But it doesn't do that. The posters who have lived with an unfair termination don't come forward; it's always those who claim they were unfairly terminated and then it turns out there were red flags up the wazoo. So yeah, residents may be blindsided, but that's due to their own lack of insight most of the time rather than lack of information about this stuff. Now a thread that names names so that we can do our research? That's ideal because MS4s know where not to apply. When those malignant programs have to SOAP year after year, it will hurt their credibility and hopefully, will lead them on a downward spiral toward shutting down.
Doesn't matter. It would still hurt the program's reputation until they're forced to make changes. For instance, if someone posts Podunk U surgery program is malignant and gives specifics that can be validated/verified, it will absolutely make some on the interview trail more cautious and more willing to ask the hard questions of the other residents during visits.
I don't know anything about NDAs, but if one is in place, doesn't that mean lawyers are already involved and there is, therefore, a paper trail of what the program's done wrong. I don't know of a single resident versus hospital case in which an NDA was issued (and that becomes known during settlement), but if you do, please let me know. A lot of times residents who didn't get in trouble contribute to these threads about their classmates. In that case, there are no NDAs. They're not going to NDA the entire program.
But that's exactly what we're NOT seeing. We're seeing people say "I didn't do anything wrong, everyone loved me, the patients adored me, I was the smartest doc in the building, and then one day, the PD woke up on the wrong side of the bed and fired me." How is that helpful?
Because there's no proof of people being unfairly targeted. If you look up legal cases in which a resident was fired, there are tons and tons and tons where the termination was considered just by the majority of us (and the court). Show me some where the resident's termination actually was due a problem with the program.
Only if the residents are being truthful and most are not, either due to lack of insight, or just plain not wanting to share the truth. Believe me, I can share stories during residency (one in particular that will make the hair curl) in which residents were devoid of insight and when they got in trouble, it became everyone else's fault.
[quote[As far as identifying programs, it's possible I would guess for someone to be at one of these programs, hear the scuttlebutt at the program, read SDN tales, and possibly figure out that they ended up at the same place. Or to PM some of the posters here to compare notes in their sleuthing.
PM who though? A throwaway account who comes here to offer the cryptic "malignant programs exist"? LOL, no one's going to PM that guy except the truly neurotic.
[/QUOTE]
This is the kind of thing I'm talking about. Yes, the PM'ing happens, I know it because I've been in those PMs. Clearly you were not. I just love how people on SDN claim that just because something hasn't happened to them, that it doesn't exist. I'm sorry if that sounds harsh, I usually find a lot of wisdom in your posts. I hinted that it happens, because I've been in those PMs. I hinted, because it's questionable if my saying that such PMs exist, is a TOS violation. However, even without referencing my experience, to me doesn't take away from the theoretical possibility that it is one way these threads can be useful. I felt comfortable saying as much. But as always, reasonable possibility is never seen as such on SDN, so I have to say the theory is proven.
Anyone listing Podunk University and then *on top* of that lists details like you suggest, is likely to be identifiable to those closest to the situation, should they come across it.
I had one attorney who specializes in employment law, warn me about employees with grievances against their employer posting anything on the internet. That even if it seems "anonymous" IP addresses and other things can be subpoenaed, that they had in fact seen this, and that information had in fact been pulled from sites *like* SDN (I'm not saying this has or has not happened with SDN). Social Security has been known to cruise people's Facebook and use photos there as evidence - another factoid from an attorney who dealt with that. Basically, do NOT underestimate the ability of what you post on the internet to destroy you in a legal case, no matter how innocuous or internet-anonymous it might seem.
Just as residents in trouble hit the webs and find themselves on SDN reading about termination, it would not surprise me in the least that those on the program side that find themselves dealing with this kind of drama, might also hit the web. I haven't heard directly but rather anecdotally, that programs do sometimes go looking on social media regarding people of interest. Given that these attorneys have mentioned these things to me, I also wouldn't be surprised if hospital legal risk management attorneys would know of this as a way to gather information in a case, and do so themselves. I was told as much by one attorney.
The one attorney did tell me that other attorneys representing employers with NDAs, have gone after people who have broken NDAs, even seemingly anonymously on the internet, even years later. Basically, if you have an NDA, don't think you can EVER go online and name that university or enough detail to identify them. There are PR people out there who make it their job to periodically look at what's online and manage it.
And I will point out, that even beyond one's relationship with their residency program, that programs can affect you after you have left them. Consider if you will, a few residents I knew personally and closely in real life. Both finished at the same time, one was in better standing than the other. Both needed and requested the exact same piece of paperwork at the exact same time. When we compared notes, it seems that one was done in a timely fashion within a few weeks, and anothers still hadn't been addressed months later, despite calls to remind them. Coincidence, or related to how to their standing with the program? This is not the only tale where it seems that a program finds a way to get back at residents long after they leave, as this sort of paperwork is involved in credentialing and new jobs. I was also privy to more such incidents, that were worse and clearly not questionable as to intent, but it's too identifying I fear.
So, I'm claiming that more details about malignant programs are shared behind the scenes by PM, and that some of those convos originate in otherwise anonymous but open threads, some like this very one.
I'm claiming that at least per one attorney's advice, given to my personal face, not to be surprised just from where employers gather info, and how, and that just about anything can be subpoenaed. Believe that or not, I guess.
Residency programs can find ways to hurt you even when you're done with them. Maybe it's not even malignant. Maybe the PC just subconsciously puts your paperwork to the bottom of their priorities.
I don't think some programs are "malignant" or full of bad people because of this kind of thing. People are human. Everyone, including program admin, can feel pushed to the wall.
As far as NDAs, actually, residents can be asked to sign them as a "routine" part of a forced resignation or termination. The only lawyers that have to be involved are the ones on the program's end that created the paperwork. And you best believe that when a resident is being forcibly pushed out, that there's a good chance hospital legal risk management is involved. There's a chance it hasn't been kicked up that far if the resident hasn't mentioned the things that will automatically get hospital attorneys involved. I can tell you that the minute the resident gets their own attorney involved, that most hospitals have a policy whereby the program admin is required to immediately notify legal risk management. However much of this can be kept silent forever and ever.
I want you to consider for a moment why you would not be aware of cases where an NDA exists. Seriously, consider. There doesn't have to be any filing or public legal proceedings for one to come into play. In fact, this is why organizations will push for them.
The only way I would know of someone else's NDA, is if one of the parties privy to it revealed there was an NDA. Most NDAs actually forbid mentioning that there is in fact an NDA in place, except in very few instances outlined by the NDA. It sort of undermines some of the very intent of an NDA if it doesn't have a clause whereby you can't even discuss its existence. You won't generally know that all info regarding something has dried up because of a NDA, because no one will tell you so. This isn't an accident.
It's possible that someone with an NDA mentions it to someone, and then that someone breaks their confidence. Any attorney will tell you not to tell anyone that you have an NDA, unless they are on the short list. Typically, you can tell a healthcare professional that is treating you about an NDA (I imagine being in such a situation someone might want to discuss how their NDA makes them feel in a MH setting), and you can tell an attorney that you have privilege with. For the obvious reasons you can discuss what is covered by an NDA with these exceptions, and also confidentiality in these situations means that the NDA still protects both parties that signed.
If I did have an NDA myself, part of the terms of the typical NDA would forbid me from even saying so.
There's a chance that fellow residents in a program might have some information to contribute. Any attorney worth their weight in salt is going to tell a resident in trouble to shut their mouth about ANYTHING taking place the moment they get representation. So no, many co-residents are going to be left in the dark about how things actually shake out. If there is an NDA at some point, I wouldn't necessarily expect them to know. Not to mention, unless there exists a relationship outside work, once someone stops showing up to work as a result of these proceedings, that also tends to put co-residents in the dark.
Despite all this about NDAs and attorney warnings, I imagine some residents are unable to contain themselves entirely, and take at least the risk of posting on SDN, anonymously, and trying to hopefully not be identifiable to a program, whether or not they have an NDA, but particularly if they do.
Programs seek NDAs precisely so a paper trail of what transpires between an employer and employee is never created in the first place, or if it is, will be sealed in some way. And to control the amount of info that is possible to leak to other employees or the internet.
The irony is that the cases where a resident has the best case, are the most likely to be silent and stay that way. This is because if the case has merit, the program will offer to do a bunch of things that a desperate resident losing a training slot, desperately needs to salvage their career, all for the sake of making things cheap and silent. Cheap and silent means that it never goes to court and the resident signs an NDA.
Yes, we've seen the cases that go to court where the publicity is bad for the program. But if you all find them so unsubstantiated and on further inspection don't seem to be too damning for the program, consider why that might be. Even good cases for discrimination are actually extremely difficult to prove, even when it's clearly what is taking place. But if the case is good, has merit, the resident has bargaining power, and the program will negotiate specifically to avoid it coming to light in court. Could the resident just choose to go to court? Even with a good case, it's not clear that the resident would end up with more of what they actually need to move forward.
The nature of training makes it such that a resident is often better off with a for-sure offer of a two-party NDA and a negotiated neutral-to-good LOR, and possibly some other things, than they are with any other thing that might come out of a court case, assuming you can even win. The former gives you a shot at another training slot. The latter, I don't see how that eases the path to board certification. Unless you win enough money to make never getting licensed/BC, pay back your loans, make up for lost income, or that none of this legal hoo-haw negatively impacts you pursuing those things with a different employer. We all know that training is a small world and constrained, and no one likes a litigious resident, even if the case was merited. We've discussed how being "reinstated" to a former position doesn't really help either.
So, if you are actually in a position to go to court and hurt a program, you are in a position to bargain for things that might help save your career. Going to court, even with a good case, not only is it not clear that you win, but even if you win, you still might not be in a better position regarding your career. On the other hand, if your case is not so clear, and it's marginal, and you can't get anything by bargaining and offering your silence to the program, then it would seem that the only chance of getting anything in that scenario, however low, is to go to court. We can argue how court in the situation of defensible termination might make things even worse for someone trying to move forward, but from a different perspective I can see why a resident might figure what the heck.
Let's not put faith in what the resident decides to do, settle or go to court. Because regardless, we can imagine someone not making a rational choice here, or getting bad legal advice.
What do YOU think a PROGRAM being advised by hospital legal risk management, does? When the resident has a good case, do you think the program is told to do what they can to settle and get silence, or do you think they can decide to go to court over the protests of legal risk management?
If a resident really wants to sue with a bad case, and they can't settle the bad case with the program (the program's attorneys won't settle it), sure, it can move forward because the resident wants to do that. But what do you think programs try to do with the cases they truly have to fear? I imagine in some cases they don't want to settle and give any merit to a case, and prefer to take their chances in court, and take the dings in PR and such just by having the case go there. But I argue far and away, when a program is going to lose in court or look really bad by not settling (moreso than by settling), then they settle. Getting a legal waiver and an NDA can be ridiculously easy.
I think where you see cases going to court, are the cases where the program doesn't feel they have to settle, and the resident isn't going to be able to get much of anything out of the program without going to court. That isn't to say they are going to be able to get anything out of the program by taking it to court. Sometimes a resident is SOL, and the only way they can put pressure on a program or get "revenge" is to go to court.
So, you have a good case that the program was wrong enough that they are going to have to settle with you in a way that lets you move forward. So all is right with the world now? They're saints and you want the students you mentor to match there? Hardly. At minimum, you don't want what happened to you, to happen to others. Here's the thing. I'm not even sure how program-specific these things are. We talk like it's evil PDs that make these things happen. I think the firing of a remediatible resident is multifactorial, and I fear that it is a combination of the way that medicine is practiced and taught, the way that training is structured, plus the other details that are hard to account for on SDN, like personalities, particular programs, residents, attendings, educational backgrounds, etc.
It would be nice if this thread had more hard facts, names, and less hints. It would be nice if there was better info on actual cases of unfair treatment of residents/former residents. The fact that less exists than I would like, well, I know why the silence exists, and I would tell you, the silence isn't because nothing is there.
The cases with merit are easy enough to silence. The cases that are ridiculous, move forward for a multitude of reasons. There is a bias. I expect this bias affects the types of cases we see reported to SDN, and how much detail accompanies them as well.
