Forced Resignation -- Please Help.

[winner123]

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.

Why then only include the opposite sex?Same sex can also be vulnerable!Then the OP,according to APD, can never even perform a simple GPE on any patient.That sounds ridiculous on part of the APD to go to such an extent.I hope APD is not regarding the poor OP as some Fetish.Let me then remind the APD that why shud we even stop there?Why not get deep into the minds of people n sack people even if they get one lewd thought.In that case I think the first one to be sacked will be the APD himself!

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[Law2Doc]

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

I don't know that a psychologists role here is "clearing" the OP. They are not weighing evidence of what happened, just evaluting the OP for a latent psychological problem that might have caused these incidents, not whether they occurred. If multiple patients found the behavior inappropriate then for hospital administrative purposes, it was inappropriate -- it's a service industry and they are the customer.

 

[winner123]

I don't know that a psychologists role here is "clearing" the OP. They are not weighing evidence of what happened, just evaluting the OP for a latent psychological problem that might have caused these incidents, not whether they occurred. If multiple patients found the behavior inappropriate then for hospital administrative purposes, it was inappropriate -- it's a service industry and they are the customer.

If this was only an inappropriate behaviour then how come does it warrant that the OP be forced to resign.

 

[smq123]

As a reminder, constantly picking on another member is considered harrassment and is a violation of the TOS.

Furthermore, while patients may drive us crazy or occasionally antagonize us, please stay respectful of them.

Finally, as an FYI, none of the moderators (including aProgDirector) get paid for being on SDN. He has generously donated a lot of time, energy, effort, and insight into this website, and his donations have been greatly appreciated by all of us.

 

[BADMD]

Why then only include the opposite sex?Same sex can also be vulnerable!Then the OP,according to APD, can never even perform a simple GPE on any patient

At the hospital where I work, none of the OB/Gyn residents, male or female, are allowed by their PD to do a pelvic exam without a chaperone.

 

[winner123]

At the hospital where I work, none of the OB/Gyn residents, male or female, are allowed by their PD to do a pelvic exam without a chaperone.

That is good n it does really protect the residents from landing into such trouble.That is a great protective mechanism which has been absent at the hospital where the OP used to work n that makes the hospital PD also guilty of negligence so he must be sacked as well.

 

[DrAwsome]

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

That's just ridiculous. The psychologist cannot "clear you" of something you have done. If OP did something inappropriate, he did, period. Psychologist cannot do anything about it.

 

[DrAwsome]

If this was only an inappropriate behaviour then how come does it warrant that the OP be forced to resign.

Because the OP has had 3 different patients complain of sexual harassment, which is uncommon and it can be a serious problem for the hospital going forward. If OP keeps having these complaints, the hospital will get sued. It makes sense for OP's PD to ask him to resign.

 

[winner123]

That's just ridiculous. The psychologist cannot "clear you" of something you have done. If OP did something inappropriate, he did, period. Psychologist cannot do anything about it.

But, the psychology asessment at least ruled out any psychological problem predisposing to any acts of sexual indecency.
The fact is that the patients have only accused OP of some problem with his behaviour n not anything else n that cud have been addressed by the PD when the first complaint was lodged.Why did the PD wait for the complaints to pile up?
The big question is y was not the OP warned after the first complaint was lodged?

 

[K31]

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.

Did I seriously just read this? Suggesting that 3 separate patients lodged sexual harassment complaints just to **** with the OP's career? And that they actually enjoyed it instead?

Seriously dude, time to join the 21st century.

 

[Top Gun]

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!

I did not say that the resident actually committed sexual harassment. If you go back and reread my post, you will note that I said, and very clearly too, then most likely what happened is that when he saw those patients, they felt uncomfortable and his actions were misconstrued. All I'm saying is that if he wishes to pursue a career in clinical medicine, he needs to change the way he approaches patients. Something about him makes them uncomfortable. He needs to do some introspection, find out what it is, and change it.

And also, at least the first time, he did conduct the breast/pelvic exams without a chaperone. That is a big no-no, especially for a male examining a female, and he should have known better from the outset. Even as a medical student, I knew better than to conduct a breast/pelvic exam on a female without a chaperone present.

We don't know what really went on, and we never will. And if there was any actual sexual harassment, who knows why the patients didn't complain right away? Maybe they felt they wouldn't be believed, or maybe they were afraid of any repercussions.
We'll never know.

 

[captaincrunch]

I certainly agree that three complaints in a short time period is concerning. To play devil's advocate, though, the first complaint came from a patient survey (i.e., the patient didn't actually make a complaint but responded to the survey - for all we know the OP's overall patient satisfaction may have been okay). The second made an allegation that the OP states is simply untrue (for the sake of argument, I'll take him at his word on this). In the third patient's case, it wasn't clear that the allegation was sexual in nature. He also wasn't given the details of the complaint, which is a little odd.

As many people of said, there may be something in his mannerisms that prompt these complaints and he needs to do some deep soul-searching if he wants to salvage his career. But it is possible that he is profoundly unlucky and got hit with unfair allegations. That being said, far too many bad residents make it through the system and the standards for advancement probably need to be raised, not lowered. For obvious legal reasons, I think any future program would be wary of taking the OP. As an aside, I know that path programs HATE being thought of as a final stopping place for medical careers on a downward spiral. They do try to weed out applicants who are there simply because they couldn't hack it in something else.

Everyone, please don't take winner123's bait. His arguments are incoherent and designed to provoke a response (and are in need for a proof-read).

 

[NotAProgDirector]

The fact is that the patients have only accused OP of some problem with his behaviour n not anything else n that cud have been addressed by the PD when the first complaint was lodged.Why did the PD wait for the complaints to pile up?
The big question is y was not the OP warned after the first complaint was lodged?

This is the first statement that warrants a response. And I completely agree.

Of course, we don't really know if the OP was warned. The original post isn't really clear on that.

As I stated earlier, the OP should have had this brought to his attention immediately, and plans put in place to address it. I would have been clear at that time that this was a "one strike and you're out" situation.

We also don't know what the complaints really said. Some complaints might be considered more serious than others. Suggestive talk might be handled differently than inappropriate physical contact, as might calling patients after the visit for social reasons.

I'm going to assume that your anger directed towards me is simply a manifestation of your disappointment with the US medical residency training system. From your past posting, it's pretty clear that you're angry with the US medical education establishment for not getting a residency. Hence, I'm not going to take it personally.

As mentioned, I do not get any renumeration at all for answering questions on this board. One of the reasons I have tried to remain anonymous is to avoid the appearance of trying to "advertise" my program here.

 

[winner123]

I did not say that the resident actually committed sexual harassment. If you go back and reread my post, you will note that I said, and very clearly too, then most likely what happened is that when he saw those patients, they felt uncomfortable and his actions were misconstrued. All I'm saying is that if he wishes to pursue a career in clinical medicine, he needs to change the way he approaches patients. Something about him makes them uncomfortable. He needs to do some introspection, find out what it is, and change it.

And also, at least the first time, he did conduct the breast/pelvic exams without a chaperone. That is a big no-no, especially for a male examining a female, and he should have known better from the outset. Even as a medical student, I knew better than to conduct a breast/pelvic exam on a female without a chaperone present.

We don't know what really went on, and we never will. And if there was any actual sexual harassment, who knows why the patients didn't complain right away? Maybe they felt they wouldn't be believed, or maybe they were afraid of any repercussions.
We'll never know.

If that is the case then how did he tackle the patients during his medical school days?Y was not his behaviour found sexually harrassing by the patients who visited his medical school associated hospital where he trained?How was he able to complete his medical school training?

 

[winner123]

I certainly agree that three complaints in a short time period is concerning. To play devil's advocate, though, the first complaint came from a patient survey (i.e., the patient didn't actually make a complaint but responded to the survey - for all we know the OP's overall patient satisfaction may have been okay). The second made an allegation that the OP states is simply untrue (for the sake of argument, I'll take him at his word on this). In the third patient's case, it wasn't clear that the allegation was sexual in nature. He also wasn't given the details of the complaint, which is a little odd.

As many people of said, there may be something in his mannerisms that prompt these complaints and he needs to do some deep soul-searching if he wants to salvage his career. But it is possible that he is profoundly unlucky and got hit with unfair allegations. That being said, far too many bad residents make it through the system and the standards for advancement probably need to be raised, not lowered. For obvious legal reasons, I think any future program would be wary of taking the OP. As an aside, I know that path programs HATE being thought of as a final stopping place for medical careers on a downward spiral. They do try to weed out applicants who are there simply because they couldn't hack it in something else.

Everyone, please don't take winner123's bait. His arguments are incoherent and designed to provoke a response (and are in need for a proof-read).

Not incoherent at all!
I believe in justice and I can't see someone being forced to resign on the basis of those issues which he has not even been properly told about.
If it was only a behavioural problem then that could have been sorted out there only.
If the OP would have really made sexual advances toward the patients then I believe a sane patient would really have raised a hue and cry at the hospital itself.Why did not the patients do so if they were really touched in a sexual way?
However,if the OP made personal phone calls to the patients n made some lewd remarks then that is a completely different issue which can be proved by analysing the records of the conversations which happned over the phone.That is too easy to prove!

 

[dragonfly99]

winner,
your argument about the OP having seen patients during med school doesn't really hold water. Medical students often don't really do very many pelvic exams at all. It would depend on where he trained (which specific US or foreign school) and how many ob/gyn rotations he did. As an aside, have a friend who did med school in Pakistan and he actually had to get some extra training right before starting residency, to learn to do a pelvic exam. He told me that in his country male doctors don't do those types of exams on women. Some schools in the US don't really allow the students to do a lot on ob/gyn rotations...and even if they did do a patient exam, there would probably be close supervision by an attending or resident. Internship is really when you first start seeing loads and loads of patients in the specific specialty you are in...

 

[winner123]

winner,
your argument about the OP having seen patients during med school doesn't really hold water. Medical students often don't really do very many pelvic exams at all. It would depend on where he trained (which specific US or foreign school) and how many ob/gyn rotations he did. As an aside, have a friend who did med school in Pakistan and he actually had to get some extra training right before starting residency, to learn to do a pelvic exam. He told me that in his country male doctors don't do those types of exams on women. Some schools in the US don't really allow the students to do a lot on ob/gyn rotations...and even if they did do a patient exam, there would probably be close supervision by an attending or resident. Internship is really when you first start seeing loads and loads of patients in the specific specialty you are in...

That means US Medical School training is deficient in many ways.
BTW,all IMG's do a lot of pelvic exams during their medical school.There r no restrictions on IMGs in this regard.
I do not know about the Pakistani resident but if he was not well-versed with the pelvic exams then it is his own fault.
Now, the blame stil shifts to the PD at the OP's program.This coz' the PD must have been aware about the fact that being a US Medical school student the OP will not be comfortable doing a pelvic exam n so the PD shud have done everything in his power to teach the resident about the pelvic exams.If that is the case then it wud be nice to know from the OP how many pelvic exam teaching sessions did the PD or Attendings hold for the OP.

 

[DrAwsome]

That means US Medical School training is deficient in many ways.
BTW,all IMG's do a lot of pelvic exams during their medical school.There r no restrictions on IMGs in this regard.
I do not know about the Pakistani resident but if he was not well-versed with the pelvic exams then it is his own fault.
Now, the blame stil shifts to the PD at the OP's program.This coz' the PD must have been aware about the fact that being a US Medical school student the OP will not be comfortable doing a pelvic exam n so the PD shud have done everything in his power to teach the resident about the pelvic exams.If that is the case then it wud be nice to know from the OP how many pelvic exam teaching sessions did the PD or Attendings hold for the OP.

This is absurd man. It is the responsibility of the OP to know how to do pelvic exams, and if he's a male, to do them with a chaperone. It is not rocket science to do a pelvic exam, after 1 or 2 the OP should have been fine, especially if htey are in OB and have to do them constantly. It is not the duty of the PD to hold special sessions for the OP -if OP does not feel up to the task then he needs to ask his residents to help him out and what not. Residents are not special and don't get special privileges. It is their duty to know when they are deficient and when they need extra help. Stop making ridiculous arguments. If you don't like the US medical system you don't have to be here. And since you did not get a residency here then you don't have to concern yourself with how we do things.

 

[Substance]

I am curious as to why your PD would not share the specifics around that one case. Could you not employ legal services to obtain that information from him?

And Winner, you sound very resentful about the American medical system because you did not get a residency spot. If you really want it that badly, write the MCAT and apply to medical schools in America. That'll guarantee you a residency spot, and maybe even a good one. Otherwise, stop complaining. It sounds ridiculous and entitled. If you want to play in the big leagues, you gotta come up through the minors.

 

[odieoh]

That means US Medical School training is deficient in many ways.
BTW,all IMG's do a lot of pelvic exams during their medical school.There r no restrictions on IMGs in this regard.
I do not know about the Pakistani resident but if he was not well-versed with the pelvic exams then it is his own fault.
Now, the blame stil shifts to the PD at the OP's program.This coz' the PD must have been aware about the fact that being a US Medical school student the OP will not be comfortable doing a pelvic exam n so the PD shud have done everything in his power to teach the resident about the pelvic exams.If that is the case then it wud be nice to know from the OP how many pelvic exam teaching sessions did the PD or Attendings hold for the OP.

COULD YOU PLEASE TYPE WORDS OUT CORRECTLY? "n" IS NOT AN ACCEPTABLE SUBSTITUTE FOR "and." "r" IS NOT AN ACCEPTABLE SUBSTITUTE FOR "are." "coz" IS NOT A WORD. "wud" IS NOT A WORD. "shud" IS NOT A WORD. FOR THE LOVE OF ALL THAT IS HOLY, THE LANGUAGE CENTER IN MY BRAIN FEELS LIKE YOU ARE DRIVING NAILS THROUGH IT EVERY TIME YOU TYPE!!

 

[sanityonleave]

...bitter, barely-intelligible rant...

Winner, FYI, as aProgDirector said -- you come off like an IMG who is bitter because they failed to secure a residency in the US and now feels it their duty to rail against the whole system. Get over it. EDIT: Just looked at his posting history... this is clearly a troll account created to make IMGs look bad. I realize he's on probation, but can we ban this guy already?

Back to the topic at hand -- I read on one of the publications hanging in the resident room a couple days ago that there are something along the lines of 1100 OB/GYN residents in the US across 290-something programs (I don't remember the exact numbers, but you get the point). The OP was one of maybe two or three (at most) terminated for inappropriate behavior re: his/her patients. A resident with three complaints against them in one year is EXTREMELY uncommon and a huge red flag.

Also, to what others have said: residents in our program, whether male/female/hermaphrodite/other, are absolutely forbidden from doing a breast or genital exam without a chaperone present, even in their clinics. Even attendings are not allowed to do pelvics in hospital without a chaperone, though they can do whatever they want in their own clinics. Honestly, given how litigious our society is and how easy it is to get a chaperone almost anywhere, it's ludicrous not to have one.

OP may very well be innocent, and it's a failing of the program if the OP was not approached at all prior to termination. But his case is not routine, and he failed to do quite a few things to protect himself / absolve himself of guilt.

 

[Rendar5]

The spelling hurts my brain...

 

[johnsmithdr11th]

I disagree. Complaints in the medical work environment are routine at every level -- from patients, nurses, interns, residents, attendings, social workers, case managers, etc. Anyone who's actually been in a residency program knows that every day, there are complaints made that are petty, trivial, or unsubstantiated. The correct answer to the OP's situation is: "there is not enough information." From a strictly logical standpoint, it's foolish to terminate a resident for this reason: simply mandate chaperones for opposite-sex exams. If I were hospital admin, this would be an obvious risk management strategy borne out of a simple root-cause analysis.

..exposes the program and hospital to a great deal of risk -- both financial and to reputation. It's not a challenge to see how letting go of a single intern in an absurdly draconian fashion makes sense to a program. Why take any risk at all? It's much less painful to simply terminate.

That's generally how the resident termination process goes: hospitals/ bureaucrats find it easier to destroy a career than fix a safety or ACGME violation.

What's interesting is how this thread seems to mirror what the OP originally experienced prior to his termination. ie, it's snowballed into "a resident with three sexual complaints"... But did the OP actually get three separate sexual complaints from patients, or was he set up to fail by his program? Ignoring that, yes, the OP should have a chaperone at all times...For instance the first patient response could have been innocuous: ie, he didn't drape the woman enough and she got cold or she had her own phobia about being alone with a man, etc" The second one was an automatic response, per the OP, that could also mean anything by "felt uncomfortable." The third response was never even relayed to the OP, so how was he supposed to learn from that mistake? And by that time, his PD, just like so many people on this thread, had already made up his or her mind about the OP having "three separate sexual harassment complaints."

We don't even know if there were actually three different *complaints* from patients at all. They could be passing comments or misunderstandings on the part of the PD.

Of course, the OP could just be a pervert or unaware of how others perceive him. And, of course he made a mistake in not getting a chaperone every time. But so many posts on this thread were quick to label this guy based on heresay. We don't know what was reported to the hospital or what was said. We have no proof that all three complaints were about a sexual harassment charge... we don't even know if there were actually three different *complaints* from patients at all. If a program wants to get rid of someone, they will use every comment out of context to paper the files.

But, it is interesting how so many people on this thread latched onto the idea that the OP had three separate, legitimate, complaints from patients, and therefore he must be damaged and a bad doctor. Those facts were not stated by the OP, because he either was not privy to the actual comments (as he stated), or he's hiding specific details. Either way, somehow it became a "fact" about the OP that people ran with on this thread... which is probably how the OP got canned at his old job. (academicians are the biggest gossips and tend to want to believe the worst in each other).

 

[greg1184]

Lesson learned: Go into radiology. An image can't cry rape.

 

[michaelrack]

Lesson learned: Go into radiology. An image can't cry rape.

There's danger even in radiology, particularly in interventional radiology.

 

[DocReborn]

Thank you for all the input -- it has been quite interesting.

An update: Cleared by psychologist and medical board with no disciplinary action. Received a VERY supportive LoR from the PD. Entering the match and hoping for the best.

Thank you again for all the advice and opinions.

Also, as a side note--- I had a chaperone present for the 2nd and third patient concerns, but did not have one present for the first encounter because I did not perform a breast exam nor a pelvic exam (just auscultation). The only mistake I made was not having a chaperone present for the ENTIRE interaction, a mistake I plan to correct during my next residency. Due to the high-volume of patients, I performed well over 100 pelvic exams, cervical checks, etc. Just sayin

 

[mig26x]

Im a hospitalist and I have a few rules I follow:

- ALWAYS get a chaperone when you do breast, rectal or vaginal exam. I write it down in my progress note with the position of the employee (nurse, tech, whatever) and first name of the person. Like: Breast exam performed in the presence of RN XY.

-Even in young female patients doing an abdominal exam were the main complaint is abd pain, therefore more palpating etc, I get a chaperon. ruq to close to R breast and lower quadrants to close to genital area. And I again report who was present during my exam.

- even if there's family present I get a chaperone

- I always ask the patient to move the gown up to reveal abd area OR I ask the RN or tech to help the pt remove the gown for breast exam.

- even if there's a patient in the other bed I get a chaperone

It might take you 3-5 minutes to find a chaperone but the peace of mind is priceless.