Drowned... now what?

[michgirl]

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Sorry for the following long post.

I'm a CA3 from a low-tier midwest program who was dismissed from residency two days ago. I had a bad luck "not to please" two most powerful attendings here on my first week as CA1. After enduring two years of abuse of all sorts, and having only 6 months out of 24 of training "credited" (doesn't matter what and how I did, with many good evals, results were reported to Boards as "unsatisfactory") I lost it. Reasons cited were "underperformance under stress", "inability to make priorities", "being very detail-oriented", "overconcern with differential diagnoses" and "issues with some faculty members". Out of 37 points of evaluation summary, I have 32 "satisfactory" and from last 6 months passed 5 - anyway, the result again was "unsatisfactory".

I kind of agree with some of this, although, giving circumstances, I still wonder how did I managed not to kill somebody. I actually had not big adverse events over CA2 at all. I know I need different atmosphere for training - more personal and benign, maybe.

PD, who was and still is supportive, offered several options. One is to appeal to GME (though I think it would not help at all). Second one is to find a CA1 or CA2 position. I can find more than one attending who would write a nice letter, but I guess it would be a task how to explain what happened to the new program and then to Boards. The third one is to change speciality. I still love Gas very much, but these two years gave me immense emotional drain and depression, being far avay from my family and my child. I still love to work quickly, still love procedures, like to have intensive but short relationship with patients and like differentials as well. My favorite rotation was ICU. Even some people I still believe told me more than once that change speciality might be a viable option for me.

I really need a kind advice, as well as information (or where to find it) about openings CA1 or CA2. Thank you!

 

[foil]

Why do we fall?
To learn how to pick ourselves back up.


You have to much invested to change now.

You've had good schooling....did you not?
Now you need to have total confidence in your ability.
Do not buckle under when things get tough.
It is those though times that feed your inner flame and make you excel.
Seek out the difficult work, the demanding person in charge.

Show no fear.
In competition of any sport, the stronger opponent thrives on instilling fear, buckling you down mentally, then proceeding to victory.
By you not showing fear..........you then instill fear in the stronger opponent.

Know.......that you are one of the best.

Take up Yoga, Buddhist studies, even quickly visit a hypnotherapist.

At this point, it's a mental game.

Pick yourself back up..........NOW


Foil 👍

 

[Pilot Doc]

My turn to quote a platitude:

Insanity: doing the same thing over and over again and expecting different results.

Sounds like the OP has realized that gas wasn't for her. It takes a lot to get fired after 2 years in a program. Someone thinks she isn't safe to let loose on the public.

Harsh. Yeah. Ignoring it and plunging back into a specialty that she only has 6 months of creditable time in ... even harsher.

Medicine has lots of good options. Seek another one. Maybe EM.

 

[otho]

Why do we fall?
To learn how to pick ourselves back up.

😱

You are so close to finishing that you need to fight for your right to finish the program.

You need the help of a competent and aggressive attorney to get readmitted to the program and full credit for the 2.5 years you have already wasted.

Not all attorneys are up to the task you need to find one who fought for the rights of other residents who were poorly treated at the medical center.

I don't care how incompetent the two pompous head in the sand attendings claim you are, a good attorney will scare your program director enought to get you back in and make sure you graduate in six months to a year.

 

[militarymd]

I know your type.

Become a FP.

We don't need another f _ g assassin loose in our specialty.

 

[urge]

I agree with Mil. Sounds to me like you need something low stress, slow paced. Psychiatry or FM.

It's not going to get any easier when you become an attending. Look at Jet's emergency tamponade. Can you see yourself handling that? I just had a ruptured AAA that come to the OR with no pulse(no a-line of course, made it to the ICU with great VS). There is no way to make it "more personal or benign". Either you have the right personality or you don't.

 

[jetproppilot]

I know your type.

Become a FP.

We don't need another f _ g assassin loose in our specialty.

YEAH, I KNOW.

Certain individuals are gonna look at Mil's response....

and maybe report it...🙄

BUT THE DUDES RIGHT.

I DID A RESIDENCY WITH A S. WHO WAS THE LAZIEST RESIDENT ON EARTH...

and she finished....

nobody intervened and dismissed THE LAZIEST, MOST SELF CENTERED RESIDENT ON PLANET EARTH....

point being it takes AN ACT OF GOD to get dismissed...

sorry, Dude/Dudette, if you were dismissed, you must've REALLY PUSHED THE ENVELOPE.

You've gotta MD degree.

You can make six figures in some other specialty.

BUH BYE.

 

[Gern Blansten]

You introduce yourself as a CA-3, but, I hate to tell you; you are a CA-1.

During this competitive time in anesthesiology, it will be tough to find a program that will take a chance on you (for good reason-you got unsatisfactory 5 out of 6 eval periods). Since you type in broken english, I assume you also speak that way and that makes me think you are an IMG. This will make it even tougher for you to find another spot. Perhaps communication skills were part of the problem.

The only thing I can say about the program is that they waited too long to let you go. That many unsatisfactories in a row is unlikely to change and they should have let you know ~ a year ago.

If an attorney somehow reverses this action, it will be a sad day for graduate medical education. Might as well just make evaluations based on participation and give everyone a participation trophy and a certificate of completion when they arrive. While I feel bad for the original poster, it is the training program's responsibility to take these types of actions for the overall well-being of the specialty. It is very difficult, but sometimes it becomes blatantly obvious that a resident is not cut out for their field of choice and would never be deemed able to practice safely and independently. When a resident graduates, it must be stated that the program feels that they are capable of "safe and independent" practice. If it is not true, that resident should not graduate. Cruel but fair.

 

[jennyboo]

Michgirl, here is what I gathered from your post (and some of it is copy/paste):

Poor evaluations with concern (on your part as well as program's) for patient safety
- only 6 months out of 24 of training "credited," that is really bad
- Evaluations saying "underperformance under stress", "inability to make priorities", "being very detail-oriented", "overconcern with differential diagnoses" and "issues with some faculty members". Very concerning evals.
- You yourself "still wonder how did I managed not to kill somebody." Seems you are at least partly aware that there are safety concerns and you have enough insight to know this (which is good).

Maybe a personality mismatch for anesthesiology
- You feel you "need different atmosphere for training - more personal and benign."
- You haven't done well emotionally during this residency: "these two years gave me immense emotional drain and depression, being far avay from my family and my child"
- You said "I still love to work quickly, still love procedures, like to have intensive but short relationship with patients and like differentials as well. My favorite rotation was ICU." BUT your evals are concerned about how you spend too much time on differentials, and ICU is very different from perioperative anesthesia. Most of us are the other way around -- we liked the OR more than the ICU.

I disagree with the above posters who felt you should fight your termination.

I get the feeling that even if you found another CA-1 position, you would not do well. You would probably have the same clinical problems (mainly, underperforming and poor priority-setting leading to dangerous clinical situations). The depression will probably not disappear. And you still won't get much differential diagnosis or ICU, which seem to be things you value a lot.

There ISN'T a more benign, more nurturing anesthesiology residency for you. It takes a lot to be fired from any residency but if it was a low-tier program to start with, they are used to "taking what they can get" and being patient with it... in other words, it takes a LOT to be "worst of the worst" to the point of being fired with very concerning evaluations such as the ones you describe.

I think your chances of success and satisfaction, and your chances of finding a job that fits your interests and personality, are better with re-applying for a different specialty. Family medicine comes to mind; internal medicine perhaps, especially if you're interested in ICU. Psychiatry is also not a bad thought, though it doesn't sound like what you're interested in. Emergency medicine sounds like it wouldn't be a bad fit for your interests, but it is somewhat more competitive to get a residency and you probably also want to consider whether the pace is too fast for you.

 

[jetproppilot]

Michgirl, here is what I gathered from your post (and some of it is copy/paste):



I disagree with the above posters who felt you should fight your termination.

I get the feeling that even if you found another CA-1 position, you would not do well. You would probably have the same clinical problems (mainly, underperforming and poor priority-setting leading to dangerous clinical situations). The depression will probably not disappear. And you still won't get much differential diagnosis or ICU, which seem to be things you value a lot.

There ISN'T a more benign, more nurturing anesthesiology residency for you. It takes a lot to be fired from any residency but if it was a low-tier program to start with, they are used to "taking what they can get" and being patient with it... in other words, it takes a LOT to be "worst of the worst" to the point of being fired with very concerning evaluations such as the ones you describe.

I think your chances of success and satisfaction, and your chances of finding a job that fits your interests and personality, are better with re-applying for a different specialty. Family medicine comes to mind; internal medicine perhaps, especially if you're interested in ICU. Psychiatry is also not a bad thought, though it doesn't sound like what you're interested in. Emergency medicine sounds like it wouldn't be a bad fit for your interests, but it is somewhat more competitive to get a residency and you probably also want to consider whether the pace is too fast for you.

.

 

[KungPOWChicken]

the bull**** about this situation is that these programs will use the f uck out of residents as slave labor and when they feel its convenient for them they'll throw them out on the road. You should have a pretty good feeling about someone within six months. If they aren't performing they should be tossed. Not used and abused for two freakin years. There was a resident at my program that got tossed with less than one year left. WTF!!!??? Couldn't figure it out sooner. The other thing is that so many attendings are lazy pieces of ****. They're stellar at writing evaluations based on the mood they're in but when it comes to getting off they're fat asses it will never happen. And, don't even mention teaching. They're too busy talking to they're colleagues about the resident they don't like or better yet what they're cooking for dinner. Most evals are subjective pieces of ****. This resident should get a shot at another program. Maybe they'll have staff who aren't complete f2cking *****s.

 

[jetproppilot]

the bull**** about this situation is that these programs will use the f uck out of residents as slave labor and when they feel its convenient for them they'll throw them out on the road. You should have a pretty good feeling about someone within six months. If they aren't performing they should be tossed. Not used and abused for two freakin years. There was a resident at my program that got tossed with less than one year left. WTF!!!??? Couldn't figure it out sooner. The other thing is that so many attendings are lazy pieces of ****. They're stellar at writing evaluations based on the mood they're in but when it comes to getting off they're fat asses it will never happen. And, don't even mention teaching. They're too busy talking to they're colleagues about the resident they don't like or better yet what they're cooking for dinner. Most evals are subjective pieces of ****. This resident should get a shot at another program. Maybe they'll have staff who aren't complete f2cking *****s.

.

 

[Apollyon]

Medicine has lots of good options. Seek another one. Maybe EM.

Not EM - if this person can't handle one horrendously ill patient, then there is NO way she can handle 4 critical undifferentiated patients.

 

[coprolalia]

the bull**** about this situation is that these programs will use the f uck out of residents as slave labor and when they feel its convenient for them they'll throw them out on the road. You should have a pretty good feeling about someone within six months. If they aren't performing they should be tossed. Not used and abused for two freakin years. There was a resident at my program that got tossed with less than one year left. WTF!!!??? Couldn't figure it out sooner. The other thing is that so many attendings are lazy pieces of ****. They're stellar at writing evaluations based on the mood they're in but when it comes to getting off they're fat asses it will never happen. And, don't even mention teaching. They're too busy talking to they're colleagues about the resident they don't like or better yet what they're cooking for dinner. Most evals are subjective pieces of ****. This resident should get a shot at another program. Maybe they'll have staff who aren't complete f2cking *****s.

I have to agree with KungPOWChicken here.

It may be that the OP wasn't a good fit, but why wait until CA-3 to tell her?

At my institution, I've heard of people (both in Neurosurgery and Ortho) getting fired in their last year of training. I can't believe that the trends seen prior to that weren't enough for serious intervention and/or re-direction. Why didn't someone tell them earlier on that they weren't a good fit and not demonstrating appropriate growth in the field?

We've had to unfortunately let a few people go in the past few years for poor performance. This was done VERY early on in their training. Usually it was after two consecutive "unsatisfactory" performance evaluations. Yet, I still have to agree with KungPOW: this was mainly based on subjective criteria.

This **** would never fly in the business world.

You have to be specific in your evaluation of someone. If you are going to level a charge that they are "too detail oriented", you have to supply specific instances on specific dates with specific patients (etc.) and a specific plan for correction. This also has to demonstrate repeated inability to either do better or improve in that same individual.

I agree that this program probably got a lot of benefit out of having this person around for so long. In a supervised role, a bad resident still provides a benefit to the hospital providing bench time and getting work done. Many programs are lazy and full of equally lazy clinicians that in lieu of using good business practices to discern problem residents and develop a plan of corrective action instead rely on impression, rumor, and innuendo. Once you get labeled as a problem resident, it gets very hard to shake that reputation. It becomes your scarlet letter. And, a lot of the time it may be just that you had the balls to disagree with a particularly opinionated and aggressive attending.

I'm not saying that this person was a good fit for anesthesia. Maybe not. But, this should have been identified well before her CA-3 year. And, unless they can provide specific details of her faults and where her care would've or could've harmed a patient, I think a good employment attorney would have a field day with this one.

-copro

 

[michgirl]

Not EM - if this person can't handle one horrendously ill patient, then there is NO way she can handle 4 critical undifferentiated patients.

Did it more than once in ICU, being all alone. Enjoyed it and did it all right.

And for 2 years I pleaded EVERY SINGLE attending there - please, give me details, please explain. Nothing, ever. Instead, nurses searched my room for unsigned syringes, so I could be castigated one time more for another "violation" and "lack attention to details".

The thing is: I did the same CA2-level of cases OK in one hospital (where attendings sit in the room and teach and still give residents some freedom) and - apparently - not OK in another one (where I was yelled at for everything). Both have typical patient ASA3 or 4.

Actually, I had LESS mistakes than many of my classmates b/o I was so careful and concentrated. Is being careful and detail-oriented bad for doing anesthesia?

Anyway, I've got it. Maybe switch of specialities would work just fine. And I will not have to explain again and again how and where I lost my self-confidence.

 

[Planktonmd]

YEAH, I KNOW.

Certain individuals are gonna look at Mil's response....

and maybe report it...🙄

BUT THE DUDES RIGHT.

I DID A RESIDENCY WITH A S. WHO WAS THE LAZIEST RESIDENT ON EARTH...

and she finished....

nobody intervened and dismissed THE LAZIEST, MOST SELF CENTERED RESIDENT ON PLANET EARTH....

point being it takes AN ACT OF GOD to get dismissed...

sorry, Dude/Dudette, if you were dismissed, you must've REALLY PUSHED THE ENVELOPE.

You've gotta MD degree.

You can make six figures in some other specialty.

BUH BYE.

Believe it or not but I actually agree with everything you said.

 

[Planktonmd]

Did it more than once in ICU, being all alone. Enjoyed it and did it all right.

And for 2 years I pleaded EVERY SINGLE attending there - please, give me details, please explain. Nothing, ever. Instead, nurses searched my room for unsigned syringes, so I could be castigated one time more for another "violation" and "lack attention to details".

The thing is: I did the same CA2-level of cases OK in one hospital (where attendings sit in the room and teach and still give residents some freedom) and - apparently - not OK in another one (where I was yelled at for everything). Both have typical patient ASA3 or 4.

Actually, I had LESS mistakes than many of my classmates b/o I was so careful and concentrated. Is being careful and detail-oriented bad for doing anesthesia?

Anyway, I've got it. Maybe switch of specialities would work just fine. And I will not have to explain again and again how and where I lost my self-confidence.

Your problems obviously have nothing to do with your academic achievement or even your procedural skills.
You seem to have an issue with reality, and you seem to want to change the world to fit your view rather than try to adapt your view to the way things are.
This issue is not going to disappear even if you change specialties and unless you are willing to accept that things are not going to be always the way you want them to be you will continue to have problems.
My sincere advice to you is to try to explore the exact cause of your fears and uncertainties and you will most likely need professional help to do that but that's OK.
The bottom line: Things are never perfect and you have to learn how to adapt.
Good luck.

 

[SleepIsGood]

Michgirl

I dont know you personally.

Take everything everyone says here with a grain of salt.

The bottom line as someone else mentioned here is that Evaluations are COMPLETELY subjective!

I know of attendings who like certain residents here and will straight up ask them , " what do you want on your eval". This happens everywhere, from the best of places to the worst of places. Certain attendings will like you. Certain attendings will dislike you and it STICKS. You could do everything correct but because of some reason they will hate you and that will not change. These guys are usually the lazy attendings, which were picked on and ridiculed when they were younger, and now with the power trip they want to come down on residents.

How are your objective points...AKTs, USMLEs, tests? And just because you are at a 'mid-tier' program it doesnt mean anything. Infact, often times its the 'low tier/ mid-tier' programs that work harder.

If you think anesthesia is a good fit for you. Then I say stick it through. There are places that will accept CA3's. You just have to be a mad person and call everywhere and be flexible to travel. Perhaps all you need is a change in environment.

 

[michgirl]

Michgirl

How are your objective points...AKTs, USMLEs, tests? And just because you are at a 'mid-tier' program it doesnt mean anything. Infact, often times its the 'low tier/ mid-tier' programs that work harder.

If you think anesthesia is a good fit for you. Then I say stick it through. There are places that will accept CA3's. You just have to be a mad person and call everywhere and be flexible to travel. Perhaps all you need is a change in environment.

Tests all among best in my class (no kidding). Nobody ever mentioned academicals as a problem.

Evals, as far as subjective they are, show that in the last summary from 37 points 32 were "satisfactory". Anyway, the whole result was "unsatisfactory".

I just thik that it wouldn't be possible to find a position where they will accept resident with such a past. And another question how to explain all of this to Boards.



I just think my

 

[lane]

Tests all among best in my class (no kidding). Nobody ever mentioned academicals as a problem.

 

[dragonfly99]

Michgirl,none of us really know you.

However, I concur with those who posted on here pointing out that evaluations are largely subjective and some attendings actually play favorites (and/or decide they hate someone) for no really good reason. Some residents actually suck clinically and are rude and rather stupid but are good at kissing ass. Some residents are good clinically but don't spend time kissing ass, or have a more quiet personality. Sometimes the lazy but ass kissing resident gets a lot better evaluation.

I would say getting credit for only 6months/24 is going to be very concerning to another anesthesiology program. I don't know that a lawyer will be able to get you back in. It might be better right now to practice some "damage control" by trying to get your program director to somehow give you credit for an entire year (do you mean you got only < one PGY1 year credit or you did a PGY1 and then only got 6 months anesthesiology credit?). If you already got 1 year credit for internal medicine, then consider trying for PGY2 emergency medicine or PGY2 internal medicine.

Nobody on here knows whether you are a good resident (clinically) or a bad resident. I will say there may be some truth on both sides. Perhaps you do have some communication issues with the attendings and/or patients. Perhaps you are a little too obsessive compulsive in emergency situations. I still find the program at fault. If they have been repeatedly not giving you credit, then they needed to either make a plan with you to make this better, or have let you go after 1 year or so.

If it makes you feel better, I have a friend who did a whole year in one specialty, was told she was clinically bad (Despite some good evals from several faculty and outscoring every resident in the program on the inservice exam). She switched to a different specialty at another program and did quite well.

I don't know, it might be better to cut your losses and just restart in another specialty. I don't recommend family practice unless you want to spend a career doing primary care medicine, particularly outpatient. Internal medicine or ER might be better options.

 

[radslooking]

Your problems obviously have nothing to do with your academic achievement or even your procedural skills.
You seem to have an issue with reality, and you seem to want to change the world to fit your view rather than try to adapt your view to the way things are.
This issue is not going to disappear even if you change specialties and unless you are willing to accept that things are not going to be always the way you want them to be you will continue to have problems.
My sincere advice to you is to try to explore the exact cause of your fears and uncertainties and you will most likely need professional help to do that but that's OK.
The bottom line: Things are never perfect and you have to learn how to adapt.
Good luck.

that's good insight plankton. i feel she is probably hamstrung by trying to be perfectionist, which is causing her to lose overall perspective of what needs to be done first, and quickly. That and some probable communication problems. I don't know any more than anyone else...just what i perceive from her posts. Its the only way I can reconcile someone who tests well, but is evaluated poorly. (who isn't lazy)

oh, and get some treatment for your depression. it may make a world of difference and give you some insight to your problems.

 

[Lonestar]

My two cents. You are finished. No matter what you try the label will follow you everywhere. I just finished residency and I had some classmates who were let go outright and others had 6 months added. Residency is full of a_hole attendings. They just thrive on the fact that they have complete control over you. We have had some decent residents given 6 months b/c one attending didn't like them. This is absurd!!! We had one resident who was let go late in his CA1 yr and then he couldn't find a pathology spot. So, i wish i could be more constructive but i would throw a wide net at multiple specialties and see what i can fish. Hope this helps.

 

[Heeed!]

If 5 of the last 6 reviews were negative then it seems to me the program knew way back then the OP was not hacking it. They were creating a paper trail to use as justification.

I recommend you get some help for your personal problems. Your professional life will not go well if you're depressed, missing your child, etc. Speak with a counselor of some sort. Maybe move home or closer to family. Get your applications together to apply for a spot in FP or IM. Take the rest of the academic year off and get your head on straight so you can start work in a new specialty in July.

 

[michgirl]

If 5 of the last 6 reviews were negative then it seems to me the program knew way back then the OP was not hacking it. They were creating a paper trail to use as justification.

I recommend you get some help for your personal problems. Your professional life will not go well if you're depressed, missing your child, etc. Speak with a counselor of some sort. Maybe move home or closer to family. Get your applications together to apply for a spot in FP or IM. Take the rest of the academic year off and get your head on straight so you can start work in a new specialty in July.

The 5 of 6 last rotations (CA2, second part) were "satisfactory". As well as 32 points of evaluations summary (out of 37). That's why I'm so bitter - after being reassured many times that everything is just OK.

 

[dragonfly99]

Hmmm.I think you have 2 choices1) forget about anesthesiology, try another specialty (perhaps IM, family practice, pathology, physical med/rehab, neurology?), perhaps closer to your family. Try to extract a promise from your program director to write you a letter of recommendation that is at least neutral and doesn't trash you, and perhaps says that you left by mutual agreement. Then get letters of recommendation from 2-3 faculty members who really like you, and are sympathetic. Hopefully they know you are in a difficult situation and will be willing to help you, maybe even suggest open residency spots or other specialties for you.2) I suppose you could consult with an employment lawyer/attorney to see if you could threaten/force your program to take you back, but I think it would be hard to be successful. It's going to be "He said, she said" and the program will pull out every single negative comment that has ever been written about you anywhere, even in an offhanded way. Still, I suppose you could try this strategy only instead of trying to get back into your program, you could try and get them to give you credit for at least 1 year of anesthesiology and then transfer into another program with advanced standing (seems like it will be hard to do, though).Related to the comments above, I also know/have known of anesthesiology programs kicking a lot of people out and/or making people repeat 6 months. One person I know this happened too was a really good medical student, much better than the other 2 folks from my med school who I know attended the program and weren't asked to do any remediation. I know sometimes good med students aren't great residents, but I just don't believe this person could have been a bad resident. Is anesthesiology just more malignant than other specialties? I know a lot of people switch out of surgery also, but usually it's because they didn't want to work that hard, couldn't deal with the hours, etc.

 

[medicinesux]

Disgusting situation if you ask me. Stringing you on for so long like this? What the heck? What I find so egregious about this situation, is how this program essentially stole 2 years of your life from you. There is a lot of things I would rather have done for 60-70 hrs a week x 96 weeks than being incessantly abused. This is time which can never be regained. A complete and utter waste. But of course this is residency where the normal workforce rules do not apply. There needs to be some sort of contract up front in residencies where you could be dismissed anytime before the end of one year and the possibility of extending your time six months or whatever if PGY 2 or higher. This way, expectations are made well known up front and you don't find yourself being dumped on the curve like a piece of overly utilized garbage in your last year. Ugh

 

[pgg]

Disgusting situation if you ask me. Stringing you on for so long like this?

There's way too much righteous indignation in this thread.

Suppose they had serious concerns and doubts after one year. They could have kicked her out then ... or tried working with her, to help her finish. I suspect that most residents, given the choice of a forced departure after one year or staying on with some hope of turning things around, would choose the latter.

Consider that had she been kicked out a year ago, in August 2007 we might have been reading a post from michgirl complaining that she was terminated too early, without getting a fair chance. And I'm sure there would be people posting reasonable arguments that the program should have worked with her, and set up a remediation program.

I don't think we should work from the mindset that completing two years somehow confers a right to finish, which is what you're implying by getting so upset about her early CA-3 dismissal. Was her program "stringing her along" for two years, leeching every bit of labor possible? Or did they give her a fair chance (and then some) in the hopes that she'd pull through? We don't know.

 

[Leverage]

Disgusting situation if you ask me. Stringing you on for so long like this? What the heck? What I find so egregious about this situation, is how this program essentially stole 2 years of your life from you. There is a lot of things I would rather have done for 60-70 hrs a week x 96 weeks than being incessantly abused. This is time which can never be regained. A complete and utter waste. But of course this is residency where the normal workforce rules do not apply. There needs to be some sort of contract up front in residencies where you could be dismissed anytime before the end of one year and the possibility of extending your time six months or whatever if PGY 2 or higher. This way, expectations are made well known up front and you don't find yourself being dumped on the curve like a piece of overly utilized garbage in your last year. Ugh

I 100% agree, if anything this speaks to the utter failure of the program. The program ought to be embarssed with themselves, but they won't be, probably something along the lines of rigtheous indignation on the programs behalf.

As far as rigthoueus indignation ppg refered to, give me a break. We have all sacfrafice a bunch to get to the point we are. People deserve better then having them waste years, not days, not months, years of their life. Any problems should have been address much earlier in traning and then fixed (guidence vs dismissal, whatever need ), but to string this out till CA3 is insane! This situation seems worse then having someone be promised partnership in the private practice world only to be let go after the put in the time.

 

[Leverage]

I know your type.

Become a FP.

We don't need another f _ g assassin loose in our specialty.

What are you talking about?

 

[pgg]

As far as rigthoueus indignation ppg refered to, give me a break. We have all sacfrafice a bunch to get to the point we are. People deserve better then having them waste years, not days, not months, years of their life. Any problems should have been address much earlier in traning and then fixed (guidence vs dismissal, whatever need ), but to string this out till CA3 is insane! This situation seems worse then having someone be promised partnership in the private practice world only to be let go after the put in the time.

Like I said, for all we know, the program DID make an effort to remediate her. We don't know. I think it's just as likely that the program was trying to help a struggling resident get through as it is a malignant program taking advantage of her cheap labor.

The fact that we "sacrifice a bunch" to get to the CA-3 year doesn't mean we have reached the goal or are entitled to finish. If that was the case, it would be a 2 year residency.

What are you talking about?

He means we don't need another FMG with broken English, failed boards, and poor crisis management skills out there taking care of patients and representing our specialty.

 

[Planktonmd]

He means we don't need another FMG with broken English, failed boards, and poor crisis management skills out there taking care of patients and representing our specialty.

I am curious, how did you know that the OP was a foreign graduate?
Is your FMG radar this sensitive?

 

[Heeed!]

I 100% agree, if anything this speaks to the utter failure of the program. The program ought to be embarssed with themselves, but they won't be, probably something along the lines of rigtheous indignation on the programs behalf.

As far as rigthoueus indignation ppg refered to, give me a break. We have all sacfrafice a bunch to get to the point we are. People deserve better then having them waste years, not days, not months, years of their life. Any problems should have been address much earlier in traning and then fixed (guidence vs dismissal, whatever need ), but to string this out till CA3 is insane! This situation seems worse then having someone be promised partnership in the private practice world only to be let go after the put in the time.

Why would the program be trying to milk out labor from a person they had doubts about. Seems to me this would cause more problems for the program than the slave labor would be worth. There is a lot of liability involved with keeping the OP working in the ORs, especially because she's deficient. Only 6 months of credit after working for 2 years?! From what little info we've been given, it seems the program did its due diligence, and even though I don't have a lot of Psych training, it seems Leverage is PROJECTING onto the program. Why so much hostility?

 

[KungPOWChicken]

the reason why I side with the original poster is because I've seen similar situations at the program that I am at. First and foremost there is little to no teaching at my program. Staff run two rooms at a minimum. In my first month I was running cases with no staff except for induction. Why because they're freakin lazy. Now these same staff would form opinions of residents in this first month. This opinion will be carried with you for the remainder of training. There is a severe lack of commincation between staff and residents meaning you receive absolutely no feedback. The only way you hear about things is through rumors and hearing staff talk about other residents in front of you. It's not about how good you are. Its about how much your staff like you. There are attendings at my program who have been practicing for 5-10 years and still haven't passed their freakin boards??? WTF??? Basically these same f@ck ups are making decisions about my career... come on. Finally, the reason why I'm so pissed off is a resident at my program had six months left and this person got fired!!!! What bull****. 2.5 years at a malignant program busting your ass to get fired with six months left. Total bull****. Many of the staff liked this person unfortunately this person pissed off a few of the wrong people. I personally now just keep my mouth shut and kiss royal ass hoping I don't piss off the wrong people. And believe me I know which ones I don't want to piss off. The thing that really pisses me off is I could have gone anywhere but I chose this program based on region even though I was somewhat hesitant based on reputation. Now I'm stuck.

 

[toughlife]

It seems that academic anesthesia has a lot of malignant personalities who thrive on making their residents' life miserable.

It's like a big power trip and sadly the worst offenders seem to be either the ones with personality issues or the dumb ones.

 

[Leverage]

Why would the program be trying to milk out labor from a person they had doubts about. Seems to me this would cause more problems for the program than the slave labor would be worth. There is a lot of liability involved with keeping the OP working in the ORs, especially because she's deficient. Only 6 months of credit after working for 2 years?! From what little info we've been given, it seems the program did its due diligence, and even though I don't have a lot of Psych training, it seems Leverage is PROJECTING onto the program. Why so much hostility?

I don't think you have a clue what projecting means. But aside from that.

Did I ever say the program was motivated by "slave labor"??? No. You are trying to create a straw man.

My point is this program did this person a huge disservice by dragging this out so long. And I think this situation is a reflection of the program being a complete faiulre. What ever problems the OP had should have been solved long ago....This is my POINT...And no I don't think just because you make to year two you are entitled to anything. But we heard nothing of poor outcomes, patients harmed, ect...What we heard was a program unable to teach priorty setting, prefoming under stress, and other lame ass subjective crap. No facts like patient endanger because of X,Y, Z.....

This is not an example of due diligence, I am thinking you might not know the meaning of this word too.

This is not even to mention the last half year was filled with satisfactory evals. It like this program said, "Oh yea we were going to get rid of you and actually already made up our mind but are just now getting around to it" Sort of BS if you ask me. Why waste this persons time?

I think it is disgusting when people, programs, or whatever abuse their authority and treat people with disrespect. This situation is yet another disgusting example of such. So sorry if you sense hostility but I know good people you have been bent over by such things.

 

[jetproppilot]

It seems that academic anesthesia has a lot of malignant personalities who thrive on making their residents' life miserable.

It's like a big power trip and sadly the worst offenders seem to be either the ones with personality issues or the dumb ones.

Read Toughie's post.

Then reread it.

Then read it again.

And realize its DA TRUTH....

as your anger/frustration/resentment builds, take some deep breaths, light a candle, pikka great Cab outta your frig, pour a full pour portion into your glass,

sit back into your favorite, most comfortable chair/couch/bed, turn on your favorite tunes, and read the

BOW YOUR HEAD thread.

It'll contribute to your inner peace.

Cheers.

 

[mm78]

Wonder if this is common in internal medicine and other specialties.

 

[Hockeyguy]

There are attendings at my program who have been practicing for 5-10 years and still haven't passed their freakin boards???

A very sad sad comment on the current state of academic anesthesiology.

 

[jetproppilot]

Wonder if this is common in internal medicine and other specialties.

"YA THINK?"

 

[radslooking]

I am curious, how did you know that the OP was a foreign graduate?
Is your FMG radar this sensitive?

her english is off, couldn't you tell?

 

[jetproppilot]

A very sad sad comment on the current state of academic anesthesiology.

Sorry Dude, you're mistaken.

Thats academics in general.

Of course there are high power/high prowess academic specialists out there....like surgeon dudes that specialize in Whipples that do one every day.... or (select your esoteric pathophysiologic process and put it here) dudes that specialize in ONE thing, and the only way to support their interest is to affiliate with an academic center.....

but like I said before, generally speaking,

IT AINT ACADEMIC ANESTHESIA.

Its ACADEMICS.

And to think dudes take shots at Mil for giving you the real-life DOWN LOW when he says

ITS ALL ABOUT THE MONEY....

hmmmmm.....

if I'm God's Gift to cardiac cath, and I can make a MIL PLUS in private practice because I'm deft, you know...I can put a stent in the coronary artery of a gravid fire ant...and I can do it ten times a day and be done at 5pm... verses a few hundred K in academics, and I'm emerging from fellowship with a cuppla hundred grand in student loans, WHATCHA THINK I'M GONNA PICK?

If I'm the Brett Favre of Spine Surgery, fellowship was easy, I tooka liking to the work, I'm deft, I can make 1.5 mil easy doing spine surgery, verses 400-500K as an academecian, and I've got 200K in student loans, a wife and a kid, emerging from fellowship,

WHATCHA THINK I'M GONNA PICK?

If I'm deft in anesthesia as a CA-3 anesthesia resident, I've got 200K in student loans and I'm a social dude, easy going, deft at my trade and yet humble enough to learn from my new private practice partners, willing to give up individuality (temporarily) in order to make partner, knowing I can make 700K-plus if I select wisely and am willing to move to a small town, verses 300K as an academecian,

WHATCHA THINK I'M GONNA PICK?

Its the medicine game, Dude.

Not the specialty.

If you are a specialist you'll make tons more in private practice.

Yeah, some will look at this response, thinking back to the thread I started in the Family Practice forum WHY MAKE 150K WHEN 450K IS OUT THERE? btw it became the MOST POPULAR THREAD OF ALL TIME in that forum, so somebodys reading my s hit) and call me cynical...money oriented....entitled....insert-your-expletive-here.....

Sorry for the disappointment.

Yeah, I wanna take care of patients.

But after my sacrifice, I wanna make some bang for my decade-plus of investment too.

Call that whatever you wish.

All I know is, current day,

IT AIN'T IN ACADEMICS.

I respect your academic anesthesia bashing.

But for accuracy you've gotta branch out and include ALL OF ACADEMIA.

Maybe the day will come where its monetarily fruitful to go into academia....God I wish that were true today cuz I'd love spending my day teaching residents...

BUT THAT AIN'T CURRENT DAY REALITY.

DON'T HATE DA PLAYA. HATE THE GAME.

Its up to you which way you wanna play.

 

[jetproppilot]

.

 

[militarymd]

hear hear..

 

[Heeed!]

I don't think you have a clue what projecting means. But aside from that.

Did I ever say the program was motivated by "slave labor"??? No. You are trying to create a straw man.

My point is this program did this person a huge disservice by dragging this out so long. And I think this situation is a reflection of the program being a complete faiulre. What ever problems the OP had should have been solved long ago....This is my POINT...And no I don't think just because you make to year two you are entitled to anything. But we heard nothing of poor outcomes, patients harmed, ect...What we heard was a program unable to teach priorty setting, prefoming under stress, and other lame ass subjective crap. No facts like patient endanger because of X,Y, Z.....

This is not an example of due diligence, I am thinking you might not know the meaning of this word too.

This is not even to mention the last half year was filled with satisfactory evals. It like this program said, "Oh yea we were going to get rid of you and actually already made up our mind but are just now getting around to it" Sort of BS if you ask me. Why waste this persons time?

I think it is disgusting when people, programs, or whatever abuse their authority and treat people with disrespect. This situation is yet another disgusting example of such. So sorry if you sense hostility but I know good people you have been bent over by such things.

Take it easy there, killer. You're chiming in with support for the OP but only have (at best) 1/2 the story. Read pgg's comments. Don't you think there might be more to the story if the OP only has credit for 6 months of training? There's a lot of information not being offered by the OP. One of the many definitions of due diligence includes "A measure of prudence, responsibility, and diligence that is expected from, and ordinarily exercised by, a reasonable and prudent person under the circumstances." It appears to me the program COULD have used those years to document the OP's performance, help remediate her, and build its case in the event they needed to terminate her. They could have also used the time to extract extra labor out of the OP, have her turn more rooms, complete more pre-ops, etc. My whole point is WE DON'T KNOW why it took so long. WE DON'T KNOW why the michgirl was given satisfactory evaluations on 32 out of 37 but was still let go. The OP didn't offer that information. That's curious to me. If it hadn't taken so long for her to be fired, we might be reading a post about early termination and being canned for one tiny mistake. Nevertheless, I don't disagree with what you've said about abuse of authority and disrespecting people. It sounds like the program, as well as the OP, have some issues. Either way, the OP was looking for advice and I offered mine earlier.

 

[Leverage]

Take it easy there, killer. You're chiming in with support for the OP but only have (at best) 1/2 the story. Read pgg's comments. Don't you think there might be more to the story if the OP only has credit for 6 months of training? There's a lot of information not being offered by the OP. One of the many definitions of due diligence includes "A measure of prudence, responsibility, and diligence that is expected from, and ordinarily exercised by, a reasonable and prudent person under the circumstances." It appears to me the program COULD have used those years to document the OP's performance, help remediate her, and build its case in the event they needed to terminate her. They could have also used the time to extract extra labor out of the OP, have her turn more rooms, complete more pre-ops, etc. My whole point is WE DON'T KNOW why it took so long. WE DON'T KNOW why the michgirl was given satisfactory evaluations on 32 out of 37 but was still let go. The OP didn't offer that information. That's curious to me. If it hadn't taken so long for her to be fired, we might be reading a post about early termination and being canned for one tiny mistake. Nevertheless, I don't disagree with what you've said about abuse of authority and disrespecting people. It sounds like the program, as well as the OP, have some issues. Either way, the OP was looking for advice and I offered mine earlier.

i can respect this

 

[CambieMD]

We can go back and forth as to whether the op was treated properly and if he/she deserves another chance in anesthesia. What I take home from this post is that we have to constantly and honestly evaluate ourselves. We should know what our strengths and weaknesses are before we are pulled on the mat and sent home. We should outline our own remidiation plan before the program does it. Talk to others and seek their input. Turn weaknesses into strengths. If that is not possible neutralize them. Compare yourself to your peers. Check to see how you measure up. (Please no locker room jokes).

When I was an FP I hired the worse employee ever. She couldn't do anything right. I kept her longer than I should have because I did not want to admit that I made a mistake.

The purpose of an education is to teach us how to access and process information. We must own our education. If we are not proactive and honest with ourselves things will keep happening to us and we will not understand why.

After the first six months you have a good idea how things are going. Seek help if things are going badly. I am slow so I have tried to work on my speed.
I have gotten attendings to help me. They pushed to move and be more decissive. Some of them seemed mean but they really hepled me. Actually, speed is a safety issue. If I am always bogged down with simple things I may not be able to pay the proper attention to a preop and miss something important. One of attendings pointed that out as pushed me all day.

I wrote too many words. The take home message from the op is we should always eveluate ourselves. Seek help before things get out of hand.

As to whether or not the op should be given another chance in gas. Would you want the op to give you a break.Would you want to break him/her. Would you want to be his/her attending. Be your anesthesia provider?

The op should take the year off and figure out what really happened over the past 24 months and move on from there.

Cambie

 

[radslooking]

The purpose of an education is to teach us how to access and process information. We must own our education. If we are not proactive and honest with ourselves things will keep happening to us and we will not understand why.

Actually, speed is a safety issue.
Cambie

Great quotes cambie. Be honest with yourself and take ownership of the problem. Blaming the system, or the program, or whatever, won't work. Fix yourself first.

 

[teep]

I know this person. OP could be a valuable asset to the medical community as a pathologist. This persons ability to memorize, digest, and resynthesize information is unparalleled, and I'd be willing to bet that they got 99/99/99 on step 1/2/3. I have no comment on any other abilities.
btw, that program isn't a low-tier program. I'd say it's roughly middle of the pack.
If this is who I think it is, then I wish you the best of luck in your future pursuits of a residency.

 

[coprolalia]

Great quotes cambie. Be honest with yourself and take ownership of the problem. Blaming the system, or the program, or whatever, won't work. Fix yourself first.

Sometimes it actually is the system, though.

-copro