In regards to recent NYC resident suicides and a warning to medical students...

[Crayola227]

As far as speaking out, especially if this were 10 years ago....

Look at the reaction the OP is getting even now. I'm not saying this totally excuses him for responsibility in reporting this behavior, but I will say a few things.

I've been involved in a situation where you are reporting the misconduct of one party against another. If the aggrieved party doesn't back that up, it goes no where. If you don't name an aggrieved party, it goes nowhere. If you have heard reportable things from the perpetrator themselves, there might be more looking into your allegation. Oh, they may talk to the offender as well, almost certainly.

And go nowhere as in, even if over the years people report report report what they hear on this account, without some witnesses coming forward to support the reports, I'm not even sure if this goes in someone's employee record. Maybe. Does that record get transferred when they leave one position and go to another? I'm not sure that it does.

So the offender has minimal consequences, record, investigation, etc, unless someone besides someone like the OP reports. But the OP reporting may quite likely lead to the perpetrator knowing there was a report. What does that accomplish? Do they stop? Well, that would make sense now, wouldn't it? But people that use power for sex don't just quit because... some power is trying to stop them. One, that's missing the very point for them, and two, if power were going to stop them, they probably wouldn't have even started.

Often what happens is that such perpetrators just take greater pains to put a lid on things, although as I said that's not their favorite move, they like bragging in some regard. But not too bad from their standpoint, they can just up the threats or even consequences such as job consequences, coercion, violence, to further intimidate victims into silence, rather than stop what they are doing. So a different exercise in power while continuing to do wrong.

Now they know someone is out to make them pay for their conduct. Unless your allegations are backed up by a victim... the person reporting is opening themselves up to a world of hurt on so many levels.

I mean, look at what is happening to OP in a freaking anonymous forum just for students/physicians.

They haven't even named the perpetrator - yet we find it more believable that the OP is making up the rumors than considering that the OP is telling the truth in some sort of revenge maneuver?

I got news for you people - people don't lie about sexual assault as much as you think, and this is not a forum, an OP, or a post written in such a way as for me to dismiss that the OP was at minimum witness to rumors of sexual harassment in their workplace. This context and the content actually make zero sense for a lie.

I don't deny that this could be rumor and the PD is innocent.

BUT as shocking as what the OP describes is, guess what, that sort of thing, exactly as written, DOES INDEED HAPPEN. Bosses in various workplaces do exactly as he said.

I would like to think that would be less likely in a physician or a PD. But that doesn't mean it doesn't happen.

I'm sitting here chewing on the idea that everything said by OP, or whatever his sources for the alleged behavior, is all just some sort of bizarre rumor that sprouted from nowhere, with no basis in reality whatsoever.... That's really what I find hard to believe.

Also that everyone finds it easier to dismiss these claims than consider what I think is a very likely possibility they are based on some disturbing facts.

No one is ever happy. If you don't report beyond an anonymous forum in SOME attempt to address harm, then you shouldn't have bothered you are a coward, if you are not a liar. If you do report, then you are _____ insert all the reasons any allegation of even just basic sexual harassment is a fabrication, and subject to all sorts of negative attention whether you reported or not.

Silence is a balm in these kinds of winds. HOW CAN ANY OF YOU READ THIS THREAD AND WONDER WHY PEOPLE DON'T REPORT THINGS IN OFFICIAL CHANNELS????

That isn't to say you should believe everything, or even anything. But if you do believe anything, believe that reporting sexual misconduct of any type no matter how close or far you are from it, is one of the hardest things ever to do in one's life. In fact, for a lot of people, it's worse than the violation itself.

It would be an awesome universe where people would just come forward in the appropriate channels about these things. But that will never happen in a universe where a thread like this represents the common response even when these anonymous words hold little to no risk of negative consequences for an innocent or perpetrator in reporting that people should just take note. It's surprising if we have to even ask ourselves why people don't come forward. Congratulations to many of you, because you're actually part of creating that, even as you wonder why someone didn't do better by reporting. Oh the irony.

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[atomi]

As far as speaking out, especially if this were 10 years ago....

Look at the reaction the OP is getting even now. I'm not saying this totally excuses him for responsibility in reporting this behavior, but I will say a few things.

I've been involved in a situation where you are reporting the misconduct of one party against another. If the aggrieved party doesn't back that up, it goes no where. If you don't name an aggrieved party, it goes nowhere. If you have heard reportable things from the perpetrator themselves, there might be more looking into your allegation. Oh, they may talk to the offender as well, almost certainly.

And go nowhere as in, even if over the years people report report report what they hear on this account, without some witnesses coming forward to support the reports, I'm not even sure if this goes in someone's employee record. Maybe. Does that record get transferred when they leave one position and go to another? I'm not sure that it does.

So the offender has minimal consequences, record, investigation, etc, unless someone besides someone like the OP reports. But the OP reporting may quite likely lead to the perpetrator knowing there was a report. What does that accomplish? Do they stop? Well, that would make sense now, wouldn't it? But people that use power for sex don't just quit because... some power is trying to stop them. One, that's missing the very point for them, and two, if power were going to stop them, they probably wouldn't have even started.

Often what happens is that such perpetrators just take greater pains to put a lid on things, although as I said that's not their favorite move, they like bragging in some regard. But not too bad from their standpoint, they can just up the threats or even consequences such as job consequences, coercion, violence, to further intimidate victims into silence, rather than stop what they are doing. So a different exercise in power while continuing to do wrong.

Now they know someone is out to make them pay for their conduct. Unless your allegations are backed up by a victim... the person reporting is opening themselves up to a world of hurt on so many levels.

I mean, look at what is happening to OP in a freaking anonymous forum just for students/physicians.

They haven't even named the perpetrator - yet we find it more believable that the OP is making up the rumors than considering that the OP is telling the truth in some sort of revenge maneuver?

I got news for you people - people don't lie about sexual assault as much as you think, and this is not a forum, an OP, or a post written in such a way as for me to dismiss that the OP was at minimum witness to rumors of sexual harassment in their workplace. This context and the content actually make zero sense for a lie.

I don't deny that this could be rumor and the PD is innocent.

BUT as shocking as what the OP describes is, guess what, that sort of thing, exactly as written, DOES INDEED HAPPEN. Bosses in various workplaces do exactly as he said.

I would like to think that would be less likely in a physician or a PD. But that doesn't mean it doesn't happen.

I'm sitting here chewing on the idea that everything said by OP, or whatever his sources for the alleged behavior, is all just some sort of bizarre rumor that sprouted from nowhere, with no basis in reality whatsoever.... That's really what I find hard to believe.

Also that everyone finds it easier to dismiss these claims than consider what I think is a very likely possibility they are based on some disturbing facts.

No one is ever happy. If you don't report beyond an anonymous forum in SOME attempt to address harm, then you shouldn't have bothered you are a coward, if you are not a liar. If you do report, then you are _____ insert all the reasons any allegation of even just basic sexual harassment is a fabrication, and subject to all sorts of negative attention whether you reported or not.

Silence is a balm in these kinds of winds. HOW CAN ANY OF YOU READ THIS THREAD AND WONDER WHY PEOPLE DON'T REPORT THINGS IN OFFICIAL CHANNELS????

That isn't to say you should believe everything, or even anything. But if you do believe anything, believe that reporting sexual misconduct of any type no matter how close or far you are from it, is one of the hardest things ever to do in one's life. In fact, for a lot of people, it's worse than the violation itself.

It would be an awesome universe where people would just come forward in the appropriate channels about these things. But that will never happen in a universe where a thread like this represents the common response even when these anonymous words hold little to no risk of negative consequences for an innocent or perpetrator in reporting that people should just take note. It's surprising if we have to even ask ourselves why people don't come forward. Congratulations to many of you, because you're actually part of creating that, even as you wonder why someone didn't do better by reporting. Oh the irony.

Weren’t you paying attention? OP was discredited because he used the term psychopath less than perfectly precise. I mean, wtf.

 

[studyaholic]

This is called "identification with the aggressor," and it also represents a sort of "master morality" as described by Nietzsche. Like the ancient Romans and Greeks, we ascribe a moral value to the strong and the weak, whereby the strong are "good," and the weak are "bad," and each deserves what they get on that basis. In this view, in most conflicts the program is judged as good and the resident bad, thereby negating grievances of the party with less power.

Eloquently said. Honestly, I'm always watchful of my behavior and actions even to the rudest people, I don't ever want to be a trigger to set someone to commit suicide. I always try to relate to why someone is behaving the way they do...The biggest problem in medicine is that everyone is trained to "empathize" with patients, be advocates for patients, but no one integrates this behavior as a human being to treat co-residents, interns, students the same way. I've seen this toxic behavior in other institutions as a medical student. Any other profession if you can't respect your colleagues, or who you deem academically inferior, you're pretty much out of a job.

Why residents are taking their lives so frequently at these specific institutions need to be looked into and as a warning to MS4s who have the fortunate opportunity to choose which program you enter, be warry of the superiors. Make sure you know why you're getting into before it's too late. Garner information from current residents about their experiences with the program.

I was blessed during medical school, when a resident pulled me aside and told me not to apply to their program. This resident said "it's better to go unmatched than match here."
Residency is stressful enough with the academics, time constraints. Unfortunately, how society is now, there is an increase in suicide, and mass homicide-suicides. Residencies are petri dishes for mental health deterioration by having a set group of people-most alpha personalities- in isolation from friends/family and placing academic pressure on them for 3-5 years. This has been recognized, and the newer programs are more focused on resident wellness and have taken initiative to prevent such breakdowns. I honestly was almost going to have a break down last year (you might be able to pull up my old posts), and was given appropriate resources at a residency wellness meeting that occurs every 2-3 months in our program. Have you taken initiative once an attending to contribute to your old program, or did you document incidences that you can still report this person?

 

[Mass Effect]

Oh jeez, of course the OP could know all about the PD's sex life, if people are gossiping about it (and likely are) AND if the gossip is true. +1 credibility points if the subject of the gossip, namely an actual female resident who was treated this way, or someone who interacted with the PD reporting actual comments they heard the PD made, to the OP.

Anyone who has actually interacted with the PD, could testify. Any one of those people, if they discussed this with OP, OP's testimony to that very affect would be admissable and not hearsay if the witness they are quoting were present in court as well.

So yeah, if OP heard about these things from direct victims/witnesses, and that's admissible in court, that's enough for me to find it a credible accusation, certainly not one I would dismiss as though it were the unlikeliest thing in the world.

Would love for an actual attorney to chime in here and explain how hallway gossip is admissable in a court of law? Witnesses, sure. But gossip?

Weren’t you paying attention? OP was discredited because he used the term psychopath less than perfectly precise. I mean, wtf.

And I explained why it was more important than "less than perfectly precise." You don't have to accept it, but it's a fact and I still say I'm extremely skeptical about this thread in the first place for multiple reasons.

 

[atomi]

And I explained why it was more important than "less than perfectly precise." You don't have to accept it, but it's a fact and I still say I'm extremely skeptical about this thread in the first place for multiple reasons.

Ok. I flat out disagree with you. This is the equivalent of an internist not being able to get past someone describing that they were “in a state of shock” But that’s not what shock is! You must be an idiot! The point is that the precise medical definition of psychopath was not important AT ALL and you focused on it because you want to discredit this guy for sone reason.

So I don’t know what’s worse. Your ridiculous ad hominem or our resident SJW fourth wave feminist who dropped a MeToo driveby about how this whole innocent-until proven-guilty is an antiquated relic of the patriarchy.

Where are all the reasonable normal people???

I would say this thread made me depressed, but of course I wouldn’t meet diagnostic criteria for that diagnosis, so I will refrain.

 

[Mass Effect]

Ok. I flat out disagree with you. This is the equivalent of an internist not being able to get past someone describing that they were “in a state of shock” But that’s not what shock is! You must be an idiot! The point is that the precise medical definition of psychopath was not important AT ALL and you focused on it because you want to discredit this guy for sone reason.

So I don’t know what’s worse. Your ridiculous ad hominem or our resident SJW fourth wave feminist who dropped a MeToo driveby about how this whole innocent-until proven-guilty is an antiquated relic of the patriarchy.

Where are all the reasonable normal people???

I would say this thread made me depressed, but of course I wouldn’t meet diagnostic criteria for that diagnosis, so I will refrain.

All I can say to this is chill out. Disagree and move on. I stand by what I said.

 

[Crayola227]

Would love for an actual attorney to chime in here and explain how hallway gossip is admissable in a court of law? Witnesses, sure. But gossip?



And I explained why it was more important than "less than perfectly precise." You don't have to accept it, but it's a fact and I still say I'm extremely skeptical about this thread in the first place for multiple reasons.

I'm not an attorney, but I did look this up and I did literally have a conversation to this very effect with an attorney advising me when I literally went to court in July.

Say a PD rapes you. Say that you come to me and say "The PD raped me and it was terrible." If you are present in court, I can go on the witness stand and say, "Mass Effect said to me that the PD raped me and it was terrible on such and such date."

I am a first hand witness to what you told me, but not to the alleged PD behavior.

 

[Crayola227]

Ok. I flat out disagree with you. This is the equivalent of an internist not being able to get past someone describing that they were “in a state of shock” But that’s not what shock is! You must be an idiot! The point is that the precise medical definition of psychopath was not important AT ALL and you focused on it because you want to discredit this guy for sone reason.

So I don’t know what’s worse. Your ridiculous ad hominem or our resident SJW fourth wave feminist who dropped a MeToo driveby about how this whole innocent-until proven-guilty is an antiquated relic of the patriarchy.

Where are all the reasonable normal people???

I would say this thread made me depressed, but of course I wouldn’t meet diagnostic criteria for that diagnosis, so I will refrain.

I never said that, if I am who you meant. I just find it hard to believe this is based on nothing, so I think it's fair that this person in an anonymous forum said beware of certain programs and on the look out for malignant programs, signs might be suicide in residents or other signs of a malignant PD.

Innocent until proven guilty applies in court. It is not the standard you have to apply in picking residency programs.

 

[atomi]

I never said that, if I am who you meant. I just find it hard to believe this is based on nothing, so I think it's fair that this person in an anonymous forum said beware of certain programs and on the look out for malignant programs, signs might be suicide in residents or other signs of a malignant PD.

Innocent until proven guilty applies in court. It is not the standard you have to apply in picking residency programs.

I wasn’t referring to you. I was referring to another poster who made a comment about people not believing women and makes these comments frequently.

I completely agree that things like this should be known. If accusations are there, it’s important to know about them. You need to use all info available to make your rank list, even rumors, because red flags are important, What’s not ok is this troubling movement that wants to create a society where men can be convicted of a crime or lose their job/career without evidence. Yes, it sucks that sexual harassment and assault often occur without evidence. Unfortunately that’s just the way it is. You can’t just change the rules for one specific crime and risk punishing innocent people. There is NOTHING wrong with not believing somebody or being skeptical without real evidence. There are those who would have us think it’s shameful to require proof.

 

[Shufflin]

I was expecting to read a meaningful discussion about the dynamics that put residents at risk of suicide in training. Boy this discussion has gone deep into Left Field...

 

[rokshana]

I'm not an attorney, but I did look this up and I did literally have a conversation to this very effect with an attorney advising me when I literally went to court in July.

Say a PD rapes you. Say that you come to me and say "The PD raped me and it was terrible." If you are present in court, I can go on the witness stand and say, "Mass Effect said to me that the PD raped me and it was terrible on such and such date."

I am a first hand witness to what you told me, but not to the alleged PD behavior.

i believe that would be hearsay and unless corroborated, would not be admissible.

 

[Apollyon]

i believe that would be hearsay and unless corroborated, would not be admissible.

Thank heavens, but I am NOT a lawyer, but, in some way, it might be. It has to do with the Confrontation Clause of the 6th Amendment.

 

[Crayola227]

Hearsay - Wikipedia

"Hearsay evidence is "an out-of-court statement offered to prove the truth of matter asserted". In certain courts, hearsay evidence is inadmissible (the "Hearsay Evidence Rule") unless an exception to the Hearsay Rule applies.

For example, to prove Tom was in town, the attorney asks a witness, "What did Susan tell you about Tom being in town?" Since the witness's answer will rely on an out-of-court statement that Susan made, if Susan is not available for cross-examination, and it is to prove the truth that Tom was in town, it is hearsay. A justification for the objection is that the person who made the statement is not in court and thus is insulated from cross-examination. Note, however, that if the attorney asking the same question is not trying to prove the truth of the assertion about Tom being in town but the fact that Susan said the specific words, it may be acceptable."

Why couldn't you go to court and offer your own personal firsthand account of what you have seen and heard? Of course you can. If you are talking about someone NOT in the court, it is more likely to come under hearsay. If they are in court for cross examination, then again, I don't think that is for sure hearsay.

This is one reason why I was saying, if the actual victims won't come to court and back up what they told you, it's generally pointless to report things.

 

[LucidSplash]

I thought we all learned the difference between criminal and civil penalties when OJ happened.

 

[ThoracicGuy]

I thought we all learned the difference between criminal and civil penalties when OJ happened.

Some people on SDN weren't alive when that trial happened...

I feel olde.

 

[Mass Effect]

I'm not an attorney, but I did look this up and I did literally have a conversation to this very effect with an attorney advising me when I literally went to court in July.

Say a PD rapes you. Say that you come to me and say "The PD raped me and it was terrible." If you are present in court, I can go on the witness stand and say, "Mass Effect said to me that the PD raped me and it was terrible on such and such date."

I am a first hand witness to what you told me, but not to the alleged PD behavior.

I think you're confusing things unnecessarily. We were talking about hallway GOSSIP. What you're describing isn't gossip. A victim telling her friend about a rape is different than a bunch of residents huddling together and discussing their PD's sex life where they egg each other on and who knows which version of the story belongs to whom. That's entirely different.

 

[Crayola227]

I think you're confusing things unnecessarily. We were talking about hallway GOSSIP. What you're describing isn't gossip. A victim telling her friend about a rape is different than a bunch of residents huddling together and discussing their PD's sex life where they egg each other on and who knows which version of the story belongs to whom. That's entirely different.

Yes, certainly we don't know what OP was witness to and the sources of info vs hallway gossip.

Where there's smoke, there's usually fire. Which isn't the end all. It's a reason to go see if there's indeed fire.

 

[pbdoctor1]

Reading OP's original statement especially about malignant PD program directors and residencies leading to physician suicide is disheartening. Physicians should be genuinely supporting future trainees as the world of medicine is long road and has a lot of challenges that needs better leadership.

There's an article on KevinMD titled "why do doctors their own so cruelly" that points out a culture of bullying and passive aggressiveness by a few physicians that is somehow bizarrely a standard of practice or normal. Recent discussions by AMA/ACGME on promoting resilience and wellness among, medical students, and residents is faulty since it is not striking at the heart of the issue which is to stop abusive behaviors especially from malignant medical residency programs. This culture of silence and stigma is disheartening.

One way to help may be more transparency to help guide medical applicants. Searching for access to a list of ACGME programs under probation if you google "ACGME probation status" provides some minimal guidance.

Hope this helps future colleagues and reduces physician burnout and suicides. Maybe more physicians will come forward to disclose these programs that may not be under this list before they quit, become fired, or blacklisted from residency programs.