Malignant Psychiatry Residency Programs

[Shikima]

“Some” psych residents.

I didn't do psych as my internship.

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[Shikima]

This fits my formulation of malignant. The tolerance of professional individuation.

There can be no doubt that the whole of medicine is extremely hierarchical.

But how you self-formulate within these steep, vertical structures is also just as important. Whether you see yourself as a victim or being bullied is also important. I found increased degrees of internal freedom by trying to understand machiavellian principles as operational software. Thinking of it, like... Human Beings socialize like this... Which removes the egocentric burden. And allows one to ... as Skikima says... negotiate personal boundaries.

And this is from someone who had to adopt this philosophy or I would end up a taxidermic specimen on the wall of an authoritarian overseer.

In short. Medicine is...at it's core... malignant towards the individual aspirant, plebe, initiate, squire, novice, and apprentice.

Programs just vary by workload and degree of mentorship and educational opportunities.

The potential for tyranny is very much the territory of relational dynamics with a PD or attending.

And you could find yourself in a malignant situation at any program.

You can also find yourself in a malignant workplace once you leave.

 

[wannabie]

You can also find yourself in a malignant workplace once you leave.

This is true!

 

[Psychotic]

You can also find yourself in a malignant workplace once you leave.

Counting the months, if not the days, until residency is over and done for me this June...

I am not in a malignant program as most would define such, but I am sick of this place, the "academics" and all that crap. I fear finding myself in a malignant workplace, and it has crippled my job search. Anybody else in this boat?

 

[Shikima]

Counting the months, if not the days, until residency is over and done for me this June...

I am not in a malignant program as most would define such, but I am sick of this place, the "academics" and all that crap. I fear finding myself in a malignant workplace, and it has crippled my job search. Anybody else in this boat?

Go into any job with eyes wide open. You'll learn where to go and not go.

 

[randomdoc1]

I've totally revised my perspective since piping in on this thread. A much more common problem is personality disordered residents who shouldn't be physicians but who will graduate residency.

Such that. Whatever you might hear on the media about an oppressed resident. think again. it's likely they're the problem.

For a program to slide into malignant, slave driving, work camps, takes a lot. And even then. That's probably just because they're functioning like a lot of the industrial psych jobs out there. And the residents are just getting used as rx'ing cogs more than it is a personally threatening problem of a PD with a PD.

There are some good points. However, I have to respectfully put in my two cents too. My program in ob/gyn was very unpleasant. I can't speak for psychiatry, but the psychiatry program I completed was good. I agree that the surgical specialties can especially be brutal but there are for sure some problematic programs. I was in New York. Nurses are unionized and everything is so pro nurses it is not even funny. For example, Invanz was regularly utilized first line for so many things just because of the easier dosing and nurses threw a fit when asked to use more targeted antibiotics for infections like endometritis (because of multiple daily dosings at the time). No surprise, the hospital I was at had the worst outbreaks of treatment resistant c diff I had ever seen and unfortunately fatalities. We had limited computers but heaven forbid we politely ask to use one if a nurse was already on it to browse facebook. Work hours are commonly exceeded in New York. One ex resident (he jumped ship, found a better program) said they had residents fill out their surveys to the ACGME before the program director and were threatened to be fired if they were honest. I believe the residents even did a strike once at Bronx Lebanon?

 

[Merovinge]

There are some good points. However, I have to respectfully put in my two cents too. My program in ob/gyn was very unpleasant. I can't speak for psychiatry, but the psychiatry program I completed was good. I agree that the surgical specialties can especially be brutal but there are for sure some problematic programs. I was in New York. Nurses are unionized and everything is so pro nurses it is not even funny. For example, Invanz was regularly utilized first line for so many things just because of the easier dosing and nurses threw a fit when asked to use more targeted antibiotics for infections like endometritis (because of multiple daily dosings at the time). No surprise, the hospital I was at had the worst outbreaks of treatment resistant c diff I had ever seen and unfortunately fatalities. We had limited computers but heaven forbid we politely ask to use one if a nurse was already on it to browse facebook. Work hours are commonly exceeded in New York. One ex resident (he jumped ship, found a better program) said they had residents fill out their surveys to the ACGME before the program director and were threatened to be fired if they were honest. I believe the residents even did a strike once at Bronx Lebanon?

I've witnessed worse than that as a med student in Ob-gyn. It would be completely absurd to argue that no places in medicine have abusive programs. I think it is fair to say the number in psychiatry is likely significantly lower than other fields.

 

[SeniorWrangler]

As an attending, I am a bit chilled at seeing complaints being chalked up to personality disordered residents who should never have become doctors...
As the old saying goes, if one person says you're a horse, they're nuts; if three people tell you you're a horse, go shopping for a saddle.

 

[MacDonaldTriad]

I'm sure Merovinge is right, but that doesn't console a psychiatry resident who believes he/she is trapped in an abusive program. So much of this is about cognitions.

 

[notdeadyet]

Interesting thread.

I do wonder how much of the view of both “malignant programs” and “malignant residents” is a problem of our own creation.

We treat medical students as some form of elevated undergrad and this trend continues into residency. You can’t coddle someone like a college student and then ding them for not behaving like a doctor.

Based on the reaction I get from colleagues, I realize I’m in the minority on this. But I personally get better results from residents (in terms of their performance and what they get from the experience) when I treat them as professionals and expect them to perform the same. There is a bit of culture shock and boundary pushing at first, but when you make the expectations explicit (and come down firmly on violations), I find that residents rise to the occasion and we have a good and collaborative learning and treatment environment because of it.

I realize that this may not be generalizable and depends on the type of residents a program attracts. But I feel pretty strongly that we need to do better job of transitioning folks from college student to medical student to resident physician.

 

[MacDonaldTriad]

I'm afraid we are running in the opposite direction over the last decade. With centralized didactics, longitudinal continuity clinics, and so many other things that take MS3 and MS4 students from their clinical assignments, it is almost impossible to give them any real responsibility for patient care. They have become tagalong observers. We have to assign a resident or intern to all of there cases because medical students are gone half of the time. The more infantilized they become, the more sub-I like the I(s) become and the more "I" like the PGY-IIs become. I know I sound like a curmudgeon, but medical students are youthful and the most capable of tolerating overnights. Why are they the most protected from this? Real learning requires work and exposure. There is no substitute. There are quality augmentations, but at the end of the day, trained physicians have to take care of patients to be good at what they do.

Now I will go take my Geritol and pull my waist belt up to my xiphoid process and shut up.

 

[WingedOx]

I'm afraid we are running in the opposite direction over the last decade. With centralized didactics, longitudinal continuity clinics, and so many other things that take MS3 and MS4 students from their clinical assignments, it is almost impossible to give them any real responsibility for patient care. They have become tagalong observers. We have to assign a resident or intern to all of there cases because medical students are gone half of the time. The more infantilized they become, the more sub-I like the I(s) become and the more "I" like the PGY-IIs become. I know I sound like a curmudgeon, but medical students are youthful and the most capable of tolerating overnights. Why are they the most protected from this? Real learning requires work and exposure. There is no substitute. There are quality augmentations, but at the end of the day, trained physicians have to take care of patients to be good at what they do.

Now I will go take my Geritol and pull my waist belt up to my xiphoid process and shut up.

I'd kind of agree, except the vast vast majority of interns rise to the occasion once the real responsibility is in front of them, and the learning curve is still steep even for the best prepared students. There's one school near me that I've found prepares their M3-4s really poorly from the interns I've worked with. My program's med school on the other hand was really rigorous in psych for M3-4, and you had the advantage of those residents knowing the system coming in. Though the former's interns were behind their classmates at month 2, you'd hardly know a difference between them by month 4 or 5.

Though I'm a little biased as well seeing as though I was a pretty abysmal med student if my transcripts and evaluations were any indication. I'd like to think I was a hell of a lot better resident once I had actual responsibility on my plate, and a boatload of call in a front-loaded program under my belt to help me feel confident, which I never was as a student.

 

[clausewitz2]

I'd kind of agree, except the vast vast majority of interns rise to the occasion once the real responsibility is in front of them, and the learning curve is still steep even for the best prepared students. There's one school near me that I've found prepares their M3-4s really poorly from the interns I've worked with. My program's med school on the other hand was really rigorous in psych for M3-4, and you had the advantage of those residents knowing the system coming in. Though the former's interns were behind their classmates at month 2, you'd hardly know a difference between them by month 4 or 5.

Though I'm a little biased as well seeing as though I was a pretty abysmal med student if my transcripts and evaluations were any indication. I'd like to think I was a hell of a lot better resident once I had actual responsibility on my plate, and a boatload of call in a front-loaded program under my belt to help me feel confident, which I never was as a student.

My biggest problem to date in a very front-loaded residency is that when I work with newly hired attendings who did not train here, they tend to treat me like a sub-I, when I really want to be mostly running an inpatient service with supervision and guidance. Thinkingabout it, this makes alot more sense if their programs did not spend the first two years in a pressure-cooker.

 

[deleted736562]

My biggest problem to date in a very front-loaded residency is that when I work with newly hired attendings who did not train here, they tend to treat me like a sub-I, when I really want to be mostly running an inpatient service with supervision and guidance. Thinkingabout it, this makes alot more sense if their programs did not spend the first two years in a pressure-cooker.

This is also somewhat true at my program. I think it's about managing their anxiety more as new attendings than anything else. They want to make sure they're always on top of things, which doesn't always make for a very good educational experience. Some of them are acty really good still.

 

[operaman]

I don't know what prompted me to look, but I pulled up the docs from that GWU lawsuit that is still (yes!) working its way through the system 2 years later. I saw @WingedOx had asked about this earlier in this thread.

You know how everyone always says not to read too much into what gets said when a lawsuit is filed? How that is one side of the story and there's always another side? Well, holy crap is that true! I feel like the plaintiff's allegations have been well described in this and other threads and on her videos and Pamela Wibble's site.

So here are some different perspectives pulled from the current public court filings. I think they are fascinating reading for all of us in medical education. It reminds me the Dr. Gu story and wouldn't surprise me in the least to see similar documents come out whenever he inevitably files his own lawsuit.

So here we go. There are thousands of pages of documents so forgive me for selectively posting two. Please know these too are simply allegations and opinion from one side and no formal rulings have been made on this case thus far. One doc is a paid professional review of the file from the PD at Northwestern. The other is testimony from the GWU PD.

 

[WingedOx]

"I believe I am qualified to review and comment on Stephanie Waggel’s training experience at GW. I charge $400 per hour for record review, preparation of reports, telephone conferences on substantive issues, any interviews that may be necessary, and research; the charge for deposition and court testimony is $600 per hour and travel time is $200 per hour. I have been paid a retainer of $3,200. I have expended approximately 10 hours to date reviewing this matter, consulting with counsel, and preparing my report which has been incurred, but not yet invoiced or paid. I have testified as an expert witness in one legal matter in the last four years"

Not bad, Dr. Anzia... not bad at all...

 

[FlowRate]

I don't know what prompted me to look, but I pulled up the docs from that GWU lawsuit that is still (yes!) working its way through the system 2 years later. I saw @WingedOx had asked about this earlier in this thread.

You know how everyone always says not to read too much into what gets said when a lawsuit is filed? How that is one side of the story and there's always another side? Well, holy crap is that true! I feel like the plaintiff's allegations have been well described in this and other threads and on her videos and Pamela Wibble's site.

So here are some different perspectives pulled from the current public court filings. I think they are fascinating reading for all of us in medical education. It reminds me the Dr. Gu story and wouldn't surprise me in the least to see similar documents come out whenever he inevitably files his own lawsuit.

So here we go. There are thousands of pages of documents so forgive me for selectively posting two. Please know these too are simply allegations and opinion from one side and no formal rulings have been made on this case thus far. One doc is a paid professional review of the file from the PD at Northwestern. The other is testimony from the GWU PD.

"The medical team decided that she was not able to see patients independently and was to function as a medical student... It must be noted that at this time, SW was not dealing with a medical illness."

And so much more.

 

[WingedOx]

Wait, I'm confused. She would have been GW residency class of 2018, right? Is she just practicing as a non-BE mental health professional based off her internship?

 

[operaman]

I'm starting to really like it when these supposedly wronged residents sue in federal court because it allows us to eventually view all the evidence in the case. Her publicly-told side of the story is so divorced from reality that if she didn't have her name and picture all over the internet, I would have thought it a different person entirely. It reminds me of every time someone posts here with a tale of woe about why they were unfairly dismissed from med school or residency; inevitably there's a flip side they seem to omit.

It's very telling for residents to see how the program is mounting its defense. Every email, every text message, every encounter has been scrutinized and entered into evidence. We often tell people who are struggling to watch their back and keep their nose clean, and this clearly shows how important that is as every instance of tardiness, missed lecture, delinquent PPD (guilty!), etc., is brought forth as a mountain of evidence of unprofessionalism.

This girl has become somewhat of a poster-child for victims of "malignancy" in medical education. There are others I have found who have similarly claimed victim status, sued, and only then had the opposing side to their story come out. Sometimes the program is really in the wrong - I recall a little kerfluffle with an Ohio urology program a few years ago where the court docs really did support the residents' case. It's worrisome when people like SW are held up as examples of resident abuse and discrimination. The more we cry wolf and provoke outrage where none is deserved, it cheapens the plight of those who really are being abused and discriminated against.

I've got a few such cases on my cloud drive; I'm toying with posting a thread in a more general forum with links to the initial news stories accompanied by copies of court documents showing the rest of the story. Seems like we keep hearing more and more from maligned residents but never get to hear anything publicly from the programs themselves. If anyone can think of old cases where a resident was suing and we never heard the outcome, I can look it up and see what docs are available. All employment discrimination suits are under federal jurisdiction so those are very easy documents to get; states can be a little more iffy.

 

[WingedOx]

I'm starting to really like it when these supposedly wronged residents sue in federal court because it allows us to eventually view all the evidence in the case. Her publicly-told side of the story is so divorced from reality that if she didn't have her name and picture all over the internet, I would have thought it a different person entirely. It reminds me of every time someone posts here with a tale of woe about why they were unfairly dismissed from med school or residency; inevitably there's a flip side they seem to omit.

It's very telling for residents to see how the program is mounting its defense. Every email, every text message, every encounter has been scrutinized and entered into evidence. We often tell people who are struggling to watch their back and keep their nose clean, and this clearly shows how important that is as every instance of tardiness, missed lecture, delinquent PPD (guilty!), etc., is brought forth as a mountain of evidence of unprofessionalism.

This girl has become somewhat of a poster-child for victims of "malignancy" in medical education. There are others I have found who have similarly claimed victim status, sued, and only then had the opposing side to their story come out. Sometimes the program is really in the wrong - I recall a little kerfluffle with an Ohio urology program a few years ago where the court docs really did support the residents' case. It's worrisome when people like SW are held up as examples of resident abuse and discrimination. The more we cry wolf and provoke outrage where none is deserved, it cheapens the plight of those who really are being abused and discriminated against.

I've got a few such cases on my cloud drive; I'm toying with posting a thread in a more general forum with links to the initial news stories accompanied by copies of court documents showing the rest of the story. Seems like we keep hearing more and more from maligned residents but never get to hear anything publicly from the programs themselves. If anyone can think of old cases where a resident was suing and we never heard the outcome, I can look it up and see what docs are available. All employment discrimination suits are under federal jurisdiction so those are very easy documents to get; states can be a little more iffy.

do it.*

I always have really mixed feelings when reading these things, particularly as someone who's had some issues along the way, particularly as a medical student, I kind of wonder what ultimately separated them from me. I mean, if someone at the school wanted to pull the trigger to boot me, it would have been complete bullsh-t, but they could have easily built the case. Hell, I did get an email from my student affairs dean in the fall of my 4th year that I was overdue for my flu shot while I was on probation for a rotation remediation (among many other things). Then of course I think of a number of physicians I knew from training who I'm amazed got through training and are practicing physicians today. Hell, I'm remembering a med prelim from my institution who was such a sh-thead during his intern year I was appalled he was passed through. Per people in his med school class, he was a complete sh-thead back then too... I just looked him up and he's a fellow at UCSF. Perhaps he grew up, but it's also a reminder of how forgiving medical training is and how many chances people get and how much it takes for people to pull the plug on you.

It's a shame the Eugene Gu thread got out of hand, because his posts have been so self-unaware that it's been like watching the crime happen in real time rather than seeing both sides make opposing arguments at trial. (or perhaps not the crime itself, but reading him post his own disciplinary letters reads like as if OJ tossed copies of "if I did it" from the white Bronco during the slow speed chase).

*apologizes to SDN moderators everywhere for encouraging such actions which will make their jobs more difficult.

 

[thoffen]

Wow. She did things like no-show for work without notifying anyone she wouldn't be there. That's pretty freaking bad.

 

[michaelrack]

xx

 

[Stagg737]

Based on the reaction I get from colleagues, I realize I’m in the minority on this. But I personally get better results from residents (in terms of their performance and what they get from the experience) when I treat them as professionals and expect them to perform the same. There is a bit of culture shock and boundary pushing at first, but when you make the expectations explicit (and come down firmly on violations), I find that residents rise to the occasion and we have a good and collaborative learning and treatment environment because of it.

My first psych rotation of 3rd year was like this. Our attending expected us to get there before him, take an H&P on any new patients, see if there was anything new with our previous ones, present them to him including our differentials and what our treatment plan would be. He basically expected us to function as interns as 3rd year students. The first week was a slap in the face and a huge adjustment, but we got the hang of the basics pretty quick. That rotation ended up being both my favorite rotation of med school and the reason I ended up choosing psych. Not everyone loves it, but that attending is notorious at my school for converting med students to psychiatry (and ones with solid foundational knowledge at that) and I thought getting a taste of how a resident is actually supposed to function was far better than the rotations where we were coddled and had less responsibility.

I've got a few such cases on my cloud drive; I'm toying with posting a thread in a more general forum with links to the initial news stories accompanied by copies of court documents showing the rest of the story. Seems like we keep hearing more and more from maligned residents but never get to hear anything publicly from the programs themselves. If anyone can think of old cases where a resident was suing and we never heard the outcome, I can look it up and see what docs are available. All employment discrimination suits are under federal jurisdiction so those are very easy documents to get; states can be a little more iffy.

Please do! I'm sure there's plenty of us who would love to read these cases, especially those considering forensic psychiatry or just want to see both sides of those stories.

 

[Noobguy]

Eastern Tennessee State had some problems a few yrs back and even lost accreditation. PD left right before we matched last yr. Too scary for me......

Heard it’s still bad. Training sounds bad, and I know they recently have had residents transfer out and fired. Lots of residents reportedly complained to ACGME at their latest visit recently.

 

[WingedOx]

I always have really mixed feelings when reading these things, particularly as someone who's had some issues along the way, particularly as a medical student, I kind of wonder what ultimately separated them from me. I mean, if someone at the school wanted to pull the trigger to boot me, it would have been complete bullsh-t, but they could have easily built the case. Hell, I did get an email from my student affairs dean in the fall of my 4th year that I was overdue for my flu shot while I was on probation for a rotation remediation (among many other things)

So......... I read beyond the first few pages and man did I ever speak too soon. The letter from the PD is way more detailed, and yeah, I feel better about any deficiency I've had along the way... geez. But of course at the same time I never needed a kidney removed.

Also I'm laughing at the fact she was given multiple repeated warnings and deadline extensions about her PPD the second year, and yet she wasn't the only resident who wan't in compliance. I think about my own residency's old program coordinator and the necessity of sending emails in increasingly larger bold red font when she needed us scatterbrained residents to do stuff and the deadline crept nearer and nearer.

 

[FlowRate]

So......... I read beyond the first few pages and man did I ever speak too soon. The letter from the PD is way more detailed, and yeah, I feel better about any deficiency I've had along the way... geez. But of course at the same time I never needed a kidney removed.

Also I'm laughing at the fact she was given multiple repeated warnings and deadline extensions about her PPD the second year, and yet she wasn't the only resident who wan't in compliance. I think about my own residency's old program coordinator and the necessity of sending emails in increasingly larger bold red font when she needed us to do stuff and the deadline crept nearer and nearer.

The insanity increases the more you read. Search the document for August 25.

 

[Crayola227]

I don't know what prompted me to look, but I pulled up the docs from that GWU lawsuit that is still (yes!) working its way through the system 2 years later. I saw @WingedOx had asked about this earlier in this thread.

You know how everyone always says not to read too much into what gets said when a lawsuit is filed? How that is one side of the story and there's always another side? Well, holy crap is that true! I feel like the plaintiff's allegations have been well described in this and other threads and on her videos and Pamela Wibble's site.

So here are some different perspectives pulled from the current public court filings. I think they are fascinating reading for all of us in medical education. It reminds me the Dr. Gu story and wouldn't surprise me in the least to see similar documents come out whenever he inevitably files his own lawsuit.

So here we go. There are thousands of pages of documents so forgive me for selectively posting two. Please know these too are simply allegations and opinion from one side and no formal rulings have been made on this case thus far. One doc is a paid professional review of the file from the PD at Northwestern. The other is testimony from the GWU PD.

I have read both documents, and I am in no way impressed with "how difficult" it is to fire a resident. It's practically cookbook to do so.

It only gets hard if an attorney becomes involved for anything beyond negotiating a "voluntary" resignation.

I imagine where things could get dicey is if the PD doesn't have the department chair and GME on their side for some reason, and the resident appeal isn't actually in front of a kangaroo court.

 

[WingedOx]

The insanity increases the more you read. Search the document for August 25.

I'm at "buddy call".

/I see she's hawking GeneSite on her current practice website... (sigh).

 

[Crayola227]

Keep in mind that I am not excusing this particular resident in any way or taking their side.

There are clearly statements of conduct that is never acceptable and there is no excuse for.

This dismissal was difficult because an attorney got involved and much as we might not like it, after reading the resident's conduct, there was clearly still a case in the court of law, at least.

Much as this case should not be used as the standard of "look at the big bad meanie malignant program," neither should it be used to show how difficult/easy it is to terminate or force residents to resign in many cases.

 

[Crayola227]

I think we forget also, and it is definitely easier for a program, and by its very terms would never reach court or the public eye, are forced "voluntary" resignations. There's many reasons both sides frequently seek this resolution. Some of those are just terminations in disguise, the resident just wanted to avoid the scarlet letter T and went for R instead.

Or just cases of non-renewal.

 

[WingedOx]

I can't believe I read that whole thing. My god, it just got worse and worse. And I haven't even filled out a March Madness bracket yet.

I'm sending Lee an invoice for the amount of time I spent reading that so that I can now contribute as an "expert" on this case now here on SDN. I'll be cheaper than Dr A. How's $200/ hour sound?

 

[Nasrudin]

Awwww. F@3k! What rabbit hole suckage of a couple hours this was. Morbidly fascinating. Characterological psychosis. Fake lefty "advocate" news coverage. Impossible level of discrepancy between the involved parties. Short skirts. Work intoxication. Did I miss a brawl in there somewhere?

I tapped out with a "Best Doctors" video coverage between possibly 2 of the dumbest homo sapiens i've ever come across. Impressed with one another. For god knows what reason. I almost launched my laptop out of my hotel window. Just to get out of this rabbit hole.

I'm questioning my entire existence right now.

I want go bench press. Or... hunt for wolves. And just shut the F up and work a grinding ED shift. Just to feel good about something we do having value.

Jesus Christ...

 

[Evidence Based]

Three hours of my life I'll never get back, but worth it for the feeling of comfort that however scared I am of starting intern year I'm pretty certain I can at least show up to work sober and take one (or 29) hints from my boss that something needs to improve.

 

[michaelrack]

Three hours of my life I'll never get back, but worth it for the feeling of comfort that however scared I am of starting intern year I'm pretty certain I can at least show up to work sober and take one (or 29) hints from my boss that something needs to improve.

Just don't wear tight clothing, and you will be ok

 

[FlowRate]

Did I miss a brawl in there somewhere?

August 25: Solo'd physical restraint of an agitated patient. Reported contact with patient's blood/bodily fluids.

Three hours of my life I'll never get back, but worth it for the feeling of comfort that however scared I am of starting intern year I'm pretty certain I can at least show up to work sober and take one (or 29) hints from my boss that something needs to improve.

The scary part is that this is the level of performance required to get kicked out of a supportive residency.

 

[WingedOx]

August 25: Solo'd physical restraint of an agitated patient. Reported contact with patient's blood/bodily fluids.

I can only imagine being the attending on call in the middle of the night when the intern asks me to "administratively discharge" a patient.

 

[clausewitz2]

I can only imagine being the attending on call in the middle of the night when the intern asks me to "administratively discharge" a patient.

Oh no, this person texted about an administrative discharge at 1 AM.

 

[Mass Effect]

So here we go. There are thousands of pages of documents so forgive me for selectively posting two. Please know these too are simply allegations and opinion from one side and no formal rulings have been made on this case thus far. One doc is a paid professional review of the file from the PD at Northwestern. The other is testimony from the GWU PD.

Wow, totally not what was portrayed earlier from the resident's point of view. I think one of the hardest things about situations like these is that the program can't talk about it. Their reputations are sullied by what the resident chooses to share and they can't respond, except in court documents. If this had never gone to court, the only version of this story would have been the resident's, out there on the Internet, with her program totally portrayed to be evil and heartless. The PD even resigned after this experience, which says something, I think.

I, for one, would love to read any others you have. I've followed a lot of termination stories in the past and would love to see both sides.

Keep in mind that I am not excusing this particular resident in any way or taking their side.

There are clearly statements of conduct that is never acceptable and there is no excuse for.

This dismissal was difficult because an attorney got involved and much as we might not like it, after reading the resident's conduct, there was clearly still a case in the court of law, at least.

Much as this case should not be used as the standard of "look at the big bad meanie malignant program," neither should it be used to show how difficult/easy it is to terminate or force residents to resign in many cases.

Wait, what?? She allegedly no-showed, left rounds to sleep in a call room, impaired, physically restrained a patient solo, and lied/mischaracterized things to her program director and others multiple times and she was allowed to go on with this for nearly 2 years. I dare say in any other profession, she would have been terminated a lot sooner.

 

[WingedOx]

Wow, totally not what was portrayed earlier from the resident's point of view. I think one of the hardest things about situations like these is that the program can't talk about it. Their reputations are sullied by what the resident chooses to share and they can't respond, except in court documents. If this had never gone to court, the only version of this story would have been the resident's, out there on the Internet, with her program totally portrayed to be evil and heartless. The PD even resigned after this experience, which says something, I think.

I, for one, would love to read any others you have. I've followed a lot of termination stories in the past and would love to see both sides.

Yeah, regardless of the reason I also responded to Crayola in another thread that even if the PD's resignation had nothing to do with this, the sheer amount of work that she had to do to compile the documentation required to make this case (likely even before the lawyers got involved) is just insane. PD is a stressful enough job even if the residents are perfect little angels. As residents, I don't think any of us came close to stressing out our PD as much as our department chair did.

Wait, what?? She allegedly no-showed, left rounds to sleep in a call room, impaired, physically restrained a patient solo, and lied/mischaracterized things to her program director and others multiple times and she was allowed to go on with this for nearly 2 years. I dare say in any other profession, she would have been terminated a lot sooner.

To segue to a previous topic, this is why I get so frustrated with Pamela Wible. While I think she does a lot of noble things, she has a serious problem with fact checking and verification of the things that she publishes. She's been promoting Waggel's cause for a long time now, and she's featuring her in the upcoming "Do No Harm" documentary that she's the centerpiece of.

If you look at Waggel's clinic that she's running today, it has Wible's fingerprints all over it. I can't knock the hustle of Wible's promotion of people going into independent practice thru her "ideal clinic" model, but helping someone set up an outpatient psychiatry practice who was never actually trained in therapy and was fired for dangerously inadequate crisis management skills is disconcerting.

 

[Liquid8]

If you look at Waggel's clinic that she's running today, it has Wible's fingerprints all over it. I can't knock the hustle of Wible's promotion of people going into independent practice thru her "ideal clinic" model, but helping someone set up an outpatient psychiatry practice who was never actually trained in therapy and was fired for dangerously inadequate crisis management skills is disconcerting.

I was trying to make sense of this. Although Waggel was kicked out of residency, it appears that she is still allowed to practice independently and market herself as a therapist. On her website I couldn't see anywhere that she claimed to be a psychiatrist, but the descriptions of someone offering therapy, medication management, mental health care and doing post graduate training at GW would imply this is the case. Maybe it is technically legal, but as an outsider there's something about it that doesn't sit right with this.

 

[Mass Effect]

I was trying to make sense of this. Although Waggel was kicked out of residency, it appears that she is still allowed to practice independently and market herself as a therapist. On her website I couldn't see anywhere that she claimed to be a psychiatrist, but the descriptions of someone offering therapy, medication management, mental health care and doing post graduate training at GW would imply this is the case. Maybe it is technically legal, but as an outsider there's something about it that doesn't sit right with this.

In some states, you can get your full medical license after one year of residency. You won't be board eligible, so you can't get board certified and most malpractice insurance companies won't cover you, but you can practice medicine.

 

[Celexa]

Yeah, regardless of the reason I also responded to Crayola in another thread that even if the PD's resignation had nothing to do with this, the sheer amount of work that she had to do to compile the documentation required to make this case (likely even before the lawyers got involved) is just insane. PD is a stressful enough job even if the residents are perfect little angels. As residents, I don't think any of us came close to stressing out our PD as much as our department chair did.



To segue to a previous topic, this is why I get so frustrated with Pamela Wible. While I think she does a lot of noble things, she has a serious problem with fact checking and verification of the things that she publishes. She's been promoting Waggel's cause for a long time now, and she's featuring her in the upcoming "Do No Harm" documentary that she's the centerpiece of.

If you look at Waggel's clinic that she's running today, it has Wible's fingerprints all over it. I can't knock the hustle of Wible's promotion of people going into independent practice thru her "ideal clinic" model, but helping someone set up an outpatient psychiatry practice who was never actually trained in therapy and was fired for dangerously inadequate crisis management skills is disconcerting.

That's a shame. And it's not like it'd actually be hard to find examples of residents really done wrong by...as I think you mentioned above, the court documents for that urology residency scandal (OSU) backed up the residents' accusations that there was rampant sexual harassment, bullying of all genders, and active attempts to ruin the residents' careers and prevent them from becoming board-certified without cause.

 

[Mass Effect]

Hey @operaman can you please post stories of other terminated residents? I would love to read "the other side" in some of these other stories, like Stephanie Waggel's.

 

[drzoidbergsgotnothingonme]

In some states, you can get your full medical license after one year of residency. You won't be board eligible, so you can't get board certified and most malpractice insurance companies won't cover you, but you can practice medicine.

Yeah, after spending a couple of hours reading that whole document, that's so upsetting to me. This is a woman who was a danger to patients, failed (or didn't show up for) most of her didactics, and apparently was impaired while on duty at least once. Not someone who should be out there practicing medicine.

And I hate that she's marketing herself as a crusader against the malignant side of medicine, when from that document it sounds like she was part of the malignant side of medicine - bullying other residents, threatening staff, etc.

 

[siliso]

Our gal had laparoscopic surgery for a cyst that turned out malignant but was cured with clear margins. A week’s inconvenience at the most. What bs to sell the poor cancer victim sob story. But to be expected of a defective person with no insight to their deficits.

 

[deuist]

What a rabbit hole this thread has been. I read Dr. Waggel's profiles on doximity and psychology today. She stated that she did residency at George Washington University and works in the field of psychiatry. She also called attention to the fact that she was named "physician of the year 2016" by Medscape even though it was not a positive accolade according to the article.

 

[Mass Effect]

I'm still waiting to read more of these. Dr. Waggle's journey was eye-opening and certainly proved there's way more to the story than meets the eye.

 

[PikminOC]

Did she have cancer? I read from Pam Wible that she did and thats why tge residency dropped her, according to pam.

 

[Mass Effect]

Did she have cancer? I read from Pam Wible that she did and thats why tge residency dropped her, according to pam.

You should read the thread and the documents posted. Cancer isn't the reason she lost her job.

 

[PikminOC]

Yes I read the documents posted. But then why did Wible say it was due to cancer? Didn't she read them?