Forced Resignation -- Please Help.

[DocReborn]

Alright, so I am in desperate need of some advice. I am going to attempt to condense my situation, unfortunately, this nightmare makes this feat exceedingly difficult.

I was constructively discharged from my categorical PGY-1 position earlier this year. This in light of receiving a few unsubstantiated patient complaints. I had solid relationships with faculty, residents and nursing staff, and academically/surgically I was exceeding expectations based on peer and faculty evaluations. The majority of patients considered my care good-excellent. I was seeing as many patients in clinic as chief residents. My in-service exam score was above the national mean. Despite all of these positives and not receiving due process or the logical step of an investigation, I was given the option to resign or be terminated as the legal dept at the hospital felt "I was a risk to patient safety". The PD informed me that an investigation was not done in order to prevent the medical board from becoming involved -- and irregardless of my pushing for an investigation despite this fact, I was refused. I was not even given the specifics of the third complaint, only that I made in inappropriate comment during an exam.

At the strong recommendation of persons in the program, I had planned on filing a grievance to fight this decision and salvage my professional career. After discussion with the PD about my plan, I was informed that I would be terminated pending the result of these proceedings. Also, that this process would be long and financially straining for me, and I should consider the effect it would have on my family (PD aware I was the only one with income for family of 3). If I decided to resign, I would be given a severance package to ease my transition into a new residency, for which the program would do everything in its power to assist me in this endeavor. In addition to this, I would be leaving in good standing, receive credit for time completed, and reassurance that the board would not be involved since the complaints remained unsubstantiated. So, after long deliberation with my wife, I resigned. I reasoned that, by appealing, we would be bankrupt, and the best possible outcome would be that I would be forcing a program that doesn't want me to perform an investigation that they weren't willing to do in the first place, and ultimately have to repeat my first year in said program that wants me to go... quite unsettling, and raises significant issues with the grievance process in general (I will leave this to another novel).

Unbelievably, since my resignation the board has become involved and investigated my case since I left a program amidst complaints of misconduct. This, despite the complaints not being written and the PD's documentation being exceptionally vague. I was forced to see a psychologist who specializes in physician misconduct 4 hours away from where I live q 2 weeks. After multiple visits and psychological tests, I was cleared... shocking. Oh, it was determined that I have situational depression and severe anxiety secondary to this situation Since the board has become involved, I have sought counsel who believes that the outcome will be favorable as the interview with investigator went well and my psychologist cleared me.

I will be starting over in August and will re-enter the match in a different specialty (IM). Because of my good standing in the program, I received LoR from virtually every faculty member, resident, and some nursing staff voluntarily. I also received a LoR from the PD --not voluntarily but without a fight. To say my chances of obtaining a residency in the coming match are slim might be an understatement. Nevertheless, I refuse to give up because a program failed to protect me, and unjustly terminated me (per faculty). Any advice would be more than greatly appreciated.

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[docu]

go to legalmatch.com and find a lawyer that could represent you. you should have probably gotten terminated because then maybe you can at least get some mediation for wrongful termination at least so the PD wont badmouth you in the future if you apply elsewhere if you can't get back in. i dont know if you can do much legally if you resigned. the more evidence you can find in your favor, the better. since you have a lot of positives, things may go in your favor. meanwhile you can also try to find another pgy1 position and apply for the match. the higher your scores and if you're an AMG, the better chance you will have to get another position. good luck.

 

[DocReborn]

I agree with you, but I worry that if the program knows I am pursuing the issue I may not get a good reference from the PD. I am an AMG from an osteopathic school -- did not take USMLE but was accepted as a first choice in an MD program with my COMLEX scores last year. I appreciate your input -- but I think I am going to focus my energy on moving forward (hopefully). Any advice as to how I should broach the subject during the match?

 

[MD forever]

Because you are AMG and based on what you have written, you may have tough road ahead if you consider fighting your previous PD. Try to safe your career and move on. Look for other specialties, IM, FM for DOs. Start looking for programs around your geographic location and if possible do observership/ externship. Try to work hard and prof you deserve a second chance. They may consider your candidacy. Forget and forgive what happen to you previously is key though sometimes this is difficult. Good luck in your future career, I will pray for you.

 

[MsKrispyKreme]

What were the first 2 patient complaints concerning?

It seems like you're hinting at sexual harassment allegations?

 

[DocReborn]

The first complaint was an audited response on a survey. She answered that she was "uncomfortable" with the physical exam. Thats all. The second complaint involved two visits and she alleged I performed a breast exam on both occasions, which is simpy untrue and ridiculous.

 

[Doctor Bagel]

The first complaint was an audited response on a survey. She answered that she was "uncomfortable" with the physical exam. Thats all. The second complaint involved two visits and she alleged I performed a breast exam on both occasions, which is simpy untrue and ridiculous.

This is something to think about, though, because most people don't get these complaints. At the minimum, I'd make sure you always have someone with you when you examine people in any sensitive way. That's good sense for anyone actually. Not to say that I think you examined people inappropriately, but there might be something in your mannerism that makes people feel uncomfortable. Maybe asking your former attendings or anyone who has directly observed patient interactions with you would be reasonable.

And that leads to probably the best thing to do in regards to your new application -- be able to talk about this stuff and to show proactive reflection/work and plans to improve any perceived deficits. Being defensive is probably the kiss of death.

 

[DocReborn]

Thats exactly what I intend to do... Actually after the 2nd complaint I made sure I had a chaperone from the moment I set foot in the door to the moment I left. Too little to late I suppose. The Psychologist I am working with is helping gain insight into what could have been misunderstood and we feel its related to my overcompensation to make women feel comfortable as I was concerned being a male OB. Thank you for your advice on the coming match!

 

[mercaptovizadeh]

This is something to think about, though, because most people don't get these complaints. At the minimum, I'd make sure you always have someone with you when you examine people in any sensitive way. That's good sense for anyone actually. Not to say that I think you examined people inappropriately, but there might be something in your mannerism that makes people feel uncomfortable. Maybe asking your former attendings or anyone who has directly observed patient interactions with you would be reasonable.

And that leads to probably the best thing to do in regards to your new application -- be able to talk about this stuff and to show proactive reflection/work and plans to improve any perceived deficits. Being defensive is probably the kiss of death.

Thats exactly what I intend to do... Actually after the 2nd complaint I made sure I had a chaperone from the moment I set foot in the door to the moment I left. Too little to late I suppose. The Psychologist I am working with is helping gain insight into what could have been misunderstood and we feel its related to my overcompensation to make women feel comfortable as I was concerned being a male OB. Thank you for your advice on the coming match!

How frightening. You never should have been made to see a psychologist in the first place, since there was no evidence of mental illness.

This makes me wonder to what degree we need to have witnesses in place so we don't end up getting charged with harassment and assault by a crazy patient.

 

[QofQuimica]

This makes me wonder to what degree we need to have witnesses in place so we don't end up getting charged with harassment and assault by a crazy patient.

Even though I'm female, my practice is that any time the patient's bra or underwear need to come off, I have a chaperone in the room with me. Some of my female colleagues will examine female patients without a chaperone. But I don't think it's a good idea for LIPs of either sex to do unaccompanied breast, pelvic, rectal, or testicular exams for exactly the reason you gave.

 

[peppy]

Thats exactly what I intend to do... Actually after the 2nd complaint I made sure I had a chaperone from the moment I set foot in the door to the moment I left. Too little to late I suppose. The Psychologist I am working with is helping gain insight into what could have been misunderstood and we feel its related to my overcompensation to make women feel comfortable as I was concerned being a male OB. Thank you for your advice on the coming match!

Yes, I can see how a male ob/gyn might be at higher risk of misunderstandings or complaints than other docs. There *are* women out there who think that all male ob/gyns are pervs even though it's not really fair to think that.
I wonder if it might be easier to get another chance if you tried to get into a specialty where you wouldn't be doing intimate exams, such as pathology? Just an idea. Please let us know how things go for you.

 

[michaelrack]

How frightening. You never should have been made to see a psychologist in the first place, since there was no evidence of mental illness.

.

maybe that is why he was sent to a psychologist instead of a psychiatrist, because there was no evidence of mental illness. It sounds like the OP is getting some benefit from seeing a psychologist.

 

[Mattchiavelli]

How frightening. You never should have been made to see a psychologist in the first place, since there was no evidence of mental illness.

This makes me wonder to what degree we need to have witnesses in place so we don't end up getting charged with harassment and assault by a crazy patient.

I can see an era where all exam rooms have some kind of CCTV in place. The OP was not talking about doing an exam and having a patient complain, they were talking about a patient saying that an exam happened which the OP said did not happen, and there is no way at all of proving that one way or the other if one party said something happened and the other said it didn't.... obviously unless someone documented a breast exam.

 

[3dtp]

I agree with you, but I worry that if the program knows I am pursuing the issue I may not get a good reference from the PD. I am an AMG from an osteopathic school -- did not take USMLE but was accepted as a first choice in an MD program with my COMLEX scores last year. I appreciate your input -- but I think I am going to focus my energy on moving forward (hopefully). Any advice as to how I should broach the subject during the match?

It doesn't sound like the PD will give you a reference anyway. This whole situation is a lesson in why residents in peril need to discuss their situation with an attorney skilled in hospital credentialing and medical staff issues long before they make a decision to resign, retire or refute. Discussing matters with an attorney does not mean you intend to litigate or threaten, and good attorneys will help you chart a course to avoid this outcome. Bad ones encourage litigation. And for goodness sake, never, ever tell anyone at your institution (or anyone else for that matter) that you've discussed the situation with an atty. Trust me, that word will spread faster and further than warm butter on hot toast, and that's the last thing you need while delicate discussions are taking place. Above all, you have to be icy cool, calm and collected.

I know that program's favorite tactics are to blindside a resident they intend to dump and then demand an immediate response or be escorted out under guard or something like that, but no decision of this magnitude must or should be made at the time of demand. I think reasonably and calmly asking the PD to put terms and actions in writing so everything is clear (which is likely to be denied) will subtly put them on notice that you will not be an easy target.

While you are still in a position of weakness, you will be better (not good but better) able to attempt some concessions, including a mutually agreeable LoR, specific steps that the program will take to keep their word (news flash: they don't), and timeframes for responses.

This is all water over the dam at this point, but for those of you that might find yourself here in the future (that includes nearly anyone in residency, on hospital staff or credentialed when the winds of favor change direction), get copies of your evaluations on a periodic basis (i.e. quarterly or a couple of weeks after every rotation completes) before there is an issue. These documents can and have been altered, amended, added to, subtracted from. If asked why, simply state that it is your policy to keep copies of the records for future reference, and the it is standard practice, as well as a legal right in most cases.

Because you are AMG and based on what you have written, you may have tough road ahead if you consider fighting your previous PD. Try to safe your career and move on. Look for other specialties, IM, FM for DOs. Start looking for programs around your geographic location and if possible do observership/ externship. Try to work hard and prof you deserve a second chance. They may consider your candidacy. Forget and forgive what happen to you previously is key though sometimes this is difficult. Good luck in your future career, I will pray for you.

Most of this is true. At this point, you are outside the match, and while it will be expensive, a good face to face meeting with PDs of other programs will allow other PDs to size things up for themselves. Tell the truth, candidly, and ask them for their help. Some may not give it, but sometimes PDs develop reputations and that can work either in your favor or against you. Some PDs have a bad reputation, others are schmoozing narcissists. Keep your ears open, talk to your colleagues and be prepared to jump on an airplane to travel to a potential program at a moment's notice. Do not understate or in any way misrepresent the facts, but do be prepared to defend yourself or otherwise explain in a positive way how you will be a better physician and what you've learned from this. Visiting with other PDs in programs of interest and letting them get to know you may benefit, especially if they know of a program with a vacancy, or have one themselves that they have not published.

It may take time, but unless you've done something that will preclude licensure, you've got a shot at another position, and you've got a certificate completing internship (if you do) making you a proven commodity. It may also take the luck of being in the right place at the right time.

Thats exactly what I intend to do... Actually after the 2nd complaint I made sure I had a chaperone from the moment I set foot in the door to the moment I left. Too little to late I suppose. The Psychologist I am working with is helping gain insight into what could have been misunderstood and we feel its related to my overcompensation to make women feel comfortable as I was concerned being a male OB. Thank you for your advice on the coming match!

Chaparones always! I have my elderly patients sometimes doff before I leave the room, and I always explain to them, that it is my goal to preserve what little dignity for them I can in my exam rooms, then excuse myself while they change.

For those few patients with genuine Axis II/Cluster B issues, I usually figure this out at first intake consultation and those patients are never! seen unchaparoned from that point forward and the name of the chaperone goes in the chart (i.e. seen with Nurse Ratched) which goes a long way to discouraging the plaintiff's attorney, and keeping boundaries between the patient and the staff. For those highly risky patients, I have a chaperone during the history portion as well. As a rule, I don't have a chaperone when I am doing prostate exams, probably because I do so many of them, but on the other hand, Penn State is well in the news today, so perhaps I should.

 

[MsKrispyKreme]

The first complaint was an audited response on a survey. She answered that she was "uncomfortable" with the physical exam. Thats all. The second complaint involved two visits and she alleged I performed a breast exam on both occasions, which is simpy untrue and ridiculous.

Hmm, I can understand the hospital's point-of-view. You presented as a huge liability.

Three different patients expressed discomfort with you during physical exams including an inappropriate comment made during the physical exam of the 3rd patient. This seems like a heck of a coincidence.

Are you sure you don't have a problem controlling sexual urges/attraction with your patients? Why did you decide to pursue a career in ob/gyn?

 

[NotAProgDirector]

I was constructively discharged from my categorical PGY-1 position earlier this year. This in light of receiving a few unsubstantiated patient complaints. I had solid relationships with faculty, residents and nursing staff, and academically/surgically I was exceeding expectations based on peer and faculty evaluations. The majority of patients considered my care good-excellent. I was seeing as many patients in clinic as chief residents. My in-service exam score was above the national mean. Despite all of these positives and not receiving due process or the logical step of an investigation, I was given the option to resign or be terminated as the legal dept at the hospital felt "I was a risk to patient safety". The PD informed me that an investigation was not done in order to prevent the medical board from becoming involved -- and irregardless of my pushing for an investigation despite this fact, I was refused. I was not even given the specifics of the third complaint, only that I made in inappropriate comment during an exam.

Given the other details mentioned, I too am somewhat concerned. Three different patients registered complaints regarding boundary issues. Presumably, these three patients were completely independent -- i.e. none of them knew the others and each made their own, independent assessment. 3 complaints like that in a single PGY year is WAY outside the norm. You present this story like you did nothing wrong. Although you may not have meant to do anything wrong, it clearly seems that you have a problem.

At the strong recommendation of persons in the program, I had planned on filing a grievance to fight this decision and salvage my professional career. After discussion with the PD about my plan, I was informed that I would be terminated pending the result of these proceedings. Also, that this process would be long and financially straining for me, and I should consider the effect it would have on my family (PD aware I was the only one with income for family of 3). If I decided to resign, I would be given a severance package to ease my transition into a new residency, for which the program would do everything in its power to assist me in this endeavor. In addition to this, I would be leaving in good standing, receive credit for time completed, and reassurance that the board would not be involved since the complaints remained unsubstantiated. So, after long deliberation with my wife, I resigned. I reasoned that, by appealing, we would be bankrupt, and the best possible outcome would be that I would be forcing a program that doesn't want me to perform an investigation that they weren't willing to do in the first place, and ultimately have to repeat my first year in said program that wants me to go... quite unsettling, and raises significant issues with the grievance process in general (I will leave this to another novel).

Several comments about this.

Every program must have some grievence process in place. It usually is not a long process -- in fact, my institution usually tries to schedule and conclude all grievence processes within a week.

What's important is what the grievence process would be, and not be. It would not be a chance for you to contact / interview these patients that complained about you to get more details, nor would a greivence committee do so. They would simply look at the information that your PD has about your performance, and ask whether the decision your PD made was reasonable given that evidence. All of the rest of your points -- that faculty and peers liked you, that you saw lots of patients, that your in service exam scores are good -- wouldn't matter at all here. The problem is multiple patient complaints specifically about sexual issues. You were going to lose your grievence hearing. I would have fired you also, given these same facts. (That does assume that I would have met with you after the first and second complaints). And the legal people were already involved. There was no "choice" here.

PD's can "make deals", just as you described. Resign without a grievence, and we'll give you a better severence package. Grieve it and win, and you keep your job. Grieve and lose, and you simply get fired. Personally, I find all of this distasteful. I don't mind if a resident grieves a dcision I make like this -- in fact, if I fire a resident, I usually encourage them to have a grievence hearing. It acts as a confirmation for me that I made the right decision, or it doesn't.

Unbelievably, since my resignation the board has become involved and investigated my case since I left a program amidst complaints of misconduct. This, despite the complaints not being written and the PD's documentation being exceptionally vague. I was forced to see a psychologist who specializes in physician misconduct 4 hours away from where I live q 2 weeks. After multiple visits and psychological tests, I was cleared... shocking. Oh, it was determined that I have situational depression and severe anxiety secondary to this situation Since the board has become involved, I have sought counsel who believes that the outcome will be favorable as the interview with investigator went well and my psychologist cleared me.

Who knows how this happened. Any of the patients might have complained directly. The hospital probably felt they had a duty to report despite your PD's promises -- think Joe Paterno. Institutions now will err on the side of being overly cautious.

I will be starting over in August and will re-enter the match in a different specialty (IM). Because of my good standing in the program, I received LoR from virtually every faculty member, resident, and some nursing staff voluntarily. I also received a LoR from the PD --not voluntarily but without a fight. To say my chances of obtaining a residency in the coming match are slim might be an understatement. Nevertheless, I refuse to give up because a program failed to protect me, and unjustly terminated me (per faculty). Any advice would be more than greatly appreciated.

Much about what you "do" depends on what's actually in your written record. There are two places you need to check: 1) your PD's letter, and 2) your medical board. You need to know whether your PD's letter talks about this, and also whether he/she will talk about it if contacted. Perhaps more importantly, you need to find out whether your medical board is going to keep all this "QA" and not report it to other medical boards, or whether they will forward all of these records if you apply for a different state license.

If both of these do not mention this issue (i.e the PD says they will not, and the board says it's all QA and not reportable to other boards), then you can safely leave the whole issue out of your application. Sort of. (See below)

If either one is going to mention it, then you'll need to somehow address it in your application. And that's not going to be easy. Simply saying that this was all trumped up, and that nothing bad happened, that patients were complaining about you needlessly is almost certainly incorrect. As I mentioned about, 3 seperate patients each describing something similar is a problem. Your description here is not going to go over well in an application, since it looks like you're not taking any responsibility for the issue. Instead, you'd probably be better of discussing that this has been a humbling experience, and that you're going to address it with introspection and chaperones.

Note that, as an IM PD, I still might not be excited about taking you. Getting a chaperone for every exam is going to be a real pain. What if there isn't one available? What if tying up a nurse makes other people slower? What if sometimes it's something you say, or the way you say it, that's the problem. You could do something when patients are not having their genitals examined, and there wouldn't be a chaperone -- and it sounds like at least 1-2 of the complaints fit this.

Even if all parties agree that it won't be in your application, not disclosing it could still be a problem. Let's say you come to my program, and lets say that a patient complaint about you like this comes to me. If I ask you if this sort of thing has happened before, what exactly are you going to do? You could lie and say no -- and if I ever find out, I would fire you immediately on the spot, even if you were scheduled to graduate tomorrow. If you tell me the truth, I would at best put you on immediate probation, and at worst fire you.

So, think and decide how you want to proceed. Most importantly, ask those you really trust around you for help and advice. Chances are, if you are coming across inappropriately to patients inadvertantly, you're probably doing the same thing to those whom you are closest to -- they just know and like you, so they don't care.

 

[GOMERE]

Sheesh. Those patients are full of themselves. Most of them are so ugly that their physical exam is their own source of physical contact/pleasure from another person. Perhaps in their own estranged mind they dreamt of you touching them inappropriately. Or maybe you're a black man or a non-white man with no blonde hair blue eye, and so they think the slightest touch is sexual harrassment leading to rape. Get out before they accuse you of more.

 

[Dr. USMLE]

.

 

[DocReborn]

I agree that my outcome was based on a risk assessment. Coincidentally, this was the first year the program had a prelim (who was female and presumably without any complaints). I do not deny that some mannerism I had made patients feel different-- see previous post. So, no I am not trying to say that I am completely without fault, but I refuse to believe that the program could not have worked with me to improve this issue.

Obviously, MsKrispy, you are in the camp believing no male should be an OB/GYN. This is fine, I do not agree, but your entitled to your opinion. I have complete control over my "sexual urges", and this is verified by a psychologist world-renowned in determining/treating sexual misconduct.

So, do I completely not understand why the hospital acted in this manner, no. Do I believe that my professional career could have benefited from more understanding and education on patient boundaries and use of chaperones, yes. I only provided a generalized description of my situation in order to gain more insight on what to do next, not argue what happened and why.

 

[mercaptovizadeh]

I could easily imagine this being the case of the OP engaging in friendly conversation - even banter - as a means of "making the patient more comfortable" during an intimate exam. While perhaps inappropriate and something that could have been perceived as flirtation by the patient, are we seriously discussing Joe Paterno in this context. Are we really discussing pedophile rape?

I'm just somewhat shocked at what people consider just cause to merit the total destruction of someone's medical career. The OP is supposedly now a pariah who is unfit in all fields of medicine except, perhaps, pathology and radiology.

From what I can tell, all of this could have been easily remediated with several coached/witnessed interviews and exams, followed by consistent chaperoning until the end of residency or at least for a probationary period.

Unless the OP is not telling us something very important....

 

[Buzz Me]

Oh man...this is EXACTLY why I always get a chaperone when doing a breast exam, genital exam or rectal exam on a female patient. In residency this came up every time we had to do a rectal exam for hemorrhoids/prolapse/bleeding, or a breast exam for a lump/abscess. ALWAYS get a chaperone, even if it's during a busy clinic, or it slows down your ER consult. ALWAYS.

 

[mercaptovizadeh]

For purposes of enlightening myself and others....are chaperones necessary for male patients getting a testicular/rectal exam by a male doctor? I had never heard of this before.

Not trying to be sexist here...just trying to assess to what degree these "X said, Y said" scenarios are mostly related to male doctors examining female patients.

 

[MsKrispyKreme]

Obviously, MsKrispy, you are in the camp believing no male should be an OB/GYN. This is fine, I do not agree, but your entitled to your opinion. I have complete control over my "sexual urges", and this is verified by a psychologist world-renowned in determining/treating sexual misconduct.

I never said that no male should be an ob/gyn. (2 of the 3 best attendings at my home ob/gyn program are males.) You, however, did not answer my question as to why YOU pursued a career in ob/gyn.

I am not so naive to believe that medicine doesn't have criminals and crazies. I have both witnessed and experienced incorrect conduct. I am merely suggesting that you have enough insight to see that you have some flaws that will merely repeat themselves when and if you match into IM. One patient complaint can be ignored, two might warrant some type of probation, the three different patients alluding to the same thing???

 

[Perrotfish]

maybe that is why he was sent to a psychologist instead of a psychiatrist, because there was no evidence of mental illness. It sounds like the OP is getting some benefit from seeing a psychologist.

He was sent to mental health so that they could document his history of psychiatric care if/when they terminated him. They use the cheapest provider available because they don't expect any care to be provided. This is a standard tactic that residencies use when firing someone: they make it sound like seeing a psychiatric provider ( and fully disclosing your care) is a condition of staying/transition peacefully, and then they use that documentation as a retroactive paper trail for firing you.

 

[Groove]

Oh man...this is EXACTLY why I always get a chaperone when doing a breast exam, genital exam or rectal exam on a female patient. In residency this came up every time we had to do a rectal exam for hemorrhoids/prolapse/bleeding, or a breast exam for a lump/abscess. ALWAYS get a chaperone, even if it's during a busy clinic, or it slows down your ER consult. ALWAYS.

Bingo. No excuse for it... ever. It will bite you in the ass if you don't.

 

[NotAProgDirector]

I'll add to my previous comments that the full investigation by the board may actually be more of a plus than a minus. When you're applying to new programs, you can point out that you underwent the evaluation and that they felt there wasn't an issue here. If you can get a written report from them, that would be very helpful (assuming it's positive).

As I mentioned, I agree that this is something that should be remediated before termination. Much depends on whether they actually met with you regarding the first episodes and developed a remediation plan, and then further episodes happened.

 

[Doctor Bagel]

He was sent to mental health so that they could document his history of psychiatric care if/when they terminated him. They use the cheapest provider available because they don't expect any care to be provided. This is a standard tactic that residencies use when firing someone: they make it sound like seeing a psychiatric provider ( and fully disclosing your care) is a condition of staying/transition peacefully, and then they use that documentation as a retroactive paper trail for firing you.

Not really because he was sent to mental health by his state board not by his program. His program just asked him to resign without any remediation as far as I can tell.

 

[dragonfly99]

This really sucks...assuming you intended nothing inappropriate and the patient complaints were just based on what you said to the patient (that was presumably misinterpreted). No wonder guys don't want to do ob/gyn any more.
I am surprised your program let you do breast and gyn exams on patients without a chaperone present...especially after even 1 complaint.

Maybe you should consider some field that doesn't require intimate exams (like neurology, psych, pathology, etc.). Fp is going to have the same issues as ob/gyn...internal med also to some extent. Even if you in actuality did nothing wrong, and were just somehow awkward with a couple of patients and came across wrong, and then presumably got a crazy 3rd one who claimed you did an extra breast exam, what if something like this happens again? You'll be screwed (career-wise). Is it really worth it? I would definitely NOT do fp in your situation (just my opinion). Too many ob/gyn issues, examining teenagers, etc. In IM we actually didn't do that many pelvic exams...but that would depend on your resident clinic population, mostly.

You should talk with your PD in a very conciliatory way, and when you have a plan of which specialty to apply to, you should ask for a LOR and hope that he doesn't poison your application. I don't see what else you can do.

 

[3dtp]

Aprogdir, excellent points. One other thing to check is the NPDB. The OP should file a Self-Query request.

In matters of professional misconduct or adverse actions which affect privileges, a report is required by the credentialing entity. This might include a report based on a decision to non-renew your contract under the present circumstances.

The self-query report will describe any adverse actions reported to the databank and costs about four bucks or so. I'm not sure if you'd have a hit in there or not, but if your state medical board is involved, I'd try to find out if your institution filed a report or do the self-query.

If there is a report, better the devil you know than the devil you don't.

 

[McGillGrad]

...

 

[VA Hopeful Dr]

For purposes of enlightening myself and others....are chaperones necessary for male patients getting a testicular/rectal exam by a male doctor? I had never heard of this before.

Not trying to be sexist here...just trying to assess to what degree these "X said, Y said" scenarios are mostly related to male doctors examining female patients.

I don't get a chaperone for those situations.

<insert Family Guy lawsuit>

 

[yappy]

OP:

Just in case things don't go in your favor I would try to acquire the patients names and be prepared to go public with them to defend your honor and name.

Gather all the personal information and go to a local or national news source and make public what happened to you [anon] so that you may restore your name and bring them down for false allegations.

 

[McGillGrad]

OP:

Just in case things don't go in your favor I would try to acquire the patients names and be prepared to go public with them to defend your honor and name.

Gather all the personal information and go to a local or national news source and make public what happened to you [anon] so that you may restore your name and bring them down for false allegations.

dafuq did I just read?

 

[NotAProgDirector]

OP:

Just in case things don't go in your favor I would try to acquire the patients names and be prepared to go public with them to defend your honor and name.

Gather all the personal information and go to a local or national news source and make public what happened to you [anon] so that you may restore your name and bring them down for false allegations.

Sure, add a serious HIPAA violation to your worries.

 

[Arcan57]

OP:

Just in case things don't go in your favor I would try to acquire the patients names and be prepared to go public with them to defend your honor and name.

Gather all the personal information and go to a local or national news source and make public what happened to you [anon] so that you may restore your name and bring them down for false allegations.

It's already been edited, and this is still the worst piece of advice I've ever seen on SDN. And that includes the "marry Eastern European prostitutes" post.

 

[K31]

Sure, add a serious HIPAA violation to your worries.

Yep, federal criminal charges are just the thing to get the residency programs beating down the door.

 

[Law2Doc]

Sure, add a serious HIPAA violation to your worries.

This. Two wrongs don't make a right, they simply add up to a much more lucrative judgement in favor of these plaintiffs.

 

[Substance]

OP:

Just in case things don't go in your favor I would try to acquire the patients names and be prepared to go public with them to defend your honor and name.

Gather all the personal information and go to a local or national news source and make public what happened to you [anon] so that you may restore your name and bring them down for false allegations.

Pre-health.

 

[gutonc]

It's already been edited, and this is still the worst piece of advice I've ever seen on SDN. And that includes the "marry Eastern European prostitutes" post.

But you have to admit that the "importing hookers to love you" thread was pretty stellar.

And yes...worst advice ever. I assume that the bulk of yappy's 2000+ posts are Lounge trolling.

 

[yappy]

This is an inaccurate assumption. For an example of my contributions you may read the thread titled "Would you do it again" where I give an accurate-insiders-view of the challenges facing dentistry - as the topic of medicine vs dentistry was raised. I provide balance and dispel some of the stereotypes.

I admit my post on this thread was not well thought out. I was responding in outrage. OP - in retrospect it would be wrong to expose your accusers as they're protected under HIPPA and you would be violating an important trust. Take the high road and move on as others have suggested.

Sorry if I have driven this thread into an unproductive direction. No need to respond to this post and derail things further - I will excuse myself and let the OP's situation remain the main topic of this thread.

But you have to admit that the "importing hookers to love you" thread was pretty stellar.

And yes...worst advice ever. I assume that the bulk of yappy's 2000+ posts are Lounge trolling.

 

[Merely]

What was the inappropriate comment that you made during the examination? Did you say like "nice tits" or something? There has to be a reason that these people are complaining. No one, especially not three independent people, will complain for no reason.

 

[DocReborn]

The PD refused to tell me the specifics...

 

[winner123]

The PD refused to tell me the specifics...

****ing US PDs and their tantrums!
Whole US Army is guilty of rapes and indecent assaults,but r never dealt in the way u have been dealt with over this very minor issue.
APD is an expert in giving authortative replies which speak volumes about his arrogance.Rather than listening to your problems n the injustices you have borne,APD will put the whole blame on you in order to save your PD who in actually guilty of all the wrongdoing coz' he did not address the issue at the start.
APD's statement that one will have the situations when one will need to do breast n other exams without a chaperone even being present is perfectly misleading n can land even his residents into trouble.This is the most absurd n foolish statement I have ever heard in my life.
OP,never do breast,genital,pelvic,rectal exams without a chaperone!
APD, u need to relearn the basics of ethics n code of conduct.I wonder how come a person like u runs an IM residency program!

 

[Top Gun]

****ing US PDs and their tantrums!
Whole US Army is guilty of rapes and indecent assaults,but r never dealt in the way u have been dealt with over this very minor issue.
APD is an expert in giving authortative replies which speak volumes about his arrogance.Rather than listening to your problems n the injustices you have borne,APD will put the whole blame on you in order to save your PD who in actually guilty of all the wrongdoing coz' he did not address the issue at the start.
APD's statement that one will have the situations when one will need to do breast n other exams without a chaperone even being present is perfectly misleading n can land even his residents into trouble.This is the most absurd n foolish statement I have ever heard in my life.
OP,never do breast,genital,pelvic,rectal exams without a chaperone!
APD, u need to relearn the basics of ethics n code of conduct.I wonder how come a person like u runs an IM residency program!

When has AProgDirector ever been arrogant? For the most part, his advice has been pretty constructive. And usually when someone posts about being fired from a program, there are two sides to the story. Very few residents who end up being fired from programs are "innocent victims." In the OP's case, there were three patients who accused him of sexual harassment. While I doubt that he intended any harassment, the complaints clearly didn't come out of nowhere. Its more likely that his way of approaching the patients made them feel uncomfortable, and his intentions were misinterpreted. And why, for the love of God, would you do a breast or pelvic exam without a chaperone present? It is strongly emphasized from Day One to have a chaperone present when doing an intimate exam. How could you go into Ob/Gyn and not know this?

While I cannot put the all of the blame on the OP, clearly something about his behavior played a role in him getting fired. He definitely needs to work on the way he approaches patients.

 

[DrAwsome]

****ing US PDs and their tantrums!
Whole US Army is guilty of rapes and indecent assaults,but r never dealt in the way u have been dealt with over this very minor issue.
APD is an expert in giving authortative replies which speak volumes about his arrogance.Rather than listening to your problems n the injustices you have borne,APD will put the whole blame on you in order to save your PD who in actually guilty of all the wrongdoing coz' he did not address the issue at the start.
APD's statement that one will have the situations when one will need to do breast n other exams without a chaperone even being present is perfectly misleading n can land even his residents into trouble.This is the most absurd n foolish statement I have ever heard in my life.
OP,never do breast,genital,pelvic,rectal exams without a chaperone!
APD, u need to relearn the basics of ethics n code of conduct.I wonder how come a person like u runs an IM residency program!

APD has been very helpful to most of us who have had questions about this difficult residency process, and has not been arrogant or inappropriate at all. This is a forum where people are free to express their opinions, thoughts, and give advice-you take it with a grain of salt if you'd like. If you don't like it, don't take it. If you don't like APD's advice, feel free to ignore it.

Making the statement that OP's PD is the one who is guilty of all wrongdoing is absolutely ridiculous. As the saying goes, there are two sides to every story. The OP has had 3 different complaints of a sexual nature, I find it difficult to believe that 3 different patients would make complaints with 0 basis. Some patients like to complain, sure, but I find it very hard to believe that 3 completely different people would make complaints about some sort of inappropriate sexual situation for no reason. OP's PD did what he thought best, and since we don't know the whole story here and we were not there, taking sides is absurd. Few people are completely innocent when complaints are made. APD has provided his advice as a program director. He actually has bothered to take time out of his schedule to provide guidance and suggestions on this. Insulting him is inappropriate and uncalled for.

Talking about the American army is also pointless; there are good and bad people in all countries in the world. Making blanket statements about millions of people based on the actions of some is immature and plain stupid. Please think before writing.

 

[DrAwsome]

When has AProgDirector ever been arrogant? For the most part, his advice has been pretty constructive. And usually when someone posts about being fired from a program, there are two sides to the story. Very few residents who end up being fired from programs are "innocent victims." In the OP's case, there were three patients who accused him of sexual harassment. While I doubt that he intended any harassment, the complaints clearly didn't come out of nowhere. Its more likely that his way of approaching the patients made them feel uncomfortable, and his intentions were misinterpreted. And why, for the love of God, would you do a breast or pelvic exam without a chaperone present? It is strongly emphasized from Day One to have a chaperone present when doing an intimate exam. How could you go into Ob/Gyn and not know this?

While I cannot put the all of the blame on the OP, clearly something about his behavior played a role in him getting fired. He definitely needs to work on the way he approaches patients.

Agreed. There definitely is some sort of problem here on the part of the OP. It seems very odd that 3 different pts. would have a complaint on this issue. If it was just one, maybe, 2 possible, but 3 and in such a short amount of time? If I were a PD I would think long and hard about keeping a resident with recurrent complaints of sexual harassment.

In my experiences as a resident, I have never myself gotten or ever heard of a complaint being made against any of my colleagues due to sexual inappropriateness. Clearly there is more to the story that we don't know about.

 

[michaelrack]

**APD's statement that one will have the situations when one will need to do breast n other exams without a chaperone even being present is perfectly misleading n can land even his residents into trouble.This is the most absurd n foolish statement I have ever heard in my life.
OP,never do breast,genital,pelvic,rectal exams without a chaperone!
!

If I may speak for my colleague (I was briefly a fellowship director), I think what APD meant is that in order to show he is taking responsibilty for his issues, the OP may need to agree to have a chaperone present for EVERY patient encounter (or at least every visit for the opposite sex)- not just genital/anal/breast exams. However, this would be somewhat impractical and slow down clinic/wards. Kind of a Catch-22 situation.

 

[winner123]

When has AProgDirector ever been arrogant? For the most part, his advice has been pretty constructive. And usually when someone posts about being fired from a program, there are two sides to the story. Very few residents who end up being fired from programs are "innocent victims." In the OP's case, there were three patients who accused him of sexual harassment. While I doubt that he intended any harassment, the complaints clearly didn't come out of nowhere. Its more likely that his way of approaching the patients made them feel uncomfortable, and his intentions were misinterpreted. And why, for the love of God, would you do a breast or pelvic exam without a chaperone present? It is strongly emphasized from Day One to have a chaperone present when doing an intimate exam. How could you go into Ob/Gyn and not know this?

While I cannot put the all of the blame on the OP, clearly something about his behavior played a role in him getting fired. He definitely needs to work on the way he approaches patients.

If the resident really sexually harrassed the ladies then why did not they raise any hue and cry at the same time.It means that they allowed the resident to sexually harrass themselves n then when they went home they got an idea to lodge a complaint on a piece of paper.That means they were also not sure if it was a sexual harassment or not or they just enjoyed it that time n then thought of playing with the resident's carreer.
I did not suggest to him to do Breast n other exams without a chaperone,it is your APD who suggested that to be done when the clinic is very busy.That means seeing more patients n then getting sued for sexual harrasment.Ha,Ha!

 

[winner123]

APD has been very helpful to most of us who have had questions about this difficult residency process, and has not been arrogant or inappropriate at all. This is a forum where people are free to express their opinions, thoughts, and give advice-you take it with a grain of salt if you'd like. If you don't like it, don't take it. If you don't like APD's advice, feel free to ignore it.

Making the statement that OP's PD is the one who is guilty of all wrongdoing is absolutely ridiculous. As the saying goes, there are two sides to every story. The OP has had 3 different complaints of a sexual nature, I find it difficult to believe that 3 different patients would make complaints with 0 basis. Some patients like to complain, sure, but I find it very hard to believe that 3 completely different people would make complaints about some sort of inappropriate sexual situation for no reason. OP's PD did what he thought best, and since we don't know the whole story here and we were not there, taking sides is absurd. Few people are completely innocent when complaints are made. APD has provided his advice as a program director. He actually has bothered to take time out of his schedule to provide guidance and suggestions on this. Insulting him is inappropriate and uncalled for.

Talking about the American army is also pointless; there are good and bad people in all countries in the world. Making blanket statements about millions of people based on the actions of some is immature and plain stupid. Please think before writing.

He is not a philanthropist.He is just getting paid for posting replies here n that is it.
Why shud I only ignore it?I also have the full right to make a rebuttal.U r no one to order me about what I shud or shud not do?
Yes, OP's PD did not take any steps at the start otherwise,if wat has been stated above is true, could not have progressed to such an extent.There r protective mechanisms at every level in all the good hospitals,but the OP's hospital seems to be a dungeon where there is no thing.Even in outpatient clinics there are nurses then why did not those patients bring into their attention at that time only?
I talked of American Army coz' Army is supposed to be more disciplined,but worst incidents have happened there as well n that too for long n most of them go scot-free even after commiting much heinous crimes than what has been stated by the OP.

 

[winner123]

Agreed. There definitely is some sort of problem here on the part of the OP. It seems very odd that 3 different pts. would have a complaint on this issue. If it was just one, maybe, 2 possible, but 3 and in such a short amount of time? If I were a PD I would think long and hard about keeping a resident with recurrent complaints of sexual harassment.

In my experiences as a resident, I have never myself gotten or ever heard of a complaint being made against any of my colleagues due to sexual inappropriateness. Clearly there is more to the story that we don't know about.

How come the Psychologist has then cleared the OP of any tendency to make sexual indecencies?