How can I clean my residency training record and find a residency training opportunity?

[jljylb]

I had a PGY-1 residency training program 3 years ago. I got a PGY-1 training certificate from the PGY-1 program which said I provided satisfactory service in the clinical rotation. The pgy-1 program did not renew my residency contract; no specific reason was told. Residency contract appeal was not approved by GME.

I had tried to apply to a new residency opportunity, but no one worked. Some programs said I got negative reference, but I cannot know the content of the negative reference from PGY-1 program.

Recently a program I applied to asked me to verify the lawsuit I was involved in in my PGY-1 year. They contacted my PGY-1 program and received the lawsuit information about me from them. This is the first time for me to know the content of the PGY-1 reference. Previously my PGY-1 program asked signing a contract about confidential reference with the program I applied to. They were not allowed to tell me the reference content. and this is the reason that I did not know what the PGY-1 program said about me. I was shocked by the lawsuit information because I did not know it. I realized how my career was destroyed by the PGY-1 reference 3 years after the PGY-1 training.
The residency training record is important for a physician's career. I had worked as a junior physician for 6 years before I came to the US. I had finished all of the USMLE steps (1,2,3) in the US. I do not think what happened to me is fair. But I do not know which section of AAMC can handle this kind of rumor issue. Can I seek your suggestions about resolving the problem?

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[rokshana]

I had a PGY-1 residency training program 3 years ago. I got a PGY-1 training certificate from the PGY-1 program which said I provided satisfactory service in the clinical rotation. The pgy-1 program did not renew my residency contract; no specific reason was told. Residency contract appeal was not approved by GME.

I had tried to apply to a new residency opportunity, but no one worked. Some programs said I got negative reference, but I cannot know the content of the negative reference from PGY-1 program.

Recently a program I applied to asked me to verify the lawsuit I was involved in in my PGY-1 year. They contacted my PGY-1 program and received the lawsuit information about me from them. This is the first time for me to know the content of the PGY-1 reference. Previously my PGY-1 program asked signing a contract about confidential reference with the program I applied to. They were not allowed to tell me the reference content. and this is the reason that I did not know what the PGY-1 program said about me. I was shocked by the lawsuit information because I did not know it. I realized how my career was destroyed by the PGY-1 reference 3 years after the PGY-1 training.
The residency training record is important for a physician's career. I had worked as a junior physician for 6 years before I came to the US. I had finished all of the USMLE steps (1,2,3) in the US. I do not think what happened to me is fair. But I do not know which section of AAMC can handle this kind of rumor issue. Can I seek your suggestions about resolving the problem?

Rumor? That you were named in a lawsuit?
Did you not know about the lawsuit?
What happened with said lawsuit?
You should probably find out about that.

 

[NotAProgDirector]

There is clearly some major confusion going on here.

First, there's no such thing as "secret lawsuits". If you're involved in a lawsuit, by law you're required to receive notice of such. It's often delivered by a process server. If this is a medical malpractice lawsuit, then it's possible that your program may have accepted notice for you -- but they are then still legally required to tell you about it (and, you're supposed to give them permission to accept service for you). If this was a lawsuit between you and your program, then of course you know about it since you probably started it. If your program sued you, then the same issues would be at play -- you should have received legal notice of such through registered mail or a process server. I can't imagine why a program would sue you, although some programs have taken out Do Not Trespass and other protection orders against disruptive employees -- so that's possible.

Or, it's possible you're confusing a "lawsuit" with probation or some other form of disciplinary event in your training. That wouldn't be a legal issue.

You also mention that your program just let you go at the end of the year, didn't renew your contract, and you have no idea why. There's something missing here. Programs don't just non-renew residents, there's a process of remediation. They must tell you what the problem is.

Fixing this now (3 years later) is going to be very complicated. The AAMC has nothing to do with this at all -- they are involved with medical schools and medical students. The ACGME oversees residency programs, but they will not help you either. There is an ombudsperson there, but the ACGME does not get in the middle of disagreements between residents and programs. Feel free to reach out to them, but I can almost guarantee you're wasting your time.

Some actual documentation of what happened would be very helpful in sorting this out. If you don't want to post it publically (which I can completely understand, since it will have your name all over it) you can send it to me in a private chat and I promise it will go no further. If your old program is actually being untruthful, then your only recourse is going to be legal in nature (i.e. taking them to court to change it) which will be time consuming and expensive.

 

[GoSpursGo]

while I am also confused about what is going on with this “secret lawsuit,” another problem I see which perhaps @NotAProgDirector could comment on is that the OP waived the chance to see the LOR, as is customary for all ERAS letters. While the program can always disclose the contents, isn’t it irregular to ask a LOR writer about the contents of the letter? While he has secondhand knowledge that a bad LOR sank him, I would not think that would enable him to go back to the PD and ask about the contents? About the best I could see is when it comes time to reapply, simply saying “I received feedback last year that a negative reference held me back. Do you feel you are able to write me a STRONG letter?” And see where that takes you. It’s possible I’m wrong, but short of the program outright lying (in which case you need a lawyer), I’m not sure how you actually open this discussion with your old program.

Second of all and bigger, even if you get to have the conversation I’m not sure how you change their mind. Clearly they knew that writing a negative letter would kill your application chances. They chose to do it because either they were legally required to because of the lawsuit (whatever that is), or they felt ethically obligated to render an honest (negative) assessment of you , or you left on such negative terms that they are being vindictive. I’m not sure how you change the calculus on any of those stances. And again I’m not sure how you can open the discussion.

NB for anyone being terminated or non-renewed: try to involve a lawyer at that point, and if the situation is not salvageable, do everything in your power to negotiate for a positive (or at least neutral) LOR as part of your separation. At that point where could pull them into a protracted legal battle, you have some small leverage and a program may decide to agree to be more helpful to you going forward in exchange for walking away amicably. Many years after the fact, unfortunately OP you have very little leverage and the program has little incentive to change their assessment of you.

I truly wish I had something more encouraging to say. I think this is going to be very difficult to untangle, but I wish you the best.

 

[Apollyon]

do everything in your power to negotiate for a positive (or at least neutral) LOR as part of your separation. At that point where could pull them into a protracted legal battle, you have some small leverage and a program may decide to agree to be more helpful to you going forward in exchange for walking away amicably. Many years after the fact, unfortunately OP you have very little leverage and the program has little incentive to change their assessment of you.

This caught my eye. We had some windows installed a few years back, and the manager was execrable. He was so bad, we said we just wouldn't deal with the company. A few weeks ago, we saw company reps at a show, and they said that that guy wasn't with them anymore. He said that the guy had good references. I said, "they tell you he's good to get rid of him where they are". That's what I thought of when I saw that part of your post.

 

[jljylb]

There is clearly some major confusion going on here.

First, there's no such thing as "secret lawsuits". If you're involved in a lawsuit, by law you're required to receive notice of such. It's often delivered by a process server. If this is a medical malpractice lawsuit, then it's possible that your program may have accepted notice for you -- but they are then still legally required to tell you about it (and, you're supposed to give them permission to accept service for you). If this was a lawsuit between you and your program, then of course you know about it since you probably started it. If your program sued you, then the same issues would be at play -- you should have received legal notice of such through registered mail or a process server. I can't imagine why a program would sue you, although some programs have taken out Do Not Trespass and other protection orders against disruptive employees -- so that's possible.

Or, it's possible you're confusing a "lawsuit" with probation or some other form of disciplinary event in your training. That wouldn't be a legal issue.

You also mention that your program just let you go at the end of the year, didn't renew your contract, and you have no idea why. There's something missing here. Programs don't just non-renew residents, there's a process of remediation. They must tell you what the problem is.

Fixing this now (3 years later) is going to be very complicated. The AAMC has nothing to do with this at all -- they are involved with medical schools and medical students. The ACGME oversees residency programs, but they will not help you either. There is an ombudsperson there, but the ACGME does not get in the middle of disagreements between residents and programs. Feel free to reach out to them, but I can almost guarantee you're wasting your time.

Some actual documentation of what happened would be very helpful in sorting this out. If you don't want to post it publically (which I can completely understand, since it will have your name all over it) you can send it to me in a private chat and I promise it will go no further. If your old program is actually being untruthful, then your only recourse is going to be legal in nature (i.e. taking them to court to change it) which will be time consuming and expensive.

Thanks for all of your comments. You are analyzing my situation with a usual thinking style. I had the same thought as you three years ago. I had spent 5 years to finish the USMLE step1 ,2,3. I tried every effort to ask for what were the problems and suggestions to improve. NO, there was no clear answers. There WAS NO a process of remediation. "They must tell you what the problem is" is a logic in your thinking model, not in my PGY-1 program. Appeal was controlled by GME dean, chair and program director, my appeal application was just ignored. My evaluation record were changed to negative 10 months after I left from the program. I have printed all of my training record, I would like to show you that privately and seek for suggestions.

 

[jljylb]

Rumor? That you were named in a lawsuit?
Did you not know about the lawsuit?
What happened with said lawsuit?
You should probably find out about that.

I did not know any lawsuit about me because I never receive lawsuit notice from the court. I heard about the lawsuit information about me from the program I applied to this year. They asked me to confirm what lawsuit I involved in the PGY-1 program. I have contacted ACGME Ombudsman to clarify the lawsuit issue. I was not given the appeal opportunity in the PGY-1 program.

 

[jljylb]

while I am also confused about what is going on with this “secret lawsuit,” another problem I see which perhaps @NotAProgDirector could comment on is that the OP waived the chance to see the LOR, as is customary for all ERAS letters. While the program can always disclose the contents, isn’t it irregular to ask a LOR writer about the contents of the letter? While he has secondhand knowledge that a bad LOR sank him, I would not think that would enable him to go back to the PD and ask about the contents? About the best I could see is when it comes time to reapply, simply saying “I received feedback last year that a negative reference held me back. Do you feel you are able to write me a STRONG letter?” And see where that takes you. It’s possible I’m wrong, but short of the program outright lying (in which case you need a lawyer), I’m not sure how you actually open this discussion with your old program.

Second of all and bigger, even if you get to have the conversation I’m not sure how you change their mind. Clearly they knew that writing a negative letter would kill your application chances. They chose to do it because either they were legally required to because of the lawsuit (whatever that is), or they felt ethically obligated to render an honest (negative) assessment of you , or you left on such negative terms that they are being vindictive. I’m not sure how you change the calculus on any of those stances. And again I’m not sure how you can open the discussion.

NB for anyone being terminated or non-renewed: try to involve a lawyer at that point, and if the situation is not salvageable, do everything in your power to negotiate for a positive (or at least neutral) LOR as part of your separation. At that point where could pull them into a protracted legal battle, you have some small leverage and a program may decide to agree to be more helpful to you going forward in exchange for walking away amicably. Many years after the fact, unfortunately OP you have very little leverage and the program has little incentive to change their assessment of you.

I truly wish I had something more encouraging to say. I think this is going to be very difficult to untangle, but I wish you the best.

What is "OP"? Can you please type the full words of it?
"NB"?

 

[wysdoc]

What is "OP"? Can you please type the full words of it?
"NB"?

OP means Original Poster (you)

 

[GoSpursGo]

OP is original poster (aka you)

NB is nota bene. It means “good note”

 

[rokshana]

What is "OP"? Can you please type the full words of it?
"NB"?

It’s a common abbreviation for original poster…if you are going to come to a social media forum, you will need to learn the lingo.

Here, Let Me Google That For You

Passive-aggressively teach your friends how to Google. For all those people who find it more convenient to ask you rather than search it themselves. Not associated with Google.

googlethatforyou.com

 

[Apollyon]

NB is nota bene. It means “good note”

Actually, "note well", colloquially taken as "take note of this". #Latin snob

 

[IlDestriero]

Sorry you’ve had these problems.
It’s still not really clear what happened, and we could have probably offered better advice 3 years ago.
You have to better explain what the lawsuit was about. Who sued who, and what was your role? Malpractice, civil, criminal?
Businesses have learned the hard way that they put themselves at risk by disclosing negative things about former employees, especially if you have documentation of good evaluations that were changed after the fact. Medicine hasn’t seemed to learn this lesson yet.
You must have some insight into what your weaknesses were and why they didn’t renew your contract. Even if you got straight 3 of 5s on all your evals and no comments. Addressing these problems is a good first step showing you understand what the problems were and how you learned from that experience and made changes to not repeat them.

 

[mistafab]

You got zero shot in another residency program if you can't tell at all why you didn't get renewed. If your story is that you don't know why you go thrown out, the program will assume you have learned nothing. If you have zero insight then you are essentially un-hirable.

 

[dozitgetchahi]

So much going on here.

Talk to us about this lawsuit. This matters for so many reasons.

If a patient sued you and/or the hospital and somehow you were never served (it rarely happens, even though it really shouldn’t), then you need to find out about that stat! If you don’t respond to a lawsuit/get an attorney/present for hearings etc then there can be a default judgment made against you without trial, and this can be $$$. However, if this happened 3 years ago, this probably all would have happened by now, and you would have been under someone else’s license as a trainee anyway. You can search dockets electronically if you have no idea what’s going on, but you need to talk to an attorney pronto if this is the deal.

However…reading between the lines here, my best guess is that you sued the hospital as part of a long remediation process, perhaps lost, and the hospital reported this to your potential new program as part of their recommendation letter.

 

[Crayola227]

Ugh, for future reference, a major goal in getting an attorney when you have issues with a program, the main goal is negotiating a neutral to positive letter of recommendation for future programs, and a mutally binding NDA (non-disclosure agreement) which basically means neither party can badmouth the other. Trying to achieve other ends and not ending up with those two items, as we often see, is literally career killing.

You often see me advise people to get an attorney, but let me make it clear, it is so that you can get the above 2 items. That is what you need to do damage control when it seems a program has turned against you. It comes up all the time that future programs can read between the lines and still be turned off in situations where you have those 2 items, and that may be true, but it's no more harmful than you trying to sue a program or the program having the legal ability to say whatever they like about you. There is at least the chance that it can appear that you and your program parted on reasonable terms.

 

[sirspamalot]

Its always best to find at least one high value reference who supports you before you're shown the door. Also, negotiate a clean exit, often with a lawyer involved. Without these things, you're doomed essentially.

 

[Goro]

Thanks for all of your comments. You are analyzing my situation with a usual thinking style. I had the same thought as you three years ago. I had spent 5 years to finish the USMLE step1 ,2,3. I tried every effort to ask for what were the problems and suggestions to improve. NO, there was no clear answers. There WAS NO a process of remediation. "They must tell you what the problem is" is a logic in your thinking model, not in my PGY-1 program. Appeal was controlled by GME dean, chair and program director, my appeal application was just ignored. My evaluation record were changed to negative 10 months after I left from the program. I have printed all of my training record, I would like to show you that privately and seek for suggestions.

So what have you been doing in the past two years?

 

[samac]

You got zero shot in another residency program if you can't tell at all why you didn't get renewed. If your story is that you don't know why you go thrown out, the program will assume you have learned nothing. If you have zero insight then you are essentially un-hirable.

This.

You keep saying you don't know why you weren't renewed and no one - including myself - will believe you don't have some idea of something that happened.

 

[Dr.Jekyll75]

getting a lawyer is def ideal in this situation. if you have proof that they changed their evals of you after you left, you can use it against them

 

[j4pac]

I’m sorry to hear about this. A lot of stuff is difficult to follow here. Why are you pursuing this three years later? That to me is odd. You still have absolutely no clue why you were non-renewed or involved in a lawsuit? Very odd. You seem oblivious and/or you are simply not telling us more to the story. The time to get a lawyer was three years ago. What have you been doing this entire time?

 

[sirspamalot]

Time to move on to something else I think, there is such a huge demand for related professionals you can find something and make good on it. Sorry but it is what it is.

 

[sirspamalot]

If you want to still be clinical care, you'll have to set your notch down below "MD" level.

Outside of clinical care there are business, sales and writing opportunities.

 

[Redpancreas]

So what have you been doing in the past two years?

Probably depressed.

 

[VA Hopeful Dr]

Care to elaborate? Similar spot as the OP (though different circumstances). I’ve searched countless hours for near a year since being out of residency and have found exactly 0 jobs that are either medically related or that my medical degree is useful for/ related to. 100% required being BC/ BE. Every single one (even the non clinical jobs- in fact those also often required 5+ years of clinical practice as an attending).

Move to South Carolina, our prison doctors only need one year of postgraduate training.

 

[j4pac]

Move to South Carolina, our prison doctors only need one year of postgraduate training.

There are many states that give an unrestricted medical license if you get through PGY-1. You can work urgent care and make pretty good money. I was making over $100/hr moonlighting at urgent care in Florida with only an internship to my name.