FCVS credentialing-- how to describe academic probation

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maesunlight

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I went through academic probation and contract non-renewal during my intern year. I have now matched at another program (yay!) however, I want to update my FCVS profile and need to describe the "reason for probation" at my initial program. Since whatever I write has the potential to follow me throughout my career I want to be particularly careful in what I say--my former program has submitted a statement to the effect of "This person did not meet terms of probation and contract was not renewed."

What I have below is my "draft' of what to enter into the FCVS "explanation of probation" text box.

2. Probation
Yes--During one of my initial intern year rotations I expressed several concerns about the quality of patient care and perceived deviance from evidenced based practices. My concerns were dismissed and after expressing these concerns, I noticed that my performance was placed under scrutiny and the quality of my interactions with team members and attendings dramatically shifted. I was given an "unsatisfactory" evaluation by the attendings I had questioned on the rotation and this evaluation resulted in me being required to repeat the rotation and complete a four month probation period. I was not informed of the required probation period until three months later, at which time I had completed three interim rotations satisfactorily without incident. I protested the terms of my probation because they depended upon the subjective evaluations of both my peers and attendings rather than any behavioral modification that could be objectively measured. I also requested that my probation evaluations not be completed by the initial attendings who gave me the unsatisfactory evaluation because I felt these attendings were not objective in their assessments of me. I was promised that my evaluations would be done by other attendings, however, this did not end up happening and the terms of my probation were maintained. Although the repeated rotation and all subsequent rotations were passed satisfactorily, the minor terms of probation related to interpersonal communication and practice based learning and improvement were not met, due specifically to evaluations filled out by those particular attendings that I specifically requested not be a part of my unbiased probation evaluations. I spoke with the GME director who informed me that I had multiple points to appeal the probation. At no time were my clinical duties ever modified or lessened nor were there concerns about my clinical safety or professional conduct. Because my initial concerns about the quality of patient care at this particular institution were never resolved, and because of how I was treated by the program administration, rather than appeal, I decided that I would prefer to complete my training elsewhere. Therefore, it was mutually decided that I was not "a good fit" for the program and/or specialty at which time I began to pursue training elsewhere and my contract was not renewed. I did complete my intern year and received credit for 12 months of training.



My question is this: what is the best way for me to approach this? Do I just let it go? If it is better for medical boards to know, then how do I explain, ( in as few words as possible) that the contract non-renewal was due to "personality conflicts" and not clinical or professional issues? Especially since my program didn't clarify this? Should I consult a lawyer?

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This is very difficult. It sounds, though, like your program is taking the high road by not going into too many details (i.e. not scuppering your chances or painting you with a scarlet red brush). Your explanation strikes me as a little defensive and over-long for sure.

I certainly am not doubting your account nor do I have any clue what went on, but given that you switched out of a specialty with zero reputation for being malignant, do you think what you wrote is 100% accurate? You are essentially accusing your former program of unfair dealing, targeting and even conspiracy, which given the fact that they chose not to say anything too negative about you, might come back to hurt you. Do you want them to disclose their side of the story completely?
 
WAY too long and don't make it sound like you're blaming the program---licensing boards will see this as a big red flag. Give only the basic info; they will ask for more info if they want it and don't want an editorial. Make it quick, objective and to-the-point. i.e. I was put on probation due to x (performance/academic/communication) concerns and got credit for all rotations, etc. etc. Feel free to add that there were no concerns about patient safety or professional conduct.

The way the PD worded it was not "personality conflicts", but that you didn't meet some criteria of your probation. If you state otherwise, you are providing conflicting info that will only haunt you in years to come.
 
The most important thing is that your description and the program's description match. If your relationship with this program is good, you could request your "residency summary". Make your description match that, assuming it's a fair representation of the facts. I agree that being defensive and blaming your program is a bad idea.
 
Great, thank you for this very helpful feedback! I was actually thinking that I could just keep it simple, but a friend who has had some recent trouble with a medical board advised me to be a bit more "defensive" in case something came up down the road. This didn't seem totally wise to me, that's why I posted here before sending into FCVS and I am glad I did! I think his situation was much different from mine-- though I do believe that what I typed above is pretty accurate and I wouldn't mind them telling their whole side of the story. I wasn't a perfect intern, but I worked very hard and my PD admitted that the occasional mistakes I made were "intern mistakes," not unusual with the learning curve. It just wasn't a "good fit."

After editing to match my summative evaluation this is what I ended up with:

After the above mentioned unsatisfactory rotation in initial PGY-1 program, a probation period of 4 months was required for difficulties with interpersonal communication and practiced based learning and improvement. The repeated and subsequent rotations were passed and there were never concerns regarding clinical safety or professionalism, however, the terms of the probation were not fully met and the yearly contract was not renewed. Credit for 12 months of rotations was awarded.

Better?
 
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I went through academic probation and contract non-renewal during my intern year. I have now matched at another program (yay!) however, I want to update my FCVS profile and need to describe the "reason for probation" at my initial program. Since whatever I write has the potential to follow me throughout my career I want to be particularly careful in what I say--my former program has submitted a statement to the effect of "This person did not meet terms of probation and contract was not renewed."

What I have below is my "draft' of what to enter into the FCVS "explanation of probation" text box.

2. Probation
Yes--During one of my initial intern year rotations I expressed several concerns about the quality of patient care and perceived deviance from evidenced based practices. My concerns were dismissed and after expressing these concerns, I noticed that my performance was placed under scrutiny and the quality of my interactions with team members and attendings dramatically shifted. I was given an "unsatisfactory" evaluation by the attendings I had questioned on the rotation and this evaluation resulted in me being required to repeat the rotation and complete a four month probation period. I was not informed of the required probation period until three months later, at which time I had completed three interim rotations satisfactorily without incident. I protested the terms of my probation because they depended upon the subjective evaluations of both my peers and attendings rather than any behavioral modification that could be objectively measured. I also requested that my probation evaluations not be completed by the initial attendings who gave me the unsatisfactory evaluation because I felt these attendings were not objective in their assessments of me. I was promised that my evaluations would be done by other attendings, however, this did not end up happening and the terms of my probation were maintained. Although the repeated rotation and all subsequent rotations were passed satisfactorily, the minor terms of probation related to interpersonal communication and practice based learning and improvement were not met, due specifically to evaluations filled out by those particular attendings that I specifically requested not be a part of my unbiased probation evaluations. I spoke with the GME director who informed me that I had multiple points to appeal the probation. At no time were my clinical duties ever modified or lessened nor were there concerns about my clinical safety or professional conduct. Because my initial concerns about the quality of patient care at this particular institution were never resolved, and because of how I was treated by the program administration, rather than appeal, I decided that I would prefer to complete my training elsewhere. Therefore, it was mutually decided that I was not "a good fit" for the program and/or specialty at which time I began to pursue training elsewhere and my contract was not renewed. I did complete my intern year and received credit for 12 months of training.



My question is this: what is the best way for me to approach this? Do I just let it go? If it is better for medical boards to know, then how do I explain, ( in as few words as possible) that the contract non-renewal was due to "personality conflicts" and not clinical or professional issues? Especially since my program didn't clarify this? Should I consult a lawyer?

Which hospital was this? This is truly disturbing, because it appears that you were retaliated against for expressing concerns about patient care. I think it's time for a federal monitor to oversee this type of situation and prevent this from happening to others, so that concerns can be raised without being attacked by an organization. I think you should consult the state's rules on reporting of this sort of incident where you are obtaining the medical license. This incidents can affect your ability to be credentialed with hospitals etc and often, hospitals intentionally harm doctors who report legit concerns as a retaliatory tool to ruin their careers and prospects. In effect, these sorts of actions have the desired chilling effect on the others in the organization, while the hospital can continue business as usual.

I definitely would not use any quoted terminology without supporting documents. It might be better to figure out what the probation was and what the former program reported, meaning, when they verified your work to the next residency program, what did they say about you, go with that. You can probably call them up and figure out what they have in their files or hire a lawyer to do so.
 
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