I don’t like my fellowship program

[wonderer MD]

I am a fellow in the first year in a 2 year fellowship program( one of the least competitive IM subspecialties). I have made few of clear mistakes one of them not checking the dose of a med but non was major patient safety wise. and I have some typos as I am still adjusting to typing as I was mainly dictating before. and there has been some comments about me not presenting in detail when presenting a new case.

Now I am being asked to do monthly meetings with PD and associate PD regarding my notes being not as good as they want it to be. I am being assured not to worry is this is about “help” and meetings it will be continued until my notes is not a problem. I hear other getting minor edits directly but non of them had a similar meetings . I think chemistry is not there with PD and department chair.

My fear is that I have been trying for the last 3 months but my notes still have typos and if they want to get someone they’ll find something in the chart. I saw their comments evaluations and some comments are not positive. and 3 out of last 9 evaluations answered “ No” to recommend me to continue in the program. I don’t know if I have the ability to improve to that degree.

I ran into a physician I know in other program ( same specialty) from the hospital where I did my residency in. who said they might have unfilled position for next year. the fellowship there sounds more mangeable and i know them from residency and they are nice people. the PDs know each other as one trained the other, looking for advice and I have some questions :

• should I tell my PD first or get the acceptance from other program first?
• If i ask about transfer to that other program behind my PD back will it be a big deal knowing that they personally know each other?
• would a transfer to other program for second year of fellowship cause problems after I graduate?

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[NotAProgDirector]

should I tell my PD first or get the acceptance from other program first?
If i ask about transfer to that other program behind my PD back will it be a big deal knowing that they personally know each other?

These are the same question. There's no perfect answer. In general, yes, the best option is to tell your current program that you don't think it's a good fit and that you're looking at other programs, including the one at your prior residency program. That said, in a truly malignant program this strategy could backfire.

would a transfer to other program for second year of fellowship cause problems after I graduate?

Not usually, although you will need to get certifications from all programs you have attended. if your current program were to report major concerns, it's possible that could cause problems in the future. But usually most hospitals and BoM will look at your most recent training, and chances are a decent program will simply document that you had some issues they were working upon that the new location is aware of and addressing and that would be it.

 

[mszzeta]

I am a fellow in the first year in a 2 year fellowship program( one of the least competitive IM subspecialties). I have made few of clear mistakes one of them not checking the dose of a med but non was major patient safety wise. and I have some typos as I am still adjusting to typing as I was mainly dictating before. and there has been some comments about me not presenting in detail when presenting a new case.

Now I am being asked to do monthly meetings with PD and associate PD regarding my notes being not as good as they want it to be. I am being assured not to worry is this is about “help” and meetings it will be continued until my notes is not a problem. I hear other getting minor edits directly but non of them had a similar meetings . I think chemistry is not there with PD and department chair.

My fear is that I have been trying for the last 3 months but my notes still have typos and if they want to get someone they’ll find something in the chart. I saw their comments evaluations and some comments are not positive. and 3 out of last 9 evaluations answered “ No” to recommend me to continue in the program. I don’t know if I have the ability to improve to that degree.

I ran into a physician I know in other program ( same specialty) from the hospital where I did my residency in. who said they might have unfilled position for next year. the fellowship there sounds more mangeable and i know them from residency and they are nice people. the PDs know each other as one trained the other, looking for advice and I have some questions :

• should I tell my PD first or get the acceptance from other program first?
• If i ask about transfer to that other program behind my PD back will it be a big deal knowing that they personally know each other?
• would a transfer to other program for second year of fellowship cause problems after I graduate?

As a faculty who supervise fellows, I cannot believe other faculty would say no to continue the program, simply due to typos and notes. Many people have typos and this most of them would not affect medical care (unless it creates confusions in understanding). Also the note itself rarely a major issue, since many attending notes (including mine) are very concise.

I feel whether the issue might be your clinical reasoning, which is what the note should reflect. Other attendings' comment on the presentation might also be a similar concern. You may need to clarify with your PD about it and be honest with yourself. The clinical reasoning can be improved by continuing to seeing patients AND reading and reflecting