Fired From Residency??

[Chicago Doc]

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I have a friend (really a friend, not me) who was fired from his residency program. Does this happen alot and what are some of the reasons? He was told that they weren't satisfied with his performance but they fired 2 of the 4 students he started with.

 

[Jim Picotte]

Yep it certainly does happen. Typically you sign yearly contracts so after it's up they don't have to renew it for you. Usually though it's pretty hard not to continue on as you have to be pretty bad. By this I mean being dangerous to patients, having a really bad attitude and difficult to work with or just not keeping up in the knowledge department (this usually makes you dangerous). It happens, but it is usually a rare event.

 

[Winged Scapula]

I wouldn't say it happens "a lot" although certainly more in some programs than others.

The reasons are typically those Jim gave: dangerous, poor attitude, poor fund of knowledge, inability to learn/be taught, or various politically/morally incorrect types of behavior (sexual harrassment, stealing from fellow residents, etc.).

To fire 50% of your residents in 1 year seems a fair bit out of the norm, however. Its hard to believe that that many could have been such problems.

 

[ERMudPhud]

Its not always that rare. Some programs are openly designed as pyramid programs. In other words people enter the program knowing that each rung up the ladder of advancement will have fewer spots than the rung below. Like a really cruel game of musical chairs. This used to be fairly common in general surgery programs but is becoming less so. Other programs seem to have a habit of "weeding" someone out every few years. Whether this is due to actual incompetence or just a need to keep the other residents on their toes and make the attendings feel like they are being academically rigourous isn't always clear.

 

[Winged Scapula]

Originally posted by ERMudPhud
Its not always that rare. Some programs are openly designed as pyramid programs. .

Are there still very many of those left (at least "openly designed")? I had thought since the RRC/AAMC recommendations that nearly all pyramidal programs had changed to graduating the same number of Chiefs as interns (barring any unusual circumstances). 😕

 

[Chicago Doc]

My friend was in a general surgery program

 

[Docgeorge]

For God Sakes man, at what hospital was your friend working?

 

[R U SED 8]

I'm also a little curious as to what an individual is left to do after being fired from a residency!? I'm guessing that w/o a LOR or any support from your previous program director, it's gotta be near impossible securing a spot elsewhere, eh?

 

[womansurg]

Originally posted by Chicago Doc
I have a friend (really a friend, not me) who was fired from his residency program. Does this happen alot and what are some of the reasons? He was told that they weren't satisfied with his performance but they fired 2 of the 4 students he started with.

Definitely something to check into when you're interviewing: what the attrition rate is of that program. Any program that can't help 50% of their residents succeed has extremely poor managerial skills. Remember - with only a rare exception, these are students who typically have demonstrated a long history of intelligence, hard work, and social adeptness as part of the ongoing trials of gaining admission into and then excelling in medical school. If a group of leaders aren't able to exact an acceptable performance out of this group of exceptional performers, then something is seriously wrong with their approach.

 

[supercut]

The program I went to school at lost 60% of last year's PGY2 class (and >50% of those "lost" were acutally fired). That's a large part of the reason I didn't stay, depsite the overall excellent skill level chiefs graduate with. I think they musta had an especially bad match that year.

 

[Chicago Doc]

Well my friend doesn't want to go through starting over fresh in a surgery program so he's going to sit out this year and reapply in anesthesiology next year. He's also moving to a place where he has more connections (hoping that will help). He was in Alabama and now he's moving to Indiana.

 

[droliver]

Did he match there or did he scramble in to it? I assume you must be talking about the South Alabama program which went 0/4 in the 2002 match. Now I've had some good students not match before when they did stupid things with their rank list, but a lot of those that don't match have pretty marginal records in medical school. Having gone to school in Mobile, I know that they don't suffer fools gladly there in their surgery program & have not been reluctant to make people repeat years or fire them if they felt they were hopeless. They did not have a pattern of being unfair to people as I remember. Is there any chance that maybe your friend just wasn't cut out for it?

 

[Chicago Doc]

I think he matched there. He didn't have the greatest record in med school and I don't really picture him as a surgeon anyway but what do I know (I'm just a 2nd year med student). I have another friend doing peds there and she's just fine but I know things differ across programs.

 

[AnneMD]

Question? How difficult is it to reapply for a residency. Meaning go back through the match if your left a program that was a bad match and couldn't secure a 2nd year position?

 

[sanfilippo]

I was on surgery at a community-based hospital where a 2nd-year female resident decided the surgery atmosphere was just killing her. She switched to radiology and reapplied through ERAS/NMRP. She matched at another community-based hospital in the city. So, it's possible, but she also knew many of the radiologists there because it was one of the hospitals she had rotated through in surgery.

Her advice to me: save your ERAS information because you never know. However, I am trying very hard to avoid that pitfall altogether by thinking through my residency decisions.
-S.

 

[supercut]

Easier said than done, though. So far I'm very dissatisfied with my current program (not specialty choice). I'm weighing my options now, one of which is to go thru the match again. I realize that things could get better here, but if I am to go thru the match I'll have to start the process soon. I could always not submit a ROL if things get better.

Anyway, I interviewed at far more programs than necessary, and I always tried to ask what I felt were appropriate questions. At every program, every resident I asked said they were happy, that they felt they were gaining great operative skills. When I asked about the things they didn't like, the answer was ALWAYS something trival, like bad cafeteria hours or difficult parking.

Realize that the unhappy residents often don't show up to the interview functions or hegde their answers. We don't want to be pegged as badmouthing the program.

 

[AnneMD]

supercut. I decided to leave my program and go through the match again. I'm praying that since I'm in a non-competitive speciality that I will get enough interviews to really go and check out some programs the second time around. I too interviewed at a lot of programs and thought I had made the right decision. But I was mistaken twice. It's wierd, but my experience has taught me what to look for when I go back around this time. I'm planning to look straight pass all the smiley happy resident faces and ask some really tough questions. I'm just praying that since the numbers in my field have gone down every year...that I will have a good shot of finding somewhere good. As for starting over. I'm using this year to read, study, and catch up on a lot of sleep that I missed during my first intern year. I'm also planning to travel a bit and enjoy life before I have to give it up again.
Another lesson learned...if I'm miserable..I can't learn..and if I don't learn..I won't be the best physician I can be for myself or my patients.