Pregnant intern year-My rights?

[studyaholic]

Hello,

I found out I was pregnant during orientation week. (Surprise, unplanned, husband's PGY 3 in another state!)
My residency is fairly new with only PGY 2 and us, PGY1. What are my rights in residency?

My program coordinator and director are pressuring me to not take maternity leave, and scheduled an elective rotation during expected delivery, and told me to save all my vacation, sick days until that time. Thats' about 6 weeks right there.

My duty hours are violated, and my upper classmen told me to NOT RECORD the violations, and lie in my logs. I have been around 90 hours a week 630 a.m. to 730 p.m. everyday, and on call 24 hour...this does not include the time I spend to write progress notes, discharge summaries after I'm off. I was kind of um told, "if you report we are violating, and something happens to this program...well we are not going to like you..." basically implied I will get harassed.

My upper class men don't share the load, or make things easier...I've been skipping dinner and breakfast, b/c my PGY2 always skips, no-one accommodates....and if I speak up they say well last year we had over 20 pts in-patient, so don't talk about ACGME 10 pt cap and duty hours to me.

Pregnancy does not make me special, but I should have rights to eat, and abide to my body's sleep requirement of at least 8 hours between shifts?

To top it off the Chief is a foreign MD, who never did rotations in the United states, so he violates ALL ACGME guidelines,and tells us to. Do I approach the program director or transfer to a well established program?

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[Natividad Resident]

Sounds like everybody in your residency is miserable, pregnant or not.

You have to decide whether you want what's on the other side of fighting this residency for your rights, vs. what you'll have to do to recover and get into another residency if you walk.

The residency is offering you a deal that allows you to not add another year to residency by taking time off. This is standard. It's convenient for the residency and for the other residents. And it's legal.

You can negotiate with your residency for a deal that allows you a leave of absence and adds time at the end of 3 years. This is inconvenient for the residency. This is hard for a new program to figure out for the first time. This adds work to the other residents. And it's legal.

You can try to change residencies. It's mid-August, and you're pregnant. Another residency that needs to fill a spot, and is willing to take you on, offers no guarantees of being better run or more hospitable. And transferring isn't a thing. What it would be is applying, interviewing, waiting, and then, if successful, you're off cycle, you're only there for a while before being out on maternity so you'll be disoriented, you're half in one class and half in the other, and you'll graduate about 6 months late. (Note: mid-PGY2 "transfers" are not even slightly a thing - 2 years of continuity in one residency is required by ACGME.)

Or, if you can figure out a way to complete an intern year and get licensed, then you have choices. You can bail on your toxic residency, move to where your spouse is, work part time in urgent care, maybe have another kid, and pick up a PGY2 spot in another residency when you're ready. Or you can stay.

I suggest the most important thing, career-wise, is keeping things friendly with your PD. You will need your PD's help to do pretty much anything.

Your chief resident isn't requiring you to break work hours. That person is empowered by the residency. You have to choose whether to start being "the one" who complains about work hours and refuses to comply. It won't make you any friends. You'll be told it's your fault for not managing your time well. You'll be resented by those who have to do "your" work. Refusing is probably what you will have to do to stay in this residency without endangering your health.

It takes a whole lot of maturity to handle a situation like this with grace and professionalism and concern for others. A whole lot of fresh interns wouldn't be able to do it. Nobody will make you do it. You should do it.

Good luck!

 

[deleted87716]

Pregnancy doesn't guarantee you a lighter workload while you're still working (e.g., until you take maternity leave). If you're in a malignant program, it will likely still be malignant even if you're pregnant.

Does that suck? Sure. Can you do anything about it? Probably not any more than you could do if you weren't pregnant.

 

[Ericslv]

Hello,

I found out I was pregnant during orientation week. (Surprise, unplanned, husband's PGY 3 in another state!)
My residency is fairly new with only PGY 2 and us, PGY1. What are my rights in residency?

My program coordinator and director are pressuring me to not take maternity leave, and scheduled an elective rotation during expected delivery, and told me to save all my vacation, sick days until that time. Thats' about 6 weeks right there.

My duty hours are violated, and my upper classmen told me to NOT RECORD the violations, and lie in my logs. I have been around 90 hours a week 630 a.m. to 730 p.m. everyday, and on call 24 hour...this does not include the time I spend to write progress notes, discharge summaries after I'm off. I was kind of um told, "if you report we are violating, and something happens to this program...well we are not going to like you..." basically implied I will get harassed.

My upper class men don't share the load, or make things easier...I've been skipping dinner and breakfast, b/c my PGY2 always skips, no-one accommodates....and if I speak up they say well last year we had over 20 pts in-patient, so don't talk about ACGME 10 pt cap and duty hours to me.

Pregnancy does not make me special, but I should have rights to eat, and abide to my body's sleep requirement of at least 8 hours between shifts?

To top it off the Chief is a foreign MD, who never did rotations in the United states, so he violates ALL ACGME guidelines,and tells us to. Do I approach the program director or transfer to a well established program?

You are in a difficult situation. Are you sure you want to stay in this program? But I think all programs are basically like this.

On another note. What does being a foreign MD have to do with anything. If he is the Chief resident that means he did do clinical work in the US. Since you mentioned that all the people in the program violate the rules and tell you to lie, I don't see why you had to bring the nationality of the your Chief into it.

I understand you got pregnant. It happens sometimes. The program you are in sounds malignant but don't think other programs are not. Most are not very sympathetic. Certain specialties much worse than FM.

 

[Makati2008]

You are in a difficult situation. Are you sure you want to stay in this program? But I think all programs are basically like this.

On another note. What does being a foreign MD have to do with anything. If he is the Chief resident that means he did do clinical work in the US. Since you mentioned that all the people in the program violate the rules and tell you to lie, I don't see why you had to bring the nationality of the your Chief into it.

I understand you got pregnant. It happens sometimes. The program you are in sounds malignant but don't think other programs are not. Most are not very sympathetic. Certain specialties much worse than FM.

Agree with this post. The OP is an IMG herself which makes me wonder why she brought that up as well. Personally with her red flag(a failed step) as well as being in a new program I don't foresee an established program wanting to risk a spot on her currently. You should put your head down and survive at least PGY-1 so you can get a medical license in some states.


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[flasheroonie]

If everyone in your program is violating ACGME hours rules and the chief and program director are openly condoning it, that's a big problem.

You can file a concern or a complaint to the ACGME, but you have to A) fully describe what you've already done within appropriate channels to try to resolve the issue within the residency program before contacting the ACGME and B) give the ACGME your contact information. There is no such thing as an anonymous concern or complaint.

More info: Concerns and Complaints

 

[TableMD]

I

Being an IMG puts you in hard spot. For example, my program doesnt interview IMGs since things are more competitive and my old place is nothing special,. A failed step exam makes it even harder.

I think you should keep a low profile, do your three years and get out. Being pregnant, having a child is very rough but you have to find a way to get through. Without a gaurantee I dont know how practical a transfer is. I dont know how useful ACGME complaints will be as far as improving your situation.

Do your time and get out and you can put the mess behind you. Use daycare, family whatever you can and dont create any enemies. This is a very vulnerable time for you professionally.

 

[Hakuna Matata]

I had a baby 1 month into residency. No lighter workload up until I delivered. I worked 24 hour shifts through 39 weeks and frequently would forget to go to the bathroom or eat. I worked my last 24 hr shift about 1 day before giving birth. So unfortunately I know firsthand that you're not entitled to an easier workload.
However, make sure to look into FMLA. I don't believe they can force you to use your vacation time in place of unpaid leave- FMLA is unpaid leave up to 12 weeks. Personally I didn't want to delay my residency graduation too much (plus needed the money), so I took 1 week of vacation and 5 weeks of unpaid time off. I will be returning to a very light elective, then be jumping back in full-time.
Sounds like a very malignant program you're a part of. Unfortunately it doesn't seem there's too much you can do about it right now. Surround yourself with a strong support system. Hang in there!


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[JustPlainBill]

So, how's life at UTSW? -- sounds like things haven't changed --- My advice -- as a PGY1, get out of there, now....set up a transfer during the PGY1 to PGY2 transition -- if you stay into PGY2, it becomes a financial hassle for the receiving residency to take you ---

 

[JonMonkey]

Baby or no baby I would get out. If that program is violating ACGME duty hours, asking you to lie about it, etc they will get caught at some point. If they do there is a chance that they are shut down...leaving you without a job. As for the pregnancy you work until you deliver and then take your maternity leave and add 3 months to the end of your residency.

 

[studyaholic]

You are in a difficult situation. Are you sure you want to stay in this program? But I think all programs are basically like this.

On another note. What does being a foreign MD have to do with anything. If he is the Chief resident that means he did do clinical work in the US. Since you mentioned that all the people in the program violate the rules and tell you to lie, I don't see why you had to bring the nationality of the your Chief into it.

I understand you got pregnant. It happens sometimes. The program you are in sounds malignant but don't think other programs are not. Most are not very sympathetic. Certain specialties much worse than FM.

No no, I'm also an IMG. Nationality has nothing to do with it, just seems like he compares things to his home country which he brings up didn't have any facilities. I meant in an aspect that this person never did rotations in a program with a residency so isn't very well versed on what residencies do...and not receptive to other people's input. No offense to any nationality!

 

[studyaholic]

Agree with this post. The OP is an IMG herself which makes me wonder why she brought that up as well. Personally with her red flag(a failed step) as well as being in a new program I don't foresee an established program wanting to risk a spot on her currently. You should put your head down and survive at least PGY-1 so you can get a medical license in some states.


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You know, after a lot of thinking, this is probably the right thing to do. I had a friend in an extremely malignant IM residency in NY, she finished 1 year didn't renew her contract -taking a year off to deliver her baby, and then hoping to apply into a PGY2 spot...which probably isn't a guarantee. I don't want to put myself into the predicament

 

[studyaholic]

Sounds like everybody in your residency is miserable, pregnant or not.

You have to decide whether you want what's on the other side of fighting this residency for your rights, vs. what you'll have to do to recover and get into another residency if you walk.

The residency is offering you a deal that allows you to not add another year to residency by taking time off. This is standard. It's convenient for the residency and for the other residents. And it's legal.

You can negotiate with your residency for a deal that allows you a leave of absence and adds time at the end of 3 years. This is inconvenient for the residency. This is hard for a new program to figure out for the first time. This adds work to the other residents. And it's legal.

You can try to change residencies. It's mid-August, and you're pregnant. Another residency that needs to fill a spot, and is willing to take you on, offers no guarantees of being better run or more hospitable. And transferring isn't a thing. What it would be is applying, interviewing, waiting, and then, if successful, you're off cycle, you're only there for a while before being out on maternity so you'll be disoriented, you're half in one class and half in the other, and you'll graduate about 6 months late. (Note: mid-PGY2 "transfers" are not even slightly a thing - 2 years of continuity in one residency is required by ACGME.)

Or, if you can figure out a way to complete an intern year and get licensed, then you have choices. You can bail on your toxic residency, move to where your spouse is, work part time in urgent care, maybe have another kid, and pick up a PGY2 spot in another residency when you're ready. Or you can stay.

I suggest the most important thing, career-wise, is keeping things friendly with your PD. You will need your PD's help to do pretty much anything.

Your chief resident isn't requiring you to break work hours. That person is empowered by the residency. You have to choose whether to start being "the one" who complains about work hours and refuses to comply. It won't make you any friends. You'll be told it's your fault for not managing your time well. You'll be resented by those who have to do "your" work. Refusing is probably what you will have to do to stay in this residency without endangering your health.

It takes a whole lot of maturity to handle a situation like this with grace and professionalism and concern for others. A whole lot of fresh interns wouldn't be able to do it. Nobody will make you do it. You should do it.

Good luck!

You know

I had a baby 1 month into residency. No lighter workload up until I delivered. I worked 24 hour shifts through 39 weeks and frequently would forget to go to the bathroom or eat. I worked my last 24 hr shift about 1 day before giving birth. So unfortunately I know firsthand that you're not entitled to an easier workload.
However, make sure to look into FMLA. I don't believe they can force you to use your vacation time in place of unpaid leave- FMLA is unpaid leave up to 12 weeks. Personally I didn't want to delay my residency graduation too much (plus needed the money), so I took 1 week of vacation and 5 weeks of unpaid time off. I will be returning to a very light elective, then be jumping back in full-time.
Sounds like a very malignant program you're a part of. Unfortunately it doesn't seem there's too much you can do about it right now. Surround yourself with a strong support system. Hang in there!


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I agree with you guys, I'm going to surround myself with positive people. I am hoping for a lighter load closer to delivery...

 

[studyaholic]

I don't want everyone to think it's a toxic malignant program.

It's definitely slightly turning into a malignant program, if people don't speak up and this person remains chief! When you speak up, they think you're a complainer. The day I said "hey i'm pregnant, I can't be skipping meals..." the chief made a joke "YOU'RE MILKING THIS PREGNANCY." He a few weeks ago when I said I already skipped lunch and now i can't skip eating dinner, he said "Oh one or two meals isn't going to hurt. Stop complaining," and he laughed it off.
I said we're covered by law, and if I have future medical complications the program has to accommodate the same as Americans with disability...and he said "So pregnancy is a disability?" Just jokes after jokes...

My husband is saying it's probably the hormones that are making me sensitive to what's going on.
On a separate note, it is a new program and kinks are being worked on...but there's alot of confusion on the roles of PGY2 expectations and PGY 1 expectations....sigh

I need to suck it up, and just be grateful to be in a residency!
Thanks for the reality check you guys!!

 

[Ericslv]

No no, I'm also an IMG. Nationality has nothing to do with it, just seems like he compares things to his home country which he brings up didn't have any facilities. I meant in an aspect that this person never did rotations in a program with a residency so isn't very well versed on what residencies do...and not receptive to other people's input. No offense to any nationality!

Fair enough. In the end you have to figure out if this program is right for you and you can survive the 3 years. Consider looking for other programs right away. Be discreet.

 

[PTPoeny]

Have compact food in your pocket at all times so you don't completely miss meals. FMLA won't apply as you won't have worked there for a year before having your baby. Expect to work just as much as everyone else with long shifts and full rosters right up until you start your leave unless you can switch to be on a rotation known to be lighter for every resident that takes it(elective?) before you deliver. Have you started talking about pumping and blocking time for that when you get back?(If that is what you want to do) Given the fact that you are having trouble finding time to eat now I have a feeling you will have trouble with that later if you want to pump.

The duty hours part sucks but doesn't really have anything to do with being pregnant. You have to figure out what you want to do about that completely separately. If you are going to negotiate to take maternity leave you might need to keep your head down about the duty hours and let that be some else's fight. And no, not every program is like this, there are programs that follow duty hours and care about making it work within the rules.

 

[scharnhorst]

I had 2 pregnant residents during my 2nd yr so sorry I'm biased but I have NO SYMPATHY

they took their sweet time with the patients and signed out right at 11 AM postcall and left me with all the discharges and other signouts

it was miserable !!!

but I understand not everyone is the same , just venting here

 

[studyaholic]

I had 2 pregnant residents during my 2nd yr so sorry I'm biased but I have NO SYMPATHY

they took their sweet time with the patients and signed out right at 11 AM postcall and left me with all the discharges and other signouts

it was miserable !!!

but I understand not everyone is the same , just venting here

Awe see, women like that tarnish our name! I actually volunteered for extra call, I come early, stay late, and I've been doing my senior's Sign Out logs! Lol I think I'm outperforming my senior, I carried 10 patients during in patient- did all their progress notes on time...had 6 discharges one time, did all d/c summaries & arrangements with consults ect on time....and once i had 4 admissions back to back during night call and did ALL on time. Meanwhile, my non pregnant senior, she's complaining 90% of the time of having so many patient, stays till 12 at night trying to catch up with her notes because she spend a good chunk of the day complaining to 5-6 other people about her patient load LOL

I literally hid my pregnancy well during the first trimester, to where all the ED during my ED rotation had no clue!

Pregnancy does not equal handicap, or intellectually disadvantaged!

 

[Keona]

The u.s. Does not protect women during and after pregnancy. It's sad but the only way you are protected is that your job cannot be taken away for being pregnant or up to 12 weeks of unpaid maternity leave. Per acgme requirements your program can't give you more time off than what they are suggesting. You are legally required to have time for pumping if breastfeeding but physicians and residents may or may not be as well protected as other careers as we obviously can't pump if it would be endangering a patient's life for us to not be available. I pumped throughout intern year and had a 5 month old. I charted, dictated, ate lunch and put in orders while pumping. It's going to be extremely hard to be a single parent during intern year. Can a family member stay with you to help? And your program sounds crazy! We log duty hours as we should and the amount of hours logged is partially used to justify increases need for a larger number of residents.

 

[feb14]

I kno this post is about 1 year old no- just curious how things ended up!
Im in an almost similar situation now and wondering what did you end up doing