Fired from Residency?

[skankhunt42]

Thought I would start a new thread away from the doom and gloom of the CRNAs.

Who here knows or knows of someone who got fired from residency? Seems there is always a good story because it takes a lot to get axed when youre unquestionably cheap labor.

I got two:

One- friend had a co resident in a EM program. Said EM program offered moonlighting in their 'fast track' urgent care wing. Residents would come in, pull an 8 hour shift, and maybe get $3-400 bucks. The way the paaperwork worked though is that after a shift you would fill out a form and submit it to the residency office.

Well- an enterprising resident sgtartedc filling out slips without moonlighting. Funny thing is, the program caught on and didnt tell him. Then, two days before graduation they call him in tell him they knew all along, and fired him.

Ouch.

Second is a guy one year ahead of me in med school. Matched into Radiology but did his prelim year in a community program in his hoemtown. He was given one elective that year and naturally he chose anesthesiology.

At the end of his rotation the faculty in charge calls over to the program and says 'hey, this guy never showed up for anesthesia, did you re-assign him?' Program director calls in the intern and the intern produces his sheet of signatures for intubations etc. Well, they look into it and showed he had not badged at the whole hospital for that month. Guy just decided to take a month's vacation.

They forced him to extend his intern year a month. The TY dire ctor called the radiology program and convinced them to fire him.

Yikes....

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[sheeed]

The intern year story suckssss

 

[Arch Guillotti]

I know 2 anesthesia residents that were railroaded out. They may have deserved it but it still wasn't pretty.

 

[skankhunt42]

I know 2 anesthesia residents that were railroaded out. They may have deserved it but it still wasn't pretty.

Ah the old make them so miserable they are forced to quit?

 

[narcotics999]

If residents are fired, what are they going to do? I don't think any program will view them favorably.

 

[Twiggidy]

They forced him to extend his intern year a month. The TY dire ctor called the radiology program and convinced them to fire him.

 

[Twiggidy]

They forced him to extend his intern year a month. The TY dire ctor called the radiology program and convinced them to fire him.

When unmatched PGY1s found out there was an open R1 position

 

[acidbase1]

Douche move to fire someone for moonlighting so long as it didn’t effect their performance/attendance as a resident. We all have/had a mountain of debt

 

[ZzzPlz]

There was an urban legend at my training program about a guy who got fired. He was doing a gyn case and the rotating Ob/gyn med students formed a line between the asleep patient’s legs, taking turns doing pelvic exams. Said resident decides to be cute and get in line. He performs the exam along with the other med students and gets caught. He was then fired from the program.

 

[Arch Guillotti]

There was an urban legend at my training program about a guy who got fired. He was doing a gyn case and the rotating Ob/gyn med students formed a line between the asleep patient’s legs, taking turns doing pelvic exams. Said resident decides to be cute and get in line. He performs the exam along with the other med students and gets caught. He was then fired from the program.

That actually wouldn't surprise me. If you do something out of line and get complained on it can be a career changer. I was a resident with a guy that did something similarly stupid - he didn't get caught, but if he had been complained on it would have followed him around for the rest of his life.

 

[skankhunt42]

There was an urban legend at my training program about a guy who got fired. He was doing a gyn case and the rotating Ob/gyn med students formed a line between the asleep patient’s legs, taking turns doing pelvic exams. Said resident decides to be cute and get in line. He performs the exam along with the other med students and gets caught. He was then fired from the program.

Damn, I had OB residents ask one time if I wanted t do the EUA, said hellllllll no!

 

[narcusprince]

There was an urban legend at my training program about a guy who got fired. He was doing a gyn case and the rotating Ob/gyn med students formed a line between the asleep patient’s legs, taking turns doing pelvic exams. Said resident decides to be cute and get in line. He performs the exam along with the other med students and gets caught. He was then fired from the program.

This seems highly subjective. Especially if the attending obgyn knew said resident did the physical exam. I could see the conversation being the patient has xyz patholgy check it out. As an attending physician I had a colorectal surgeon ask me to palpate a rectal cancer. Colorectal cancer runs in my family so with the attending guidance I felt the mass. Never did I feel like it crossed the line.

 

[skankhunt42]

If residents are fired, what are they going to do? I don't think any program will view them favorably.

If its a clear cut firing, then those residents are toxic for sure. Liekly going to have to pull a lot of sstrings to find some **** residency elsewhere. But as some posters have alluded to, most of the time a firing is just residents being made miserable and fcorced to resign (thats easier than straight up firing). When those guys apply for something else, I am sure there is a lot of looking under the hood. Some ENT resident applied to the gas program I'm at because it turned out he was being asked to resign. I'm sure he sung a 'saw the anesthesia light' tune on the interview trail.

 

[abolt18]

Gen surgery resident got fired a couple months into PGY-2 year for just sucking big-time. This individual was my never-present and exceptionally incompetent junior, right into my intern year.

Was on probation previously, but just could not get their act together apparently. During my month on the service with this person there was an event where they were nowhere to be seen and I, the newly minted intern, was left to deal with a bleeding out, hemodynamically unstable post-op patient who had to go back to the OR emergently.

 

[Twiggidy]

This seems highly subjective. Especially if the attending obgyn knew said resident did the physical exam. I could see the conversation being the patient has xyz patholgy check it out. As an attending physician I had a colorectal surgeon ask me to palpate a rectal cancer. Colorectal cancer runs in my family so with the attending guidance I felt the mass. Never did I feel like it crossed the line.

I get that, but technically, if you aren't a part of that training program, it could be considered that you aren't part of the consent for "surgery". I remember coming across this issue once some did mention the words "assault and battery". They could have been being a bit melodramatic but if an unsuspecting patient finds out and wants to sue you can bet those words will come up.

 

[Psai]

Need more details

 

[leaverus]

Douche move to fire someone for moonlighting so long as it didn’t effect their performance/attendance as a resident. We all have/had a mountain of debt

huh?? did you actually read the story or am I reading your post wrong? the dude got fired for NOT moonlighting but still handing in payment forms to the office. douche move on his part, I mean WTF. and the 2nd story, good lord, what kinda lazy ass people are med schools allowing in these days; i'm surprised he was able to work hard enough to match into radiology but then decides to take a vacation?? doesn't make sense, again WTF. btw, where did he actually get signatures from - did he just forge them??

the only person I know of who got fired while I was in residency was a year ahead of me and partaking of a little ketafol while on call. good thing no patients were harmed.

 

[Twiggidy]

I get that, but technically, if you aren't a part of that training program, it could be considered that you aren't part of the consent for "surgery". I remember coming across this issue once some did mention the words "assault and battery". They could have been being a bit melodramatic but if an unsuspecting patient finds out and wants to sue you can bet those words will come up.

Now that I'm remembering it more, it was on a rotation where we "shadowed" affiliated physicians in private practice so I think the issue was that the students weren't "priviledged" at that hospital. Basically they said we couldn't touch the patients AT ALL (I dont even think scrubbing in) and especially in "sensitive places".

Again, maybe they were being melodramatic.

 

[pgg]

Well- an enterprising resident sgtartedc filling out slips without moonlighting. Funny thing is, the program caught on and didnt tell him. Then, two days before graduation they call him in tell him they knew all along, and fired him.

This story is BS.

First, no way the program keeps writing checks for shifts they knew he wasn't working.

Second, no way a PD keeps a resident who's demonstrated bad judgment and lack of integrity to the point of committing theft. No one would keep this untrustworthy person around treating patients even another week. Who knows what else they might lie about or cheat on.

 

[Twiggidy]

huh?? did you actually read the story or am I reading your post wrong? the dude got fired for NOT moonlighting but still handing in payment forms to the office. douche move on his part, I mean WTF. and the 2nd story, good lord, what kinda lazy ass people are med schools allowing in these days; i'm surprised he was able to work hard enough to match into radiology but then decides to take a vacation?? doesn't make sense, again WTF. btw, where did he actually get signatures from - did he just forge them??

the only person I know of who got fired while I was in residency was a year ahead of me and partaking of a little ketafol while on call. good thing no patients were harmed.

these people must be kicked out of the system. if they're forging signatures and moonlighting sheets they aren't too far from committing some other type of fraud in the field.

as far as the second situation, in med school, an anesthesia resident passed out in the OR. Long story short they found out he was using the fentanyl.......but they let him come back an finish. that shows how much it takes to get FIRED from anesthesiology residency. I do wonder what happened to him. I genuinely hope he stayed clean

 

[narcusprince]

these people must be kicked out of the system. if they're forging signatures and moonlighting sheets they aren't too far from committing some other type of fraud in the field.

as far as the second situation, in med school, an anesthesia resident passed out in the OR. Long story short they found out he was using the fentanyl.......but they let him come back an finish. that shows how much it takes to get FIRED from anesthesiology residency. I do wonder what happened to him. I genuinely hope he stayed clean

This is a topic worthy of debate. Im of the stance that if you get caught abusing anesthesia drugs you should not be in the field. I believe this is a disservice to the resident. Relapse rate is like 90%. And the second time around is the worst.

 

[skankhunt42]

huh?? dF. btw, where did he actually get signatures from - did he just forge them??
.

Yeah he forged them

 

[Twiggidy]

This is a topic worthy of debate. Im of the stance that if you get caught abusing anesthesia drugs you should not be in the field. I believe this is a disservice to the resident. Relapse rate is like 90%. And the second time around is the worst.

Agree

 

[skankhunt42]

This is a topic worthy of debate. Im of the stance that if you get caught abusing anesthesia drugs you should not be in the field. I believe this is a disservice to the resident. Relapse rate is like 90%. And the second time around is the worst.

Don't agree with this...I think you want a system where people might seek help and try to rehabilitate themselves. If having a drug problem meant automatically loosing your field of medicine, it would push people in the opposite direction. But I certainly would hope a recovering adict would think seriously about another field.

 

[anbuitachi]

I have heard of about a resident who got fired because the resident was stealing supplies from the hospital. Also heard of a few residents here getting fired over the years for using drugs, including someone who only tested positive for marijuana.

 

[Twiggidy]

Don't agree with this...I think you want a system where people might seek help and try to rehabilitate themselves. If having a drug problem meant automatically loosing your field of medicine, it would push people in the opposite direction. But I certainly would hope a recovering adict would think seriously about another field.

you can practice medicine, but you shouldn't practice anesthesiology

 

[anbuitachi]

you can practice medicine, but you shouldn't practice anesthesiology

I kind of agree with this. I've seen people getting let go to go to rehab, get better, go back to anesthesiology retraining program, only to relapse and get fired. There definitely are success stories as well but why risk it. this is your life on the line

 

[deleted171991]

I remember this kind of discussion about somebody in my program. The logic was simple: if it's a serious character flaw or a bad personality fit, it cannot be fixed and the sooner the resident is let go the better. If it's a knowledge issue, then there is still a chance.

To be honest, I don't think people should be kept around if there is serious lack of medical knowledge either. The person went on to fail her boards (as predicted), now she's a board-certified attending. She was one of the cases that proved to me that one doesn't need much medical knowledge to practice anesthesia.

 

[dannyboy1]

I kind of agree with this. I've seen people getting let go to go to rehab, get better, go back to anesthesiology retraining program, only to relapse and get fired. There definitely are success stories as well but why risk it. this is your life on the line

Gonna kind of disagree. We live in a free society and people should make decisions about how they want to live their life, and then live with the consequences, if a recovering (or not) drug user wants to practice anesthesia, who am I to say no. It’s not as if every addict who OD’s got his drugs from an anesthesia cart. Drugs are readily available on the street. Seek and you shall find...

 

[Twiggidy]

Gonna kind of disagree. We live in a free society and people should make decisions about how they want to live their life, and then live with the consequences, if a recovering (or not) drug user wants to practice anesthesia, who am I to say no. It’s not as if every addict who OD’s got his drugs from an anesthesia cart. Drugs are readily available on the street. Seek and you shall find...

Who are you to say no? You're an anesthesiologist who should have pride in the field. Plain and simple, it's a risk and a liability and I'd honestly would not complain if a known drug abuser was unable to get malpractice insurance for anesthesiology. I think few of us think of our field this way, but being an anesthesiologist is the ultimate privilege. We, unlike just about anyone else in the hospital, can obtain and administer just about any drug to a patient without an order. We have access and opportunity that rivals the pharmacists. Speaking of, if a pharmacist was a recovering drug user should they be working in the pharmacy? Sorry, but absolutely not. Being a drug abuser (current or former) simply shows a lack of discipline and control which I think are two very important qualities for an anesthesiologist outside of medical knowledge and skill. I'm a liberal as the next man but when it comes to pride in my field I have to take a stand.

 

[Psai]

Gonna kind of disagree. We live in a free society and people should make decisions about how they want to live their life, and then live with the consequences, if a recovering (or not) drug user wants to practice anesthesia, who am I to say no. It’s not as if every addict who OD’s got his drugs from an anesthesia cart. Drugs are readily available on the street. Seek and you shall find...

We owe our patients more than a passed out doctor high on fentanyl in the or

 

[pgg]

A person who self reports diversion and drug use and seeks help before he is motivated by legal consequences is a somewhat different risk than someone who was caught.

Lack of self reporting, abuse of an opioid, and comorbid psychiatric conditions (including personality disorders) are the big 3 risk factors for relapse. Relapse has a high mortality rate.

I'm of the opinion that anesthesiologists who have diverted should change fields or retire, and CRNAs should fall back on ordinary nursing or retire. The drugs have permanently altered their brain chemistry and risk/benefit analysis. The practice of anesthesia, with its solitary nature and easy access to drugs, is a unique risk not found in any other specialty.

I'll concede there may be a subset of self-reporters who may be able to safely re-enter the right kind of practice under the right circumstances.

 

[narcusprince]

To hold a resident until the day before their graduation shows a level of vindictiveness and recklessness that the PD should lose their job. That resident was lied to and likely told everything was good. Disappointing in the resident and terrible move by the PD.

 

[dannyboy1]

To hold a resident until the day before their graduation shows a level of vindictiveness and recklessness that the PD should lose their job. That resident was lied to and likely told everything was good. Disappointing in the resident and terrible move by the PD.

Apparently even with fraud/stealing a resident body is very valuable. Not the point of this thread but just goes to show how underpaid residents really are..

 

[dannyboy1]

A person who self reports diversion and drug use and seeks help before he is motivated by legal consequences is a somewhat different risk than someone who was caught.

Lack of self reporting, abuse of an opioid, and comorbid psychiatric conditions (including personality disorders) are the big 3 risk factors for relapse. Relapse has a high mortality rate.

I'm of the opinion that anesthesiologists who have diverted should change fields or retire, and CRNAs should fall back on ordinary nursing or retire. The drugs have permanently altered their brain chemistry and risk/benefit analysis. The practice of anesthesia, with its solitary nature and easy access to drugs, is a unique risk not found in any other specialty.

I'll concede there may be a subset of self-reporters who may be able to safely re-enter the right kind of practice under the right circumstances.

I know of a guy who self reported, there were no performance issues or suspicions, and was still let go. Wrong thing to do IMO. now you set a precedent where you can’t even go for help if you need it..

 

[Psai]

A person who self reports diversion and drug use and seeks help before he is motivated by legal consequences is a somewhat different risk than someone who was caught.

Lack of self reporting, abuse of an opioid, and comorbid psychiatric conditions (including personality disorders) are the big 3 risk factors for relapse. Relapse has a high mortality rate.

I'm of the opinion that anesthesiologists who have diverted should change fields or retire, and CRNAs should fall back on ordinary nursing or retire. The drugs have permanently altered their brain chemistry and risk/benefit analysis. The practice of anesthesia, with its solitary nature and easy access to drugs, is a unique risk not found in any other specialty.

I'll concede there may be a subset of self-reporters who may be able to safely re-enter the right kind of practice under the right circumstances.

Why would you self report anything to your program? The less they know the better imo

 

[AdmiralChz]

If residents are fired, what are they going to do? I don't think any program will view them favorably.

Well, if they were truly fired then yes. That’s usually a rare instance in my limited experience, more typically the resident’s contract is either not renewed or they are encouraged to resign (or be fired and have that mark on their record).

I have a few stories:

- Resident filled an open CA-1 spot at my program a number of years ago, had already completed another residency and was working as staff in a city a few hours away. He was a very strange guy and a total personality mismatch for Anesthesia - our chair randomly knew his old residency chair and reached out for more info after having a run in with him, turns out he was fired his last year of residency for some violent reason and he fabricated his documents. Since he jumped into an open slot in the middle of the year somehow this fell through the cracks. Hospital police literally pulled him out of whatever assignment he was on and escorted him to his locker which he cleaned out and he was fired on the spot.

- MUCH more common, in a big program like mine (>20 per year) we had 1 or 2 every could of years just be poor fits for Anesthesia, having book smarts but being just dreadful/dangerous/frozen in pressing situations like difficult airways or crashing patients. It’s pretty apparent by 6 months who can get by and who can’t. They worked hard but it was clear it wasn’t going to happen. In all of these situations our program worked with the person to find them another spot somewhere, typically in the same institution - off the top of my head I know people who switched into Neuro, FM and Psych and one who quit medicine altogether.

- We also had an ED with lots of moonlighting opportunities (paid crappy though), but we forbidden to do external moonlighting. A resident a few years ago was moonlighting at a rural ED an hour or so away on the weekends when the wife of his chairman or PD was brought in as a patient. He was fired that weekend, which was a big wake up call to anyone doing external stuff (and which is why I usually recommend against it).

 

[leaverus]

you can practice medicine, but you shouldn't practice anesthesiology

I believe some of us who've been on this forum long enough remember an excellent resident and frequent poster here to whom this happened, and who is now a successful physician - just not in anesthesia.

 

[leaverus]

- We also had an ED with lots of moonlighting opportunities (paid crappy though), but we forbidden to do external moonlighting. A resident a few years ago was moonlighting at a rural ED an hour or so away on the weekends when the wife of his chairman or PD was brought in as a patient. He was fired that weekend, which was a big wake up call to anyone doing external stuff (and which is why I usually recommend against it).

I think these sort of scumbags who don't get caught later go on to become anesthesia partners who won't hesitate to crap on and screw over everyone else in the group just to make a little extra $$; speaking from personal experience of course.

 

[dannyboy1]

Well, if they were truly fired then yes. That’s usually a rare instance in my limited experience, more typically the resident’s contract is either not renewed or they are encouraged to resign (or be fired and have that mark on their record).

Non renewal and firing are the same thing essentially. Anyone who is looking to hire this person in the future will be asking about this period of employment. Same with any applications for state liscence or hospital privileges. They all ask to list previous training programs and if the program was completed or not. The only thing that yearly contracts do is that it gives the hospital the opportunity to fire someone without the headaches involved (he was not fired, just not rehired)

 

[pgg]

Why would you self report anything to your program? The less they know the better imo

People self-report so they don't die.

Recovery (at least, recovery with a chance of success) involves inpatient rehab, absence from practice for an extended period (literature suggests a year+), ongoing frequent drug testing, ongoing scheduled counseling, and supervised practice. None of this can be concealed from a residency program.

I think what you're suggesting is taking a couple weeks of quiet vacation from the program to self-treat cold turkey or do a week of inpatient rehab somewhere, which is unlikely to be successful.

 

[pgg]

To hold a resident until the day before their graduation shows a level of vindictiveness and recklessness that the PD should lose their job. That resident was lied to and likely told everything was good. Disappointing in the resident and terrible move by the PD.

Don't get worked up about it; the story is obviously BS for the simple reason that continuing to pay a person for fraudulently reported moonlighting shifts is a criminal act on the part of the faculty who knew about it. No PD is going to risk personal repercussions like this for the sake of messing with or screwing some resident. Not to mention, the liability of keeping this guy involved with patient care when you know he falsifies documents for personal gain. If this guy later gets caught diverting drugs for sale, how do you defend the decision to say nothing and keep him around after you knew he was stealing from the hospital?

It's bull****.

I have great admiration and respect for real-life trolls with the patience to string a thief along, but this didn't happen.

 

[skankhunt42]

Don't get worked up about it; the story is obviously BS for the simple reason that continuing to pay a person for fraudulently reported moonlighting shifts is a criminal act on the part of the faculty who knew about it. No PD is going to risk personal repercussions like this for the sake of messing with or screwing some resident. Not to mention, the liability of keeping this guy involved with patient care when you know he falsifies documents for personal gain. If this guy later gets caught diverting drugs for sale, how do you defend the decision to say nothing and keep him around after you knew he was stealing from the hospital?

It's bull****.

I have great admiration and respect for real-life trolls with the patience to string a thief along, but this didn't happen.

My friend swears by it. I could confirm with him, but when he told it to me the tone of it was that this behavior had started late in the third year and likely they were unsure which ones were fabricated. I imagine they froze moonlighting payments then fired him. The point being is that instead of perhaps firing him a month or two earlier, they just milked him for a few more weeks to avoid F-ing over his co-residents. I'm sure they could claim that they needed the time to internally investigate. I don't think this is that far fetched...

But it was a bit of an urban legend at his program....maybe some of the facts got embellished over the years...

 

[Ronin786]

I think these sort of scumbags who don't get caught later go on to become anesthesia partners who won't hesitate to crap on and screw over everyone else in the group just to make a little extra $$; speaking from personal experience of course.

I disagree. While the risk benefit ratio of moonlighting outside of your program's scope isn't worth it to me personally, I can understand the allure.

Think about a resident with a family and kids who can make a couple extra bucks by pulling weekend shifts once a month. Residencies shouldn't be allowed to prohibit your ability to work outside of your program. But they do, because they can.

 

[leaverus]

I disagree. While the risk benefit ratio of moonlighting outside of your program's scope isn't worth it to me personally, I can understand the allure.

Think about a resident with a family and kids who can make a couple extra bucks by pulling weekend shifts once a month. Residencies shouldn't be allowed to prohibit your ability to work outside of your program. But they do, because they can.

no man, I didn't mean moonlighting itself. I meant the fraudulent scumbags who submit for reimbursement for moonlighting they never actually did.

 

[NITRAS]

My program fired a pgy2 in IM we picked up after one of the interns moved to EM. He was terrible, couldn’t handle simple stuff much less the complicated train wrecks we admitted with the only staff in house in the ED. .... I was told he had phenomenal board scores.

IMO, integrity issues are unfixable. So much in all of medicine revolves around integrity. You are going to harm patients and other professionals.

Putting a drug addict in anesthesia is like having an alcoholic tend bar. It’s just a bad idea.

 

[T-burglar]

I’m my program we ****canned between 1 and 2 residents during orientation seemingly every year. I never disagreed with it, they were always unsafe and a very bad fit for acute care. One of them I remember was told she had to stop holding the laryngoscope with two hands and then dropped it on the patient’s teeth from height. Another wouldn’t place LMAs because she couldn’t mentally put her hands in someone’s mouth.

 

[nimbus]

I’m my program we ****canned between 1 and 2 residents during orientation seemingly every year. I never disagreed with it, they were always unsafe and a very bad fit for acute care. One of them I remember was told she had to stop holding the laryngoscope with two hands and then dropped it on the patient’s teeth from height. Another wouldn’t place LMAs because she couldn’t mentally put her hands in someone’s mouth.

 

[Twiggidy]

I’m my program we ****canned between 1 and 2 residents during orientation seemingly every year. I never disagreed with it, they were always unsafe and a very bad fit for acute care. One of them I remember was told she had to stop holding the laryngoscope with two hands and then dropped it on the patient’s teeth from height. Another wouldn’t place LMAs because she couldn’t mentally put her hands in someone’s mouth.

Wow if this is true. How the hell do you get that through a rotation, interviews, and internship only to find out the person you matched for your program can't touch someone's mouth? I feel like the laryngoscope issue can be fixed with a good week or two of "code reds".

 

[Psai]

I’m my program we ****canned between 1 and 2 residents during orientation seemingly every year. I never disagreed with it, they were always unsafe and a very bad fit for acute care. One of them I remember was told she had to stop holding the laryngoscope with two hands and then dropped it on the patient’s teeth from height. Another wouldn’t place LMAs because she couldn’t mentally put her hands in someone’s mouth.

Why would you need to put your hand in someone's mouth to place an lma?