Fired from residency program. What do I do now?

[Crayola227]

I'm very happy you were able to get help and get sober. However, I disagree with two of your statements, one in a good way, and one in a bad way.

First, is this:

This is not true. Sure, you're no longer in a residency program. But as already mentioned you might be able to take your prior training, get a license, and do something medical. And you certainly might get back into a residency program.

Second:

This is simply not true. Quitting is hard. It's this hard:


Moving forward:

As I mentioned earlier in the thread, sober you will find that you're a different person. You may, or may not, want to be a physician. And, being a physician might be a bad idea for your health. Or it might be fine. You'll need to explore this.

You've been sober for a few months now. This may seem like a long time to you, but it's a very short time for us. Few programs will consider you unless you have sustained sobriety -- at least 6 months, but more likely at least 1-2 years. So you need to look at this using a long, slow timeline. What you need to do is get back into some sort of medical work -- ideally clinical. Might be a scribe somewhere. Or volunteer in a clinic. Etc.

Then you'll need a job to help pay the bills. As mentioned, you could try to get a license with your past training and ongoing alcohol monitoring -- it's possible that would help you get clinical experience. This will depend upon the state -- some are notoriously more hard to get a license in. You could work doing insurance reviews / prior auths / chart reviews. There are options, you'll need to hunt for them. Plan for many people to turn you down -- you need to take each rejection, use it as fuel for the next application.

Or, you need to walk away from medicine and find a new plan. This isn't failure, it's success of a different flavor. The long hours and stress of medicine might make it more difficult to maintain your sobriety, easier to slip up. You're smart, you can do something else also.

It's scary. Prior to all of this, your life/career was on a straight track. Now you've jumped the rails, and the direction forward isn't so clear. But you can move forward, you need to choose a direction, make a plan, and take it one step at a time.

This confuses me, because honestly, on this board, the typical message seems to be if you end up not finishing residency for any reason, particularly for any reason related to mental health/substance abuse/professionalism reasons, and especially if 5 years post-grad, that you're basically toast for ever getting another spot.

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[NotAProgDirector]

This confuses me, because honestly, on this board, the typical message seems to be if you end up not finishing residency for any reason, particularly for any reason related to mental health/substance abuse/professionalism reasons, and especially if 5 years post-grad, that you're basically toast for ever getting another spot.

It's not easy, and depends upon the details, but for an otherwise well performing grad not impossible. Professionalism issues and mental health issues (other than substance) are more difficult to recover from, as it's much harder to prove that you've changed. Substance use is probably the "easiest" in this list to bounce back from, since most people with abuse issues who are off substances are fully functional and without issues, and it's straightfoward to prove that they are substance free.

 

[Kisangani]

Well done OP. I am sure that battling such an addiction while coping with all you have lost was more challenging than any of us can imagine, but is great that you have finally beat it.

On another note, the support that the OP is getting with respects to reentering the medical field surprises me greatly. Even though he managed to sober up, doesn't his admittance of going to work (as a surgery resident no less) demonstrate a pretty unforgivable level of irresponsibility and disregard for the safety of his patients? In addition, he is also statistically likely to relapse in the future. Why should he be given additional opportunities when there is already a surplus of residency applicants for a limited number of spots? Not only that, I find this sort of rhetoric seems to come from the same people who frequently post on the premed and medical student forums who tell people to give up on medicine if they have any sort of legal infarction or major red flag in their portfolios. Why should this guy be any different? Is it because he completed medical school and was on his way to being a surgeon? Just because someone is a doctor, that does not mean that they can indulge in whatever reckless, destructive behaviors they want without any consequences. Perhaps there was a reason why his institution had a zero tolerance policy towards alcohol/drug abuse in the first place. While it is a shame that his career has to come to end after so many years of work and sacrifice, it is likely for the best as it is doubtful many patients would be conformable if they knew that their surgeon had a history of operating on others while drunk.

 

[Crayola227]

Well done OP. I am sure that battling such an addiction while coping with all you have lost was more challenging than any of us can imagine, but is great that you have finally beat it.

On another note, the support that the OP is getting with respects to reentering the medical field surprises me greatly. Even though he managed to sober up, doesn't his admittance of going to work (as a surgery resident no less) demonstrate a pretty unforgivable level of irresponsibility and disregard for the safety of his patients? In addition, he is also statistically likely to relapse in the future. Why should he be given additional opportunities when there is already a surplus of residency applicants for a limited number of spots? Not only that, I find this sort of rhetoric seems to come from the same people who frequently post on the premed and medical student forums who tell people to give up on medicine if they have any sort of legal infarction or major red flag in their portfolios. Why should this guy be any different? Is it because he completed medical school and was on his way to being a surgeon? Just because someone is a doctor, that does not mean that they can indulge in whatever reckless, destructive behaviors they want without any consequences. Perhaps there was a reason why his institution had a zero tolerance policy towards alcohol/drug abuse in the first place. While it is a shame that his career has to come to end after so many years of work and sacrifice, it is likely for the best as it is doubtful many patients would be conformable if they knew that their surgeon had a history of operating on others while drunk.

there is a lot wrong with your post, but I will point out that yes, the profession is more protective of those who have completed medical school than it is towards the hordes of those applying, most of whom really don't qualify

at the same time, no one has suggested that because the OP is a physician that they are not bound by ethical and legal obligations no matter what, far from it

you also don't seem to really grasp the realities and complexities of the number regarding graduate medical education as they relate to # of slots and # of applicants

lI'm also not sure that you seem well versed or sensitive to issues regarding the destructiveness of addiction, and how that relates to behavior while on substances, and how it relates to behavior after someone has entered recovery

physicians are people too, and we don't just end their careers because patients are uncomfortable at the idea of their medical conditions

I have known physicians who have been affected by DM1, seizures, bipolar disorder, panic attacks, anxiety, ADHD, cancer, alcoholism, heroin addiction, the list continues, all of which present various challenges in the carrying out of their duties, and patients theoretically might take issue with

it is the personal responsibility of the physician, their personal health providers, colleagues, and the medical board, to ensure fitness for duty and protect patient safety, otherwise physicians are also entitled to privacy regarding their health, and protection under the ADA for certain conditions from discrimination in the workplace

if the OP has recovered and is under the care and supervision of the appropriate health providers, and the medical board, it is NO ONE'S, not even a patient's, business what health history they have

the truth is that patients will think what they like about whatever information they have access to, that doesn't mean that as a profession we should crucify physicians with health conditions on the altar of public opinion

 

[Crayola227]

Well done OP. I am sure that battling such an addiction while coping with all you have lost was more challenging than any of us can imagine, but is great that you have finally beat it.

On another note, the support that the OP is getting with respects to reentering the medical field surprises me greatly. Even though he managed to sober up, doesn't his admittance of going to work (as a surgery resident no less) demonstrate a pretty unforgivable level of irresponsibility and disregard for the safety of his patients? In addition, he is also statistically likely to relapse in the future. Why should he be given additional opportunities when there is already a surplus of residency applicants for a limited number of spots? Not only that, I find this sort of rhetoric seems to come from the same people who frequently post on the premed and medical student forums who tell people to give up on medicine if they have any sort of legal infarction or major red flag in their portfolios. Why should this guy be any different? Is it because he completed medical school and was on his way to being a surgeon? Just because someone is a doctor, that does not mean that they can indulge in whatever reckless, destructive behaviors they want without any consequences. Perhaps there was a reason why his institution had a zero tolerance policy towards alcohol/drug abuse in the first place. While it is a shame that his career has to come to end after so many years of work and sacrifice, it is likely for the best as it is doubtful many patients would be conformable if they knew that their surgeon had a history of operating on others while drunk.

anyone with a medical degree, especially one who can be licensed, should be encouraged to safely utilize that unique education in the service of healthcare as a field

this is different than the realities of telling the hordes of pre-med applicants with red flags, that they might be better served personally by putting their talents to work outside of trying to obtain admittance to medical school

surely you must see the difference?

 

[gutonc]

Well done OP. I am sure that battling such an addiction while coping with all you have lost was more challenging than any of us can imagine, but is great that you have finally beat it.

On another note, the support that the OP is getting with respects to reentering the medical field surprises me greatly. Even though he managed to sober up, doesn't his admittance of going to work (as a surgery resident no less) demonstrate a pretty unforgivable level of irresponsibility and disregard for the safety of his patients? In addition, he is also statistically likely to relapse in the future. Why should he be given additional opportunities when there is already a surplus of residency applicants for a limited number of spots? Not only that, I find this sort of rhetoric seems to come from the same people who frequently post on the premed and medical student forums who tell people to give up on medicine if they have any sort of legal infarction or major red flag in their portfolios. Why should this guy be any different? Is it because he completed medical school and was on his way to being a surgeon? Just because someone is a doctor, that does not mean that they can indulge in whatever reckless, destructive behaviors they want without any consequences. Perhaps there was a reason why his institution had a zero tolerance policy towards alcohol/drug abuse in the first place. While it is a shame that his career has to come to end after so many years of work and sacrifice, it is likely for the best as it is doubtful many patients would be conformable if they knew that their surgeon had a history of operating on others while drunk.

Congratulations on both completely missing the point and being a Grade A a-hole at the same time.

The OP has a disease. He wasn't being irresponsible...he was sick.

The good news is that he has a chance of beating his disease. Yours is most likely terminal.

 

[TennisShoeChic]

Congrats on the sobriety!!!! As Doug Stamper said on House of Cards- **** the zero. If you’re a social media user and not already, consider checking out the SoberGrid app. It’s not exclusive to AA and I enjoy the comraderie.

 

[Kisangani]

anyone with a medical degree, especially one who can be licensed, should be encouraged to safely utilize that unique education in the service of healthcare as a field

this is different than the realities of telling the hordes of pre-med applicants with red flags, that they might be better served personally by putting their talents to work outside of trying to obtain admittance to medical school

surely you must see the difference?

Yeah, I see the difference, but that does not change the fact that the OP endangered the lives of his patients for god knows how long by continuing to work while his addiction was spiraling out of control. If someone is an addict (or has any of the diseases you mentioned) it is their responsibility to remove themselves from practice or to get help before it reaches that point. Why would the OP knowingly go show up to a rotation intoxicated? Addiction or no addiction, this is something that any reasonable person would refrain from doing. There must have been something in back of his head telling him that is not something he should have been doing. If this is not something that should disqualify a person from practicing, I don't know what is? There is very little room for error in this profession since lives are at stake based on the competence of medical practitioners.

 

[gutonc]

Yeah, I see the difference, but that does not change the fact that the OP endangered the lives of his patients for god knows how long by continuing to work while his addiction was spiraling out of control. If someone is an addict (or has any of the diseases you mentioned) it is their responsibility to remove themselves from practice or to get help before it reaches that point. Why would the OP knowingly go show up to a rotation intoxicated? Addiction or no addiction, this is something that any reasonable person would refrain from doing. There must have been something in back of his head telling him that is not something he should have been doing. If this is not something that should disqualify a person from practicing, I don't know what is? There is very little room for error in this profession since lives are at stake based on the competence of medical practitioners.

Are you really a med student? Because your understanding of the pathology underlying addiction is woefully inadequate and, quite frankly, makes your education much more suspect than you seem to the think the OP's behavior was.

 

[Crayola227]

Yeah, I see the difference, but that does not change the fact that the OP endangered the lives of his patients for god knows how long by continuing to work while his addiction was spiraling out of control. If someone is an addict (or has any of the diseases you mentioned) it is their responsibility to remove themselves from practice or to get help before it reaches that point. Why would the OP knowingly go show up to a rotation intoxicated? Addiction or no addiction, this is something that any reasonable person would refrain from doing. There must have been something in back of his head telling him that is not something he should have been doing. If this is not something that should disqualify a person from practicing, I don't know what is? There is very little room for error in this profession since lives are at stake based on the competence of medical practitioners.

I think what you fail to understand, is that what is often part and parcel of many mental health conditions, are effects on insight and judgement

this aspect of many mental health conditions, as opposed to some other conditions, can be especially concerning, and does present its own challenge to the safe practice of medicine

that's why we need to look out for each other - not only by monitoring one another for any diminished capacity, but also creating an environment where coming forward, "catching" and addressing its causes, does the most to protect patient safety while also seeking to minimize permanent negative impact to a potentially impaired physician's career. There is a balance in maintaining patient safety and creating a space for physicians with mental health conditions.

It's not that someone with a substance abuse disorder has NO insight or judgement, and NO responsibility in the consequences stemming from an impairment of either. However, if someone has a disease, recovers, and can safely practice again, they should.

Your little narrative doesn't take any of this into account.

 

[rokshana]

Yeah, I see the difference, but that does not change the fact that the OP endangered the lives of his patients for god knows how long by continuing to work while his addiction was spiraling out of control. If someone is an addict (or has any of the diseases you mentioned) it is their responsibility to remove themselves from practice or to get help before it reaches that point. Why would the OP knowingly go show up to a rotation intoxicated? Addiction or no addiction, this is something that any reasonable person would refrain from doing. There must have been something in back of his head telling him that is not something he should have been doing. If this is not something that should disqualify a person from practicing, I don't know what is? There is very little room for error in this profession since lives are at stake based on the competence of medical practitioners.

spoken like a person who hasn't actually had any real medical experience...maybe you should wait til you have actually graduated and worked as at least as an intern...notice what the actual doctors on this thread have said...and at the moment, i'd take the alcoholic over the judgmental...

 

[Dakota45]

I'm very happy you were able to get help and get sober. However, I disagree with two of your statements, one in a good way, and one in a bad way.

First, is this:

This is not true. Sure, you're no longer in a residency program. But as already mentioned you might be able to take your prior training, get a license, and do something medical. And you certainly might get back into a residency program.

Second:

This is simply not true. Quitting is hard. It's this hard:


Moving forward:

As I mentioned earlier in the thread, sober you will find that you're a different person. You may, or may not, want to be a physician. And, being a physician might be a bad idea for your health. Or it might be fine. You'll need to explore this.

You've been sober for a few months now. This may seem like a long time to you, but it's a very short time for us. Few programs will consider you unless you have sustained sobriety -- at least 6 months, but more likely at least 1-2 years. So you need to look at this using a long, slow timeline. What you need to do is get back into some sort of medical work -- ideally clinical. Might be a scribe somewhere. Or volunteer in a clinic. Etc.

Then you'll need a job to help pay the bills. As mentioned, you could try to get a license with your past training and ongoing alcohol monitoring -- it's possible that would help you get clinical experience. This will depend upon the state -- some are notoriously more hard to get a license in. You could work doing insurance reviews / prior auths / chart reviews. There are options, you'll need to hunt for them. Plan for many people to turn you down -- you need to take each rejection, use it as fuel for the next application.

Or, you need to walk away from medicine and find a new plan. This isn't failure, it's success of a different flavor. The long hours and stress of medicine might make it more difficult to maintain your sobriety, easier to slip up. You're smart, you can do something else also.

It's scary. Prior to all of this, your life/career was on a straight track. Now you've jumped the rails, and the direction forward isn't so clear. But you can move forward, you need to choose a direction, make a plan, and take it one step at a time.

Every one of my former mentors (as well as my former program director) has advised me to go into another field all together. I went before my state's licensing board shortly after getting terminated and they offered the same recommendation (in addition to rehab). I think part of it is my state and its reputation for being very unforgiving with this sort of thing. My status as a resident is apparently also very significant in making a comeback into medicine unlikely. I was told that had I been an attending physician when this incident had occurred, programs would be much more likely to show mercy on me following rehabilitation. As to your second point, I didn't mean that getting clean is by any means easy, but to someone who is addicted it may appear to be something completely unobtainable (this is in large part what prevented me from putting a full effort into getting sober years ago).

I have a bachelor's degree in chemical engineering and while it has been a while since I have learned anything new in that field, I feel like this is a field that would be more willing to hire someone like me (if surgery is unlikely to be salvageable at this point). Aside from this background being a surgeon is really all I really know how to do, so my options are naturally limited.

 

[itisallrelative]

Hello, first time poster here just desperately looking for advice on how to handle the situation I am in. I have been more or less sitting at home for the last few days in a state of paralysis trying to come to terms as to what has happened to me. I am currently/was a third year general surgery resident and was abruptly fired from my program on Friday for showing up for a rotation intoxicated. I have had a problem with alcohol since I was an undergrad and my alcoholism has recently gotten to the point that I need to drink intermittently throughout the day to function at my optimum. While I was moonlighting late last week, I was called to the PD's office and told that my residency program has a zero tolerance policy for alcohol/drug intoxication while on call, and that it results in an automatic dismissal. I have absolutely no clue on how to handle this mess that I have got myself in. Becoming a surgeon has been all I ever wanted to do since I was in high school and now less than 2 years out I have no program to train at. I also don't have skills in any other field whatsoever. Is reapplying to another program an option? Do you think there is some way for me to appeal the decision of my PD (even though he said the dismissal was final)? I could really use some advise right now as this about the lowest I have ever felt in my life to this point.

They actually followed that policy? Anything else going on?

 

[NotAProgDirector]

It is really unfortunate if true that the board addresses this issue differently for residents and fully trained physicians. It really shouldn't matter, treatment options should be the same, and I would expect that long term outcomes would be similar. Unfortunately I expect much of the difference is a combination of protocol (at best) and laziness (at worst) -- a physician with a full license who runs into a problem still has a license, and the board needs to address that. A resident on a training license, if fired, loses that license -- so the board can just ignore them.

The real difference between a resident and a trained physician in this predicament is that you need a new training program, not just a new job. Your current state might be unforgiving, but others would likely give you a restricted license (esp a training license) with ongoing monitoring. You're going to want to avoid MA, CA, FL, TX, and PA which tend to be more notoriously difficult, but that leaves quite a few states.

So the real hurdle here is a new training program (in one of the 45 other states). Only you can decide whether you want to try, but you need to start working on it now if that's what you want. If you go back to working in Chem Eng, and then 5 years later decide you want to come back to medicine, you're going to get nowhere. If you apply to a residency program now, you're likely going to get nowhere also. But you could build towards a new spot in 1 to 2 years. The real goal would be next year's match.

This won't be easy. And your career in surgery is probably over. If you really want GS again, you'll need to hunt for a PGY-2 position. You'll need a letter from your prior PD. You would need to convince them that you were truly sorry for your behavior, and that you have a safe plan for proceeding. You are willing to repeat your entire PGY-2 to prove this. You'll need some serious luck, but it might be possible.

More realistic is a residency in another field. Perhaps IM or FM, perhaps with a focus on addiction (if you're interested). If you have an otherwise strong application, a decent amount of sobriety under your belt, and a healthy dose of honesty/self reflection, it can be done. I had an app from someone in a similar story - was in a competitive surgical subspecialty, alcohol problem, fired. Now sober. I would have considered interviewing him -- except he didn't talk about it at all in his personal statement or even his application -- just mentioned he left the program for "medical / personal reasons". One of his LOR's spilled the beans. Big mistake in my book -- I want to see that the applicant really understands the gravity of the situation, and how they plan to proceed.

So, the TL;DR version: You don't have enough sobriety yet to apply for a spot. You'd need to get some sort of clinical job for now. Maintain sobriety for at least 6 months. Determine whether GS is the right field for you, and whether your prior PD will help/advocate for you to get a PGY-2 position somewhere else. Or, look at another field. Or go down a different path, but recognize that's probably an irreversible decision.

 

[itisallrelative]

It is really unfortunate if true that the board addresses this issue differently for residents and fully trained physicians. It really shouldn't matter, treatment options should be the same, and I would expect that long term outcomes would be similar. Unfortunately I expect much of the difference is a combination of protocol (at best) and laziness (at worst) -- a physician with a full license who runs into a problem still has a license, and the board needs to address that. A resident on a training license, if fired, loses that license -- so the board can just ignore them.

The real difference between a resident and a trained physician in this predicament is that you need a new training program, not just a new job. Your current state might be unforgiving, but others would likely give you a restricted license (esp a training license) with ongoing monitoring. You're going to want to avoid MA, CA, FL, TX, and PA which tend to be more notoriously difficult, but that leaves quite a few states.

So the real hurdle here is a new training program (in one of the 45 other states). Only you can decide whether you want to try, but you need to start working on it now if that's what you want. If you go back to working in Chem Eng, and then 5 years later decide you want to come back to medicine, you're going to get nowhere. If you apply to a residency program now, you're likely going to get nowhere also. But you could build towards a new spot in 1 to 2 years. The real goal would be next year's match.

This won't be easy. And your career in surgery is probably over. If you really want GS again, you'll need to hunt for a PGY-2 position. You'll need a letter from your prior PD. You would need to convince them that you were truly sorry for your behavior, and that you have a safe plan for proceeding. You are willing to repeat your entire PGY-2 to prove this. You'll need some serious luck, but it might be possible.

More realistic is a residency in another field. Perhaps IM or FM, perhaps with a focus on addiction (if you're interested). If you have an otherwise strong application, a decent amount of sobriety under your belt, and a healthy dose of honesty/self reflection, it can be done. I had an app from someone in a similar story - was in a competitive surgical subspecialty, alcohol problem, fired. Now sober. I would have considered interviewing him -- except he didn't talk about it at all in his personal statement or even his application -- just mentioned he left the program for "medical / personal reasons". One of his LOR's spilled the beans. Big mistake in my book -- I want to see that the applicant really understands the gravity of the situation, and how they plan to proceed.

So, the TL;DR version: You don't have enough sobriety yet to apply for a spot. You'd need to get some sort of clinical job for now. Maintain sobriety for at least 6 months. Determine whether GS is the right field for you, and whether your prior PD will help/advocate for you to get a PGY-2 position somewhere else. Or, look at another field. Or go down a different path, but recognize that's probably an irreversible decision.

The thing is, why hasn't Chair, PD, etc. discussed a move prior to simply removing at PGY3?

 

[itisallrelative]

spoken like a person who hasn't actually had any real medical experience...maybe you should wait til you have actually graduated and worked as at least as an intern...notice what the actual doctors on this thread have said...and at the moment, i'd take the alcoholic over the judgmental...

...Halsted? *Meant to reply to that tough guy you responded to, rokshana.

 

[itisallrelative]

They actually followed that policy? Anything else going on?

Or, listen, you can go for a real Hail Mary and try for Canada or UK (UK might actually be more do-able). Might be interesting. Might be worth it (less questions asked, maybe). Keep that in the back of your head. Hand tremors can be worked w/o need for the bottle.

 

[ThoracicGuy]

Or, listen, you can go for a real Hail Mary and try for Canada or UK (UK might actually be more do-able). Might be interesting. Might be worth it (less questions asked, maybe). Keep that in the back of your head. Hand tremors can be worked w/o need for the bottle.

No, Canada or UK would not be options.

 

[d2305]

The 1st step is the hardest.

 

[alkylate]

A little off the topic but something I'm curious about. Given your experiences in the medical field (I'm still a med student so probably don't have as good of a perspective), how prevalent/problematic is substance abuse in our field? Are tragedies like these (getting fired 2/2 substance abuse) few and rare or does it happen more than we would like? How about at the upper-levels? I recently read the story of the USC dean and was shocked by that story, is it as rare as we are lead to believe or do you guys think it happens?

 

[Apollyon]

A little off the topic but something I'm curious about. Given your experiences in the medical field (I'm still a med student so probably don't have as good of a perspective), how prevalent/problematic is substance abuse in our field? Are tragedies like these (getting fired 2/2 substance abuse) few and rare or does it happen more than we would like? How about at the upper-levels? I recently read the story of the USC dean and was shocked by that story, is it as rare as we are lead to believe or do you guys think it happens?

17% of docs are impaired in some way - drugs, alcohol, psychological, that's all comers. That's 1/6. Also, a number of them are comorbid.

So, even more frequent than one a week.

 

[gutonc]

A little off the topic but something I'm curious about. Given your experiences in the medical field (I'm still a med student so probably don't have as good of a perspective), how prevalent/problematic is substance abuse in our field? Are tragedies like these (getting fired 2/2 substance abuse) few and rare or does it happen more than we would like? How about at the upper-levels? I recently read the story of the USC dean and was shocked by that story, is it as rare as we are lead to believe or do you guys think it happens?

Substance abuse is at least as prevalent in medicine as it is in the general population. So, it's a real problem. As a student, in an average sized med school class (let's assume 150), based on CDC data (which is as flawed as any other data, so we'll just use it for the purposes of an example), 12-15 of your classmates already have substance abuse issues (mostly alcohol). Some of them will be able to keep it together as residents/fellows/attendings and be able to function and hide it from their colleagues/bosses. Others won't.

Getting fired will definitely depend on when you "get caught" and the circumstances surrounding it. If you are still a trainee, you are likely to face the same fate as the OP. If you are a fully licensed and BC physician who already has a job if/when it happens, your chances of continuing on are much better.

One of the partners in my small-ish group is currently on his 3rd restricted practice agreement with the state BOM. The first was based on a patient complaint for being drunk at work (which he admitted to) and which resulted in a 6 month suspension of his license. The other 2 (both after stints in rehab) were after DUIs where he called his lawyer and Betty Ford/Hazelden/the medical board in quick succession. He's currently the biggest 12 stepper I've ever met (and I grew up in a family of alcoholics, so I know my 12 steppers).

TL;DR...at least one of your close med school/residency friends has a substance abuse problem. Help him/her out if you can.

 

[Crayola227]

A little off the topic but something I'm curious about. Given your experiences in the medical field (I'm still a med student so probably don't have as good of a perspective), how prevalent/problematic is substance abuse in our field? Are tragedies like these (getting fired 2/2 substance abuse) few and rare or does it happen more than we would like? How about at the upper-levels? I recently read the story of the USC dean and was shocked by that story, is it as rare as we are lead to believe or do you guys think it happens?

sadly much more common than many going in expect

some have suggested that rates of substance abuse and mental health issues are higher in medicine compared to gen pop, but I don't have a citation for you

 

[AdmiralChz]

The specific rates of substance abuse, of course, vary greatly among specialties. The highest are Anesthesiology (likely due to easy access) and Psychiatry I believe which I never fully understood.

 

[alkylate]

It seems to be a problem that we unfortunately cannot ignore. Do you guys think that in time the taboo associated with substance abuse/mental illness in our field will eventually improve? I wouldn't be surprised that it could be a barrier to seeking help

 

[Crayola227]

It seems to be a problem that we unfortunately cannot ignore. Do you guys think that in time the taboo associated with substance abuse/mental illness in our field will eventually improve? I wouldn't be surprised that it could be a barrier to seeking help

I think there's been progress, for the most part.

The rise of PHPs has mostly been to provide a non-punitive avenue for physicians to get help they need. That's its own topic, has controversy, and like anything effectiveness and all that comes up.

Same with EHPs, various counseling and health services for those in training or practice.

Overall, I think the attitude at least has been towards recognizing that substance use disorders and other mental health conditions as treatable conditions, and towards a greater appreciation of the fact that physicians are humans and subject to all the same health issues as any patient.

I think awareness has come a long way, and stigma has gone down. As far as the nuts and bolts of actually addressing these issues, there's still a long way to go, IMHO.

 

[Crayola227]

The specific rates of substance abuse, of course, vary greatly among specialties. The highest are Anesthesiology (likely due to easy access) and Psychiatry I believe which I never fully understood.

I could speculate on the latter, and it might be offensive.

A lot of people have personal reasons that draw them into health care to begin with (personal or loved ones suffering). Obviously there's a ton of other factors for picking any career path.

Same with specialty choice. Lifestyle, money, what we find intrinsically interesting intellectually, etc etc.

In my experience, a lot of people seem to pick psychiatry because they have a lot of empathy. Yes, I think most people who pick medicine in general have a lot of empathy as part of what draws them. I think it's especially important in psych, and you know what, I think it's its own brand of empathy that brings you into that, vs anesthesia, let's say.

People that go into psych, quite simply, like treating mental health conditions. We tend to like things we not only feel we understand, but we feel we can be effective in doing. In my experience, those going into psych seem to have had more personal experiences with mental health challenges, perhaps compared to colleagues in other fields. Or at least it seems to be part of what drives the choice.

The short-winded non-PC offensive stereotype is that people go into psych because they themselves are "crazy." That is what makes them different enough to want to pick a field that is so unique compared to the rest of medicine, why they care and can stand patients that a lot of others "don't," and why they think they can and are able to help such patients.

I'm sure others have other theories. The practice of psych drives you to drink? I kid, I kid.

 

[Apollyon]

I could speculate on the latter, and it might be offensive.

A lot of people have personal reasons that draw them into health care to begin with (personal or loved ones suffering). Obviously there's a ton of other factors for picking any career path.

Same with specialty choice. Lifestyle, money, what we find intrinsically interesting intellectually, etc etc.

In my experience, a lot of people seem to pick psychiatry because they have a lot of empathy. Yes, I think most people who pick medicine in general have a lot of empathy as part of what draws them. I think it's especially important in psych, and you know what, I think it's its own brand of empathy that brings you into that, vs anesthesia, let's say.

People that go into psych, quite simply, like treating mental health conditions. We tend to like things we not only feel we understand, but we feel we can be effective in doing. In my experience, those going into psych seem to have had more personal experiences with mental health challenges, perhaps compared to colleagues in other fields. Or at least it seems to be part of what drives the choice.

The short-winded non-PC offensive stereotype is that people go into psych because they themselves are "crazy." That is what makes them different enough to want to pick a field that is so unique compared to the rest of medicine, why they care and can stand patients that a lot of others "don't," and why they think they can and are able to help such patients.

I'm sure others have other theories. The practice of psych drives you to drink? I kid, I kid.

But, you know what? I've known a LOT of psychiatrists in my career, and there have been some REAL space cadets, and others that were just plain weird, but, to a person, you could not flank any of them. They have all known how to address where they are weak, and play to their strengths. It's really remarkable, especially when you contrast them with other specialties, where it is beyond easy to set one of them off.

 

[d2305]

The co-founder of AA was a physician. One can read about his exploits in the text of alcoholics anonymous.

 

[wholeheartedly]

I regret to inform you all that Dakota45 turned out to be a returned troll and Kisangani was a socketpuppet of that account as well. This story is untrue.

On behalf of the moderator staff I would like to say that, despite the bogus OP, we greatly appreciate your contributions to the discussions in this thread and the support and advice you were all willing to give a fellow colleague who was struggling with something overwhelmingly difficult.

While it's incredibly disappointing that someone would fabricate this kind of story for some sort of online entertainment, I'm inclined to let the thread remain as there are likely quite a few others struggling with addiction who could still benefit from the content here.

Please don't let this dissuade you from providing your advice and support in the future.

 

[rokshana]

DAMN SAM....that is CRAZY!

 

[SouthernSurgeon]

It seems like the trolling/catfishing is intensifying here of late

 

[wholeheartedly]

It seems like the trolling/catfishing is intensifying here of late

For the most part it seems like we've had just a few very persistent ones who keep coming back over and over.

 

[ThoracicGuy]

I regret to inform you all that Dakota45 turned out to be a returned troll and Kisangani was a socketpuppet of that account as well. This story is untrue.

On behalf of the moderator staff I would like to say that, despite the bogus OP, we greatly appreciate your contributions to the discussions in this thread and the support and advice you were all willing to give a fellow colleague who was struggling with something overwhelmingly difficult.

While it's incredibly disappointing that someone would fabricate this kind of story for some sort of online entertainment, I'm inclined to let the thread remain as there are likely quite a few others struggling with addiction who could still benefit from the content here.

Please don't let this dissuade you from providing your advice and support in the future.

That guy really played the long game with this trolling.

 

[SouthernSurgeon]

For the most part it seems like we've had just a few very persistent ones who keep coming back over and over.

Maybe it’s just the persistence and/or elaborate nature

 

[gutonc]

Closing.