for those who want residency reform

[turquoiseblue]

Please sign this petition for the end of unfair hiring/firing practices in residency.

http://www.thepetitionsite.com/1/end-unfair-dismissals-in-acgme-residency-programs

Another petition for expanding medical residencies:

http://www.thepetitionsite.com/1/expanding-us-medical-residency-programs-programs

Another petition regarding j1 visa abuse by program directors:

http://www.thepetitionsite.com/1/j1-visa-abuse

Thanks!!!

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Members don't see this ad.

 

[odieoh]

Turq-

I hate to burst your bubble but I don't think these online petitions where people just sign as "anonymous" are going to get much attention.

Besides that they are fairly poorly written, both of them. The first one rambles on and has random /'s placed throughout. The second one shifts from first to third person randomly, sometimes within a single sentence.

In the first one I love the "He worked the entire year" bit, but then you go on to say how he was fired in his 11th month. . .I realize 11/12 is really close to a full year but when you use words like "entire" you better not contradict yourself in the very next sentence.

I feel for you and the position you are in but I think you just need to move on.

 

[turquoiseblue]

thanks odeioh

i think the anonymous names can be downloaded onto paper somehow. it just doesnt show up online for those that don't want to be seen by others.


I am moving on as we speak, just found this from a long time ago and someone wanted me to try to 'revive' that spirit as they felt they were gravely wronged as well. so it's not just me there are plenty out there. just want to see how far it can go. i am just doing moreso as a favor to a friend as well as to others who want reform who lost their jobs.

most of the work is done....all i need now is signatures.....
i will improve on the writing aspect of it eventually....just hope " we the people" at least get the point enough to sign it.

 

[lipomas]

What if we don't want to sign it? You are glossing over the fact that residents can be fired for incompetence. "Bad mouthing" them may actually be an honest assessment of their skills. This petition is calling for even unqualified residents to be given extra chances. If you are serious about this you need to provide evidence (or even well-worded opinions) that competent residents are being fired for no good reason.

Isn't it a bigger waste of medicare money to train incompetent physicians? I would say yes.

 

[zihuatanejo]

What if we don't want to sign it? You are glossing over the fact that residents can be fired for incompetence. "Bad mouthing" them may actually be an honest assessment of their skills. This petition is calling for even unqualified residents to be given extra chances. If you are serious about this you need to provide evidence (or even well-worded opinions) that competent residents are being fired for no good reason.

Isn't it a bigger waste of medicare money to train incompetent physicians? I would say yes.

I think that you are letting malignant programs off the hook too easily. An ethical program director has a duty not only to produce safe and competent physicians or surgeons but to also provide an educational environment that is conducive to those goals. This means an environment free of harrassment and intimidation. There must also be sufficient mentorship, guidance, and supervision to allow residents to develop their clinical skills. If despite all these conditions being met, a resident is not meeting a minimum standard that is expected of someone at his/her stage of training, the resident should not just be summarily dismissed but instead should be given ample opportunities to remediate. If after being placed on probation and many chances at remediation, the resident is still not performing as expected, then perhaps that resident is not suited to that specialty and should be encouraged to pursue another specialty that he/she can succeed in. The program director should assist the resident in this process.

If every program out there acted like I outlined above, hardly anyone would be complaining about malignant programs or unfair termination practices. Outside of a few very technical or difficult to master surgical specialties, almost all residents can and should be able to complete their residencies if they are motivated to learn and succeed. Medicine is not rocket science, and residents who graduated from medical school and passed their USMLEs are certainly equipped to complete their residency programs if they are in the right educational or training environment.

 

[ShyRem]

I just can't sign it as written. It's too poorly written with unclear objectives that can be twisted in many many ways.

 

[turquoiseblue]

is there a good writer in the house? maybe someone can rewrite it much better and PM it to me and i will see if i can replace what already is there? a friend actually wrote most of the first one, not me. does it cover too many issues at once? thanks....

 

[NotAProgDirector]

I will say what others have said, more bluntly. This is a gigantic waste of time. First, online petitions are useless for making large system changes like this. The same person can sign them multiple times. They only allow for one side of a story to be told. This one is really poorly written. I hate to say it, but if this is the best writing you can muster, it's not a great surprise that you struggled in a residency where good communication skills are a must. If it is not your best work, then it demonstrates that you don't put your full effort into your work which is equally problematic. And the worst thing about this petition is that it doesn't make any useful suggestions about how to fix the problems. Might as well sign a petition asking for world peace.

If you really want to fix this problem, this is a waste of time. First, you have combined two problems into one: 1) Residents terminated from programs unfairly; and 2) non US citizens taking residency spots from US citizens. These are two separate issues with separate solutions.

1) Unfair terminations

Residents are terminated from residency programs. Some of those terminations are fair -- the resident was unable to perform satisfactorily in a program despite adequate support. Some are not, where a resident is unfairly branded as unsatisfactory and then continues to get poor evaluations because people are biased. And some are truly malicious. Separating these will be very difficult. Residency evaluations are by nature subjective, and any subjective evaluation is subject to bias. It's like defining "Good Art" from "Bad Art" (although, to be fair, performance in residency is much more defined than art quality).

So, your best option would be some sort of standardized, independent review that can be requested by a resident when terminated. Although the ACGME already requires such, it's done in house and hence is not very independent in many cases. So, a possible solution would be to have a national, independent review board to review resident terminations.

I could see two ways of doing this:

A) Through the ACGME. You could lobby the ACGME to mandate this. It would be paid for via program dues to the ACGME. When a resident is terminated, they could request an ACGME review and the ACGME would send an official to do so. This would require an entire flotilla of new ACGME officials, and given all of the ACGME's new initiatives it's not clear they would be very interested.

B) Through a standalone, resident created service. I could imagine residents creating their own independent board to review terminations. This would be paid for by residents -- either all residents would pay dues, or you could charge a fee paid by a resident whom is terminated. You would still need ACGME by-in to make this happen, as you need to mandate it to make it required. Or, you could offer this as a service, and then have this office try to stand up for those it feels were truly wronged.

In either case, the way to address this is to try to get it on the ACGME's radar. And to do that, you would try to discuss it with the Council of Review Committee Residents. Although the ACGME's website is vague about this committee, each RRC has resident members, and this Council includes all of them together (I believe). Hence, if you could get the Resident Council to agree that this was an important issue for the ACGME to address, there is some chance that they would do so.

2) US Citizens vs FMG's

Whether or not this is a problem is debated on several threads. If you believe it is, then there are several ways to address it:

A) You could try to affect visa policy. Disallowing H1b visas for FMG's would likely be the most effective way to addess it, and/or limiting the number of H/J visas available each year.

B) You could try to decrease GME funding for non-US citizens. Decreasing funding to 50% for non US citizens would certainly change priorities.

Both of these need to be addressed by Congress. Writing an online petition to all of Congress is a waste of time. You need to speak to a single person in Congress, presumably one of your state's senators or HR members. You need to get them engaged in this "problem". You need to convince them that this is something worth investing their time, energy, and political capital into. If you can get someone in congress, or perhaps more importantly one of their key staffers, interested in this issue then it might get amended into a bill somewhere.

None of these solutions are easy. All will take years of concerted effort. You personally are unlikely to personally benefit from the fight. Instead of trying to address the ACGME or Congress directly, you might want to get the resident section of the AMA interested in this, and then perhaps they would put their political muscle behind it. But if you want to really make a change, forget the online petitions and start doing something that will really effect change.

 

[turquoiseblue]

Thanks for the input aProgDirector. good ideas. if anyone wants to help me out in this huge task by all means you are welcome to it!!

it is true that we need to target the ACGME in this. that is one thing we did not address. i will check with the RRC.

i did email this (the first one) to congress and congress.org, and i have a friend that wants to send it out to various congress-people too. that's one tiny step for humankind. lol.

 

[NotAProgDirector]

Perhaps you did not read my post with a critical enough eye.

Sending this "petition" with minimal "signatures" to "Congress" with it's poor grammar, lack of focus, and lack of an action plan will only hurt your cause. It will make you look unprofessional and clueless. It will certainly ensure that any further communication with congressional offices will end up in the trash.

 

[turquoiseblue]

Perhaps you did not read my post with a critical enough eye.

Sending this "petition" with minimal "signatures" to "Congress" with it's poor grammar, lack of focus, and lack of an action plan will only hurt your cause. It will make you look unprofessional and clueless. It will certainly ensure that any further communication with congressional offices will end up in the trash.

it wasn't sent as a petition, just the letter part was sent. i understand that the petition doesn't have enough signatures to be sent.
this was made in simple terms as these are politicians who no nothing about medicine. I found out that i'm not able to edit them anymore. someone else took over the account and wants to do it themselves. they keep deleting everytime i try to correct it without asking me. so it's not mine at all..i thought it was joint, but i guess not. so i give up on writing this.
but anyone is welcome to sign.

I did ask the ACGME if they'd consider helping residents out more though as you were stating in your original paragraph of ideas.
I've heard of people asking homeland security and all that jazz about the visa issues before, so im sure someone is covering that ground. Here is the guy to contact about that issue if anyone is interested. I will try but others should too-- maybe the more the marrier.

[email protected]
Alejandro N. Mayorkas
U.S. Citizenship and Immigration Service
Office of the Director
20 Massachusetts Avenue NW, Suite 5110
Washington, DC 20529

 

[turquoiseblue]

.......

 

[Arcan57]

Does anyone have data on the number of residents that resign or are terminated from residency that complete a residency at another program?
Is there data to back up resigning from a program as being a death sentence for practicing medicine?

 

[lipomas]

I think that you are letting malignant programs off the hook too easily. An ethical program director has a duty not only to produce safe and competent physicians or surgeons but to also provide an educational environment that is conducive to those goals. This means an environment free of harrassment and intimidation. There must also be sufficient mentorship, guidance, and supervision to allow residents to develop their clinical skills. If despite all these conditions being met, a resident is not meeting a minimum standard that is expected of someone at his/her stage of training, the resident should not just be summarily dismissed but instead should be given ample opportunities to remediate. If after being placed on probation and many chances at remediation, the resident is still not performing as expected, then perhaps that resident is not suited to that specialty and should be encouraged to pursue another specialty that he/she can succeed in. The program director should assist the resident in this process.

If every program out there acted like I outlined above, hardly anyone would be complaining about malignant programs or unfair termination practices. Outside of a few very technical or difficult to master surgical specialties, almost all residents can and should be able to complete their residencies if they are motivated to learn and succeed. Medicine is not rocket science, and residents who graduated from medical school and passed their USMLEs are certainly equipped to complete their residency programs if they are in the right educational or training environment.

I am not letting malignant programs off the hook. I did not say that there were not malignant programs. What I said was that bad residents can and should be fired for incompetence. Medical residency should not be like a unionized shop where you can't lose your job unless you do something criminal. If someone is not cut out to be a physician, in my view it is the duty of the residency program to identify these individuals and not give them a stamp of approval as a competent physician. Does this mean that abuses of residents by programs does not happen? Of course it doesn't mean that. But it is not an all-or-nothing situation. I would bet my future career earnings in their entirety that a majority of dismissed residents were dismissed with good reason. It does not mean that all dismissed residents will not make fine physicians, but it does mean that many will not. It also does not mean that the reasons for dismissal were all unfixable. But unfortunately many residents, perhaps even more than program directors, are not willing to acknowledge their own deficiencies.

I am not willing to tar and feather all residency program directors who dismiss residents as being ignorant (or corrupt) individuals who bad mouth people that they happen to dislike for some personal reason. It's a bit of an odd leap to suggest that most fired residents are the victims of some sort of ill-conceived personal vendetta. This is even harder to believe when many dismissed residents cannot seemingly put a sentence together correctly or explain why they were let go without claiming some sort of bias or unproven allegation.

Residents who are dismissed or who are on probation and may get dismissed should not immediately jump to the conclusion that they are the victim of a conspiracy or discrimination. They should find out what their issues are and work to correct them. Unless a program director is incompetent, they would take this action as evidence that the resident is potentially redeemable because after all, it is a training program. But when residents confronted with this stand fast and protest and claim to have done nothing wrong it just makes the resident look bad and makes it easier to dismiss them.

It's funny how a lot of people on this forum think that program directors are more likely than residents to be evil and/or incompetent. Residents can be bad too.

 

[turquoiseblue]

Does anyone have data on the number of residents that resign or are terminated from residency that complete a residency at another program?
Is there data to back up resigning from a program as being a death sentence for practicing medicine?

I hear the yearly number is around 200+ residents. I read this off an article I have been unable to relocate a while ago. I wish I could find it.

This may also answer your question: http://forums.studentdoctor.net/showthread.php?t=562930&page=2

I among others may feel like living proof of this. 0-1 interviews out of hundreds of applications with no acceptance. It may "raise red flags" to have a past residency. either that or GME doesn't want to fund anymore because it is partially used up due to capped funding.

I have seen proof of residents that resigned or were terminated or dismissed that made it out into another residency and completed it. I do not know the statistics though.

I hope someone can find the actual statistics and post it here.

 

[Cerberus]

1. I would never sign such a poorly written petition even if I did agree with it.

2. I don't have a lot of pity for IMGs who did not perform well and are whining about not getting a position because a foreign graduate, with far better credentials did. You chose to enter an international medical program. Nothing in life comes for free, don't expect those of us who worked hard to advocate for less qualified people to be our collegues simply because they are US citizens.

 

[gutonc]

I among others may feel like living proof of this. 0-1 interviews out of hundreds of applications with no acceptance. It may "raise red flags" to have a past residency. either that or GME doesn't want to fund anymore because it is partially used up due to capped funding.

You need to stop being so disingenuous regarding your experience. Your "red flags" are pretty large and pretty bright. You got fired from one residency and quit another. Nobody is even getting to the point of looking at your funding eligibility.

 

[turquoiseblue]

1. I would never sign such a poorly written petition even if I did agree with it.

2. I don't have a lot of pity for IMGs who did not perform well and are whining about not getting a position because a foreign graduate, with far better credentials did. You chose to enter an international medical program. Nothing in life comes for free, don't expect those of us who worked hard to advocate for less qualified people to be our collegues simply because they are US citizens.

I apologize that it is poorly written. I've asked the owner to completely improve upon it big time. I hope they will be able to do that.

The fact is that many did get a position and then thrown out, sometimes without warning. is that what you call training? it's not supposed to be a job. you're not supposed to be at the level of an attending like they expect. that's why it is called training. these particular PD's that throw people out have defeated the purpose of a true residency training program. they don't even seem to realize we have capped funding and will have a hard time getting in again. It probably was easier before there was capped funding, but now it's changed so PD's should change accordingly. if they take you in, they shouldn't throw you out like garbage because where are these residents going to go? it is very difficult to get a position after that. if it were easier, i would understand, but it isn't. and think about it--200 people per year thrown to the trash. and why is it consistently around that number? Also, they can't get a job easily at all as they are overqualified and the economy is bad too..not to mention the heavy debt after paying for med school for those that paid. it's a huge downer.

 

[turquoiseblue]

You need to stop being so disingenuous regarding your experience. Your "red flags" are pretty large and pretty bright. You got fired from one residency and quit another. Nobody is even getting to the point of looking at your funding eligibility.

this is exactly why we need something done about residency programs and the fact they are not hiring me or anyone else in my shoes..i think that being accepted into residency and completing some of it should count for something...it doesn't even give you a one up on one who hasn't done any residency at all.

 

[142348]

this is exactly why we need something done about residency programs and the fact they are not hiring me or anyone else in my shoes..

As a resident, I think the red flags in your file would stop anyone AMG or IMG. You were fired from one residency, and quit one. Why should anyone take a chance on you? There are more than enough applicants now so why would a PD take a chance on you when they have dozens of applicants with no blemishes. A bad PD didn't make you quit and if I had to guess wasn't the reason you were fired.

Having read your posts, your communication skills are lacking. You are unable to effectively communicate what your intentions are as has been demonstrated in multiple posts. I think this contributed to your residency difficulties.

Instead of railing against all PD's and residency programs maybe you should look inside and realize that the flaws that lead to your dismissal are probably within yourself.

 

[turquoiseblue]

As a resident, I think the red flags in your file would stop anyone AMG or IMG. You were fired from one residency, and quit one. Why should anyone take a chance on you? There are more than enough applicants now so why would a PD take a chance on you when they have dozens of applicants with no blemishes. A bad PD didn't make you quit and if I had to guess wasn't the reason you were fired.

Having read your posts, your communication skills are lacking. You are unable to effectively communicate what your intentions are as has been demonstrated in multiple posts. I think this contributed to your residency difficulties.

Instead of railing against all PD's and residency programs maybe you should look inside and realize that the flaws that lead to your dismissal are probably within yourself.

just so you all get your story straight, i voluntarily resigned from my first one prior to ACGME trial i was told i was doing well on probation and about to get out when some nurse screwed me over with a story she exaggerated to make it like a crime to accidentally leave a needle in a patient's room. (later, i was getting a blood draw by a nurse, and she left an open needle next to me when leaving the room...i could have poked myself...(just to show you the irony of it all)).

for the second one i fell ill and was hospitalized for a month and i tried to return and they didn't let me finish. but they told me i was in good standing and that they'd say good things about me...go figure that one!

this is more about residency reform and their injust firing and hiring practices. stay on the subject please!

by the way if my writing skills are lacking then why am i first author of 3 publications...figure that one out too!

and again, i didn't write that petition...and if i did, many would think it was bad, just because i wrote it, even it if was good. and i know that for a fact....pple hate me..that's all there is to it. but do i care? no.

 

[odieoh]

just so you all get your story straight, i voluntarily resigned from my first one prior to ACGME trial i was told i was doing well on probation and about to get out when some nurse screwed me over with a story she exaggerated to make it like a crime to accidentally leave a needle in a patient's room.

for the second one i fell ill and was hospitalized for a month and i tried to return and they didn't let me finish. but they told me i was in good standing and that they'd say good things about me...go figure that one!

this is more about residency reform and their injust firing and hiring practices. stay on the subject please!

by the way if my writing skills are lacking then why am i first author of 3 publications...figure that one out too!

Turq-

I think what irritates people about your posts sometimes, myself included, is that you make yourself out to be both A: a victim of a corrupt system and B: a crusader against all that is evil in residency programs. If one truly were a victim, it would make sense that they would go on a crusade. I'll not rehash the details but from our own past exchanges it seems clear you were a victim of your own choices and performance and nothing else. As such your crusade is misguided because you are not a victim of the things you are crusading against.

You also throw around "facts" that have no backing, such as the 200 number you came up with:

I hear the yearly number is around 200+ residents. I read this off an article I have been unable to relocate a while ago.

Then later on:

and think about it--200 people per year thrown to the trash. and why is it consistently around that number?

You don't even know if the number is 200 and now you are saying it is consistently so? If so what are you implying, some sort of PD conspiracy to screw approximately 200 residents per year?

I guess it just boils down to the fact that your posts are really flaky and well. . .I dunno you don't elicit a lot of sympathy from the general way you go about things. I really have no idea what my point is here except that sometimes your posts can be exasperating.

 

[turquoiseblue]

Turq-

I think what irritates people about your posts sometimes, myself included, is that you make yourself out to be both A: a victim of a corrupt system and B: a crusader against all that is evil in residency programs. If one truly were a victim, it would make sense that they would go on a crusade. I'll not rehash the details but from our own past exchanges it seems clear you were a victim of your own choices and performance and nothing else. As such your crusade is misguided because you are not a victim of the things you are crusading against.

You also throw around "facts" that have no backing, such as the 200 number you came up with:


Then later on:


You don't even know if the number is 200 and now you are saying it is consistently so? If so what are you implying, some sort of PD conspiracy to screw approximately 200 residents per year?

I guess it just boils down to the fact that your posts are really flaky and well. . .I dunno you don't elicit a lot of sympathy from the general way you go about things. I really have no idea what my point is here except that sometimes your posts can be exasperating.

the 200 is a legit number. it was consistent over a number of years, but im not sure if it is still the same, but recently i saw someone say it was 200, which verified what I have seen, so that's why i think around 200 it is.

it may or may not be a conspiracy...u or i do not know that....it is just a curiosity to see why is it always around 200 per year for the most part...generally speaking.

but o well just want to see what congress does about this whole 'red flags' thing where you have a hard time getting back in the system. i mean why can't i get another chance....i wasn't kicked out the second time..just fell ill...that shouldn't be a reason to not let me finish the program so i can get a PGY2. now im stuck having to do PGY1 all over again.

im not on a cruisade just posted up some stuff and emailing here and there to see if anything can be done....nothing big or anything that anyone else probably hasn't done before.

i can get licensed i found out so i may just do something with that..like work with a medispa or cruiseship..or work for a doctor... and apply everyyear hoping to get in but probably most likely not getting anything at all which is probably my reality for the rest of my life...o well.

 

[Cerberus]

the 200 is a legit number. it was consistent over a number of years, but im not sure if it is still the same, but recently i saw someone say it was 200, which verified what I have seen, so that's why i think around 200 it is.

it may or may not be a conspiracy...u or i do not know that....it is just a curiosity to see why is it always around 200 per year for the most part...generally speaking.

Keep it coming. I haven't laughed that hard all day.

 

[glamqueen]

I know better than to go to a medspa, but are cruise doctors usually licensed grads plus only one year of internship etc.? Seriously? No offense, but if I get sick enough at sea to see the doc on a ship, I'm kind of wanting a doc who completed residency.

Note to self: Don't get sick on a cruise.

 

[turquoiseblue]

I know better than to go to a medspa, but are cruise doctors usually licensed grads plus only one year of internship etc.? Seriously? No offense, but if I get sick enough at sea to see the doc on a ship, I'm kind of wanting a doc who completed residency.

Note to self: Don't get sick on a cruise.

cruise doctors are usually full doctors. the job im talking about is just injecting botox among other small procedures. just know that licensed doctors are allowed to do these things, like h&ps,etc just like NP's are allowed to do certain things.

 

[turquoiseblue]

does anyone want to make a new petition regarding residency reform in terms of hiring and firing practices? just go to ipetition.com or thepetitionsite.com and write it and post the link. I want to take the other one off and put in a better new improved one.

Thanks!

 

[PlutoBoy]

Turqoise, I honestly wish you good luck! I know the position you are in is hard and I really hope you can achieve something that is good for you.

Best of luck!

 

[142348]

First off,

I know what you are going through is difficult and I do know what it is like to face illness. I was hospitalized for nearly 3 weeks during my internship and my internship and advanced programs had to work with me to get me caught up.

As for the issues people have raised here:

1) You keep citing 200 residents per year, what data do you have to support that?

2) I am currently at a large hospital with 400 residents. I have seen residents leave for various reeasons and all were able to find new residencies. It seems your evidence is as anecdotal as mine. Do you ahve any data to show that the majority of those fired never get another residency?

While you and a few others have had bad outcomes it seems as though this is i the far minority (<1%) of the 80,000 + residents that are out there every year.

 

[turquoiseblue]

First off,

I know what you are going through is difficult and I do know what it is like to face illness. I was hospitalized for nearly 3 weeks during my internship and my internship and advanced programs had to work with me to get me caught up.

As for the issues people have raised here:

1) You keep citing 200 residents per year, what data do you have to support that?

2) I am currently at a large hospital with 400 residents. I have seen residents leave for various reeasons and all were able to find new residencies. It seems your evidence is as anecdotal as mine. Do you ahve any data to show that the majority of those fired never get another residency?

While you and a few others have had bad outcomes it seems as though this is i the far minority (<1%) of the 80,000 + residents that are out there every year.

To answer your questions:

1)I don't have the data off hand for the 200. It was in an AMA news article I saw a few years ago showing a yearly trend. I can't find it. Here is something from 2000, it may have changed: http://www.ama-assn.org/amednews/2000/05/08/prsa0508.htm I emailed the ACGME to get that data. Hopefully they will get back to me.

2) That's great they all found residency. Maybe it was because they left for family reasons? My reasons aren't that great. I left for "personal reasons". Maybe I'm not saying it right on my application. It must have been in a different specialty right? They must all be US grads? I am an FMG with low scores with a grad date that is getting older and older with unfinished residency programs on my record and back in the pool of applicants so maybe that is the root of the problem? I wish there was data I could find about this.

This is an interesting journal article I saw regarding ACGME and unions: http://www.ncbi.nlm.nih.gov/pubmed/19240433

very few have knowledge of ACGME clinical competencies before residency: http://www.ncbi.nlm.nih.gov/pubmed/20520027

Attrition rates in residency programs (1994): http://www.ncbi.nlm.nih.gov/sites/pubmed

Attrition rates of US medical graduates (July 15, 2010) http://archsurg.ama-assn.org/cgi/reprint/143/12/1172.pdf

an example of how a resident can make a difference (has something to do with attrition): http://www.hcplive.com/general/publications/Resident-and-Staff/2008/2008-03/2008-03_11

An article on resident dismissal: http://www.ejbjs.org/cgi/content/extract/87/10/2353

Medicare funding info: http://www.aamc.org/advocacy/library/gme/dgmebroc.pdf

 

[turquoiseblue]

Turqoise, I honestly wish you good luck! I know the position you are in is hard and I really hope you can achieve something that is good for you.

Best of luck!

thanks plutoboy! i hope so too!

 

[turquoiseblue]

i put up a new petition. let me know if you like it:

http://www.thepetitionsite.com/1/end-unfair-dismissals-in-acgme-residency-programs

 

[ShyRem]

eh. changed my mind. Not worth it.

 

[odieoh]

eh. changed my mind. Not worth it.

Yup. Pretty much pure facepalm.

 

[turquoiseblue]

i hated to write this.....don't get me wrong....i wish it would be someone else's experience up there, not mine.....

so you thought the other one was much better?

 

[SouthernSurgeon]

so you thought the other one was much better?

I would say they are both equally poorly written and thought out. Hard to call one "better" than the other, rather they are both just "bad"

This has been beaten to death and you obviously aren't willing to listen. You are not the victim of some terrible persecution or conspiracy theory, and your story evokes little sympathy, especially when you are unwilling to accept responsibility.

 

[turquoiseblue]

I would say they are both equally poorly written and thought out. Hard to call one "better" than the other, rather they are both just "bad"

This has been beaten to death and you obviously aren't willing to listen. You are not the victim of some terrible persecution or conspiracy theory, and your story evokes little sympathy, especially when you are unwilling to accept responsibility.

what does accepting responsibility mean? to lay down and die and not ever get into a residency program again just because i should believe im an incompetent person that will never make it in life just because some random program director said so (which they never told me, but is that what i should do, in your opinion)?

 

[odieoh]

Turq-

I actually thought this one was written a bit more carefully. Its just. . .I don't even know how to explain. First of all its kind of painfully personal, you are using your personal account and trying to make it into a political issue, several political issues at that. Most importantly you offer no real solution. I mean read what I suppose is the best solution you offer:

Possibly special programs can be created for these residents or they can be transferred to better suited hospitals, so that they can continue on to become doctors rather than lose their hard earned careers!

That is such an incredibly frustrating statement for many reasons:
1. It is very vague, and weakly worded. "possibly?"

2. Have you even thought out the nuts and bolts of what it would take to implement any of this? Who would create special programs and why? Assuming that there is a large pool of people who are unfairly dismissed (a large assumption), in order to create a special program for them you would have to be able to identify that they were unfairly dismissed, which no governmental agency is going to be able to do. If you clearly identify that they were unfairly dismissed, that opens up their programs to lawsuits.
So problem one, no way to identify who would be eligible for such a program, especially since the other demographic who would be trying to get in to such a program would be those who have truly performed poorly/are incompetent. Problem 2: Even if you could clearly identify a pool of people who were unfairly dismissed, where in the world are you going to set up a new residency program for that pool, especially since unfairly terminated residents come from a wide variety of specialties and from different years within those specialties? What is a "better suited hospital"? You really seem to have childlike attitudes at times that there is this vague "someone" out there who is magically going to be able to fix everything. (Possibly Congress?)
3. I guess along those same lines you seem to have the idea that every wrong in this world must be righted. While I wish that were the case, unfortunately the way of the world is that bad S#@% happens all the time and most of it never gets fixed.

If there is any realistic fix for unfairly terminated residents it is not going to be some magical second residency program. Its going to be reform in the process programs must go through in order to fire residents. While that stinks for people who have already been terminated, its the hard truth.

 

[turquoiseblue]

Turq-

I actually thought this one was written a bit more carefully. Its just. . .I don't even know how to explain. First of all its kind of painfully personal, you are using your personal account and trying to make it into a political issue, several political issues at that. Most importantly you offer no real solution. I mean read what I suppose is the best solution you offer:



That is such an incredibly frustrating statement for many reasons:
1. It is very vague, and weakly worded. "possibly?"

2. Have you even thought out the nuts and bolts of what it would take to implement any of this? Who would create special programs and why? Assuming that there is a large pool of people who are unfairly dismissed (a large assumption), in order to create a special program for them you would have to be able to identify that they were unfairly dismissed, which no governmental agency is going to be able to do. If you clearly identify that they were unfairly dismissed, that opens up their programs to lawsuits.
So problem one, no way to identify who would be eligible for such a problem, especially since the other demographic who would be trying to get in to such a program would be those who have truly performed poorly/are incompetent. Problem 2: Even if you could clearly identify a pool of people who were unfairly dismissed, where in the world are you going to set up a new residency program for that pool, especially since unfairly terminated residents come from a wide variety of specialties and from different years within those specialties? What is a "better suited hospital"? You really seem to have childlike attitudes at times that there is this vague "someone" out there who is magically going to be able to fix everything. (Possibly Congress?)
3. I guess along those same lines you seem to have the idea that every wrong in this world must be righted. While I wish that were the case, unfortunately the way of the world is that bad S#@% happens all the time and most of it never gets fixed.

If there is any realistic fix for unfairly terminated residents it is not going to be some magical second residency program. Its going to be reform in the process programs must go through in order to fire residents. While that stinks for people who have already been terminated, its the hard truth.

i see what you are saying odieoh. i removed those weirdo ideas of mine and just made it for reform of programs only. I changed the story to third person.

 

[Law2Doc]

i see what you are saying odieoh. i removed those weirdo ideas of mine and just made it for reform of programs only. I changed the story to third person.

I think you have to realize that for every 1 person unfairly dismissed, as perhaps you were, there are 99 others who were very reasonably dismissed. So the real problem I see, in addition to what odieoh already described, is that you really don't help yourself making this a political issue and trying to pool a group of unfairly dismissed residents. In fact by doing so you are tying your small boat to a sinking ship full of lead. I feel bad for you. But most of us know or have heard of residents who were dismissed for darn good reason, who also run around talking about how unfairly they were treated. That you embrace such person and make it a political argument turns us off to your plight. I think you need to focus on you and your own little ship, and leave the ballast alone. Don't kid yourself that this is something congress or the ACGME or any other political group or groundswell ought to deal with. The only issue on your plate should be your own. One person's plight with convincing evidence that they were well regarded and doing well up until the point that the program cast them aside might be compelling to someone. But talking about the plight of all the poor unfairly treated folks out there, and I'm sorry but suddenly your own strong argument becomes everyone else's lousy argument. Figure out an individual fix. Making it a group argument means you are as lousy as the worst person in that group. And a lot of us have met such a person and don't feel compelled to help him/her.

 

[turquoiseblue]

I think you have to realize that for every 1 person unfairly dismissed, as perhaps you were, there are 99 others who were very reasonably dismissed. So the real problem I see, in addition to what odieoh already described, is that you really don't help yourself making this a political issue and trying to pool a group of unfairly dismissed residents. In fact by doing so you are tying your small boat to a sinking ship full of lead. I feel bad for you. But most of us know or have heard of residents who were dismissed for darn good reason, who also run around talking about how unfairly they were treated. That you embrace such person and make it a political argument turns us off to your plight. I think you need to focus on you and your own little ship, and leave the ballast alone. Don't kid yourself that this is something congress or the ACGME or any other political group or groundswell out to deal with. The only issue on your plate should be your own. One person's plight with convincing evidence that they were well regarded and doing well up until the point that the program cast them aside might be compelling to someone. But talking about the plight of all the poor unfairly treated folks out there, and I'm sorry but suddenly your own strong argument because everyone else's lousy argument. Figure out an individual fix. Making it a group argument means you are as lousy as the worst person in that group. And a lot of us have met such a person and don't feel compelled to help him/her.

true, it is hard to sift out the unfair from the fairly dismissed. That is where I need to find data to separate the two and there probably isn't any. i should put a disclaimer that some are fairly dismissed. i guess it is an iffy arguement overall, and i can understand being dismissed. not all of us are that good. in my past program everyone was a resident in their own country before they were residents so they were really good and i was just starting out and i wasn't good at all in comparison. it happens whether we like it or not, but the part i don't understand is that you can't get another chance at all as you're applying to other programs and none of them want you because of this big red flag that's been created. it's like you went to medical school for nothing.
you can't just do a certain number of hours and move elsewhere like you can in transferring colleges, you have to start all over again and redo everything.

 

[ShyRem]

Turq, you have other red flags besides your intern year history. Don't pin all your problems on that. With your flags you were lucky to get the first chance, nonetheless the second.

I think your time and energies would be best spent at this point by figuring out how to rectify the issues in your application. Which are several and not at ALL relegated to failing to finish intern year twice. You need to get a plan together to prove to PDs that you are fully capable and competent and able of doing WELL in a program. This will not be simple with your history. First you need to get a mentor to get a plan together. This will likely NOT include petitions that will not help you and which ignore your red flags.

 

[lipomas]

If there is such a conspiracy, what on earth would be the benefits to those perpetrating it? It doesn't make sense. Why would a program keep a resident on for several months, pay them, and then eliminate the position?

A proper conspiracy theory has to have logic to it. For as wacky and ill-conceived as many of the 9/11 and Kennedy assassination conspiracy theories are, at least they all have an explanation as to why the conspiracy would exist. What is your reason, exactly, to prevent you from becoming a physician? It would be like a supermarket hiring someone to kneecap you in the parking lot after you paid for your food. Who does it actually benefit?

As for whether being dismissed should raise "red flags" to other program directors considering bringing on such a person - I would hope so!

 

[turquoiseblue]

If there is such a conspiracy, what on earth would be the benefits to those perpetrating it? It doesn't make sense. Why would a program keep a resident on for several months, pay them, and then eliminate the position?

A proper conspiracy theory has to have logic to it. For as wacky and ill-conceived as many of the 9/11 and Kennedy assassination conspiracy theories are, at least they all have an explanation as to why the conspiracy would exist. What is your reason, exactly, to prevent you from becoming a physician? It would be like a supermarket hiring someone to kneecap you in the parking lot after you paid for your food. Who does it actually benefit?

As for whether being dismissed should raise "red flags" to other program directors considering bringing on such a person - I would hope so!

i never said there was a conspiracy. its just that some pds throw you away so easily...not caring that it's going to be a long road trying to get another position. it benefits the residents that can't get a position after being ousted or resigning from another one. it would protect any current resident from having this ever happen to them. of course there are outliers who really are that bad, or people that are pure criminal that should not be doctors...i mean i got into residency and stayed there in good standing and just because i got ill and recovered, i cant finish it...is that fair? and why me..why does everyone else that got ill have a nice pd where they helped them to finish. well that pd is nice.and said im in good standing..etc..but i dont think it was fair that i couldn't finish so i can get a PGY2.
it's just about protecting residents, that's all.

 

[turquoiseblue]

Turq, you have other red flags besides your intern year history. Don't pin all your problems on that. With your flags you were lucky to get the first chance, nonetheless the second.

I think your time and energies would be best spent at this point by figuring out how to rectify the issues in your application. Which are several and not at ALL relegated to failing to finish intern year twice. You need to get a plan together to prove to PDs that you are fully capable and competent and able of doing WELL in a program. This will not be simple with your history. First you need to get a mentor to get a plan together. This will likely NOT include petitions that will not help you and which ignore your red flags.

True Shyrem, im trying to improve my application this time around...maybe it will be better because my publications are finally published...but im sure that's probably not that big of a help either though. i think i need to pass step 3..and im working on that...hopefully i will. petitions do not help me at all, you're right. i think i'll lay the petition to rest. people can sign it if they want but im not going to worry about it anymore until i see a few hundred signatures, if ever.

 

[odieoh]

i never said there was a conspiracy. its just that some pds throw you away so easily...not caring that it's going to be a long road trying to get another position. it benefits the residents that can't get a position after being ousted or resigning from another one. it would protect any current resident from having this ever happen to them. of course there are outliers who really are that bad, or people that are pure criminal that should not be doctors...i mean i got into residency and stayed there in good standing and just because i got ill and recovered, i cant finish it...is that fair? and why me..why does everyone else that got ill have a nice pd where they helped them to finish. well that pd is nice.and said im in good standing..etc..but i dont think it was fair that i couldn't finish so i can get a PGY2.
it's just about protecting residents, that's all.

Turq-

We've been through it before but I really wonder if you were in good standing before your illness. I know you say the PD told you you were, but had there been any negative feedback documented during the year? As has been mentioned usually if there is a devastating illness programs will work with you to help you finish if there are no other issues. So the possibilities are 1. Your PD is Satan incarnate, or 2. There was a lot more going on than we know and you were on the rocks even before the illness.

Obviously its a personal thing and you don't have to tell if you don't want to but it may shed some light on the situation. I would be interested to know what illness kept you out for so long?

 

[Doctor Bob]

If there is such a conspiracy, what on earth would be the benefits to those perpetrating it? It doesn't make sense. Why would a program keep a resident on for several months, pay them, and then eliminate the position?

A proper conspiracy theory has to have logic to it.

It's so blindingly obvious that everyone has overlooked it.

Every residency program draws blood or gets urine from residents at the start of their training right? Usually they say that it's part of a drug screen or health exam. All of that blood/urine actually goes into creating a DNA profile of each resident. The residents are then either observed over the course of their training, or subjected to various "stressors" (ie: constant berating from staff, unwarranted firing, or continuity clinic) to see how they react. Their actions and responses are analyzed and with multiple residents subjected to the stressors (for example... ~200 residents per year get unwarrantedly fired) they can look for gene patterns that correlate to these responses.

In time, a gene map of what each PD considers to be their "ideal resident" can be constructed and clones can be grown, each perfectly suited to that residency program and at a substantial discount to GME.

And with all of them clearly labeled "grown in the USA" and grown in the exact quantities required there will be no more spots for FMGs/IMGs.

US grads will, of course, be unaffected because all of the US grads will be clones, and the non-clones that wanted to go to medical school will get free tuition to a vocational school of their choice (from the GME money saved by using minimum wage clone residents) where they can get a job with less stress, more free time, and equivalent net income. Oh, say... auto mechanic or heating and air conditioner repair.

So ultimately it's a double ended conspiracy to both create the perfect resident and screw all the FMGs/IMGs out of residency spots.

 

[odieoh]

It's so blindingly obvious that everyone has overlooked it.

Every residency program draws blood or gets urine from residents at the start of their training right? Usually they say that it's part of a drug screen or health exam. All of that blood/urine actually goes into creating a DNA profile of each resident. The residents are then either observed over the course of their training, or subjected to various "stressors" (ie: constant berating from staff, unwarranted firing, or continuity clinic) to see how they react. Their actions and responses are analyzed and with multiple residents subjected to the stressors (for example... ~200 residents per year get unwarrantedly fired) they can look for gene patterns that correlate to these responses.

In time, a gene map of what each PD considers to be their "ideal resident" can be constructed and clones can be grown, each perfectly suited to that residency program and at a substantial discount to GME.

And with all of them clearly labeled "grown in the USA" and grown in the exact quantities required there will be no more spots for FMGs/IMGs.

US grads will, of course, be unaffected because all of the US grads will be clones, and the non-clones that wanted to go to medical school will get free tuition to a vocational school of their choice (from the GME money saved by using minimum wage clone residents) where they can get a job with less stress, more free time, and equivalent net income. Oh, say... auto mechanic or heating and air conditioner repair.

So ultimately it's a double ended conspiracy to both create the perfect resident and screw all the FMGs/IMGs out of residency spots.

You forgot to add an evil twin. Also if you could add a part where PD's wear a plastic mask that makes them look and talk exactly like a resident in order to spy, and then at a strategic dramatic moment they reach up and rip off the mask revealing their true identity. I think you've nailed it otherwise.

 

[turquoiseblue]

what if they're part of the global elite...like lady gaga.. what if it is social Darwinism...it's a tough call...maybe we need to get the FBI and CIA in on this!!!

 

[turquoiseblue]

u know, some memories are coming back of my program where i resigned....the attendings were so mean...all of them...except maybe one that actually had the heart to write me a LOR at all. the rest acted like they never knew me....i hated it there...the residents were really mean and nasty too...sometimes they made me cry...there was not a single friendly person there i could trust..everyone was out for themselves...no one was a team player..i wanted to go to lunch with a resident and she yelled at me for it....and sometimes i got so fed up i would talk back to their mean selves just to make myself feel better or try to make them realize they shouldn't be talking to me like that and see how it feels..attending or senior residents..and they'd report me at every chance they got..the whole environment was very vindictive...and vengeful...the nurses were mean also...i dont know what it was but it was just pure mean....and mistrusting environment where people liked to threaten each other and report each other....that could be part of it...its' not paranoia it was real...i went back there years later and i heard how rude the attending was all over again.....they never changed after years....i think it is an awful hospital to work at...it is unfortunate i got stuck there. i think the only nice person there was the secretary and that one attending..they always were on my side but that's not much in comparison to all the people that didn't like me there....fellow interns didn't even like me..one was my friend and she stabbed me in the back and was so rude to me...and wanted me to stay past the nightfloat time (this was before they started enforcing time limits on residents)...
why do i deserve all that?
i worked at other hospitals and it was so much better...nothing like this hospital i was at...