PDs

[Lostin_space]

What level of involvement do your typical PDs have in residency program?

I am concerned about the gross lack of involvement our PD has in our residency program. We don't interact with our PD until late into the 3rd year and before that we don't have any contact. She takes leaves frequently, whether it be personal, medical, etc. Last year I believe she was gone for about 2 months or so, this year it's been about the same. We don't really have meetings with PD, we are not really allowed to email her without going through the coordinator or chiefs. We are not even allowed to get in touch with the PD without having either chief or upper resident contact her. So uninvolved that she does not even know who some of the underclass residents are - recently asked who some of the jr residents were. We were absolutely shocked. Like - you don't know who your residents are? Senior residents are typically recommending other residents to have as limited contact with PD as possible.
I find this quite atypical and worrying. Where I did internship our PD was super involved, knew exactly what our career aspirations were, would meet with us on a regular basis, etc.
Coordinator is also quite rude and offensive, especially to jr residents. When someone says something that the coordinator does not like or agree with, she accuses them of lying or making up stuff or being difficult.
What would you all do in this situation?

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[BigRedBeta]

That's bizarre. I did a peds residency though so our general outlook is much gentler and my PD looked a little like Santa Clause...but we had annual 1 on 1 meetings with him each year, he knew us all well enough that it was an undeclared rule he would be writing one of your LOR's if applying to fellowship and he was actively present at things like morning report and noon conferences. Even as a medical student I knew who the residency PD's were for standard clerkship specialties.

While I don't disagree with starting with your senior residents and the chiefs for questions or concerns - the chain of command often takes care of smaller problems faster than going to the top - to a degree there are some things only the PD can fix.

If you feel like it's been negligent, then consider going to the chair of the department or the head of the GME office.

 

[Lostin_space]

That's bizarre. I did a peds residency though so our general outlook is much gentler and my PD looked a little like Santa Clause...but we had annual 1 on 1 meetings with him each year, he knew us all well enough that it was an undeclared rule he would be writing one of your LOR's if applying to fellowship and he was actively present at things like morning report and noon conferences. Even as a medical student I knew who the residency PD's were for standard clerkship specialties.

While I don't disagree with starting with your senior residents and the chiefs for questions or concerns - the chain of command often takes care of smaller problems faster than going to the top - to a degree there are some things only the PD can fix.

If you feel like it's been negligent, then consider going to the chair of the department or the head of the GME office.

The chair is quite involved with our education, and they don't get along with the PD. We don't have 1:1 with the PD at all - ever. What you describe is what I'm used to, and certainly how it was where I did my internship. I'm not talking about going to the PD for something minor like can I change a call or something but for big things I should be able to talk to the PD. I find it abnormal and extreme. When PD is gone there is also no one to cover, she cancels her clinics, so residents on her service take the day off. I find the whole thing crazy.

 

[hipster22]

What level of involvement do your typical PDs have in residency program?

I am concerned about the gross lack of involvement our PD has in our residency program. We don't interact with our PD until late into the 3rd year and before that we don't have any contact. She takes leaves frequently, whether it be personal, medical, etc. Last year I believe she was gone for about 2 months or so, this year it's been about the same. We don't really have meetings with PD, we are not really allowed to email her without going through the coordinator or chiefs. We are not even allowed to get in touch with the PD without having either chief or upper resident contact her. So uninvolved that she does not even know who some of the underclass residents are - recently asked who some of the jr residents were. We were absolutely shocked. Like - you don't know who your residents are? Senior residents are typically recommending other residents to have as limited contact with PD as possible.
I find this quite atypical and worrying. Where I did internship our PD was super involved, knew exactly what our career aspirations were, would meet with us on a regular basis, etc.
Coordinator is also quite rude and offensive, especially to jr residents. When someone says something that the coordinator does not like or agree with, she accuses them of lying or making up stuff or being difficult.
What would you all do in this situation?

What specialty is this?

 

[NotAProgDirector]

My residents have my personal cell number and are free to call me anytime. Or pager. Or email. Or stop in my office. Anytime.

 

[Lostin_space]

My residents have my personal cell number and are free to call me anytime. Or pager. Or email. Or stop in my office. Anytime.

Yeah, that's how my old PD was. He had an open door policy, we could always go in to talk to him, could ask him anything. I find it almost pathologic that our PD does not want contact pretty much with residents. And this is not new. I find this to be quite problematic. I have even heard that if a jr resident calls him she would get upset and ask why is a senior resident not getting in touch with her. I honestly believe the PD has a personality disorder. She did not even greet us when we first started! She no longer does yearly evaluations, now they are done by the associate PD. Does not do the required ACGME meetings. I don't want to make a big deal out of this but I don't see how this is normal. Am I wrong here?

 

[bashwell]

Yeah, that's how my old PD was. He had an open door policy, we could always go in to talk to him, could ask him anything. I find it almost pathologic that our PD does not want contact pretty much with residents. And this is not new. I find this to be quite problematic. I have even heard that if a jr resident calls him she would get upset and ask why is a senior resident not getting in touch with her. I honestly believe the PD has a personality disorder. She did not even greet us when we first started! She no longer does yearly evaluations, now they are done by the associate PD. Does not do the required ACGME meetings. I don't want to make a big deal out of this but I don't see how this is normal. Am I wrong here?

I'm no one important, but I don't think you're wrong, though please definitely don't make a big deal out of this! You don't want to be on the PD's sh** list. (Or anyone else with any say over what happens to you in residency for that matter).

 

[22031 Alum]

Yeah, that's how my old PD was. He had an open door policy, we could always go in to talk to him, could ask him anything. I find it almost pathologic that our PD does not want contact pretty much with residents. And this is not new. I find this to be quite problematic. I have even heard that if a jr resident calls him she would get upset and ask why is a senior resident not getting in touch with her. I honestly believe the PD has a personality disorder. She did not even greet us when we first started! She no longer does yearly evaluations, now they are done by the associate PD. Does not do the required ACGME meetings. I don't want to make a big deal out of this but I don't see how this is normal. Am I wrong here?

You're not wrong, but unfortunately as @SouthernSurgeon said there's not much you can do about it. Put your head down and get through residency with the help of people who are supportive- the associate PD, perhaps. This is not something that you are going to be able to change.

There's a possibility that your PD is just a figurehead, and the associate PD runs things but hasn't been out of residency/in academics long enough to formally hold a PD title. I've heard of a couple of programs transitioning that way.

Just out of curiosity, did you get any inkling of this stuff on your interview day?

 

[Crayola227]

it was interesting I read some time back the list of qualifications you need to hold the PD title from ACGME - you see how like everything in medicine there's a numbers game going on.

Now, you said that there are some ACGME required meetings not taking place?

I don't know anything about that, but if you read all the rules and regulations ACGME and your specialty board has regarding what they want to see in a program, and that's not happening where you are AND there's essentially proof, then you could file a complaint.

However, I would never do so in residency unless I was 110% sure that it would remain anonymous whisteblower thing. Also, unless patients or residents were in bodily danger, I would never do anything to put my program at risk of losing accreditation, so if I did turn my program in for something, I would be sure that it was something relatively fixable.

Even when you graduate you won't have all ties severed with this program, you will still need them to help with paperwork for licensing.

You might want to want until you already are settled into a job somewhere with all credentialing and licensing to do something about this. I would urge you to not forget about it after graduation if you really feel it is a quality issue.

Lastly, to play Devil's Advocate, if there are other staff members below the PD seeing to it that the program is doing what it is supposed to be doing, I don't know the fact that the PD doesnt' want to be bothered and acts in name only is such an issue.

You do mention the staff below them being dicks, but I'm afraid that's to be found anywhere you go in admin. (yes there are people that want to make the world a better place via admin.... and some get their souls crushed. maybe that was your PD once upon a time?)

 

[mvenus929]

Our PD knows us all and interacts with us as a group at least once per month. We don't get a terrible amount of one-on-one time with her, but see her often because her office is by the PC's and IT guy's offices, and where we have moral boosting snacks. I have a closer relationship to the associate PD than the actual PD, mostly because he still acts as an attending quite frequently (our PD does on occasion, but not very often). Our chair is also super involved. We tend not to need to go to the PD for many things, because they tend to get resolved faster if we go through the chiefs or PC, but she does have an open door policy.

 

[22031 Alum]

Now, you said that there are some ACGME required meetings not taking place?

I don't know anything about that, but if you read all the rules and regulations ACGME and your specialty board has regarding what they want to see in a program, and that's not happening where you are AND there's essentially proof, then you could file a complaint.

If the associate PD or other designee is doing those things, it's fine. Even if they aren't, I'm surprised you would even suggest filing a complaint, as the most paranoid "Residencies are out to get you" person on these forums. OP would gain nothing from poring over ACGME rules to file a complaint. A PD who doesn't want to do their duties isn't going to turn into a wonderful caring mentor if forced to. So all OP would get is the exact same situation they're in now, with the added "benefit" of being on their PD's radar as a complainer.

 

[IlDestriero]

That's not normal at all.
The chairman should replace her.


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Il Destriero

 

[Lostin_space]

That's not normal at all.
The chairman should replace her.


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Il Destriero

The chairman is truly awsome, and we are all very found of him. Very involved, he's the only one who ever even has any type of meetings with us, who writes letters for us, he handles numerous services in the program, only one who protects us against crap. I truly find it concerning. And it's not just me who feels this way - this is across the board.

 

[IlDestriero]

It sounds like the chairman is doing the job of the PD. I'm not sure why he would. It's not his job.
If our PD disengaged, there would be a new PD by the next day. The chair certainly isn't going to do it. If you can't do your collateral duty, someone else will. If you can't do any, maybe it's time for the soft firing.


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Il Destriero

 

[marsh20]

Your PD seems quite absent. However, the grass does seem greener on the other side. I hated ever coming in contact with my PD. She was always very intrusive and felt she had a right to give us advice about our personal lives. She would have group supervision and she would ask us to present cases in front of her otherwise she would threaten us with pop quizzes. She would leave early during those supervision meetings too. She was a terrible PD.

We were always told by our chief residents, NOT to contact her directly but go through the chiefs first.

 

[22031 Alum]

It sounds like the chairman is doing the job of the PD. I'm not sure why he would. It's not his job.
If our PD disengaged, there would be a new PD by the next day. The chair certainly isn't going to do it. If you can't do your collateral duty, someone else will. If you can't do any, maybe it's time for the soft firing.


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Il Destriero

This is all true and good, but if the chair, associate PD, and other faculty aren't stepping up to make the PD do her job, a resident cannot expect to make it happen. I'm getting a "how do I fix this??" vibe from OP's posts- the answer is, you can't. For all you know, she may have been just as terrible when she was more involved.

 

[gracie369]

Definitely sounds strange. Why are you complaining? Do you need to meet with him/her? Honestly if your residency is going ok other than the PD not knowing all of the residents count your blessings. You could be in the PDs office every week "discussing" your deficiencies.

 

[Crayola227]

If the associate PD or other designee is doing those things, it's fine. Even if they aren't, I'm surprised you would even suggest filing a complaint, as the most paranoid "Residencies are out to get you" person on these forums. OP would gain nothing from poring over ACGME rules to file a complaint. A PD who doesn't want to do their duties isn't going to turn into a wonderful caring mentor if forced to. So all OP would get is the exact same situation they're in now, with the added "benefit" of being on their PD's radar as a complainer.

ah, I didn't explain myself well

what I mean is that if official rules are being violated and there's proof, than *in theory* one may file a complaint
and that the only way I would even consider it is if there was some way to maintain total anonymity which may or may not be possible
doesn't mean it's a good idea or something I recommend

in fact, I think I suggested that this person wait until they are not only done with residency but fully settled with another job to even think of crossing the program in this way

I am the most paranoid on this forum, I don't want to see residents ****ed
at the same time, I believe in trying to make residency better
so, I just meant to point out the most realistic courses of action, whether or not they are worth it or a good idea, is up to the judgment of the OP
a program could be soooo crap that ethically I would think you would be forced to act, if only for patient safety

this doesn't sound like that

 

[mimelim]

****, I was in Mexico this weekend rock climbing and was texting with my PD and program coordinator while 800 feet above the desert floor about the most random stuff. Gotta always count your blessings.

I agree 100% with @SouthernSurgeon. There is nothing to be gained by making waves on this now.