punishment fit the crime? To think back to my own experiences which many others who read this may share, I have been planning out how to become a physician since I was in high school 12 years ago; shadowing doctors, identifying colleges with high medical school acceptance rates, completing all the pre-med courses, unpaid research, thousands of hours of time preparing for tests, hundreds of thousands of dollars invested awaiting repayment. I am very optimistic now that I am almost at the end of the journey of becoming an attending physician and to imagine having that taken away in one sudden swoop is a devastating thought. To this end, I am deeply sympathetic with Dr. Ramkissoon. I do not know her personally, but I know personally the hours of time, and efforts she had to have invested to be in the position she was professionally.

After some consideration and thought, I am of the opinion that her punishment of losing her residency, and thus probably her career as a budding neurologist does not fit the 'crime' of belligerently berating and perhaps physically injuring an innocent person while in an altered [intoxicated] state of mind one night of her life. We all have bad nights, and I am of the opinion that if she wasn't a physician, she would be one of many people who lost their cool and acted inappropriately on a drunken weekend night out and would not have made national headlines. I think the bottom line is that physicians, resident physicians, medical students and anyone on this journey need to be also recognized as human beings vulnerable to stressors, that we do indeed make mistakes in our private lives and have bad days. I am in agreement perhaps that physicians need to be held to higher standards due to an oath taken to act out of the benefit for others first and that we are never really "off duty" as our personal and professional identities are sometimes deeply interwoven. With regard to this resident though, I can guess if she has matriculated this far in her program, she has the knowledge required and bedside manner to treat patients with neurological illness. She should be reprimanded for her inappropriate behavior, but perhaps with a leave of absence where she can undergo mental health counseling, community service and other sorts of punishment that do not erase the years and efforts of progress she has made.

I have read a lot of things in the media, but none from the medical community, moreso from outraged individuals who do not have a good conception of this journey of becoming an attending physician. I am intrigued in the opinions of other residents and those in the medical community and just putting this out there to see how people feel. Thank you for reading.

On the bright side, it's fortunate for you/her a second residency took a chance on you/her and now you're/she's more than halfway through. Hope you/she makes good on this second chance.

 

[DokterMom]

Losing it for 30 seconds is one thing.


But losing it for 5+ full minutes, verbally and physically assaulting an Uber driver and destroying his personal property, all while knowing you are being filmed?

Personally, I can't believe that these particular five minutes of infamy were an isolated incident. I suspect she is a pretty "high maintenance" person and that her program was not particularly sympathetic to giving her [another] second chance after she brought down such excruciating public embarrassment.

While she didn't finish her neurology residency, she should still be able to practice medicine.

 

[Apollyon]

Felony assault (which I have no idea this was our not) is a great way to get canned. No, I feel no pity for Dr. Ramkissoon. It makes no difference at which point she was in training. Actually, it does - the closer to being attending, the greater should be the penalty for such childish behavior. Where I work, people were falling over themselves to defend Joe Paterno - not for the person he was, but because of his football acumen. That is equally *****ic.

No matter how one rationalizes, that doesn't make it any more right. Average Joes are pleading this same crime down to 4-6 months in the county lockup, instead of 1-1/3 to 4 in the state penitentiary.

 

[NotAProgDirector]

This type of public behavior will get you fired from almost any job -- except those jobs where you're irreplaceable (like sports teams, unfortunately). The fact that the repercussions to her are so great is her fault, not her program's responsibility. Her program isn't "punishing" her, she brought this on herself.

 

[AdmiralChz]

If you really don't think the punishment fits the crime, watch the full video again. It's hard to imagine worse conduct, especially with the "don't you know who I am" nonsense. We must expect more from our physicians.

 

[Trauma Surgeon]

Being the devil's advocate here!

Some post suggest that this was the final straw… some others that no other punishment could fit the crime…

At a meeting not long time ago, I had this discussion with a PD from a very "respected" and "ivey league" institution in regards to no matter what it is (almost) impossible to fire someone in Europe. Then he told me a story that had taken place at his institution maybe 5-6 years earlier. One of the attending surgeons, that is an extremely well respected and one of the bests in his field of surgery, had lost it on one of the residence and after abusing her verbally he ended the assault by literally shaking her and tossing her aside. After a meeting at highest level the hospital decided his punishment were to take anger management classes (how many or for how long I don't know). Maybe some of you out there know the story or the surgeon, I have hard time to believe this PD was telling be a fictional story from his department, even though there were some alcohol involved when this story were being told

Also, if she was over the bridge (attending), yes she would have gotten fired but she could find another position since she did not loose her license. But, as a resident, the punishment is harsher, she both lost her job and any prospect of being able to practice as an "board certified" neurologist.

Disclaimer: I'm not the original poster or the resident fired.

 

[Beachlife]

Thank you for the interesting replies.

To clarify, I am not her, lol. I am not certain if she did get another residency position, but if so good to know.
I am a resident who passed the halfway mark in my program recently, and was having a brief heated argument with my companion in a public place. It wasn't threatening, abusive, obnoxious etc. it just got me thinking that this was us having a bad day and then thinking more of Dr. Ramkissooon having a bad night. Could I have lost my residency position for my behavior? (I doubt it) but it got me thinking..What is that line that one has to cross though to lose their residency position? Is it well defined? Should it be?

Another question I had; if the same video were taken, and came to view of her program director, without making national headlines do you think she would've received the same penalty? Should making the national spotlight matter in her program's decision?

I personally think without media involvement and national spotlight focused on her, she probably would not have had as harsh a punishment.
I surmise the program was concerned about their public reputation at stake and distanced themselves from her. I think it would have spoken more about the school if they stood by her side and helped her get the right sort of help.
The media thrives on stories like this; a bratty doctor who treats other's 'beneath' her like this while drunk. I am of the opinion they do this more so for entertainment purposes, ratings and revenue then anything else. I don't think any media outlet had a moral concern obligation for her not to practice medicine. However I feel the amount of attention they gave was a large contributor in her eventual fate.

 

[bashwell]

Being the devil's advocate here!

Some post suggest that this was the final straw… some others that no other punishment could fit the crime…

At a meeting not long time ago, I had this discussion with a PD from a very "respected" and "ivey league" institution in regards to no matter what it is (almost) impossible to fire someone in Europe. Then he told me a story that had taken place at his institution maybe 5-6 years earlier. One of the attending surgeons, that is an extremely well respected and one of the bests in his field of surgery, had lost it on one of the residence and after abusing her verbally he ended the assault by literally shaking her and tossing her aside. After a meeting at highest level the hospital decided his punishment were to take anger management classes (how many or for how long I don't know). Maybe some of you out there know the story or the surgeon, I have hard time to believe this PD was telling be a fictional story from his department, even though there were some alcohol involved when this story were being told

Also, if she was over the bridge (attending), yes she would have gotten fired but she could find another position since she did not loose her license. But, as a resident, the punishment is harsher, she both lost her job and any prospect of being able to practice as an "board certified" neurologist.

Disclaimer: I'm not the original poster or the resident fired.

1) In terms of practical realities: It's no surprise people in positions of power ("an extremely well respected and one of the bests [sic] in his field of surgery") can get away with things that others can't. Sure, that's not fair, but look at the two candidates for the highest office of the land -- Trump and Hillary. Both have arguably done a lot of shady stuff in their lives, stuff that would have gotten most other people fired, maybe even imprisoned. Yet they're the frontrunners of the two major political parties. And whoever is elected is going to become the President, despite their arguably shady past. Life is unfair, the rich and powerful tend to get away with things that the poor and weak don't, etc.

2) In terms of fairness or unfairness: If we want fairness, then both this surgeon and Dr. Ramkissoon shouldn't get away with lighter "punishments," but rather have more severe "punishments". In other words, perhaps someone could argue both deserve to lose their licenses for their respective behavior. Yet I thought Dr. Ramkissoon did find another position -- not in neurology, but in another field (e.g., family medicine)? If that's what happened, then it's possible she got better than she deserved.

 

[bashwell]

Thank you for the interesting replies.

To clarify, I am not her, lol. I am a resident who passed the halfway mark in my program recently, and was having a brief heated argument with my companion in a public place. It wasn't threatening, abusive, obnoxious etc. it just got me thinking that this was us having a bad day and then thinking more of Dr. Ramkissooon having a bad night. I admit though I have no idea if this was an isolated incident or not for her.

Another question I had, just for the purpose of light conversation is; If the same video were taken, and came to view of her program director, without making national headlines do you think she would've received the same penalty? Should making the national spotlight matter in her program's decision?

I personally think without media involvement and national spotlight focused on her, she probably would not have had as harsh a punishment.
I surmise the program was concerned about their public reputation at stake and distanced themselves from her. I think it would have spoken more about the school if they stood by her side and helped her get the right sort of help.
The media thrives on stories like this; a bratty doctor who treats other's 'beneath' her like this while drunk. I am of the opinion they do this more so for entertainment purposes, ratings and revenue then anything else. I don't think any media outlet had a moral concern obligation for her not to practice medicine. However I feel the amount of attention they gave was a large contributor in her eventual decline. I am sure many will disagree..

1) Practically speaking, I think it probably did make some sort of a difference. Most hospitals probably wouldn't want to have a doctor publicly known for behaving the way she did on staff, seeing patients, etc. Patients could just Google her name and find out what she did. It'd be risky (financially, reputation wise) for a hospital to be associated with such a doctor, having them see patients, be involved in patient care, and all that stuff.

2) But that's not really all that different from other types of businesses. For example, would Microsoft or Apple want to continue to employ a programmer (even if they're a very good programmer) who is well known for identity theft and related criminal activities? At the very least, it'd be a risk/benefit calculation for them to make. Are they worth the risk in light of an era where many are concerned about the NSA, revelations from Snowden, Asange, and so on?

3) I don't necessarily think her punishment was overly "harsh". It would've been much harsher to have revoked her license entirely.

4) And I'm sure the media thrives on a lot of nonsense. But, welp! That's the media. No surprise there.

 

[cbrons]

No, the punishment did not fit the crime. She should have paid a fine or something. Lost her career? Lol. If that happened to every drunk where im from, half the town would be unemployed.

Felony assault (which I have no idea this was our not) is a great way to get canned. No, I feel no pity for Dr. Ramkissoon. It makes no difference at which point she was in training. Actually, it does - the closer to being attending, the greater should be the penalty for such childish behavior. Where I work, people were falling over themselves to defend Joe Paterno - not for the person he was, but because of his football acumen. That is equally *****ic.

No matter how one rationalizes, that doesn't make it any more right. Average Joes are pleading this same crime down to 4-6 months in the county lockup, instead of 1-1/3 to 4 in the state penitentiary.

I know you are making a point about people defending stupidity with stupid reasoning, but it brings up a larger point about considering the consequences of the bad behavior in question. I think that should be taken into consideration.

Joe Paternos stupidity and ignorance allowed for the rape of multiple children over a several year period. He deserves to have his entire career awash in shame over that. And any of the school admins who are equally culpable should get the electric chair.

This womans behavior was really bad and embaressing, but who did she actually hurt? The fake cab driver's feelings?

Sent from my SM-N910P using SDN mobile

 

[bashwell]

No, the punishment did not fit the crime. She should have paid a fine or something. Lost her career?

Hmmm but has she lost her career though? Did she ever lose her license?

And I thought she even got accepted to a new residency (not neurology, but another field)? If so, then it's a second chance for her.

This womans behavior was really bad and embaressing, but who did she actually hurt? The fake cab driver's feelings?

Actually, what she did to the Uber driver wasn't exactly insignificant. She physically assaulted the driver, damaged his property, attempted to steal or maybe did steal some of his items, etc.

Sure, she might not have done a whole lot of damage since she's a petite woman, but if she had been bigger and stronger (or if she had been a man -- unless we shouldn't treat men and women equally under the law), then she could have done a lot more damage.

What Ramkissoon did was similar to what a Taco Bell executive named Benjamin Golden did to another Uber driver in California. He got fired, and he even got charges filed against him by the Uber driver. Should he not have gotten fired, but just paid a fine? Not sure.

As for Ramkissoon, did the Uber driver even file charges against her? It seems he would've been within his rights to file charges against her, but I don't know if he ever did.

 

[ThoracicGuy]

I am on the latter half of finishing my residency in the Miami area. Close to home, last January 2016 a neurology resident at University of Miami Anjali Ramkissoon made national headlines for a notorious incident with an uber driver. This was caught on camera, uploaded and went viral. She was in the final year of her neurology residency and was subsequently terminated in April 2016 just prior to what I would presume would have been a June 2016 graduation.
http://www.nydailynews.com/news/nat...er-driver-viral-video-fired-article-1.2611674

I am in no way condoning her actions but I cannot help but wonder, does the punishment fit the crime? To think back to my own experiences which many others who read this may share, I have been planning out how to become a physician since I was in high school 12 years ago; shadowing doctors, identifying colleges with high medical school acceptance rates, completing all the pre-med courses, unpaid research, thousands of hours of time preparing for tests, hundreds of thousands of dollars invested awaiting repayment. I am very optimistic now that I am almost at the end of the journey of becoming an attending physician and to imagine having that taken away in one sudden swoop is a devastating thought. To this end, I am deeply sympathetic with Dr. Ramkissoon. I do not know her personally, but I know personally the hours of time, and efforts she had to have invested to be in the position she was professionally.

After some consideration and thought, I am of the opinion that her punishment of losing her residency, and thus probably her career as a budding neurologist does not fit the 'crime' of belligerently berating and perhaps physically injuring an innocent person while in an altered [intoxicated] state of mind one night of her life. We all have bad nights, and I am of the opinion that if she wasn't a physician, she would be one of many people who lost their cool and acted inappropriately on a drunken weekend night out and would not have made national headlines. I think the bottom line is that physicians, resident physicians, medical students and anyone on this journey need to be also recognized as human beings vulnerable to stressors, that we do indeed make mistakes in our private lives and have bad days. I am in agreement perhaps that physicians need to be held to higher standards due to an oath taken to act out of the benefit for others first and that we are never really "off duty" as our personal and professional identities are sometimes deeply interwoven. With regard to this resident though, I can guess if she has matriculated this far in her program, she has the knowledge required and bedside manner to treat patients with neurological illness. She should be reprimanded for her inappropriate behavior, but perhaps with a leave of absence where she can undergo mental health counseling, community service and other sorts of punishment that do not erase the years and efforts of progress she has made.

I have read a lot of things in the media, but none from the medical community, moreso from outraged individuals who do not have a good conception of this journey of becoming an attending physician. I am intrigued in the opinions of other residents and those in the medical community and just putting this out there to see how people feel. Thank you for reading.

 

[QofQuimica]

Thank you for the interesting replies.

To clarify, I am not her, lol. I am not certain if she did get another residency position, but if so good to know.
I am a resident who passed the halfway mark in my program recently, and was having a brief heated argument with my companion in a public place. It wasn't threatening, abusive, obnoxious etc. it just got me thinking that this was us having a bad day and then thinking more of Dr. Ramkissooon having a bad night. Could I have lost my residency position for my behavior? (I doubt it) but it got me thinking..What is that line that one has to cross though to lose their residency position? Is it well defined? Should it be?

I would say that assaulting another person, vandalizing their property, and publically threatening them all cross the line. I don't know about you, but I'm 41 years old, soon to be 42, and I've certainly had my share of, ahem, "heated discussions" with other people over the past four decades. But I've never assaulted any of them. Heck, I don't even get drunk, A) because the hangover the next day is a b****, and B) because I don't like feeling like I'm out of control. Never mind actually being out of control.

Another question I had; if the same video were taken, and came to view of her program director, without making national headlines do you think she would've received the same penalty? Should making the national spotlight matter in her program's decision?

I personally think without media involvement and national spotlight focused on her, she probably would not have had as harsh a punishment.
I surmise the program was concerned about their public reputation at stake and distanced themselves from her. I think it would have spoken more about the school if they stood by her side and helped her get the right sort of help.
The media thrives on stories like this; a bratty doctor who treats other's 'beneath' her like this while drunk. I am of the opinion they do this more so for entertainment purposes, ratings and revenue then anything else. I don't think any media outlet had a moral concern obligation for her not to practice medicine. However I feel the amount of attention they gave was a large contributor in her eventual fate.

I have no idea, and I don't really care. The fact that life isn't always fair is hardly media-worthy news.

 

[deleted480308]

I would likely distance myself as well from someone making the news in that manner

 

[Mad Jack]

I am on the latter half of finishing my residency in the Miami area. Close to home, last January 2016 a neurology resident at University of Miami Anjali Ramkissoon made national headlines for a notorious incident with an uber driver. This was caught on camera, uploaded and went viral. She was in the final year of her neurology residency and was subsequently terminated in April 2016 just prior to what I would presume would have been a June 2016 graduation.
http://www.nydailynews.com/news/nat...er-driver-viral-video-fired-article-1.2611674

I am in no way condoning her actions but I cannot help but wonder, does the punishment fit the crime? To think back to my own experiences which many others who read this may share, I have been planning out how to become a physician since I was in high school 12 years ago; shadowing doctors, identifying colleges with high medical school acceptance rates, completing all the pre-med courses, unpaid research, thousands of hours of time preparing for tests, hundreds of thousands of dollars invested awaiting repayment. I am very optimistic now that I am almost at the end of the journey of becoming an attending physician and to imagine having that taken away in one sudden swoop is a devastating thought. To this end, I am deeply sympathetic with Dr. Ramkissoon. I do not know her personally, but I know personally the hours of time, and efforts she had to have invested to be in the position she was professionally.

After some consideration and thought, I am of the opinion that her punishment of losing her residency, and thus probably her career as a budding neurologist does not fit the 'crime' of belligerently berating and perhaps physically injuring an innocent person while in an altered [intoxicated] state of mind one night of her life. We all have bad nights, and I am of the opinion that if she wasn't a physician, she would be one of many people who lost their cool and acted inappropriately on a drunken weekend night out and would not have made national headlines. I think the bottom line is that physicians, resident physicians, medical students and anyone on this journey need to be also recognized as human beings vulnerable to stressors, that we do indeed make mistakes in our private lives and have bad days. I am in agreement perhaps that physicians need to be held to higher standards due to an oath taken to act out of the benefit for others first and that we are never really "off duty" as our personal and professional identities are sometimes deeply interwoven. With regard to this resident though, I can guess if she has matriculated this far in her program, she has the knowledge required and bedside manner to treat patients with neurological illness. She should be reprimanded for her inappropriate behavior, but perhaps with a leave of absence where she can undergo mental health counseling, community service and other sorts of punishment that do not erase the years and efforts of progress she has made.

I have read a lot of things in the media, but none from the medical community, moreso from outraged individuals who do not have a good conception of this journey of becoming an attending physician. I am intrigued in the opinions of other residents and those in the medical community and just putting this out there to see how people feel. Thank you for reading.

I've been drunk plenty of times and never reached the point of assault and vandalism. That is not behavior that is acceptable and can just be brushed aside. In any of my prior positions, such behavior would have instantly resulted in an employee's termination. That you think medicine should be different speaks to a personal sense of entitlement and a disconnection from the idea that actions have consequences.

 

[bashwell]

I could be wrong, but as far as I'm aware:

1) The Uber driver never filed charges against her, even though he could have.

2) Ramkissoon can still practice medicine since she didn't lose her license.

3) Ramkissoon is in another residency (not neurology but another specialty). She has the opportunity to become an attending in a different specialty.

Things could have turned out much worse for her than they did.

 

[deleted480308]

I could be wrong, but as far as I'm aware:

1) The Uber driver never filed charges against her, even though he could have.

2) Ramkissoon can still practice medicine since she didn't lose her license.

3) Ramkissoon is in another residency (not neurology but another specialty). She has the opportunity to become an attending in a different specialty.

Things could have turned out much worse for her than they did.

She basically hit the lottery



































The lottery........aaaaaaaand an uber driver

 

[Apollyon]

This womans behavior was really bad and embaressing, but who did she actually hurt? The fake cab driver's feelings?

You know that, if you shoot at someone, and completely miss, it is still attempted manslaughter/murder, right? Saying "who did she actually hurt" is immaterial.

 

[Mad Jack]

She basically hit the lottery



































The lottery........aaaaaaaand an uber driver

 

[cbrons]

You know that, if you shoot at someone, and completely miss, it is still attempted manslaughter/murder, right? Saying "who did she actually hurt" is immaterial.

Thats right, and the penalty for attempted murder is less than the penalty for actual murder.

Sent from my SM-N910P using SDN mobile

 

[Mad Jack]

Thats right, and the penalty for attempted murder is less than the penalty for actual murder.

Sent from my SM-N910P using SDN mobile

She should have been charged. If she were, say, a black male, I guarantee she'd have been in a jail cell at best or in the ground at worst. She got off without charges because she's female and a doctor, that's plenty of slack. Losing her job is a minor punishment in comparison to actually getting locked up.

 

[Goro]

Answer: yes, it sure does.

You seem to be arguing that because she's a doctor, that she's somehow above the law? She's a special snowflake who should be treated differently?

Actions have consequences.

I am on the latter half of finishing my residency in the Miami area. Close to home, last January 2016 a neurology resident at University of Miami Anjali Ramkissoon made national headlines for a notorious incident with an uber driver. This was caught on camera, uploaded and went viral. She was in the final year of her neurology residency and was subsequently terminated in April 2016 just prior to what I would presume would have been a June 2016 graduation.
http://www.nydailynews.com/news/nat...er-driver-viral-video-fired-article-1.2611674

I am in no way condoning her actions but I cannot help but wonder, does the punishment fit the crime? To think back to my own experiences which many others who read this may share, I have been planning out how to become a physician since I was in high school 12 years ago; shadowing doctors, identifying colleges with high medical school acceptance rates, completing all the pre-med courses, unpaid research, thousands of hours of time preparing for tests, hundreds of thousands of dollars invested awaiting repayment. I am very optimistic now that I am almost at the end of the journey of becoming an attending physician and to imagine having that taken away in one sudden swoop is a devastating thought. To this end, I am deeply sympathetic with Dr. Ramkissoon. I do not know her personally, but I know personally the hours of time, and efforts she had to have invested to be in the position she was professionally.

After some consideration and thought, I am of the opinion that her punishment of losing her residency, and thus probably her career as a budding neurologist does not fit the 'crime' of belligerently berating and perhaps physically injuring an innocent person while in an altered [intoxicated] state of mind one night of her life. We all have bad nights, and I am of the opinion that if she wasn't a physician, she would be one of many people who lost their cool and acted inappropriately on a drunken weekend night out and would not have made national headlines. I think the bottom line is that physicians, resident physicians, medical students and anyone on this journey need to be also recognized as human beings vulnerable to stressors, that we do indeed make mistakes in our private lives and have bad days. I am in agreement perhaps that physicians need to be held to higher standards due to an oath taken to act out of the benefit for others first and that we are never really "off duty" as our personal and professional identities are sometimes deeply interwoven. With regard to this resident though, I can guess if she has matriculated this far in her program, she has the knowledge required and bedside manner to treat patients with neurological illness. She should be reprimanded for her inappropriate behavior, but perhaps with a leave of absence where she can undergo mental health counseling, community service and other sorts of punishment that do not erase the years and efforts of progress she has made.

I have read a lot of things in the media, but none from the medical community, moreso from outraged individuals who do not have a good conception of this journey of becoming an attending physician. I am intrigued in the opinions of other residents and those in the medical community and just putting this out there to see how people feel. Thank you for reading.

 

[AdmiralChz]

Again, please view the entire video. Youre not going to find much sympathy here, the violence and nastiness was as bad as it could have possibly been. Very few jobs would allow her to stay on, so why would a physician who we expect to be at least semi-reputable be allowed a pass with this sort of behavior?

If she's my employee, I'd probably have no choice but to let her go.

 

[Mad Jack]

Again, please view the entire video. Youre not going to find much sympathy here, the violence and nastiness was as bad as it could have possibly been. Very few jobs would allow her to stay on, so why would a physician who we expect to be at least semi-reputable be allowed a pass with this sort of behavior?

If she's my employee, I'd probably have no choice but to let her go.

That's what I don't understand- if you'll get fired for such behavior at Taco Bell, why should you get a free pass as someone that is supposed to be an upstanding and well-respected member of the community?

 

[Apollyon]

Thats right, and the penalty for attempted murder is less than the penalty for actual murder.

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You miss the point. It's not about completion of commission of a crime. You asked who was hurt. In NY, the actions depicted in the video would constitute assault and battery. In Pennsylvania, it would be aggravated assault. I do not know Florida law, but I suspect that assault has a similar standard. Your statement about a more severe penalty is valid, but also isn't relevant here. That makes it sound like you are trying to divert the point. To restate, my point is that forceful speech towards another, and laying on of hands, is the crime, even if no one is "hurt". If you can't (or won't) see that, that's on you, man.

 

[Terry Toma]

This womans behavior was really bad and embaressing, but who did she actually hurt? The fake cab driver's feelings?

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The image of her employer was hurt. And so her employer fired her. That seems eminently reasonable to me. Do you think that this single resident's value to the hospital exceeds the value of the goodwill hit she caused?

I haven't started my medical career yet, but I have worked in a number of professional roles. I can't imagine that I would have kept any job I ever had if I'd made the news for similar antics.

 

[cbrons]

Do you think that this single resident's value to the hospital exceeds the value of the goodwill hit she caused?

Actually, yes I do. I think her value to society is high enough to not outright fire her as well.

I haven't started my medical career yet

Ah, well, the sacrifice involved in getting to where she was at when terminated is likely beyond your understanding, empathy, and comprehension then.

She was acting like a drunk fool. Her behavior was punished by being publicized on national television. She didnt kill anyone, or even hurt anyone (except herself). So no, I actually dont think she should have had her livelihood revoked for the incident.

As far as, "if she was a black male" etc. etc. that's argumentum ad absurdium. Even if its true that a male who did the same thing would get a more extreme or equally unjust punishment does not legitimize the situation.

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[bashwell]

Actually, yes I do. I think her value to society is high enough to not outright fire her as well.



Ah, well, the sacrifice involved in getting to where she was at when terminated is likely beyond your understanding, empathy, and comprehension then.

She was acting like a drunk fool. Her behavior was punished by being publicized on national television. She didnt kill anyone, or even hurt anyone (except herself). So no, I actually dont think she should have had her livelihood revoked for the incident.

As far as, "if she was a black male" etc. etc. that's argumentum ad absurdium. Even if its true that a male who did the same thing would get a more extreme or equally unjust punishment does not legitimize the situation.

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How do you know she "had her livelihood revoked" though? She got fired from her neurology residency, but did she lose her medical license? Also, didn't she get a second chance at a different residency, not neurology but a different specialty? If so, then she still has the potential to be an attending, make attending money, have a great life, in fact most likely she'll have a better life (financially) than the uber driver she assaulted and the vast majority of her fellow Americans.

Also, she did "hurt" the uber driver. Okay, not in the way you may expect since it seems you're attempting to play down what happened to the uber driver (e.g., "who did she actually hurt? The fake cab driver's feelings?"), and at the same time exaggerate what happened to her (e.g., she had her "livelihood revoked for the incident" -- unless you know something we don't know, which is possible), but she did physically assault him (e.g., hit him, attempted to knee him in the groin), attempted to steal the keys to his car -- and the car is his "livelihood," damage his property including his car -- again the car is his "livelihood," cost him other customer(s) he could have been driving at the time -- which again is his "livelihood," smashed his cell phone -- and his phone is presumably how he has access to his uber account and thus customers who are his "livelihood," etc.

 

[cbrons]

How do you know she "had her livelihood revoked" though? She got fired from her neurology residency, but did she lose her medical license? Also, didn't she get a second chance at a different residency, not neurology but a different specialty? If so, then she still has the potential to be an attending, make attending money, have a great life, in fact most likely she'll have a better life (financially) than the uber driver she assaulted and the vast majority of her fellow Americans.

Also, she did "hurt" the uber driver. Okay, not in the way you may expect since it seems you're attempting to play down what happened to the uber driver (e.g., "who did she actually hurt? The fake cab driver's feelings?"), and at the same time exaggerate what happened to her (e.g., she had her "livelihood revoked for the incident" -- unless you know something we don't know, which is possible), but she did physically assault him (e.g., hit him, attempted to knee him in the groin), attempted to steal the keys to his car -- and the car is his "livelihood," damage his property including his car -- again the car is his "livelihood," cost him other customer(s) he could have been driving at the time -- which again is his "livelihood," smashed his cell phone -- and his phone is presumably how he has access to his uber account and thus customers who are his "livelihood," etc.

So you think smashing someones 400$ cell phone (which you will be forced to replace) is the same as being locked out of practicing a specialty you spent 8 years (school-residency) training for? A lifetimes income as a neurologist in other words?

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[bashwell]

So you think smashing someones 400$ cell phone (which you will be forced to replace) is the same as being locked out of practicing a specialty you spent 8 years (school-residency) training for? A lifetimes income as a neurologist in other words?

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I'm just responding to you on your own grounds. You said she "had her livelihood revoked". You didn't qualify your statement any further than that. If someone has their "livelihood revoked" it means they have lost their source of income to make a living. Unless she lost her medical license, then she did not have "her livelihood revoked". In fact, people here and in other threads are even saying she got a second residency in a different specialty. If that's true, then she definitely did not have "her livelihood revoked". She'll likely make at least $200k/year. That's great.

For example, how much does the average neurologist make per year? I've read around $250k. Let's say she's doing psych or FM. If she becomes a psychiatrist or family physician, how much do they make on average? I've read not much less than a neurologist, maybe around $225k. But all these depend on many other factors like where she is practicing, etc. It's possible (depending on other factors) she could make just as much money in another specialty or even more than she would have made as a neurologist.

Also, there's nothing to say she's permanently "locked out" of neurology forever. If she becomes an attending FM or psychiatrist, and she demonstrates she's truly changed, and if for whatever reason she still really wants to become a neurologist (maybe she wants to take after her father who is a neurologist), then she could apply to do a second residency in neurology. It's possible a neurology program may have compassion on her in the future and take her for a second residency.

But all this is besides the point. If she suffers other unrelated consequences as a result of being punished in accordance with the law, then shouldn't that be on her? For example, let's take an extreme example so it's more obvious. If a murderer murders someone, but suffers other unrelated consequences like he loses his job and now has to go to prison, then should the legal system lessen his punishment for murder and not imprison him so that he doesn't have to go to prison and lose his job?

 

[bashwell]

Look, I'm all for being compassionate toward people who have f*** up or whatever. Maybe it was a one-off incident.

But my point is, hasn't she already been shown a lot of mercy? As I said above, at least as far as I'm aware:

-the uber driver didn't press charges against her even though he could have
-she didn't get her medical license revoked
-she got accepted into a second residency in a different specialty
-she still has the potential to make more money (probably at least $200k if not more) than most people in the US including the uber driver
-she got to go on national television (ABC News) to explain herself which most drunks who assault others don't get to do
-she's a Caribbean graduate which is fine and good, but there are Caribbean graduates who would love to have not one but two chances at getting into residency in the US
-her father is a physician (neurologist) and presumably can help her if she is financially set back by all this
-if she does well enough in the future, becomes an attending in a different specialty (e.g., psych, FM), she could potentially find a forgiving neurology program and be able to do a second (third?) residency in neuro (again) and thus become a neurologist, so she's not completely "locked out" of neurology forever, unless there's something that's not public knowledge

The worst things that happened to her were that she was publicly shamed for her actions and she got fired from her neuro residency. But she still has a very bright future if the above is all true.

 

[deleted480308]

So you think smashing someones 400$ cell phone (which you will be forced to replace) is the same as being locked out of practicing a specialty you spent 8 years (school-residency) training for? A lifetimes income as a neurologist in other words?

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no. I don't think it's worth it. Which is why it was soooooo dumb for her to make that choice.

She chose this. Not her employer. She avoided jail and still has a career as a physician. She came out on the better end of likely scenarios given her choices

 

[QofQuimica]

Ah, well, the sacrifice involved in getting to where she was at when terminated is likely beyond your understanding, empathy, and comprehension then.

You're welcome to your opinion like everyone else, but don't crap on the premed just because s/he hasn't been to med school yet. With all respect, I could make the same argument to you: meh, you're just a med student; you haven't tried applying for a medical license or hospital privileges yet, so you can't fully appreciate how egregious her behavior was for a physician, etc.

 

[cookymonster]

Where's the confirmation that she got a second residency position?

 

[Beachlife]

Thanks for the comments. I can tell how polarizing this topic is based on the responses. It is indeed an interesting debate, hopefully that can be continued in the most respectful of ways..
While I am not entirely sure of her fate in a second residency, and i havent been able to answer this question via a google search, perhaps an idea is to allow her to finish a career in medicine, but serve in an underserved population for X amount of years. It wouldn't jeopardize her livelihood, nor negate the amount of time she put into medicine. However it would mean serving a population that most likely truly need the services, on an income that is likely to be less than the earning potential in other areas and hopefully one that lets her further develop humanity/empathy and counter her ego.
I think it would be an interesting middle ground....

 

[evilbooyaa]

Thanks for the comments. I can tell how polarizing this topic is based on the responses. It is indeed an interesting debate, hopefully that can be continued in the most respectful of ways..
While I am not entirely sure of her fate in a second residency, and i havent been able to answer this question via a google search, perhaps an idea is to allow her to finish a career in medicine, but serve in an underserved population for X amount of years. It wouldn't jeopardize her livelihood, nor negate the amount of time she put into medicine. However it would mean serving a population that most likely truly need the services, on an income that is likely to be less than the earning potential in other areas and hopefully one that lets her further develop humanity/empathy and counter her ego.
I think it would be an interesting middle ground....

If you don't arrest her and convict of her a crime, you can't force her to do underserved community service just to make everyone feel better.

If she's truly matched into family medicine then she's going to be just fine going forward. Agree that if she keeps her head down for a few years and is still dead-set on neurology, she could be considered for a second residency in Neurology. Maybe she should be (or already is) keeping an ear to the ground for any neurology programs that are losing a resident for a year (pregnancy, dismissal, switching fields, etc.) as if she did it quickly, she could save herself a few years.

 

[lymphocyte]

So you think smashing someones 400$ cell phone (which you will be forced to replace) is the same as being locked out of practicing a specialty you spent 8 years (school-residency) training for? A lifetimes income as a neurologist in other words?

Your signature makes a big deal about the term "provider" commodotizing the profession. But here you are comparing a $400 cell phone to a lifetime's income as a neurologist. It's more than just money. And it's more than just this one person. It's about maintaining high standards for her residency, her hospital, and the profession in general.

And she isn't "being locked out." She committed battery in a drunken way and likely violated her employment contact, and the hospital fired her as result. She's welcome to go elsewhere, as she apparently has.

She did have the great misfortune of 1) being recorded and 2) having her Facebook pictures leaked. That sucks, and I feel badly for her. Everybody deserves redemption, which Google sometimes makes impossible.

Actually, yes I do. I think her value to society is high enough to not outright fire her as well.

You seem to think people more "valuable" to society shouldn't be punished like the rest of us. But some would argue doctors, lawyers, teachers--all of them should be held to higher standards precisely because we invest so much trust in them to do the right thing when nobody's looking.

I don't think a drunken mistake makes her a bad person. Who knows what else was going on in her life? But actions have consequences, and the hospital had every right to fire her and perhaps even an obligation. At the very least, the rules are the rules, and they apply to everybody.

 

[deleted480308]

Thanks for the comments. I can tell how polarizing this topic is based on the responses. It is indeed an interesting debate, hopefully that can be continued in the most respectful of ways..
While I am not entirely sure of her fate in a second residency, and i havent been able to answer this question via a google search, perhaps an idea is to allow her to finish a career in medicine, but serve in an underserved population for X amount of years. It wouldn't jeopardize her livelihood, nor negate the amount of time she put into medicine. However it would mean serving a population that most likely truly need the services, on an income that is likely to be less than the earning potential in other areas and hopefully one that lets her further develop humanity/empathy and counter her ego.
I think it would be an interesting middle ground....

Or we could just let her be an adult since charges weren't filed and she can take her resume to the marketplace like everyone else and see who wants to hire her.....it's silly to "make her work for poor people"

 

[VA Hopeful Dr]

Or we could just let her be an adult since charges weren't filed and she can take her resume to the marketplace like everyone else and see who wants to hire her.....it's silly to "make her work for poor people"

And if she landed a 2nd residency, it seems like that is exactly what happened

 

[Perrotfish]

That's what I don't understand- if you'll get fired for such behavior at Taco Bell, why should you get a free pass as someone that is supposed to be an upstanding and well-respected member of the community?

The issue is that medical education is so long, so relentlessly abusive, so expensive (funded by non-dischargable loans), and so unforgiving of failure that failing or firing someone really destroys their life. No sane court system would give someone 10 years in prison and a million dollar fine for what this video showed, but that's effectively what this physician's residency is doing by firing her. Honestly this is one of the biggest problems with our medical training system: there is just no middle ground between complete success and absolute destitution, and so when someone needs remediation educators/employers are always left trying to figure out which is better of two bad options. No one would blink an eye if an attending was fired for this kind of behavior, but firing a resident is an insanely harsh penalty regardless of the crime.

 

[bashwell]

The issue is that medical education is so long, so relentlessly abusive, so expensive (funded by non-dischargable loans), and so unforgiving of failure that failing or firing someone really destroys their life. No sane court system would give someone 10 years in prison and a million dollar fine for what this video showed, but that's effectively what this physician's residency is doing by firing her. Honestly this is one of the biggest problems with our medical training system: there is just no middle ground between complete success and absolute destitution, and so when someone needs remediation educators/employers are always left trying to figure out which is better of two bad options. No one would blink an eye if an attending was fired for this kind of behavior, but firing a resident is an insanely harsh penalty regardless of the crime.

If this is what happened, then I'd completely agree with you. That'd be too harsh.

However, if she was able to get a second residency like some people are saying, then she'll be fine.

 

[deleted480308]

The issue is that medical education is so long, so relentlessly abusive, so expensive (funded by non-dischargable loans), and so unforgiving of failure that failing or firing someone really destroys their life. No sane court system would give someone 10 years in prison and a million dollar fine for what this video showed, but that's effectively what this physician's residency is doing by firing her. Honestly this is one of the biggest problems with our medical training system: there is just no middle ground between complete success and absolute destitution, and so when someone needs remediation educators/employers are always left trying to figure out which is better of two bad options. No one would blink an eye if an attending was fired for this kind of behavior, but firing a resident is an insanely harsh penalty regardless of the crime.

But the court system didn't fire her...a private company did. And almost every company would fire someone with that much bad publicity shining on them, particularly if they were non-essential

 

[Perrotfish]

But the court system didn't fire her...a private company did. And almost every company would fire someone with that much bad publicity shining on them, particularly if they were non-essential

That's the point, though: residencies have many privileges not granted to other employers. They have the right to collaborate with each other as a trust, both to control and coordinate hiring and to set employee wages. They're private organizations that have been given the right to determine who is eligible for a government license, making them the sole gateway into a profession. Residencies effectively 'own' their residents in a way that would be completely illegal for any normal employeer, and they argue that they need these extraordinary privileges because residency is a unique form of education, and not just a normal job. In fact, they've convinced the government that they're so unique that they don't even have to pay their own employees. Residency is so intertwined with the government that the tax payers pay every Residents' salary, and about 70K in tuition besides!

When it comes to employee rights, though, they insist that they have the right to act like any other corporation. At will employment, no whistleblower protections, no clear due process, and no external oversight. No one expects them to be held to a higher standard than any other private organization. Its perfectly reasonable for an employee to be fired, on the first offense, for no reason other than being an embarrassment.

This is a really crappy combination.

 

[deleted480308]

That's the point, though: residencies have many privileges not granted to other employers. They have the right to collaborate with each other as a trust, both to control and coordinate hiring and to set employee wages. They're private organizations that have been given the right to determine who is eligible for a government license, making them the sole gateway into a profession. Residencies effectively 'own' their residents in a way that would be completely illegal for any normal employeer, and they argue that they need these extraordinary privileges because residency is a unique form of education, and not just a normal job. In fact, they've convinced the government that they're so unique that they don't even have to pay their own employees. Residency is so intertwined with the government that the tax payers pay every Residents' salary, and about 70K in tuition besides!

When it comes to employee rights, though, they insist that they have the right to act like any other corporation. At will employment, no whistleblower protections, no clear due process, and no external oversight. No one expects them to be held to a higher standard than any other private organization. Its perfectly reasonable for an employee to be fired, on the first offense, for no reason other than being an embarrassment.

This is a really crappy combination.

You're preaching to the choir about how bad govt licensing of professions is (even when subcontracted to private entities)....but my response would be less regulation, not requiring when someone can and can't be fired.

 

[Perrotfish]

You're preaching to the choir about how bad govt licensing of professions is (even when subcontracted to private entities)....but my response would be less regulation, not requiring when someone can and can't be fired.

Less or more would both be fine, but this middle ground is the worst of all worlds. You have employees who are 'owned' by their employer in a way that much more closely resembles the military than a normal private employer, but those employees have none of the thousands of protections that organizations like the military put in place to try and mitigate employee abuse.

 

[NotAProgDirector]

... that failing or firing someone really destroys their life.

No, it doesn't. I've terminated a handful of residents over the years. Every single one of them has found a way to continue. Sometimes, given the gravity of the issues involved, I worry that the system may be too forgiving.