Non renewal

[somedr]

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Hi everyone

I was informed today that my program wasn't going to renew my categorical contract.No reason was stated and in the 2nd meeting with the program director he just handed me a paper saying "this is to inform you that the department of medicine is not renewing your contract for the 2012-2013 year" no reason was stated except that you didnt show improvement. The past few days have been tough in the ICU where the PD is there.
There are 3 residents where I got into a suppositely discussion with and they called
it an arguement and after that they all added up. Everything i did multiplied. There have been
few evaluations of me and they are good other than my previous ICU rotation which he
himself filled up. I am in a very confusing situation.
He says he will help me get in anywhere I want. He wants me to just go and he will help me anyway he can. Very confusing. No reasoning no nothing. The PD met me once before and told me not to challange things. Thats all and the past 3 months were great and now this agruement has multipied my negatives and he just threw this at me.
Spoke of appealing to house staff but he grew furious
He just said do your work! Thats all. I wrote this letter I can change it.

Please help me in this situation

 

[QofQuimica]

As painful as it is to hear, it sounds like your PD did tell you why he wants you out. He sees you as someone who "challenges things," gets into fights with other residents, and performs badly in the ICU. The good news at least is that he's willing to help you find a new position. I'd take him up on it, because it doesn't sound like you have any future at your current program. And when you get to your new program, focus on just getting through and avoid making waves. My personal yardstick is that if it won't hurt patients and it's not illegal/immoral, it's usually best to just let it go rather than pick a fight. Even in the rare situations where it's necessary, pick your fights very carefully.

to you.

 

[jdh71]

Hi everyone

I was informed today that my program wasn't going to renew my categorical contract.No reason was stated and in the 2nd meeting with the program director he just handed me a paper saying "this is to inform you that the department of medicine is not renewing your contract for the 2012-2013 year" no reason was stated except that you didnt show improvement. The past few days have been tough in the ICU where the PD is there.
There are 3 residents where I got into a suppositely discussion with and they called
it an arguement and after that they all added up. Everything i did multiplied. There have been
few evaluations of me and they are good other than my previous ICU rotation which he
himself filled up. I am in a very confusing situation.
He says he will help me get in anywhere I want. He wants me to just go and he will help me anyway he can. Very confusing. No reasoning no nothing. The PD met me once before and told me not to challange things. Thats all and the past 3 months were great and now this agruement has multipied my negatives and he just threw this at me.
Spoke of appealing to house staff but he grew furious
He just said do your work! Thats all. I wrote this letter I can change it.

Please help me in this situation

GO!

And do it while you still have the PDs good graces. He said he'd help you find a spot. So start looking. Many categorical programs have PGY2 spots open up all of the time. Put out feelers. You don't have to get specific with anyone about your reasons for leaving.

 

[Smurfette]

GO!

And do it while you still have the PDs good graces. He said he'd help you find a spot. So start looking. Many categorical programs have PGY2 spots open up all of the time. Put out feelers. You don't have to get specific with anyone about your reasons for leaving.

This.

Use your PD now to get help finding a spot. Don't burn more bridges trying to fight it, because you will still likely lose and at that point, your current program will not be willing to help you get a spot elsewhere. At least they gave you notice now and not six months from now...there's a lot of people who find out with far less notice.

It is awful to learn you are not being renewed. I feel for you. It's a scary feeling to know you have to go through a residency search again. But don't waste time fighting it. If they don't want you there, that is not an environment you'd want to continue working in and it will only get more uncomfortable with time. Find a place that wants you so you can thrive and learn your specialty well. Good luck.

 

[peerie]

But keep in mind that if the program is as unethical as it sounds, then likely the PD is just saying he will help you in order to make you go quietly. Understand that he might never respond to you again once you leave. That would make sense wouldn't it? Someone who will behave the way you describe is not going to suddenly become kind and ethical. Remember that, and plan accordingly.

Prepare yourself emotionally for a very, very upsetting time and seek trusted counsel from people you know. Be very careful and find support privately. Keep your head up, keep your heart too.

 

[dragonfly99]

I would sign up for the Match now so that you can scramble later.
Start looking for open spots now.
ICU rotation is tough - I've been a medicine resident so I know. Often, problems may show themselves there. This can be problems related to patient care or not - it sounds like yours was more personal issues. I agree w/Q...most disagreements are not worth fighting in a hospital...particularly if you are an intern. It sounds like you are a FMG so maybe there were cultural misunderstandings as well...what you perceived as maybe a spirited discussion was perceived as an argument by other people. This has happened to the best of us. It sounds like you don't have a future where you are. There is no point in fighting it. If you go quietly and try for good evaluations the next few months, you will hopefully get credit for all of your intern year.

When you are feeling more calm, maybe you could meet with your PD again and see what he is willing to do to help you find another spot. Also, decide if you want to stay in this specialty or go to a different one. I would advise that you carefully ask your PD if he thinks you can get all or most of the credit for your intern year, and just emphasize that you really want to do well, and it was never your intention to have harsh words with these other people, and you regret the misunderstanding, etc. Sometime the hospital can be a harsh place...you learned that the hard way.

Also, if there is even the perception that you aren't pulling your weight, aren't getting the work done, etc. then you need to correct that. One of the hard things in the ICU is organizing all the data - make sure you have all your patient's labs, imaging test results, etc. and to present them at rounds. I always found the MICU challenging and I never felt I'd totally mastered it.

 

[NotAProgDirector]

I am going to agree with much of the advice here.

First, the PD's behavior here is a mixed bag. On the good side, they are giving you lots and lots of notice that you will not be renewed for next year. You will have a much better chance of finding a new spot starting now, rather than starting in April or May. Second, they say they are going to help you, and if true that's a good thing.

On the bad side, it's unacceptable to base your letter of recommendation on whether you "fight this" or not. Whatever process your program has in place to review these decisions should be your right to use. His "letter" shouldn't change based upon that.

But, regardless, this is real life. As mentioned above, if you fight this you are going to either 1) lose, and then have a PD that's not willing to help you, or 2) "Win", and get your spot back in this program, only to be under the microscope and likely fired again some time in the future. So, really, you have no choice.

So:

1. You need to find a spot before your current position expires. You have your PD's attention now -- you're filling a spot in their schedule that would be a pain to address if you left. Given what you've written above, they may fire you immediately if someone else who can fill the spot becomes available. Do not waste time. Find a new spot (for next year) ASAP.

2. Talk to your PD about what he will support you for. Most likely, you will need to repeat your PGY-1. Your current program doesn't think you'll be ready to be a PGY-2, so I doubt that your PD will support you for a new PGY-2 position in July. Again, you need to be clear with your PD about this so that you don't waste your time.

3. Your choices at this point are going to be VERY limited. I'm assuming (based upon the grammar of your post) that you're an IMG. As an IMG terminated / non promoted from a program, you may never get a new spot. Your career here in the US may be over. I say this not to beat you down, but to be realistic. Getting a spot will be very difficult. You will need to really convince a program that you're worth a second shot. And if you get any offer, you take it. You no longer get the luxury of choosing the part of the country that you're in, and you may need to change fields.

4. If there are other programs in your geographic area, that's probably the place to start. You could go visit them, you might be able to even do a 1-2 week rotation at them (during an elective block, if your program offers them in your PGY-1 year).

Good luck. You have a rough road in front of you.

 

[somedr]

Thank you everyone for their valuable advice.I spoke to several people in the program.
All of whom were very upset and shocked. I spoke to even the 1 out of 3 people.
She was very nice and told me she never said anything positive or negative.
This has been a good time to think. Yes I will complete PGY-1 year and they will be
giving me credit. The PD is furious at this time. I will not speak to him.Worse thing is
he is the ICU attending and I have to eye with him daily and present to him.
Anyways I will be quiet and do that.
I have already enrolled in the websites and I feel Swap is a good option.I am trying my best to find a swap position. I have reached out to people I know. Obviously they were very shocked by this. They told me to start looking.

1. I will do well these coming months
2. I will be proactive and try to land into a better program (This program is a community program)
3. I will speak to him again after some time to see if he would give me more advice.
4. I spoke to 2 out of the 3 people. They said they hadn't spoken about me to PD recently so basically then there is a group of a particular ethnic group that is basically negatively influenced the man to this point.
5. I won't fight this. There is no point. I know its unfair without a hearing ( I didnt know the US would be so Unjust but this is how the system is). I feel judging by the advice I got here and elsewhere.
I got a good deal. Decent LOR+ Completion of the PGY-1 Year+ Help with finding a position elsewhere.
So in this case there is a possibility of finding an even better position elsewhere.

PD according to the residents (This guy is a new PD, was formerly Associate PD and ICU chief) is a good guy at heart but he is extremely angry with me. Formally I have met him for the 2nd time although we had conversed before and it was fine.

2ndly i spoke to one attending, who was the previous chief resident as well. She told me that Your senior residents were not happy with your attitude and your problem with taking orders

Anyways I wasn't ever approached or told about anything. I was counselled once and told not to challenge things and you will be fine.

Anyways I feel one needs to go through hardships to have personal growth.I see it fairly
now that its best that there is some place better for me to my PGY2 than this.
Although sometime my heart says wish there was a fair hearing.As one of my mentors
and chief of service at another hospital "out of all the animals. man is the most malicious"
My only issue is not getting close to seniors, not talking much, just keeping to myself and trying to know why i am doing something.

Anyways.Thank you all. I will God-Willing find a spot somewhere.
I am preparing my resume again and I will ask the chairmen of medicine who gave me
a good evaluation to give LOR
Other than that, there is a long search ahead. I have full faith, I will succeed.
Thank you and please keep the advice coming!

 

[peppy]

Sorry to hear that you've run into this problem. 🙁
One thing you could try, as you look for new spots, would be to see if you can "put a positive spin on it" by saying that you've come to the realization that this specialty isn't for you and that you've developed an interest in a different specialty. Perhaps the PD would be willing to support you in trying for a spot in Family Medicine or Psych programs even if he feels (justified or not) that you aren't a good fit for IM.
As things currently stand, it is generally easier to get into Family Med and Psych than IM so this might be the best way to ensure that you get a spot somewhere.
I do sympathize with you for being forced into this situation though. Hope you end up somewhere that you get along better with the PD!

 

[jakstat]

..

 

[dragonfly99]

You can sugar coat it but pretty much they are going to figure out something bad went on - I mean that you didn't get along with someone and/or you did something seen as not optimal. Most people don't just switch specialties...a few do, but usually with the full backing of the PD. In this situation I would just say (if switching specialties) that I wasn't a good fit for that specialty and what I like about this new specialty is x, y z that is different from my old specialty. But I wouldn't out and out lie if I was asked if there was a conflict, etc. You could say well I asked my senior residents some questions about why we were doing things and I think they perceived it as more of an argument but that wasn't my intention - and I intend to be more diplomatic in the future, and would of course make sure none of these type discussions happened in front of patients or families.