First let me say that I two was recently placed on resident corrective action (RCA) two weeks ago for failing to progress in a a couple of the core competencies. There was no behavior or patient adverse events. I knew I was not the best resident in my class, but this came as a big shock. I came back from vacation to a surprise meeting on Monday with my PD that outlined why I was on RCA and went through a multipage document on negative feedback from senior residents and attendings. I was then escorted to employee health for psych and learning disability evaluation to determine if I was safe to work. I won't get into the details of the events or examples that lead to this, but I was pretty shell shocked and heart broken.
Part of the program is that I have a chief resident mentor and faculty mentor that I meet with twice a month who gives me feedback from others and also act as my liaisons to the department. Additionally I have to meet with a psychologist monthly and also write a journal of mistakes I have made and the learning points. The program is for 6 months and on re-evalation I can either be taken off RCA, extend the program, or be terminated. While this is a lot of work and meetings, it has enabled me to develop a support system and advocates within the residency program. They serve as intermediaries on my behalf. Their honest feedback has been helpful and I encourage you to seek out a similar support system. The biggest thing is that we have to prove to the department that there is improvement, having mentors can help facilitate that by having someone speak positively for you.
On my own introspection, the biggest problem that I had was not seeing the unwritten rules of my residency program. I thought if I show up, work hard, and don't make any egregious errors then I would be fine, but this is not true. What I learned is that the standard is to be just above the standard (if that makes sense). AKA: going above and beyond is actually the standard. Many people will say this, but I have thought of ways that prove it and include being seen by the attendings in the OR even if it's not your case, staying late for procedures, and not leaving when someone says you can go (even if you want to). My program has a very micromanaging environment and even though I am not a junior resident I still have to run everything by a senior resident regardless of how trivial. If you are having problems with clinical judgement having it filtered by a senior resident can help. Plus if an adverse outcome occurs, you have loaded the boat. These are things that I came up with but I am sure there are more.
I applaud you for your own introspection. Having to go through something like this is emotionally devastating and scary. I am routing for you/us. It's hard to look at the situation objectively, come up with a plan, and institute the plan but it sounds like you have done just that. Hopefully the things I mentioned can help you, no matter what ends up happening.
