My progam needs help

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This is not the place to get this kind of help. You need to involve the gme office if it is as bad as you state. Incompetence is not acceptable.
 
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To get help about self learning, I think you need to post them in the forum for your specialty. I know that feels a little less anonymous, but people outside your specialty won't be able to give you good advice about learning and goals to make you competent in your specialty.

That's amazing that you have no didactics and manage to remain accredited. Do people regularly lie on anonymous surveys due to fears of retaliation?
 
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Getgo123 said:
I appreciate your thoughts. I suppose the question is "do people really feel that the surveys are actually anonymous"?
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I can see how they don't feel that way in a small program. Or if all the reviews are negative, it's possible all the residents could be targeted somehow. I have a friend at a program that sounds fairly malignant. Her program recently got quite bad reviews in their anonymous survey that she thinks were written by residents about to graduate. Everyone else was too scared to submit an honest evaluation.
 
I have no pity for people unwilling to stand up for their education. If it's that bad, transfer. But complaining on here won't lead to real change. Or better still, warn applicants to the severity of the situation. Let the program match 80% fmgs for a year and see how that goes for the pd and chair.

Medicine is not meant to be self taught. The system exists as it does for good reason, as both book knowledge and skills are necessary.
 
It is not that easy to transfer in residency. Especially in a more competitive field req. high board scores/research, etc. Most times you have to deal with what you got.

To the OP, take the initiative if you can't leave an teach yourself by doing a lot of reading and getting what you can from the seniors.
 
mlw03 said:
I have no pity for people unwilling to stand up for their education. If it's that bad, transfer. But complaining on here won't lead to real change. Or better still, warn applicants to the severity of the situation. Let the program match 80% fmgs for a year and see how that goes for the pd and chair.

Medicine is not meant to be self taught. The system exists as it does for good reason, as both book knowledge and skills are necessary.
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Well, that's not helpful. If you're stuck in a malignant program, it's easy to feel like there are no choices. From reading SDN, you get the impression that most people's careers are essentially over if they get fired, and that an angry PD could fire you (by not renewing your contract) pretty easily. IMO, worrying about retaliation is pretty valid, and I can understand the op and his fellow residents for not reporting this stuff.
 
then it's a continuing cycle of negativity.

while some people are not really anonymous on here, that's by choice, and it's possible to remain unknown. there are also multiple websites where residents can objectively review the residency programs. to say nothing of the fact that ACGME site reviews are only valid if residents honestly answer the questions of the site reviewer. there are outlets by which a resident receiving a poor education can make it known to the outside world. while i grant that it may be tough for someone currently in a program to get out (but i don't think it's impossible), there's no excuse for allowing residency applicants to come in and think all is rosy.

Doctor Bagel said:
Well, that's not helpful. If you're stuck in a malignant program, it's easy to feel like there are no choices. From reading SDN, you get the impression that most people's careers are essentially over if they get fired, and that an angry PD could fire you (by not renewing your contract) pretty easily. IMO, worrying about retaliation is pretty valid, and I can understand the op and his fellow residents for not reporting this stuff.
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OP, I agree w/one of the above comments that you will probably get better advice on a forum for residents in your specialty. Also, I agree with you that if you are really going to be incompetent, it may be better to get out. It would be better to be a competent IM doc or anesthesiologist than an incompetent surgeon, for example. Your dream is to be good at your specialty, not to be scary and incompetent. Besides, spending several years being trained by a tyrannical and perhaps incompetent department chair is not a good way to live your life. I guess in your situation I would look around to see if I could get out some way but into a residency in the same specialty...but it may be difficult or impossible if you are already in a competitive specialty.

Having fellow-organized conferences might be possible, but if the faculty is really unsupportive even that may be impossible. Besides, I'm not a fan of resident or fellow-organized conferences in general. IMHO it's kind of a way to pawn off the work on to us and off of the faculty...occasionally it can be good but mostly that's what it is.

It's sad that some programs just want to use residents to do work but I have no trouble believing that it goes on. I'm sure the OP is at some program with a huge number of FMG/IMG's who have no other option if they get canned. I also think it's ridiculous that some other poster would blame the OP and his coresidents for the entire situation. If they are really at that type of program there is no reason not to fear retaliation. Even at half decent programs trainees often are coached about what to say on their program evaluations. The reality is that programs are like individual people - most do not like getting negative feedback and their reaction to it tends to be defensive. Malignant programs are worse than average in this regard.
 
Getgo123 said:
It's not always possible to involve the gme office without fear of retaliation from my program director/chair. This issue is not germaine to my program alone. I am simply trying to make a bad situation better. I want to understand how to learn in this environment. I also want to hear from more experienced residents who have had to create their own curriculum to learn.
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Medicine is essentially a self taught field. Pick up the textbook for your speciality, and read it. Then read it again. Keep your mouth shut and graduate. If you try and change things now, you will end up unemployed and unemployable, and the program will go on.
 
Either you go with the flow or leave.

Never heard of a program that is so bad and can't be changed. Contact ACGME or whichever program it's affiliated with.

If its so bad for all the residents, then all residents should sign a petition, send it to the program director, then to the chairman of the department, then to do the DME, then to the respective specialty college.
 
Hmmmmm.

I understand the fear of retaliation. It was definitely warranted at the program I where I did my residency, and we all brainstormed and concluded that it was difficult (actually, impossible) to give constructive feedback. It was such a small program that we could be easily identified, so no survey was anonymous.

We dealt with it by reading ourselves (in areas/rotations that were poorly taught and we were scutted out). We figured which sources to use by inquiring past successful seniors. I agree, it's not always easy to pick up and leave. Sometimes you have to buckle down and deal with it. I wish you the best of luck.
 
You and your fellow residents needs to contact the ACGME together - [email protected]

As a coordinator I can tell you that ACGME resident surveys really are anonymous and you need to be honest on them.
 
Coordinator704 said:
You and your fellow residents needs to contact the ACGME together - [email protected]

As a coordinator I can tell you that ACGME resident surveys really are anonymous and you need to be honest on them.
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I call bull**** on this.

Sure the ACGME may try to preserve confidentiality on their end, but the programs aren't stupid. A program can tell which residents are dissatisfied and through that make the inference as to who blew the whistle.

If the ACGME wanted to gain credibility, they would interview not current residents but recently graduated residents from a particular program. It's hard for residents to be unabashedly honest about a program's shortcomings when that program has those residents' professional futures by their throats.
 
That is a darn fine idea, so I imagine it'll never actually come into being.

Substance said:
I call bull**** on this.

Sure the ACGME may try to preserve confidentiality on their end, but the programs aren't stupid. A program can tell which residents are dissatisfied and through that make the inference as to who blew the whistle.

If the ACGME wanted to gain credibility, they would interview not current residents but recently graduated residents from a particular program. It's hard for residents to be unabashedly honest about a program's shortcomings when that program has those residents' professional futures by their throats.
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Presuming you're in a specialty which offers board certification, one thought which comes to mind is looking into which materials are commonly used to prepare for the board examinations/recertifications. If you're not sure, contact the certifying board in your specialty - they should be able to recommend resources that practicing docs in your specialty commonly use to review. Use these as a foundation for familiarizing yourself with what's considered important, must-know information in your specialty, and design your own reading program/curriculum around the idea of covering all of that information at some point during the course of your residency.

Good luck to you. Sounds like a terrible situation, but take what you can from it and focus on the bigger picture, namely ensuring you are competent to practice in your specialty once residency is completed.
 
dynx said:
1. open book
2. read book
3. close book
repeat PRN
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As snide as this comes off, I think it's the right idea. OP, you gain nothing fighting with a PD who isn't interested in change. You can't fight City Hall. You probably get yourself on your PDs $$&@ list without accomplishing anything. But there's no reason you can't find ways to learn in spite of him. There are plenty of lectures and podcasts on a multitude of subjects in every specialty out there you can watch, often by the big name people in the field. Check out your subspecialty organizations/journals. There are very good books written in every specialty. While medicine shouldn't ideally be self taught, passing boards certainly can be accomplished this way. If others in your residency are of like mind, there's no reason you guys can't divide up topics and find a time to give each other some version of didactics, or a journal club of good teaching board relevant articles. While I agree with dragonfly that resident lectures are a poor excuse for attending run didactics, beggars can't be choosers.

I otherwise agree with the notion that residency is really just a few short years you put in to get to a goal, and you are often best advised to keep your head down and plow through, with as little antagonizing the higher ups as possible. But there's really no reason you can't accomplish learning outside of the confines of the program if so inclined. Nothing is stopping you from outside reading, podcasts, study groups and other self learning. And honestly a lot of folks who have good didactics don't get as much out of them as you might think. A great lecture given after a hard night of call is often a wasted hour that could have been better spent sleeping. I'd say even with good didactics most of what residents learn comes from other avenues.
 
Law2Doc said:
As snide as this comes off, I think it's the right idea. OP, you gain nothing fighting with a PD who isn't interested in change. You can't fight City Hall. You probably get yourself on your PDs $$&@ list without accomplishing anything. But there's no reason you can't find ways to learn in spite of him. There are plenty of lectures and podcasts on a multitude of subjects in every specialty out there you can watch, often by the big name people in the field. Check out your subspecialty organizations/journals. There are very good books written in every specialty. While medicine shouldn't ideally be self taught, passing boards certainly can be accomplished this way. If others in your residency are of like mind, there's no reason you guys can't divide up topics and find a time to give each other some version of didactics, or a journal club of good teaching board relevant articles. While I agree with dragonfly that resident lectures are a poor excuse for attending run didactics, beggars can't be choosers.

I otherwise agree with the notion that residency is really just a few short years you put in to get to a goal, and you are often best advised to keep your head down and plow through, with as little antagonizing the higher ups as possible. But there's really no reason you can't accomplish learning outside of the confines of the program if so inclined. Nothing is stopping you from outside reading, podcasts, study groups and other self learning. And honestly a lot of folks who have good didactics don't get as much out of them as you might think. A great lecture given after a hard night of call is often a wasted hour that could have been better spent sleeping. I'd say even with good didactics most of what residents learn comes from other avenues.
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I agree with the above that sometimes you have to make it through and learn as much as you can through the way. If you have an interesting case, read about it and then ask your Attendings questions about management- learn that way. Medicine is all about see one, do one, teach one, right? Do your best to learn and teach what you know to your juniors so you learn it even better Good luck!
 
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I did my internship in a medicine program that was previously given a "1 year renewal", which basically is the last step before probation. During the review process interviewers from the RRC interviewed every single resident in groups of 3-4 people and asked very specific questions about things like work hours and quality / quantity of education. They also had a stack of complaints submitted by residents which they asked us about. I'm talking even the most inane things like "indians get special treatment" were brought up during the interview.

If you have legitimate complaints about the quality of YOUR FEDERALLY FUNDED EDUCATION by all means write the ACGME. Even if you do so anonymously, your complaint will land on somebody's desk and eventually in a folder that will be used to beat the program director over the head when it comes to their next site review.

Things I would suggest:
1. Don't discuss your concerns with anyone in the hospital administration. The GME director may be golfing buddies with your PD and you may suffer all kinds of retaliation.

2. Do not inform anyone in the hospital of your intent to complain. These types of programs instill a culture of ruthless backstabbing among residents and your shoulder to cry on may burn you the first chance they get.

3. Show up on time, work hard and stay below the radar. I don't know where you went to med school but chances are you had to do quite a bit of self study. Residency is unfortunately more of the same.
 
Gasworks said:
I did my internship in a medicine program that was previously given a "1 year renewal", which basically is the last step before probation. During the review process interviewers from the RRC interviewed every single resident in groups of 3-4 people and asked very specific questions about things like work hours and quality / quantity of education. They also had a stack of complaints submitted by residents which they asked us about. I'm talking even the most inane things like "indians get special treatment" were brought up during the interview.

If you have legitimate complaints about the quality of YOUR FEDERALLY FUNDED EDUCATION by all means write the ACGME. Even if you do so anonymously, your complaint will land on somebody's desk and eventually in a folder that will be used to beat the program director over the head when it comes to their next site review.

Things I would suggest:
1. Don't discuss your concerns with anyone in the hospital administration. The GME director may be golfing buddies with your PD and you may suffer all kinds of retaliation.

2. Do not inform anyone in the hospital of your intent to complain. These types of programs instill a culture of ruthless backstabbing among residents and your shoulder to cry on may burn you the first chance they get.

3. Show up on time, work hard and stay below the radar. I don't know where you went to med school but chances are you had to do quite a bit of self study. Residency is unfortunately more of the same.
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Keep in mind that if the ACGME finds reason to make a program unaccredited, then you would not be board eligible; certainly you want things fixed, but you don't want to screw yourself over by getting the program in so much trouble it affects your ability to find a job or be boarded in your specialty. A program can only have so many things to fix and still remain accredited. Certainly a lone resident does not want to be the "person held responsible" for a negative review. Be honest in answering RRC/ACGME questions, but don't intentionally try to send your program under the bus; you could also get run over in the process. There's a big difference between just being honest and intentionally trying to cause trouble.
 
Looking for constructive feedback - already pretty upset and really would appreciate no hammering over the head. I know I am complaining, I am just trying to see the silver lining here. Is there hope?
 
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Getgo123 said:
So I am now told that we are not meeting our surgical numbers on a daily basis by senior residents (we simply do not have the volume). Yet when the ACGME case logs were reviewed, magically, everything was OK. Senior residents say that all programs "fudge numbers". Additionally, we are constantly encouraged to log in as attendings to confirm billing and export files. At my level of training, I am not on par surgically with any of my friends in the same field.

Residents take advantage of the system, leaving for hours at a time and hazing junior residents there is no leadership- only one full time faculty member in the entire department.

I expressed my concerns about these issues and am not alone, however reporting at this point would directly target me (as it is a very small program).

I would be willing to start my residency in this field over completely if given the opportunity and sacrifice the time I spent here. I just don't have that option, given the competitiveness of the field. What else can I do to survive this on a daily basis?

Looking for constructive feedback - already pretty upset and really would appreciate no hammering over the head. I know I am complaining, I am just trying to see the silver lining here. Is there hope?
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The worst case scenario is not just that the residency ship sinks, but that you go down with it. To avoid that happening, the first thing for you to do is not to falsify any records, whatever the pressure on you to do so.

Also, keep your own records of what you have learnt and are doing. This gives you some level of check over what you have done, and something which you can use to demonstrate the training you have had. You might be surprised, if you keep good records, to look back at the end of a year and see how much you have learnt.

You have friends in other programs in the same speciality. Is there any possibility of you arranging secondments to other programs? Even a week or two here and there could help you, if longer periods aren't possible.

Good luck.
 
Getgo123 said:
Looking for constructive feedback - already pretty upset and really would appreciate no hammering over the head. I know I am complaining, I am just trying to see the silver lining here. Is there hope?
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Your situation sounds terrible! Do you mind if I ask what program you're currently in? (Feel free to PM me if you'd like.) I'm really sorry about what you've been doing through...have you thought about looking around at other options in case your program gets put on probation?
 
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Getgo123 said:
Probation sounds like a disastrous scenario and also unlikely, since I do care about my coresidents (and my own) future. We have reaccreditation for a few more years before another site visit.

It's incredible. After reviewing the ACGME guidelines, we meet very few of the criteria. We have a very low patient census (3-4 patients per resident most days, all day), in house lectures are scarce, no M&M, one grand rounds the entire year, no conferences, residents double logging as primary surgeons. Some of our attendings are not board certified and are operating (seniors are logging in as primary surgeon under different attendings). We are forced to purchase all of our own equipment (there is very little functional equipment). Last minute our director throws together mid year evaluation forms, has us all retroactively sign them, and puts up a song and dance about resources and numbers. I wonder how they allow this program to exist. It almost seems like someone is clearly not telling the truth or there has been a sloppy review of the program.

This is the time for me to learn and make mistakes. Right now, I feel like I have no clinical or surgical exposure and I have no idea if any change can be made. I am reading, is there anything else?

TO reply to a previous post: Yes, I have gone on one away week (during my vacation), unfortunately I am unable to assist in procedures at other institutions.
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Sounds like all you can do is keep reading and self teaching, keep your head down, and dont personally commit any fraud. Reporting things this drastic will put a swift end to your program, and basically create career impediments for yourself and all your coresidents.
 
If it really is this bad, I would argue you have a moral obligation to open your mouth. What happens when a patient dies because an undertrained surgeon makes a mistake? Are you going to be able to sleep knowing you knew about this situation and kept your mouth shut to protect yourself and your co-residents? This situation sounds like it's a big mistake away from some state official snooping around, finding out what's going on, and putting everyone involved out of a job.

I'm not trying to sound holier-than-though. I understand your reluctance to blow the whistle. But what you are describing is major fraud. If you are complicit you're putting your own career in jeopardy if/when what's happening becomes public knowledge.

Getgo123 said:
Probation sounds like a disastrous scenario and also unlikely, since I do care about my coresidents (and my own) future. We have reaccreditation for a few more years before another site visit.

It's incredible. After reviewing the ACGME guidelines, we meet very few of the criteria. We have a very low patient census (3-4 patients per resident most days, all day), in house lectures are scarce, no M&M, one grand rounds the entire year, no conferences, residents double logging as primary surgeons. Some of our attendings are not board certified and are operating (seniors are logging in as primary surgeon under different attendings). We are forced to purchase all of our own equipment (there is very little functional equipment). Last minute our director throws together mid year evaluation forms, has us all retroactively sign them, and puts up a song and dance about resources and numbers. I wonder how they allow this program to exist. It almost seems like someone is clearly not telling the truth or there has been a sloppy review of the program.

This is the time for me to learn and make mistakes. Right now, I feel like I have no clinical or surgical exposure and I have no idea if any change can be made. I am reading, is there anything else?

TO reply to a previous post: Yes, I have gone on one away week (during my vacation), unfortunately I am unable to assist in procedures at other institutions.
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Seems like you'll absolutely have to do fellowship to be competent. I mean you might be a bit embarrassed at first if your competency is not up to par, but with dedication you will probably make it to be a good attending. So there's no need to start over or sabotage your career. Let a better fellowship program be your silver lining and at worst become a good subspecialty attending.
 
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Getgo123 said:
I wholeheartedly agree on the fellowship aspect. Unfortunately, we do not have many seniors match into fellowship. Of the four, one matched at a private clinic.

I can deal with the malignancy of the program, hazing by senior residents, and program director. I just hate that I may not be competent (as many seniors feel is the case when they graduate). Even our board pass rate is 25% by graduates (I am told).
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That's terrible! Did you know any of this when you were interviewing?
 
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Getgo123 said:
The program went through a lot of changes when I arrived. We lost two surgical sites and gained one where residents were unable to do surgery as primary surgeons.

In addition to this, my program director is incredibly inappropriate with residents and is constantly threatening and making personal comments. This person isolates people and calls them names in front of other residents (even in front of the GME people). No one does anything.

A part of me wants to report everything to the ACGME, but if I am wrong about anything, I will lose my job and my career will be put into jeopardy. Or if I am right andwe are put on probation, I will be targeted. I wish that there was a way to have someone investigate the issues with my program without it affecting me or other residents.
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You say its impossible to switch. Have you tried?
 
I think you need to try and get out...if it's general surgery, is there no way to get into another general surgery program? If it's a surgical specialty, could you start over @PGY1 or 2 in a general surgery program, then transfer/finish back into your chosen surgical subspecialty? If not, are you sure it's going to be better to be a surgeon fearful of being incompetent (or actually being incompetent and harming patients) versus being an IM doctor or anesthesiologist or some other specialty and being decently trained?

This is just a crappy situation and I'm not sure what we can do to help/give advice here.

I find some people's comments on here incredibly unhelpful to the OP. If you've never been in a program where the PD or department threatens people, you don't understand the situation he is in. I experiences this on a very minor scale in residency, I would say a 1/10 versus the 10/10 the OP is experiencing. I don't think it is fair to blame the OP since he's pretty much trapped in a situation where he doesn't really have the power to fix it. Crappy didactics you can overcome, but lack of patient cases and lack of "good"/competent attendings in a procedural specialty is not something fixable by the OP. He can only vote with his feet, potentially.

I feel like the ACGME should be interviewing residents who graduated from programs 1-3 years after they graduate...or even 1year out, then 5 years out. Of course this doesn't tell you exactly what a program is up to THIS year, but one of the best predictors of future and present behavior is past behavior. This is true for individuals and institutions as well...

I do think it is true that sometimes programs "fudge" numbers by "counting" surgical cases or other procedures when 2 residents are there...or they may slightly exaggerate numbers by other methods. But large scale "making up" of things and pretending they have grand rounds, or that you are seeing lots more clinic patients and doing many more cases than you are doing...I don't think that is very common at all. I do think ACGME needs to do more to really investigate these types of programs...invariably they have a lot of FMG/IMG types who will likely not have other good options if they leave a particular residency. They are more likely to take abuse and less likely to report the program to the ACGME. They are more likely to lie on the ACGME survey at the end of the year. Most of us would do the same if we were in their position. Don't judge until you've walked in their moccasins...
 
[QUOTE=dragonfly99;11995024}
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Getgo123 said:
To make matters worse, I think I am academic person who was targeted the moment I entered the door. Two nights ago my program director stopped me in the hall to ask if I had billed for an attending. When I told the pd that I did, they forcibly grabbed me by the wrist and told me not to tell them I had done something when I didn't. I calmly repeated that I had done it and left. I received an email yesterday saying that I needed to visit the hospital psychologist. Is this the process where they fire me?

I am so disheartened. I have no idea what I could even transfer into, I spent so much time and money on this field, if I could have matched somewhere else I would have been there already. This is the specialty that has usually already matched someone internally by the time that they post a vacancy.
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Get out now!!!!! Dont' even think about staying at this point. This kind of punitive psychology is the classic first step in the firing of a resident by a malignant program. Just keep your head down and apply for a prelim or something in the match. That way you don't have to ask to be "released" from the program.
 
This does sound ominous...the being sent to the psychologist. Whatever you do, try not to act angry, since they will just use it against you. You may want to get out...general surgery spot elsewhere, etc. Or just switch to internal medicine...I know you don't want to, but they may force you out anyway.
I think you should start a diary at home, and record things that happened,who said what, and when. Not in order to obsess over what is going on, but just to protect yourself in the future. It might help if you need to interview in another specialty, or if you ever had to pursue legal action in the future.
 
A few years ago I found myself in a similar situation. In a highly competative surgical subspecialty residency. This was after the 80-hour rule went into effect. My circumstances were similar in some ways, worse in others:

-one full-time faculty member
-typically (usually) performing procedures without supervision (senior or staff)
-genuine 100+ hours awake in the hospital working per week
-very high census
-very high complication rate
-completely malignant hospital leadership towards the program
-complete lack of didactics
(unique circumstances transpired shortly after I started the program that resulted in the above situation...circumstances not present when I rotated there)

On self-education: you folks who think you can self-teach yourself ~7 feet of small print textbooks in circumstances similar to the above in 5 years are completely out of touch, or, are in a specialty where you more or less review in residency information that was covered in medical school, or you are a crackhead like Halstead.

To the pious amongst us who are in search of grenades to jump on, please submit your real name in this forum and I'll publish the program name. We will all watch you 'walk the walk' of your moral obligations. I didn't think so.

To those who think the ACGME is all-powerful. I think the TSA is more likely to close down my old program than the ACGME. I was once naive enough to think that any organization (i.e. ACGME) that would have the organs to place Duke on probation certainly would have had a field day with my program. Not so. Never underestimate the power of personal and political connections.

Regarding the "go see the psych" bit: This is an old crotch-kick technique is well known. It is arguably more actionable in court that anything else you could sue the program about. If you're going to quit anyway, I'd ask to speak with hospital risk management (i.e. the most powerful people in the hospital) about this without delay. It'll stop.

Regarding "just go to another program": In my specialty this wasn't possible. I'd suspect it is the same in a few other specialties as well unless you found someone interested in trading for a spot in hell.

End of the story: I transferred to a primary care residency. I signed a contract outside the match taking an advanced year position without my first program even having a clue that I was considering leaving. It is a straightfoward process to switch/quit, despite what the armchair lawyers here will tell you.

Final note: don't be afraid to carry around a recording device. They are cheap and small. While the practice of making recordings may or may not be legal, in the real world having solid dirt on someone considering shanking you never hurts.
 
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Getgo123 said:
This is scattered, but I am scared and amazed at how things have progressed.
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Things you need to do:

1) STOP POSTING HERE. It is possible (probable) that you could be identified by people within your program based on the information you have saved here.

2) RECORD/SAVE EVERYTHING. If you have anything in writing (emails from PD, etc) to corroborate what you are posting, save it. Back it up outside the medical center's emails.

3) BURY YOUR HEAD IN THE SAND. Work your butt off and be the quiet soldier. Don't let your displeasure/thoughts show through.

4) FIND ALLIES. Within the program, or outside it. You need to identify some people who understand your situation and can help.
 
southernIM said:
Things you need to do:

1) STOP POSTING HERE. It is possible (probable) that you could be identified by people within your program based on the information you have saved here.

2) RECORD/SAVE EVERYTHING. If you have anything in writing (emails from PD, etc) to corroborate what you are posting, save it. Back it up outside the medical center's emails.

3) BURY YOUR HEAD IN THE SAND. Work your butt off and be the quiet soldier. Don't let your displeasure/thoughts show through.

4) FIND ALLIES. Within the program, or outside it. You need to identify some people who understand your situation and can help.
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He's right, particularly about number 1.

The best thing for you to do is to delete your posts, appeal to the mods to have this thread deleted, and then submit a request to google to clear the cache of this thread.
 
work on leaving ASAP. These are just general points to consider for anyone else or any MS4's making rank lists

it's not just ACGME to worry about- anyone running that sloppy of a program probably has medicare fraud going on too (whether intentional or out of ignorance), HIPAA violations, less than stellar join commission reviews, etc. ACGME is not the only governing body that needs to be happy for you to have a program to make it through residency.

Furthermore it sounds like one or more people in a position of much power is unstable and you could easily be on the receiving end of it. You do not have to ever do anything actually wrong as these people often do not operate with respect to reality which is why they are unstable.
 
Getgo123 said:
To make matters worse, I think I am academic person who was targeted the moment I entered the door. Two nights ago my program director stopped me in the hall to ask if I had billed for an attending. When I told the pd that I did, they forcibly grabbed me by the wrist and told me not to tell them I had done something when I didn't. I calmly repeated that I had done it and left. I received an email yesterday saying that I needed to visit the hospital psychologist. Is this the process where they fire me?

I am so disheartened. I have no idea what I could even transfer into, I spent so much time and money on this field, if I could have matched somewhere else I would have been there already. This is the specialty that has usually already matched someone internally by the time that they post a vacancy.
Click to expand...


Maybe I am a skeptic, but I am not sure this all adds up. I want to believe you and think that you have been wronged, but somehow, there is also something you are telling us that could have led to being sent to the hospital psychologist?
 
It could be that OP because of his high standards acts anxious around other people or has been too vocal in his criticism. This, in addition to the program wanting to threaten him, is enough to cause them to send him to a psychologist.

I would try as much as you can to be conciliatory with the psychologist. Act bland and don't say anything specific about any specific people. Act benign and act confused about why you would be sent there. Be sickeningly nice to the psychologist, I guess.
I don't know...if they want to make up or find something on you, they will, and you can't really control that. Most psychologists are actually nice people, so maybe he/she won't give the PD the ammo he wants.

Anyway, I think the OP needs to leave. I think the advice by the former surgical resident on here (see above) is good. I also agree w/the advice about deleting this thread. I don't think you should let your program know you are leaving, but just make ready to leave. I know you don't want to, but really think about whether being a crappy plastic surgeon, urologist, etc. is worthwhile. It sounds like your training may be irreparably damaged. You could do family practice and be the kind of guy who does minor procedures, or you could do IM and then go on and do critical care or nephro or something, and be the "procedure guy". I know of a nephrologists who does mostly procedures all day, and is the guru for fixing all the patients with difficult dialysis access, etc. You other option is what someone suggested above...try to stay there, finish up a few years, then go do a fellowship somewhere.
 
dragonfly99 said:
It could be that OP because of his high standards acts anxious around other people or has been too vocal in his criticism. This, in addition to the program wanting to threaten him, is enough to cause them to send him to a psychologist.
Click to expand...

Agree with this. I wonder if the OP actually did verbalize his/her complaints about the lack of didactics and the low volume to anyone else in the program. Another resident or attending could have easily brought it to the attention of the PD. You have to be careful whom you trust. Many times, other residents whom you think are your friends are only too willing to take advantage of you, or to screw you over, especially if it potentially benefits them. If the OP did make known his/her dissatisfaction to any other resident or attending, someone could have tipped off the PD. Then the PD became pissed off, and now is looking for an excuse to get rid of the OP.

Anyway, I agree with what others are saying. The fact that the program is now trying to send the OP to disciplinary psychiatry means that he/she needs to prepare an escape plan right now.
 
I appreciate all of your responses. I would delete this thread but it has been enormously helpful to have people comment on my present situation. It feels less isolating.
 
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