List of Programs That Terminate Residents

[rokshana]

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What? I think you misunderstood what I was saying. I said most posters don't PM throwaway accounts with no post history for advice. You're not a throwaway account with no post history, so I'm unclear on why you inserted your experience with PMs into this.

And for the record, I currently have 11 messages in my PM (accumulated over the past 8-9 days), if we're going to compare for irrelevant purposes. Just saying.



Again, you misunderstood my point, so please don't insult me due to your misunderstanding.



No one said these threads can't be useful. The difference of opinion is in what makes them useful.



It shouldn't be a surprise to any adult who is competent at adulting that your relationship with your boss matters and that it can make a difference when it comes to requests being done when you want it done versus when it's convenient for them to get it done. It sucks, but it's the way the world works and does not distinguish malignant programs from non-malignant programs.



NDAs are made as part of settlements so I'm confused as to why a resident would be fired or forced to resign and also forced to sign an NDA upon termination unless some settlement was offered (LOR, etc). That would mean they can't talk to anyone to say they were fired and get advice? That's ridiculous. Now legally, it may make sense for the resident not to speak out until they go through the legal process and/or appeals, but signing an NDA upon forced termination from residency just doesn't sound realistic to me.

@aProgDirector have you heard of residents being given NDAs as a "routine part of a forced resignation"?



Yes, of course, and no one is disputing that. That actually makes sense and during the process, I agree that residents should keep their mouth shut.

I just couldn't read anymore, but my bottom line for those still reading is that I firmly believe there are some malignant programs out there that target residents and don't believe in due process if they don't like you. These programs are, by far, the minority and most residents who are terminated actually had deficiencies in either academics or professionalism, whether or not they know/acknowledge it.

I’m impressed you read that far...

 

[NotAProgDirector]

@aProgDirector have you heard of residents being given NDAs as a "routine part of a forced resignation"?

Somewhat. I'm assuming that by "forced resignation" you're talking about a situation where a resident is in trouble (academically or otherwise) and they a given a choice: resign and the program will not report the problem to new employers, or appeal the process and have a chance at continuing but then the program would be more honest with their assessment. Whether this is a "fair choice" or a "Hobson's choice" depends upon the details.

In any case, if a program agrees to minimize the problems displayed by the resident if they resign, the agreement might include that the resident also not denigrate the program's reputation -- else the resident might leave and publically blame the program for all the problems, and the program would not be able to defend itself. Oftentimes these agreements are not in writing, aren't a "legal NDA". Traditional NDA's usually involve a payment to someone to keep quiet. In this case, both parties agree to keep their disagreement private.

 

[Crayola227]

What? I think you misunderstood what I was saying. I said most posters don't PM throwaway accounts with no post history for advice. You're not a throwaway account with no post history, so I'm unclear on why you inserted your experience with PMs into this.

And for the record, I currently have 11 messages in my PM (accumulated over the past 8-9 days), if we're going to compare for irrelevant purposes. Just saying.



Again, you misunderstood my point, so please don't insult me due to your misunderstanding.



No one said these threads can't be useful. The difference of opinion is in what makes them useful.



It shouldn't be a surprise to any adult who is competent at adulting that your relationship with your boss matters and that it can make a difference when it comes to requests being done when you want it done versus when it's convenient for them to get it done. It sucks, but it's the way the world works and does not distinguish malignant programs from non-malignant programs.



NDAs are made as part of settlements so I'm confused as to why a resident would be fired or forced to resign and also forced to sign an NDA upon termination unless some settlement was offered (LOR, etc). That would mean they can't talk to anyone to say they were fired and get advice? That's ridiculous. Now legally, it may make sense for the resident not to speak out until they go through the legal process and/or appeals, but signing an NDA upon forced termination from residency just doesn't sound realistic to me.

@aProgDirector have you heard of residents being given NDAs as a "routine part of a forced resignation"?



Yes, of course, and no one is disputing that. That actually makes sense and during the process, I agree that residents should keep their mouth shut.

I just couldn't read anymore, but my bottom line for those still reading is that I firmly believe there are some malignant programs out there that target residents and don't believe in due process if they don't like you. These programs are, by far, the minority and most residents who are terminated actually had deficiencies in either academics or professionalism, whether or not they know/acknowledge it.

My point about PM'ing wasn't random PMs. It was the fact that vague hints in threads about programs, can lead to PMs where more detail about specific programs is shared. I've seen it go both ways, from throwaway accts to more established ones, or the other way. I wouldn't be surprised if newbie/throwaways messaged one another as well as those like myself.

The rest of my post was addressing why in some ways it will never be safe for a resident/former resident to out and out name a specific program or other identifying elements. We take this as some sort of sign it's made up or without merit, or say whatever else about it. A program can get back at you in a number of ways that I enumerated, from the mild (de-prioritzing paperwork essential to your career) to more serious (lawsuit, especially if an NDA is in place, even if it's on the internet). I mentioned real world examples I've been privy to, as well as the latter point being explained to me by two different attorneys.

I'm not saying that a boss being spiteful about your paperwork is proof of malignancy. I'm saying that, no matter how far one thinks they've gone from a malignant program, there is still some harm they can do to you, essentially meaning that one is never totally safe from their negative influence. This is one reason some residents, even without an NDA or pending legal case, might not ever come forward with a program name. I find this far from ridiculous on their part.

Lastly, I suggest that some of the cases that might represent the most egregious and accurate information about a program, likely steps were taken to seal them in some way.

Also, keep in mind that an NDA doesn't mean you can never list an employer as an employer or other ridiculous things like that. They give guidelines on what can or cannot be said about the term of employment, and they usually say you cannot reference the NDA directly.

I don't see why we need to argue this last point. Residents can be asked to sign an NDA when they are forced to resign. What do you mean by settlement? Do you think the settlement is in court, or out of court? Do you think it must include money? Do you think it must include concessions to the resident? Because the answer to all those things depends and there is no one answer. Some settlements are made in an attempt to keep a case from ever going to court, or after they go to court to get them to end sooner, this is even more likely if it looks to drag on, or there is a risk of losing, and losing would be worse than settling in some fashion. It does not have to include money or concessions to the resident, although it often does. Sometimes the only concession the resident will have in a forced resignation is merely that it is not a termination, and this might make them willing to sign an NDA.

I don't assert that every program every resignation includes an NDA. I'm saying that a contentious separation of resident from a program can include an NDA, and this could be a factor in what information about the situation is ever revealed to the likes of anyone like the rest of us.

It's fine if people think these threads are useless without more identifying details. I'm explaining how they might have utility for some anyway, and I'm explaining why a lack of detail might not represent a case without merit.

My personal theory is that the cases with the most merit, are the ones most likely to have been settled by the program in exchange for an NDA. In fact, what makes me the most hesitant about a resident story on SDN isn't the lack of details, but the presence of them. If the resident has a good case AND they are a rational individual, they likely have an attorney and are actually following their advice. Which means no SDN details, before an NDA is enacted, and if the case is good enough, there will be an NDA and then it will be sealed forever. It takes either a brave or foolhardy individual (depending on the details of the case) to take a program all the way to court.

 

[Mass Effect]

Somewhat. I'm assuming that by "forced resignation" you're talking about a situation where a resident is in trouble (academically or otherwise) and they a given a choice: resign and the program will not report the problem to new employers, or appeal the process and have a chance at continuing but then the program would be more honest with their assessment. Whether this is a "fair choice" or a "Hobson's choice" depends upon the details.

In any case, if a program agrees to minimize the problems displayed by the resident if they resign, the agreement might include that the resident also not denigrate the program's reputation -- else the resident might leave and publically blame the program for all the problems, and the program would not be able to defend itself. Oftentimes these agreements are not in writing, aren't a "legal NDA". Traditional NDA's usually involve a payment to someone to keep quiet. In this case, both parties agree to keep their disagreement private.

Thank you. That's exactly what I was asking. You're right about traditional NDAs. So what we have here, it sounds like, is a negotiation for the terms of the resignation.

 

[Crayola227]

Sometimes these agreements are in writing and are a legal document.. Money may or may not be included.

 

[MedicineZ0Z]

Residents should never ever be dismissed due to poor performance without being given a chance to at least repeat the year. Of course that should come after extensive remediation, and this should include a very specific plan that has objective parameters.
We set this high bar for physicians, yet let midlevels do the exact same job and they have less knowledge than the same residents who need to remediate. It's absurd.

 

[deleted480308]

Residents should never ever be dismissed due to poor performance without being given a chance to at least repeat the year. Of course that should come after extensive remediation, and this should include a very specific plan that has objective parameters.
We set this high bar for physicians, yet let midlevels do the exact same job and they have less knowledge than the same residents who need to remediate. It's absurd.

Midlevels do not do the same job and the state legislators are quite clear that “we” don’t set the midlevel bar

 

[MedicineZ0Z]

Midlevels do not do the same job and the state legislators are quite clear that “we” don’t set the midlevel bar

Uh huh... have you ever set foot in a hospital or clinic?

 

[deleted480308]

Uh huh... have you ever set foot in a hospital or clinic?

I am a doctor

 

[rokshana]

Uh huh... have you ever set foot in a hospital or clinic?

Have you ever had a referral for a mid level? ‘Nuf said.
Just because they are hired to do a similar job does not mean they are capable of doing the same job...as sb pointed out I’m a doctor.

 

[MedicineZ0Z]

Have you ever had a referral for a mid level? ‘Nuf said.
Just because they are hired to do a similar job does not mean they are capable of doing the same job...as sb pointed out I’m a doctor.

Patient gets referred to specialist. Guess who they see the first visit? A midlevel. With a lovely statement "Dr so n so available for consultation if needed" at the end of the note. The midlevel is literally doing everything, with 0 supervision. Not just follow up visits.

 

[deleted480308]

Patient gets referred to specialist. Guess who they see the first visit? A midlevel. With a lovely statement "Dr so n so available for consultation if needed" at the end of the note. The midlevel is literally doing everything, with 0 supervision. Not just follow up visits.

You have crap specialists. I promise you those midlevels aren’t giving the same level of care a doctor gives

 

[MedicineZ0Z]

You have crap specialists. I promise you those midlevels aren’t giving the same level of care a doctor gives

It happens everywhere. And of course they aren't.

 

[Mass Effect]

Residents should never ever be dismissed due to poor performance without being given a chance to at least repeat the year. Of course that should come after extensive remediation, and this should include a very specific plan that has objective parameters.
We set this high bar for physicians, yet let midlevels do the exact same job and they have less knowledge than the same residents who need to remediate. It's absurd.

Most residents who are dismissed aren't just dismissed for poor knowledge.

You have crap specialists. I promise you those midlevels aren’t giving the same level of care a doctor gives

The best midlevel I ever had was a derm PA and she was on par with the average physician in my experience and better than the worst physicians I met. That said, I have met and have had multiple midlevels care for me and she is the only one I would say was anywhere near a physician's capability, knowledge, or performance (at least in her specialty). The others I've encountered have been way worse.

 

[Raryn]

It happens everywhere. And of course they aren't.

Doesn't happen in my practice.

 

[deleted480308]

Most residents who are dismissed aren't just dismissed for poor knowledge.



The best midlevel I ever had was a derm PA and she was on par with the average physician in my experience and better than the worst physicians I met. That said, I have met and have had multiple midlevels care for me and she is the only one I would say was anywhere near a physician's capability, knowledge, or performance (at least in her specialty). The others I've encountered have been way worse.

Anecdotes aside, there just isn’t much overlap on that ven diagram.

Of course nfl quarterbacks are better throwers than the rest of us, but uncle rico could throw a pass over that mountain. If coach had only put him in, we’d be state champs. I just know it

 

[deleted480308]

It happens everywhere. And of course they aren't.

It doesn’t happen everywhere, I’ll repeat that your specialists are crap

 

[VA Hopeful Dr]

It doesn’t happen everywhere, I’ll repeat that your specialists are crap

Yep. The first time an initial consult visit is with a mid-level will be the last time I refer to that person.

 

[NotAProgDirector]

Residents should never ever be dismissed due to poor performance without being given a chance to at least repeat the year. Of course that should come after extensive remediation, and this should include a very specific plan that has objective parameters.
We set this high bar for physicians, yet let midlevels do the exact same job and they have less knowledge than the same residents who need to remediate. It's absurd.

I'm going to disagree slightly. If we have a resident who reaches the end of their PGY-1 and isn't ready for PGY-2, we usually give them 6 months. If they aren't making clear progress after 6 months, there's not much point to continuing and all we're doing is using up their medicare funding. If they are making progress at the 6 month mark and we think they will be ready for PGY-2 work by 12 months, then we would continue them. So I think the decision is more nuanced.

Patient gets referred to specialist. Guess who they see the first visit? A midlevel. With a lovely statement "Dr so n so available for consultation if needed" at the end of the note. The midlevel is literally doing everything, with 0 supervision. Not just follow up visits.

It can work, in the right situation. If you refer a patient to our Urology group for Lower Urinary Tract Symptoms (i.e. BPH symptoms in a male), they are seen by an NP first. Much of the evaluation and workup is completely protocolized. They can check the appropriate labs, order any imaging, and teach the patient how to self cath if necessary. They get in quickly and get the treatment they need. The key is triage -- if I send a patient to them with a positive urine cytology, they get seen by a doc right up front for a cysto. They look at all consults and decide which need to be seen by NP's and which by MD/DO's.

Same in our Endo group. Send a 67 yo with Type 2 DM and an A1c of 9.8 who needs "tuning up", they get seen by one of our NP's who does only diabetes management. She's great at what she does. Send a 19yo with Type 1 DM who might consider going on a pump, and they get seen by the MD/DO.

 

[IlDestriero]

We set this high bar for physicians, yet let midlevels do the exact same job and they have less knowledge than the same residents who need to remediate. It's absurd.

As noted, midlevels don’t do the exact same job. Just because they are held to lower standards for education, licensure, etc. than we are doesn’t mean that we as physicians have to lower our standards at all. I’m not training CRNAs, I’m training Pediatric Anesthesiologists. If you don’t have what it takes (judgement, critical thinking under extreme pressure, procedural, etc.) than you don’t get to graduate and call yourself a fellowship trained Pediatric Anesthesiologist.

 

[MedicineZ0Z]

As noted, midlevels don’t do the exact same job. Just because they are held to lower standards for education, licensure, etc. than we are doesn’t mean that we as physicians have to lower our standards at all. I’m not training CRNAs, I’m training Pediatric Anesthesiologists. If you don’t have what it takes (judgement, critical thinking under extreme pressure, procedural, etc.) than you don’t get to graduate and call yourself a fellowship trained Pediatric Anesthesiologist.

I'm making more of a general point. Anesthesiologists train CRNAs who then go out into rural areas and practice solo with 0 supervision. You have to admit there's something wrong with that. It's like residents who have more supervision than midlevels with low to moderate experience.

 

[deleted480308]

Yep. The first time an initial consult visit is with a mid-level will be the last time I refer to that person.

I recently fired our pediatrican when they wouldn’t guarantee the kids could be scheduled with a doctor instead of NP

 

[IlDestriero]

I'm making more of a general point. Anesthesiologists train CRNAs who then go out into rural areas and practice solo with 0 supervision. You have to admit there's something wrong with that. It's like residents who have more supervision than midlevels with low to moderate experience.

I’m not responsible for what the CRNA programs consider adequate training. Nor am I responsible for what rural surgeons and administration considers an adequate anesthesia provider. I wouldn’t accept a solo CRNA for my care or that of my family, but I also don’t live in a rural wasteland with a microscopic regional “hospital”.

I am responsible for the residents and fellows that come through my hospital. If they can’t meet minimum standards than they can’t graduate. We’ve remediated people. We’ve also not recommended people for jobs at major hospitals managing the most complex patients. Very appropriate. I wouldn’t recommend any of our SRNAs or CRNAs for a solo practice position either because they’ve never been utilized in that way, evaluated for that role, or trained by us to function independently.

 

[Crayola227]

I've been constrained by both who is covered on my health insurance, and who takes my insurance, to have to have NPs and PAs for a lot of my care. Some of the time even they agreed it was probably inappropriate that they be responsible for my care... but someone has to write the refills, and someone is better than no one, I guess. They pledged to reach out to the supervising doc. I find myself having to oversee a lot of what they do.

The midlevel problem is real. Not sure why the docs in this thread have such a hard-on for declaring it's not. Great, you who are doctors, are seeing patients, and some of you haven't had to resort to midlevels on your staff or for your personal care. That doesn't mean it's a non-issue for some patients.

 

[Goro]

No mean feat for Z to hijack a ten page thread on residencies and turn it to his obsession with midlevels. That takes some talent.

 

[lemonsieur89]

Moses Cone Hospital- Internal Medicine - 2016, and 2019

Kennerly v. Moses H. Cone Memorial Hospital - The Graduate Medical Education Compliance Project (GMECP)

On brief review, Solianny Kennerly was an internal medicine resident from 2013 to 2016, in North Carolina. Her petition provides a long list of discriminatory infractions related to race, gender, and pregnancy. There are issues of what seem to be…

gmecomplianceproject.org

What the case describes is pretty interesting, and shocking that harrassment occurs even now by some program directors, and that there truly are malicious programs. It is unfortunate that this resident had to go through this.

 

[Mass Effect]

Moses Cone Hospital- Internal Medicine - 2016, and 2019

Kennerly v. Moses H. Cone Memorial Hospital - The Graduate Medical Education Compliance Project (GMECP)

On brief review, Solianny Kennerly was an internal medicine resident from 2013 to 2016, in North Carolina. Her petition provides a long list of discriminatory infractions related to race, gender, and pregnancy. There are issues of what seem to be…

gmecomplianceproject.org

What the case describes is pretty interesting, and shocking that harrassment occurs even now by some program directors, and that there truly are malicious programs. It is unfortunate that this resident had to go through this.

This is certainly interesting, but I'd love to hear the other side. This person is claiming the program director, senior residents, multiple attendings (including her mentor), her peers, AND junior residents (5 interns?) all conspired against her with false evaluations. That's crazy. In all of those people, not one person was a decent human being who had the guts to say "wait, why are we witch-hunting one of our own?" Nah, logically speaking, there's likely more to it than that and until we read the other side, we have no idea what the real story is.

Also interesting how every attending who said she lacked medical knowledge is "inexperienced" and every other attending is so incompetent at doing their jobs that she constantly had to correct them, inviting retaliation. Yeah, definitely need the other side.

 

[BoardingDoc]

Moses Cone Hospital- Internal Medicine - 2016, and 2019

Kennerly v. Moses H. Cone Memorial Hospital - The Graduate Medical Education Compliance Project (GMECP)

On brief review, Solianny Kennerly was an internal medicine resident from 2013 to 2016, in North Carolina. Her petition provides a long list of discriminatory infractions related to race, gender, and pregnancy. There are issues of what seem to be…

gmecomplianceproject.org

What the case describes is pretty interesting, and shocking that harrassment occurs even now by some program directors, and that there truly are malicious programs. It is unfortunate that this resident had to go through this.

Case was dropped by the plaintiff.

 

[Mass Effect]

Case was dropped by the plaintiff.

Probably because she graduated, which goes to show it's exceedingly difficult to terminate a resident.

 

[Raryn]

My favorite line is "Dr [Attending] stated Dr. [Resident] was being defensive, though she was always right, and did not accept feedback"

No one except my wife is always right.

 

[Crayola227]

Or as I've said, possibly some buy out.

Cases get dropped for a lot of reasons.

 

[lemonsieur89]

This is certainly interesting, but I'd love to hear the other side. This person is claiming the program director, senior residents, multiple attendings (including her mentor), her peers, AND junior residents (5 interns?) all conspired against her with false evaluations. That's crazy. In all of those people, not one person was a decent human being who had the guts to say "wait, why are we witch-hunting one of our own?" Nah, logically speaking, there's likely more to it than that and until we read the other side, we have no idea what the real story is.

Also interesting how every attending who said she lacked medical knowledge is "inexperienced" and every other attending is so incompetent at doing their jobs that she constantly had to correct them, inviting retaliation. Yeah, definitely need the other side.

I think it is entirely possible, particularly if it is a small program, and if the program director controls other faculties who may be young. If a program director wants someone out, the faculty are not going to come in the way and would simply just do what the PD tells them to do. A search reveals that this person has been a licensed physician for several years and board certified and so has been practicing 'safely', and would have been wrongfully terminated, which thankfully she was not , as it seems. I think the case may have been dropped as she was about to graduate and she may have filed the case to 'buy time', as once you file a case, then any action that a program takes would be seen as retaliation, and so she probably withdrew it once it came to graduation-looking at the dates when filed and dates when withdrawn. Or the program may have been getting ready to 'counter-sue' and she wanted to avoid that, as once the case is withdrawn, the program can't respond to the case legally in writing.

Apparently, there has been quite some history in this particular program: Greensboro doctor accused of soliciting teen for sex in Fayetteville :: WRAL.com

Regardless.. very interesting program this is given everything that has happened... lol. thoughts?

 

[Mass Effect]

I think it is entirely possible, particularly if it is a small program, and if the program director controls other faculties who may be young. If a program director wants someone out, the faculty are not going to come in the way and would simply just do what the PD tells them to do

This is not always true and I speak from experience. I've seen this happen and faculty does come forward and go to bat for the person being wrongly targeted. Most times, however, the person being disciplined is being disciplined for legitimate reasons and that's why faculty doesn't get involved or if they do, they add to the number of complaints.

A search reveals that this person has been a licensed physician for several years and board certified and so has been practicing 'safely'

I have no idea if this person is a good, safe physician or not and neither do you (unless you know her). There are a lot of licensed and board-certified physicians whose questionable practices never come to light or come to light years later. Look up FBI raides involving physicians if you want proof of that or do a search on general malpractice cases to see crazy stories of what licensed and board-certified physicians sometimes do. That's not to say that doctors can't make mistakes and learn from them. I certainly have. But the bar of a good, safe physician isn't being licensed or board-certified, sadly. One thing you can say is that the fact that she's board-certified shows the lack of medical knowledge cited in the documents either improved or was an unfair accusation.

and would have been wrongfully terminated, which thankfully she was not

Again, board certification and licensure doesn't tell me this. If this person was as argumentative as they say, if she did pass off all work to those she was supervising (interns), if she demonstrated unprofessional behavior, if she was not able to take feedback, if she did not follow the recommendation of her attendings, if she did have this attitude of always being right and never listening to anyone, then no, I don't agree it would have been a wrongful termination. I would have tried to remediate her on the basis of all those things first, but termination wouldn't have been unreasonable for someone with this many problems and complaints from everyone, from attendings to senior residents to interns. Actual, legit witch hunts where everyone is wrong/conspiring are extremely rare to the point that they almost never, if ever, happen.

More likely, this person did at least most of the things people complained about and some of them on their own would be enough to raise major red flags from the program director and set off this chain of events. Program directors have a duty to protect the public from someone who can't be taught and can't weigh other options, whether it's due to lack of medical knowledge or a personality structure that prevents the ability to see anyone else's point of view but her own. It's just not good for patient care.

 

[AlmostAnMD]

Too many posts to read, maybe someone said something similar, but thought I'd drop my two cents as an attending as well as an ex-chief resident

It's not a bad thing to fire residents. My program refused to do it. We had a couple I begged our PD to fire. They were incompetent and contributed nothing positive to the program. They drag the overall morale of the group down by simply being allowed to continue working. Instead they just get "talked to."

It's not a bad thing to fire residents. Maybe in some cases, but I argue it's even worse to keep crap ones around. Made my chief year hell.

 

[ace_inhibitor111]

Too many posts to read, maybe someone said something similar, but thought I'd drop my two cents as an attending as well as an ex-chief resident

It's not a bad thing to fire residents. My program refused to do it. We had a couple I begged our PD to fire. They were incompetent and contributed nothing positive to the program. They drag the overall morale of the group down by simply being allowed to continue working. Instead they just get "talked to."

It's not a bad thing to fire residents. Maybe in some cases, but I argue it's even worse to keep crap ones around. Made my chief year hell.

I’m sure if you fired everyone who wasn’t in the Top 50% of performance it would’ve made your Chief year paradise. That doesn’t mean these people who have been through the ringer that is medical education and accrued hundreds of thousands of $$ in debt should have their careers ended because it makes one year of your life easier.

 

[PTPoeny]

I’m sure if you fired everyone who wasn’t in the Top 50% of performance it would’ve made your Chief year paradise. That doesn’t mean these people who have been through the ringer that is medical education and accrued hundreds of thousands of $$ in debt should have their careers ended because it makes one year of your life easier.

No, some residents need to be fired. I know this is an unpopular opinion, but I firmly believe some residents need to be fired. We had a prelim who managed to "get a flat tire" or "hit a deer" on Friday or Monday every single time he had both Saturday and Sunday off so he would have a three day weekend. Everyone else ended up doing more work with no notice. He also frequently couldn't be found during the day and didn't answer pages so the nurses stopped paging him and just paged the upper.

Maybe there was something crazy going on with his family that needed extra time, but I was at an awesome residency and people would have helped if he had said something. He could at least have gone through FMLA and gotten days off scheduled of ahead of time so we weren't left scrambling after someone should have already been there. Repeatedly calling in at the last minute is wrong.

He got fired just a few months into his advanced program because he pulled the same stuff there. He was plenty smart when he could be bothered to do his work, he just didn't usually bother.

 

[Mass Effect]

I’m sure if you fired everyone who wasn’t in the Top 50% of performance it would’ve made your Chief year paradise. That doesn’t mean these people who have been through the ringer that is medical education and accrued hundreds of thousands of $$ in debt should have their careers ended because it makes one year of your life easier.

That isn't at all what that poster said. Of course not everyone will be in the top 50% performance wise. Of course someone will be in the bottom 10%. But whether you're in the top 50% or the bottom 10%, it's no excuse for poor behavior, taking advantage of sick days, pushing off work to others, bullying others, intimidating others, or just plain being an ass. Most terminations at the resident level are due to unprofessionalism OR incompetence plus lack of insight/inability to correct the problems. It's rarely due strictly to performance.

Speaking as someone who also had an atrocious chief year, I agree with that poster. Until you've seen THAT resident, you'll have no idea what we're talking about.

 

[ace_inhibitor111]

@PTPoeny
@Mass Effect

^^What you are both describing are residents who refuse to work. What the original post describes are residents who continue to work, but are in his opinion incompetent. Aka “They were incompetent and contributed nothing positive to the program.”

Sounds more like they annoyed him and didn’t do things the way he wanted so deserved the boot. Way different story from not showing up and pushing work on others.

 

[Goro]

@PTPoeny
@Mass Effect

^^What you are both describing are residents who refuse to work. What the original post describes are residents who continue to work, but are in his opinion incompetent. Aka “They were incompetent and contributed nothing positive to the program.”

Sounds more like they annoyed him and didn’t do things the way he wanted so deserved the boot. Way different story from not showing up and pushing work on others.

No, it sounds like they were incompetent.

Being unteachable is another reason residents get fired, BTW.

 

[NotAProgDirector]

Answering posts like this, my first step is to look at your post history. Usually, there is more to the story and sometimes a review of past posts helps clarify the picture.

Your post history is bizarre. Today you have posted this diatribe above. Then:

Position Wanted - Immediate start for PGY 1 in Florida or Georgia any specialty needed ASAP please let me know if something Is available. I’m fm/em but not picky! - your program is closing and you need a new spot.

Position Wanted - PGY2 FM with rich OB experiences -- you're at a "super friendly" FM program looking to trade.

Position Wanted - PGY 1 FM resident in west palm beach FL needing to get back closer to North Florida Jacksonville/ gainesville/ southGeorgia area d/t family emergency - great FM program, just looking for something closer to home.

Given the post above, there are lots of terms we could use for your program, but "super friendly" doesn't seem appropriate. Trying to trade with someone into a program that's closing is, well, horrible. Or you're being dishonest with us, or yourself. We can't help you.

 

[Raryn]

Hi there,
I read your post And it really resonated with me and I could actually really use some advice from you and I was wondering if you could help me/give me a bit of direction on my next move because I have just found myself in this situation of losing my job unexpectedly. Forgive me for the length but I want you to know the facts so you can give your best opinion.. first background on me to show you who I am as a person.. I graduated with honors from Baylor, I was an athlete all the way through, went on to get a masters of science Degree again with honors and publish three journals as first author as well as complete medical school, got a full scholarship for it with the army. I was a medic for 6 years now I’m a captain and a provider flight surgeon for the Army. I had to take a year off during medical school when I got very sick and had two surgeries but recovered and got right back to it, interviewed and joined in the match. Now I’m very use To hard work and challenges and dealing with all kinds of people and teamwork and grueling hours. I honors passed most of my clinical rotations and I usually go far and above because I do genuinely love medicine and patients it shines very easily as a ton of LOR can attest to. I’m extremely responsible, disciplined, I have integrity and honor. Anyone who knows me well would say that no hesitation. I matched into an FM program and everything was great, I did have to learn to balance family kids and work life but I made it happen. However, life hit This past November my mom got diagnosed with a serious cancer totally out of the blue and underwent surgery quickly and now going through chemo. But a week after her diagnosis my engagement to my man of 5 years was called off we separated and I had raised his kids as if they were mine for 4 of those years so I lost them too and we had to split assets and move out etc. Needless to say I was stressed and tearful trying to do my best on an inpatient Internal Medicine rotation. I admit I struggled and was emotional . Tried to hide it but nurses started asking my bosses what was wrong with me etc and the two seniors on the rotation with me would say horrible jokes about my mom That she was going to pass away to get over it just like patients die every day which upset me. and if I forgot to say something correctly while presenting a case on rounds they would yell and embarrass me in the hall in front of the whole team to where a patient complained. I took full responsibility that I was distracted and not at full capacity but I never endangered a patient I’ve never killed a patient I’ve never made a major medical error to compromise them. They did the same to the other female intern as well among many more things but they ended up having to go to HR and got written up etc but because of all of that happening in a 3 week span of time I was struggling, often sad and had trouble being early From trouble sleeping, I was usually 5-10 min late from cleaning my face off in the bathroom too. long story short I did start standing up to them which then caused my chief to get involved and then my program director got wind of these events and said she wanted me to take some time off and use my pto to have time to heal and process these life events that took place because she didn’t think I was safe to handle my patients in such a state. Which at the time I thought it was completely supportive, And I have great insight And didn’t want it to ever get to a point where I would hurt a patient so I definitely agreed I knew I needed a minute to adjust to things and a few weeks to see my mom also pack and move to an new place would all be good. I did go through counseling as well to process grief reaction That was life changing and helpful .. however upon Trying to return I tried after 2 weeks and my PD said no and then I tried after 3 weeks and then she informed me that a committee had put me on fmla my pto was gone and she told me I would require a clinical sign off from a clinical professional before I could return which wasn’t disclosed to me in the beginning or I would have promptly taken care of that. I did jump on it and get the ok to return, and they said I couldn’t be late Ever or have any mess up in performance on rounds because November wasn’t my best performance I’d be watched closely. I agreed and understood so I made a point to be 1 hour early everyday and each day improved on things I had been weak on during my grief month trying to get back into the groove of the routine to prove to myself I was strong and overcoming struggle and to show them too but it had felt as though the upper class residents didn’t trust me at all anymore and doubted me whereas they hadn’t before. They picked apart every single move I made with negativity rather than positive reinforcement or encouragement and truthfully I did begin to feel singled out but just blew it off and did my job. prior to November I was good friends with these co residents, my evaluations and milestones were far above average for performance and knowledge base... I had no issues. Well they had a meeting with me this Past Tuesday which was me at one end of a table and 8 of the residents I’d been on this service with and one by one they went down the line stating harsh judgements. I sat quietly listened didn’t argue and then apologized where I needed to own up to something like for forgetting to update the patient list we keep with general info for everyone and then I stood up for myself on two things I had documentation to back me up and two Attendings backed me up as well.. but they felt as though that was me disrespecting their position and let me have it after the bosses left. They said that day that I would be put on a remediation proactive plan and as long as I showed I was following it and back to normal I was good. So I continued to show up early carry my weight know my patients inside and out as before but today out of the blue my PD pulls me out of rounds and said she had to let me go from the program today, I’m an FM PGY1/ intern.. so I’ve just been in since July. or rather the language said they were choosing to separate with me from the program. I was given nothing to sign or any explanation as to what that meant for me long term my future how it would affect my ability to obtain another job and they didn’t give me anything explaining why they made that decision after they said the plan was a remediation action plan to get back to where I was prior to november. Nothing was given in writing that explained their reasonings for forcing me out or what I did that caused my contract to break. They said they would give me glowing letters of recommendation and state all the positives but that The fit didn’t work anymore. So now after complete shock I’m trying to research how and what I’m suppose to do to secure another PGY1 spot half way through and I’m not sure what wording to use to inquire about openings and what to say for why I’m no longer with my other program. Now that program is only AOA and didn’t get full accreditation and I wonder if that played a part but I don’t know. Anyway, you mentioned you worked with ERAS and people in my position and they found successful placement elsewhere. Could you tell me how I should go about this what my best chances of securing a spot would be? Do I go through eras or just go through scramble or do I just cold call every program In the country to inquire about an opening and what do you suggest my explanation be as to why I left or am wanting to transfer? Please I beg of you any advice you can provide to help me develop a plan to tackle this would mean so much to me. I just want to get back to work and do a great job and have people see my actual potential now that all that is behind me. I know I will succeed I just don’t know how to go about this process ... again I’m sorry it’s so long I’m just really desperate and hoping you’re just the person to help me with this. Thank you so much for everything you can offer!

Holy wall of text batman.

 

[deleted480308]

Answering posts like this, my first step is to look at your post history. Usually, there is more to the story and sometimes a review of past posts helps clarify the picture.

Your post history is bizarre. Today you have posted this diatribe above. Then:

Position Wanted - Immediate start for PGY 1 in Florida or Georgia any specialty needed ASAP please let me know if something Is available. I’m fm/em but not picky! - your program is closing and you need a new spot.

Position Wanted - PGY2 FM with rich OB experiences -- you're at a "super friendly" FM program looking to trade.

Position Wanted - PGY 1 FM resident in west palm beach FL needing to get back closer to North Florida Jacksonville/ gainesville/ southGeorgia area d/t family emergency - great FM program, just looking for something closer to home.

Given the post above, there are lots of terms we could use for your program, but "super friendly" doesn't seem appropriate. Trying to trade with someone into a program that's closing is, well, horrible. Or you're being dishonest with us, or yourself. We can't help you.

Sounds like someone doesn’t have the integrity they claim

 

[LucidSplash]

Answering posts like this, my first step is to look at your post history. Usually, there is more to the story and sometimes a review of past posts helps clarify the picture.

Your post history is bizarre. Today you have posted this diatribe above. Then:

Position Wanted - Immediate start for PGY 1 in Florida or Georgia any specialty needed ASAP please let me know if something Is available. I’m fm/em but not picky! - your program is closing and you need a new spot.

Position Wanted - PGY2 FM with rich OB experiences -- you're at a "super friendly" FM program looking to trade.

Position Wanted - PGY 1 FM resident in west palm beach FL needing to get back closer to North Florida Jacksonville/ gainesville/ southGeorgia area d/t family emergency - great FM program, just looking for something closer to home.

Given the post above, there are lots of terms we could use for your program, but "super friendly" doesn't seem appropriate. Trying to trade with someone into a program that's closing is, well, horrible. Or you're being dishonest with us, or yourself. We can't help you.

It’s like people do not understand basic functions of an Internet forum like the search function.

 

[hallowmann]

Sounds like someone doesn’t have the integrity they claim

Within 2 hrs they claim they are at a very supportive program and then claim that its "really malignant". I think I know

Hey, I’m at a super friendly FM program that fits what you’re looking for in west palm and trying to get closer to Jacksonville .. Georgia would be closer if you’re interested in trading? Where is your program?

Hi there,

I am trying to transfer into another program myself in the same specialty because my current program is not only very malignant but is now not taking new interns and losing its academic stance.. I’m brand new to trying to figure out how to do this transfer thing and I was worried I would be treated differently as well.. can you help me with first just how do I go about getting that process started? how did you find the new program and what was your general statement for telling them you wanted to transfer in? I don’t want to say anything bad about my current program and there’s no bad blood i just wasn’t sure how people go about saying they’d like to transfer and how to find the program and apply? Any advice you have would be awesome .. I’m an intern so I feel like this is the time to kind of get this started right?

The only west palm beach AOA program I found is run by HCA, so I suspect OP's description as very malignant is accurate. I will say that some malignant programs do tend to attract a certain personality type.

For people reading this in the future, I would probably avoid an HCA sponsored residency

 

[Helpful Troll]

... I graduated with honors from Baylor, I was an athlete all the way through, went on to get a masters of science Degree again with honors and publish three journals as first author as well as complete medical school, got a full scholarship for it with the army. I was a medic for 6 years now I’m a captain and a provider flight surgeon for the Army. ...

If you ever served as a flight surgeon for the Army you have an unrestricted medical license in a US State likely having completed at least intern year. What is your Med School YOG? 2013?

 

[Gastrapathy]

If you ever served as a flight surgeon for the Army you have an unrestricted medical license in a US State likely having completed at least intern year. What is your Med School YOG? 2013?

Yeah I caught that too. But the terminology “provider flight surgeon” made me just move on

 

[Swampurt]

1. Trios Health - Kennewick, WA - PGY1 and PGY3 residents in the same year.