Match violation?

[j4pac]

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I think the OP actually had a fairly reasonable question and it sounds like they are just trying to help out someone they care about but his/her slow-revealing of facts (including that they already had a position and are soon to graduate) have upset people and caused them to jump to assumptions. It would certainly bother me if my program did the same thing and we also ended up with a "subpar match," as I care about my program and my co-residents, and a crappy (if they really are subpar) resident will create more work for everyone.

I'm not sure why people take so much issue when someone brings up what they think is an ethical dilemma. And quite frankly, if the PD promised a position to the applicant himself directly outside the match, that is a pretty flagrant match violation. Common practice or not in the real world, we're talking about the Match here, which has pretty specific rules about what you can and cannot do, and there are good reasons for this. If the PD promised the position to the spouse, then it gets fuzzier as the applicant isn't being pressured into taking the spot, but I still agree with the OP it's certainly against the spirit of the match.

Whether or not it's actually a Match violation depends on all the details, of which there are more than what we've heard, and really depends on what the NRMP says--not what a bunch of people on an anonymous forum say.

OP--I think aProgDirector has given you the best advice. Ultimately the decision is up to you and the coordinator if you're going to pursue anything, but as aProgDirector points out, if the end-game is to get revenge, it actually will hurt the residents more than the PD (if it is a match violation) as the program won't be able to participate in the match for some time. But if the PD really is a cancer on the program, perhaps it'd actually be better for the PC to talk with the PD's superior about her concerns. I know our GME director would take things pretty seriously if he heard a PD was doing all sorts of ethically questionable stuff (and unless the other job the PC took is actually better, I assume it must be a fair amount of questionable stuff for her to quit over it)

I'd still personally keep quiet unless the PD had a continuous habit of ethical issues, in which case I'd discuss it with his/her boss and not the NRMP. (Well, I'd actually encourage the PC to do it--she's really the one in the place to bring up the concerns at the OP points out).

RB...if the guy would have been a little bit more upfront and communicated clearly people wouldn't have jumped down his throat. People can only work off of what they are given. And quite frankly...I don't think that a resident should be trying to help a PC who is out to get people. He shouldn't be sticking his nose in it. If the PC wants to scream match violation...what's stopping him/her? The PC doesn't have repercussions. The resident on the other hand, does. He should do what a resident is suppose to do and lay low and get the heck through residency. Of course...if there is a GROSS unethical match violation...he should report. But this is iffy...at best. BTW...I like love ya man. 🙂

 

[j4pac]

I never said I don't agree with the opinion.. the majority opinion is don't get involved or report it. OK, thanks for the "expert" opinion. No skin off my back, I'm done in 3 months. As stated, I don't think it is ethical and I believe it is against the spirit of the match. However, this is not personal enough to me to report. My involvement was out of respect and friendship of the coordinator, who I have known since a student, and I was hoping to help her with some guidance and couldn't speak about this with other people at my program. Thanks for being an objective medical community.

BTW...it's reassuring that you aren't the one out to get someone. I'll nix my comment about not wanting you to be apart of PM&R. But you really should be careful moving forward...it can hurt you.

 

[thehundredthone]

BTW...it's reassuring that you aren't the one out to get someone. I'll nix my comment about not wanting you to be apart of PM&R. But you really should be careful moving forward...it can hurt you.

Was that a little invocation of Burnett's law I saw?

 

[j4pac]

Was that a little invocation of Burnett's law I saw?

Lol. Keep in mind that I've worked with some fantastic physicians that I have absolutely no desire to with with, and visa versa.

 

[RangerBob]

RB...if the guy would have been a little bit more upfront and communicated clearly people wouldn't have jumped down his throat. People can only work off of what they are given. And quite frankly...I don't think that a resident should be trying to help a PC who is out to get people. He shouldn't be sticking his nose in it. If the PC wants to scream match violation...what's stopping him/her? The PC doesn't have repercussions. The resident on the other hand, does. He should do what a resident is suppose to do and lay low and get the heck through residency. Of course...if there is a GROSS unethical match violation...he should report. But this is iffy...at best. BTW...I like love ya man. 🙂

I love ya too man 🙂

You start at Mayo next year right? You're going to have one the nicest senior residents ever. I was a co-intern with him--you'll recognize him by his big family.

I pretty much agree with everyone you say--if the PC's trying to get back at the PD, the resident should stay out of it unless the PD is just plain bad news and doing all kinds of ethically questionable stuff--but even then, I'd still go to the GME coordinator or whoever is above the PD, because if they go to the NRMP and it is a match violation, it really hurts the residents that are there now pretty bad, and they don't deserve that.

99 out of a 100 times, a resident is smart to keep quiet and not make waves. Which is sort of sad, but it really is the truth when it comes to residency training.

 

[j4pac]

I love ya too man 🙂

You start at Mayo next year right? You're going to have one the nicest senior residents ever. I was a co-intern with him--you'll recognize him by his big family.

I pretty much agree with everyone you say--if the PC's trying to get back at the PD, the resident should stay out of it unless the PD is just plain bad news and doing all kinds of ethically questionable stuff--but even then, I'd still go to the GME coordinator or whoever is above the PD, because if they go to the NRMP and it is a match violation, it really hurts the residents that are there now pretty bad, and they don't deserve that.

99 out of a 100 times, a resident is smart to keep quiet and not make waves. Which is sort of sad, but it really is the truth when it comes to residency training.

I know who you are talking about. I'm facebook friends with him but I only briefly met him on my interview. Are you looking toward fellowship or practice?

I started a one-year war with our neighboring naval hospital...so my advice is more do as I say, not as I do. 🙂 it's important to know how to pick battles and understand the potential fallout of the battles.

 

[Doctor4Life1769]

Y'all can get a room now 😉 lol jk

 

[RangerBob]

I know who you are talking about. I'm facebook friends with him but I only briefly met him on my interview. Are you looking toward fellowship or practice?

I started a one-year war with our neighboring naval hospital...so my advice is more do as I say, not as I do. 🙂 it's important to know how to pick battles and understand the potential fallout of the battles.

I'm debating doing a SCI fellowship or neuro-rehab (non-ACGME). Overall still TBD

 

[Raryn]

I think the OP actually had a fairly reasonable question and it sounds like they are just trying to help out someone they care about but his/her slow-revealing of facts (including that they already had a position and are soon to graduate) have upset people and caused them to jump to assumptions. It would certainly bother me if my program did the same thing and we also ended up with a "subpar match," as I care about my program and my co-residents, and a crappy (if they really are subpar) resident will create more work for everyone.

I'm not sure why people take so much issue when someone brings up what they think is an ethical dilemma. And quite frankly, if the PD promised a position to the applicant himself directly outside the match, that is a pretty flagrant match violation. Common practice or not in the real world, we're talking about the Match here, which has pretty specific rules about what you can and cannot do, and there are good reasons for this. If the PD promised the position to the spouse, then it gets fuzzier as the applicant isn't being pressured into taking the spot, but I still agree with the OP it's certainly against the spirit of the match.

Whether or not it's actually a Match violation depends on all the details, of which there are more than what we've heard, and really depends on what the NRMP says--not what a bunch of people on an anonymous forum say.

OP--I think aProgDirector has given you the best advice. Ultimately the decision is up to you and the coordinator if you're going to pursue anything, but as aProgDirector points out, if the end-game is to get revenge, it actually will hurt the residents more than the PD (if it is a match violation) as the program won't be able to participate in the match for some time. But if the PD really is a cancer on the program, perhaps it'd actually be better for the PC to talk with the PD's superior about her concerns. I know our GME director would take things pretty seriously if he heard a PD was doing all sorts of ethically questionable stuff (and unless the other job the PC took is actually better, I assume it must be a fair amount of questionable stuff for her to quit over it)

I'd still personally keep quiet unless the PD had a continuous habit of ethical issues, in which case I'd discuss it with his/her boss and not the NRMP. (Well, I'd actually encourage the PC to do it--she's really the one in the place to bring up the concerns at the OP points out).

Here's the thing: A PD can promise whatever the hell position they want to an applicant, and as long as they formally fill it in the match, it isn't a violation. Promising a position isn't the problem, quid pro quo is a bit more of one. Demanding that an applicant rank the program is a flat-out violation.

 

[RangerBob]

Here's the thing: A PD can promise whatever the hell position they want to an applicant, and as long as they formally fill it in the match, it isn't a violation. Promising a position isn't the problem, quid pro quo is a bit more of one. Demanding that an applicant rank the program is a flat-out violation.

I think timing matters here--if it's after interview season has started then yes, PD's promise positions all the time and that's OK as long as they don't say "I'll rank you first but you have to rank us first," etc. But if the PD guaranteed the applicant a position prior to the application process then I believe they're technically "subverting the match" (vague statement by the NRMP, but the program has effectively removed one position from consideration for other applicants), which would be a violation. Of course, you could argue PD's do this all the time without being as overt--plenty of programs know they'll be ranking some of the home applicants and/or visiting students to match before the interview season even begins.

Typically this is the sort of thing no one cares about--the PD is happy because they got the applicant they want, and the applicant is presumably happy they matched at the program--so there'd be no one to report the violation.

t sounds like it's only an issue in this case because the PC knew about the offer/guarantee, the applicant is considered a sub-par applicant and the OP's program could've had a stronger resident had they filled through the match, and that the PD seems to have a lot of questionable ethical behavior.

This is just my interpretation of the NRMP's policy--only they could actually say if it's really a Match violatoin. But even if the NRMP actually does determine there's a Match violation, it really hurts those residents the most, so nothing actually gets fixed or made better and the program is worse off. Hence why I think it's better to let it go.

 

[IlDestriero]

Just let the PD sleep with your wife next time and you won't have this problem. Remember that at fellowship time, which is even less transparent and connections, charm, and partner potential trump scores, etc. You'll see it again when you're trying to get your sweet 90th percentile income ultra competitive job.
If you remember that life's not fair and they don't owe you anything, you'll be ahead of a lot of dreamers.

--
Il Destriero