Most common ways to fail out of Psychiatry residency

[tinyhandsbob]

For those who have experienced Psychiatry residency, I was wondering how common it is for psych residents to be involuntarily terminated by their institution (e.g. terminated, asked to resign, not renewed, forced out etc) and what are the most common reasons/pitfalls for the involuntary terminations? Are programs who get rid of struggling residents relatively quickly the exception or the norm? What are some of the more difficult aspects of a Psych residency where one could fail out if they don't perform and how many chances would one get in your program to remediate problems before the program decides to cut ties. In your experience are most such situations related to specific performance (i.e. the resident just couldn't learn task x or y quickly enough) or something else (e.g. first exposure to certain psych settings etc) ?

I'd also be curious to find out if there is a residency year where people are most likely to fail out and a point after which you're unlikely to.



Thanks!

---

Members don't see this ad.

 

[Celexa]

it's incredibly rare and primarily due to severe professionalism or patient safety issues (ie lying about patient care).

 

[calvnandhobbs68]

Aren't you still applying to medical school?

Anyway, yes it's very very rare that someone gets fired from any residency (despite what you read on SDN) and even moreso from a psychiatry program. I'm sure all of us have seen very questionable residents graduate from every program we're in due to the difficulty and process it takes to actually remediate and fire someone.

 

[MacDonaldTriad]

I would bet that the most likely reason for a psych resident to be let go when they want to stay is not passing step III.

 

[clausewitz2]

I had someone in my year who was asked to resign at the very beginning of PGY-3. I have told the story before but essentially the combination of being clinically clueless, being totally unwilling to learn, and having zero insight into why anyone might not think your performance is adequate despite being repeatedly told is the magic combination you need to be disen-residented.

 

[Sushirolls]

Substance Use Disorders can lead to termination.

 

[Psychresy]

Substance Use Disorders can lead to termination.

That's unfortunate.

 

[robellis]

I had someone in my year who was asked to resign at the very beginning of PGY-3. I have told the story before but essentially the combination of being clinically clueless, being totally unwilling to learn, and having zero insight into why anyone might not think your performance is adequate despite being repeatedly told is the magic combination you need to be disen-residented.

Ah yes the good old 50 mg haldol q6

 

[Stagg737]

I'm aware of one resident who was terminated d/t professionalism/performance. They frequently would show up at noon, skip clinic without taking sick days, etc. I feel like if you just show up, put the effort in to learn, and don't commit any obvious crimes that it's nearly impossible to get fired from a psych residency.

 

[clausewitz2]

Ah yes the good old 50 mg haldol q6

You forget it was IV

 

[tinyhandsbob]

Aren't you still applying to medical school?

Anyway, yes it's very very rare that someone gets fired from any residency (despite what you read on SDN) and even moreso from a psychiatry program. I'm sure all of us have seen very questionable residents graduate from every program we're in due to the difficulty and process it takes to actually remediate and fire someone.

What does the lengthy required remediation process consist of and is it specific to residencies?

 

[calvnandhobbs68]

What does the lengthy required remediation process consist of and is it specific to residencies?

I don’t get your question. What do you mean is it specific to residencies?

 

[hamstergang]

What does the lengthy required remediation process consist of and is it specific to residencies?

Are you planning to fail out of residency before you even start med school, or is there some specific situation we could help you understand?

 

[Stagg737]

I don’t get your question. What do you mean is it specific to residencies?

I think they mean do different programs have different remediation policies.

What does the lengthy required remediation process consist of and is it specific to residencies?

It depends. I’ve seen programs where missing a month or two d/t illness or maternity leave they just make up the month or two after they finish 4th year. I've also heard of one or two people being forced to repeat an entire year/not being allowed to progress d/t professionalism issues (not showing up).

 

[NickNaylor]

There are many extrinsic factors which present significant barriers to a resident being fired or their contract not being renewed, regardless of fields. Hospitals get money and are interested in retaining that income. Programs that have residents routinely not complete their training is a big red flag to prospective applicants. Losing a resident can introduce significant administrative and scheduling issues that the program would rather not deal with. In general, I think leadership at most programs are more motivated to remediate and work with a resident than terminate them - it's just easier in the long run. Additionally, being terminated from a program is extremely unlikely to come out of the blue - someone who is terminated has probably had numerous formal warnings or discussions about their deficiencies, been provided with opportunities to address them, and have failed to do so. Only people that are utterly clueless - or people at a program that is extremely poorly run - would see a termination as coming out of the blue.

tl;dr: as long as you're willing to work, learn, and improve, and you don't engage in any grossly unprofessional behavior, termination at any residency program should not be a concern.