I've been following this thread and SDN for a while now. I've read quite a few similar threads but this one seemed different than many of the others. It seems to have sparked a more interesting debate than the others. Maybe because of the disturbing and unsettling nature of the claim of being fired with just one week left in your intern year.
I was quite taken aback by those who empathized with the OP, or at least sympathized with the ramifications that the program's actions would have on this person's future career. I thought it was important that this thread have more contributions from those who have been in this situation. I believe that the OP did the wrong thing by withdrawing from the forum as their experience may benefit others. Obviously, that will be the last thing on their mind at this point but it's important nonetheless. I'm not singling out the OP. It seems that the OPs in most of these cases do the same. But I think if you come on here seeking advice you should repay those who have invested their time and emotion with something, anything, even an update.
My experience was not quite as scandalous as the OPs but it was, for me, just as calamitous. I cannot impress on those who've been fortunate enough to not have their own similar personal experience the physical, mental, and emotional toll something like this can take. I can assure you that most who've not experienced it cannot appreciate this. I didn't post my own personal experience on these forums because--though I think there are members here who can offer valuable advice--I just don't think it's feasible for a resident to present enough information (including from third-parties) to convince those who think they're getting a completely biased viewpoint without unacceptably sacrificing their own privacy.
Unlike the OP, I wasn't terminated but allowed to finish out my contract which was not renewed. I also received full credit for the year. Unfortunately for me I was in a categorical program and by the time I was notified the Match had come and gone. Like the OP, the reason for non-renewal fell under the oft used and maligned "professionalism" tag. Also like the OP I was never put on probation prior to the non-renewal. I had met with the PD a couple of times over the course of a month and a half and just like that it was over. Like other posters on this thread have already pointed out, the word "professionalism" is used countless times by PDs, administrators, and everyone in between but I've never heard the term properly defined. I think there a lot of people here who think that to be terminated from residency your breach of however they've defined "professionalism" has to be egregious. I can assure you too that that's not the case. The worst offense I ever committed was being curt with several nurses and a senior resident after an overnight call with no sleep. I can say with absolute clarity and certainty that I took much more than I ever gave from other residents, nurses, and attendings but I didn't realize that I had broken the cardinal rule of internship which is to never say anything but "thank you, may I have another."
I felt I worked extremely hard and was dedicated to doing the best I could. I definitely made mistakes and, if given the chance, would definitely do things differently but I deserved better than I got. It was said by someone on this thread that personality can take you farther in residency than professionalism or even competence, and after my experience, I definitely believe it. The only senior resident that I had any problems with throughout my time in the program was essentially an absentee resident. Would any of you consider it unprofessional if a senior resident decided to go to a nearby restaurant with friends while they're supposed to be on-call in the hospital and one of the assigned responders to codes? And, in case you're wondering no one was covering for them. I was told "just page me" if needed. After calling out this particular resident on their absenteeism while on-call, she responded by verbally abusing and threatening me. I was not the only resident who had had problems with this resident not being present or doing their fair share. She was, however, popular and well-liked in the program so of course she was able to get away with a lot.
I was once chewed out over the phone by a senior surgical resident after being asked to update a family on a patient's status and plan of care.
This patient needed surgery and was becoming septic due to the delay. They were being treated medically only since the patient's spouse told me that they were told the patient was too sick and would never survive the operation though without the operation there was also essentially zero chance of survival. Essentially, the spouse was told the patient would die either way. However, the note claimed that the spouse had refused the surgery and that if the spouse changed their mind the team was definitely willing to do the surgery. I told the spouse verbatim what the attending physician had written in his note just a few hours prior. I, as a float resident, had unfortunately gotten caught up in a case of poor communication between the primary team and the patient's family. After speaking with the spouse and reviewing their options as laid out by the attending (not by me) they decided to go ahead with the surgery. I spoke with the senior resident on call who then began yelling at me because I had given the patient's family hope that something could be done. I explained to them that I had simply updated the family with what the attending had written in his note but it didn't stop me from getting an earful.
I had and have never done anything that had risen to those levels of "unprofessionalism" but I also realized that people are under stress in a hospital and you can't expect to be in a pressure-cooker and not have something blow. I wasn't the type to go running to complain as soon as someone hurt my feelings. Fun fact: when the team arrived in the morning and found that the patient wasn't dead they decided to take them to the OR. The same resident was nothing but nice when face-to-face with me.
I mentioned the examples above not because I think I'm unique but because it's just one example of how not everyone is held to the same standard. I understand my culpability for the position I was put in but it was also painfully obvious that once you're "on their radar" you're not held to the same standard as other residents but a higher one. There are other more obvious examples of preferential treatment but the "lack-of-professionalism" label can be an extremely useful weapon for a PD to wield when needed and many residents could be portrayed in an unflattering light if desired. The same mistakes or lapses that would be overlooked without so much as a word from higher-ups would spell the end for those under the microscope. I wonder how many here can appreciate not only having to perform their duties but doing so knowing that you have no margin for error.
If your program is supportive, I think a "troubled" resident can many times muster what it takes to weather the storm. But, if your program offers you no support or guidance, and you lack adequate social support you are essentially doomed to fail. I went through the process alone without so much as an advisor, mentor, or friend, and I cannot adequately put into words just how demoralizing an experience it can be. Medicine, as we all know, is not just like any other job where you can pull yourself up by the bootstraps and start over somewhere new just like that. Yet, it seems many programs are callous and make these decisions hastily even if the intent isn't malicious. And what recourse does the resident have? Resident support and advocacy is glaringly absent in medicine. The definition of "due process" can vary widely from one GME to another. The ACGME doesn't institute minimum standards or universal standards to ensure that a resident in one program is afforded the same opportunities and treated the same as one in another. After my ordeal, I've learned to pay attention to GME policies and procedures and its amazing how generous some are compared to mine.
We don't know the whole story behind the OP's or others' cases but, after my experience, I do not doubt that there at least some residents that are terminated that are more competent and professional than those that are promoted. The next time you hear or read about another resident termination know that in most cases the truth probably lies somewhere in between. The resident probably shares some of the fault and the program probably does as well. Those that are quick to pile on the resident hardly ever seem to feel there should be any accountability on behalf of the program. I don't doubt that in many cases programs do such a reprehensible job communicating with the resident that it's no wonder the resident is lost. Given the stakes for the resident that is inexcusable. It's unfortunate, I think, that it's much easier for the program to move on without a hiccup than the aggrieved resident. If it weren't maybe we wouldn't see such callous decision-making on the part of the program. There's no incentive for them to work through their problems with a resident so those that are not inclined to do so won't.
