Probation during IM Residency

[mountainboy]

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[chessknt]

You will have to credential at the hospital where you do fellowship where this will become known. I would probably inform your future PD of this development and accept whatever decision he or she decides to make.

If nobody else was covering you this does seem like a grave lapse in judgement and looks very bad coming from someone about to graduate instead of a brand new intern who could better claim ignorance.

It is also strange that this was for a vehicle rather than, say, a sick family member at home. I havo no idea what you would need to be doing in person so frequently and so long for a car accident. The claims adjuster usually inspects a car by himself then cuts you a check for damages. You shouldn't have needed to be in person for any part of this process beyond getting it to a shop or scrap yard and could have simply made phone calls from work if there were issues.

 

[deleted480308]

1. Thank your current PD that you still have a job. A lot of people would fire you.
2. Tell your fellowship PD so they don’t hear it from someone else, then thank them profusely if you still have a fellowship.
3. Never ever ever leave the building when on call until you are done training. Ever. You don’t have a track record of good judgment on when it’s ok.

You clearly need a new car insurance company

 

[Psai]

Dude...

 

[IMGASMD]

I’ve heard institutional academic probation that doesn’t show up on any reports contingent on improvements. So a slap on the wrist so you know you better buckle up.

But like the other posters have already said, patient abandonment speaks more of lapse in judgement than anything else.

The only person who will know what will or not show up on your report is your PD, so ask them. Whether you speak to your fellowship director..... that’s a very tough call, especially if my stalking skill is up to par, cardiology? Three years? Don’t want to be in your shoes.

 

[Moose A Moose]

I’m calling bull s hit. You’re lucky your PD didn’t do the same.

 

[jhamaican]

I wouldn't say anything to your fellowship program yourself. Why tell on yourself? If your IM program says something, that is out of your control anyway.

You are on probation by your IM department, not your future fellowship program. Fellowship is a fresh start.

Just make sure you don't have any more mishaps, graduate successfully, and start with a clean slate.

I doubt they would go out of their way to inform your fellowship program unless you really pissed someone off personally, or continue to under perform or have other lapses in judgement.

Don't even bother asking your PD if it will show up in the future. Why remind them, or give them the idea, to even say something to your fellowship?!

Just be invisible for the rest of residency. Don't say a mumbling word to anyone (current program or future fellowship) or mess up again. It is wholly on your program if they want to notify your fellowship and mess up your future. Don't help them in the matter. Do not remind them. Do not give them any ideas.

 

[GastriqueGraffin]

The worst part of all this is you want to appeal. This shows you have learned nothing from your error. Physicians are one of the highest paid professions for a reason and it’s because we are always ready to work when we are called up because lives are on the line. Leaving when you are on call would get you fired almost definitely in the real world. As far as telling your fellowship, I wouldn’t but I’d ask your IM PD your question after doing some serious reflecting.

 

[chessknt]

OP is in a tough spot since asking the PD if this will be reflected on PD reference letters is a transparent way of asking if this needs to be disclosed which sounds like trying to evade responsibility which he is not trying to do. In all likelihood this will show up in the PD's form reference letter (eg Mountainboy was placed on probation for 6 months because xyz and no further issues were encountered). A credentialing committee that sees this will throw up a flag given the seriousness of this issue (not a RN complaining that he was mean, this is an actual patient safety concern that could have real medicolegal implications for their hospital) and the fellowship PD will be alerted and likely pissed off that he/she is learning this from a credentialing committee.

If you have 3 years at this place you dont want to start off as the problem child--come forward now in a show of good faith with your future PD to demonstrate maturity. It seems unlikely that you will get kicked out before you start but if you do then you can always apply again after atoning for these errors with a year of perfect employment as a hospitalist. If the PD learns of it any other way you are on the **** list there and IMO chances are higher you will get cut off. Appealing this would be an enormous mistake given the low probability of success and high probability of pissing off your program administration.

 

[deleted480308]

OP is in a tough spot since asking the PD if this will be reflected on PD reference letters is a transparent way of asking if this needs to be disclosed which sounds like trying to evade responsibility which he is not trying to do. In all likelihood this will show up in the PD's form reference letter (eg Mountainboy was placed on probation for 6 months because xyz and no further issues were encountered). A credentialing committee that sees this will throw up a flag given the seriousness of this issue (not a RN complaining that he was mean, this is an actual patient safety concern that could have real medicolegal implications for their hospital) and the fellowship PD will be alerted and likely pissed off that he/she is learning this from a credentialing committee.

If you have 3 years at this place you dont want to start off as the problem child--come forward now in a show of good faith with your future PD to demonstrate maturity. It seems unlikely that you will get kicked out before you start but if you do then you can always apply again after atoning for these errors with a year of perfect employment as a hospitalist. If the PD learns of it any other way you are on the **** list there and IMO chances are higher you will get cut off. Appealing this would be an enormous mistake given the low probability of success and high probability of pissing off your program administration.

But op is actually, literally, trying to evade responsibility

 

[whoknows2012]

I think this I not necessarily the place to get good advice on this since few people have enough background to truly know what the best answer is. My first impression was let the dust settle a bit, maybe get another month or 2 of good feedback and go to someone in the leadership you trust and explain to them your question clearly (ie I was thinking of informing my fellowship program). To me that shows maturity and good judgement. Unfortunately their answer may be it’s best to inform the fellowship PD in which case you kinda have no choice now AND it probably means they would’ve been informed anyway. At my program fellowship programs didn’t necessarily know about all probation and it depended on the timing and the offense. Most IM programs try to handle it internally with the goal of remediation the issue as opposed to dooming your career as that negatively effects everyone including the program as it looks poorly on them too.

As far as going outright and telling your fellowship PD without discussing first with you IM program leadership that’s a quick way to look bad on both ends bc you may find out after your IM program had no intention of informing the fellowship PD. This is your future I would think carefully how you handle this and weigh all advice with someone who you trust. Hope this helps and good luck.

 

[whoknows2012]

Also as far as everyone rushing to judgement and proclaiming the OP is trying to evade responsibility put yourself in their shoes for a moment how would you handle it? Whatever happened happened, it was both a mistake and poor judgement and he/she was punished for it. If the program felt it was egregious enough they could’ve removed them from the program. They didn’t and therefore (whether it be bc of program policy or a general sense that this won’t happen again and the person can learn) remediation is possible/likely. What’s the point of having a probation or remediation policy if the second someone screws up (whether truly a mistake or poor judgement) they’re proclaimed a lost cause. I’ve seen enough in my role as chief resident to know how these things work and have participated in remediation plans that’s have worked and succeeded quite well.

 

[Gastrapathy]

What would be your grounds for appeal? I'm surprised you weren't dismissed and an appeal is likely to harden some very kind and forgiving hearts. The argument that you got away with it doesn't mitigate the choice to take the risk with the lives of others so I wouldn't emphasize that again.

@Moose A Moose is right. I also find your excuse for why you abandoned patients to be highly suspect. You didn't need to walk off the job 15 times for a matter of hours each time to deal with a totaled car. You can't come up with a new story now but don't expect the fellowship PD to find that story credible.

Probation is typically disclosed in program letters of recommendation, end of training evaluations and to licensing boards. Increasingly, formal remediation is also disclosed. Hiding from this won't change the institution's policy on that (they aren't going to forget somehow). Your GME handbook probably explains this. You can also find out your institution's policies by talking with your program coordination or the GME office equivalent.

CA, for example, asks about "unusual cirmunstances" which include probation and a variety of other scenarios (google form l3a-l3b). This kind of language is increasingly common and is being copied by credentialing committees.

 

[Gastrapathy]

@whoknows2012 Rushing to judgment? That phrase means making a judgment without the facts. Take what the OP said in the most favorable light and he's fortunate to only have been placed on probation. Now he's asking for advice about how to escape all meaningful consequences. Residents have been dismissed for far less. This wasn't a single impulsive mistake. He reports that he abandoned patients 15 times. He says that he lives 10 minutes away which suggests to me that he went home "to deal with his totaled car." His conduct would get him fired if he was a Walmart security guard. Its only in the overly protective cocoon of GME that he's escaping with a lower administrative sanction. He should feel incredibly fortunate.

 

[whoknows2012]

What would be your grounds for appeal? I'm surprised you weren't dismissed and an appeal is likely to harden some very kind and forgiving hearts. The argument that you got away with it doesn't mitigate the choice to take the risk with the lives of others so I wouldn't emphasize that again.

@Moose A Moose is right. I also find your excuse for why you abandoned patients to be highly suspect. You didn't need to walk off the job 15 times for a matter of hours each time to deal with a totaled car. You can't come up with a new story now but don't expect the fellowship PD to find that story credible.

Probation is typically disclosed in program letters of recommendation, end of training evaluations and to licensing boards. Increasingly, formal remediation is also disclosed. Hiding from this won't change the institution's policy on that (they aren't going to forget somehow). Your GME handbook probably explains this. You can also find out your institution's policies by talking with your program coordination or the GME office equivalent.

Agree re; finding out your institutions policy on this including what I’ve said above. If you can’t find it in the gme handbook that’s where asking someone would be helpful

 

[whoknows2012]

@whoknows2012 Rushing to judgment? That phrase means making a judgment without the facts. Take what the OP said in the most favorable light and he's fortunate to only have been placed on probation. Now he's asking for advice about how to escape all meaningful consequences. Residents have been dismissed for far less. This wasn't a single impulsive mistake. He reports that he abandoned patients 15 times. He says that he lives 10 minutes away which suggests to me that he went home "to deal with his totaled car." His conduct would get him fired if he was a Walmart security guard. Its only in the overly protective cocoon of GME that he's escaping with a lower administrative sanction. He should feel incredibly fortunate.

Rushing to judgment was in response to posters saying the OP was trying to be evasive. He made a mistake, owned it and is now asking next steps. I agree appealing could make things worse but it’s still a reasonable question in my opinion. It’s not like he’s appealing the trouble he’s in he’s asking for a slighter lesser “sentence,” hopefully based on some evidence that he’s been performing well.

Again, re; the actually act of leaving patients unattended the reasons for it are irrelevant bc whether it’s to take a nap at home or go to gym (as I knew of a co-resident who did that) or deal with his “car” it’s equally bad and shows poor judgement. Whether you guys believe it or not, the program could’ve dismissed him entirely if they felt it was bad enough and the fact that they didn’t means they probably are open to a second chance and aren’t necessarily looking to sink his career. Finding out if this will be reported to licensing boards and program letters is paramount as this should dictate your next step (to say somebting to fellowship PD or not)

 

[Gastrapathy]

I agree that the reason is irrelevant but coming up with a "reason" that defies credibility is not. The coverup may not be worse than the crime in this case but it doesn't help.

The advice the OP needs is to just try really hard to stay out of trouble and feel fortunate that he's likely to get to finish residency.

 

[IM2GI]

Not much new to add but I will summarize:

a) Stunned you were not fired. We all know that typically too many people show up to a code anyway, but it is an enormous sign of poor judgment as stated.

b) No one is believing you left 15 times for a simple car insurance situation. Maybe once or twice, at which time you tell your attending, hey look I got in a car accident can you please cover me for an hour, and most reasonable people would say sure. A skeptical person would assume you have a substance abuse or sexual thing going on.

I know people who have had delayed starts to fellowships. Find out how this impacts your graduation date and inform your future PD and get your act together.

 

[DrMetal]

I.

You'd also be wise to protect your anonymity, you've likely already said too much.

 

[anonperson]

thread deleted

OP, **** (foul language removed by Moderator)

Just admit you used this as an excuse to screw around.

My car got totalled in residency. I never had to meet the insurance agent ever. I did everything by email and the agent went to the towing yard to see the car on their own. I got a check in the mail.

I think if you try to appeal, this could go much worse for you. Be thankful they didn't fire you, which they easily could have

There is obviously more to this story so it will be impossible to give you accurate advice.

 

[Redpancreas]

OP, think it's worth paying the SDN fee to convert to Gold just to delete this thread...

 

[Anicetus]

OP may have been better off just admitting that we went to jack off in the on call room and file for hypersexuality disorder.

 

[IMGASMD]

OP may have been better off just admitting that we went to jack off in the on call room and file for hypersexuality disorder.

15 mins? I miss being young........

 

[ThoracicGuy]

I miss all the good threads...

 

[Raryn]

I miss all the good threads...

Me too. Wonder exactly what OP did, sounds like a doozy.

 

[LuciusVorenus]

Me too. Wonder exactly what OP did, sounds like a doozy.

It's killing me not knowing. Something about not showing up to codes / not being at the hospital for hours at a time?

 

[CatFactorial]

It's killing me not knowing. Something about not showing up to codes / not being at the hospital for hours at a time?

I’m quite certain it involved coding a car insurance agent who refused to give a good quote.

 

[IMreshopeful]

It's killing me not knowing. Something about not showing up to codes / not being at the hospital for hours at a time?

Yeah apparently had to leave the hospital multiple times and a day for car insurance related reasons. Smells of BS

 

[CDI]

The “Mountain” part of OPs username gives me a pretty good clue which hospital this resident is at. Suspect!