Probation Question

[Stingarov]

/Resolved

(Much about clarification of options given fear of non-renewal or termination).

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[deleted480308]

Can you turn your behavior around? Are you capable of enduring the stress? It might be that psych treatment could be good for you as a person regardless of career implications

 

[Stingarov]

Can you turn your behavior around? Are you capable of enduring the stress? It might be that psych treatment could be good for you as a person regardless of career implications

Yes I can. I agree

 

[LucidSplash]

@aProgDirector shpuld weigh in here. But I will say that if you resign, you will have to report this on every licensing and credentialing application for the rest of your life. So it isn't like you'll escape negative effects that way.

 

[Stingarov]

I hear you LucidSplash. I don't intend to be anything but honest and forthright.

 

[ThoracicGuy]

I hear you LucidSplash. I don't intend to be anything but honest and forthright and could even say "I resigned to take time off and focus on myself and my own shortcomings after events x y and z due to deficiencies in these areas." Will not be trying to avoid explaining this if reapplying or otherwise doing something like heck, teaching.

Your chances of finding a new spot somewhere else is not good. Just do your probation, straighten up, and be a model resident for the rest of your training.

 

[Aonyx]

This is a pretty detailed post of what sounds like a pretty uniqe situation. You might consider editing some of the details out. Just a thought.

 

[Crayola227]

um, if you still want to practice clinical medicine like, ever, why are we even talking about resigning right now?

Sure, I can tell you right now what i's and t's to cross to try to poise yourself for a nice resignation, but that's only a good idea if you can't make probation work for you.

Sometimes probation is a necessary formality before you get terminated, and you want to avoid termination at all costs. After termination you have no rights. While you are still an employee you have rights and you are in a position to negotiate a resignation.

But if the probation is in good faith, you want to make it work. Still, play smart. Look out for yourself. I guarantee the program is looking out for itself.

I don't know if you have any psych dx.

I would:

1) consult an attorney familiar with employment law, possibly ADA NOOOOOOOWOWWWWWW!

FACT: such an attorney can help protect your personal medical information. You are free to sign over as much of your HIPAA rights as you want to your employer and HR.... but.... sometimes it's best if your attorney helps you control the flow of this information. Especially since the program can tell the Medical Board whatever they want that you've revealed, and that can follow you forever.

How complicit in building a case against you to not only terminate you, but ruin you forever to any Medical Board, do you want to be?

However, for now, it's best if any legal advice you get right now stays a super secret. Remember anyone can be made a witness, including your personal medical providers (the Board can subpoena!!!), any co-residents, your friends... So watch your words and don't talk to anyone about your attorney, and talk to your attorney about what's OK to say. Trust me, people love to talk in programs.

You want to be cooperative to fix things and not antagonize the program, you also need to protect yourself by not making it too easy to fire you. If they are looking to fire you, badmouth you, build a terrible case against you, share it with the Board, and any reference that should ever call them, then you want to be poised to negotiate a resignation package that includes a confidentiality agreement on both sides. However, the more dirt the program gets on you that makes a case for firing, and the less of a counter-case you have with the help of an attorney, the less they're going to have any reason to have to work with you.

2) get your own psychiatrist, NOWOOWOOWOWOW (this is not as medical advice)
@Perrotfish has mentioned before you really want to think long and hard before you give your employer, through HR or PD, access to your psych info.

3) if this was the type of probation reported to the Medical Board, or you're having dealings with them, I would get an attorney that specializes in board dealings.

4) Use the SDN search function in the upper right corner, search all forums, member crayola227, for the following terms

probation
remediation
resignation
termination
ADA
attorney
discrimination

5) By doing so, you'll learn some tips and tricks for how to document things that are happening and lay the groundwork for a graceful exit, should it come to that. I also have in there advice on navigating the politics as you try to get along at this program. You'll end up in threads were you can read a lot about being in hot water at a program.

Basically,
1) You want to make things work here. On the off chance this probation is for real a chance for you to get better, stay, succeed, you need to pursue that 100%. However, in case it isn't, and it's just formality to fire you, you need to protect yourself medicolegally and be poised for an exit.
2) Here is a post where I detail what your attitude needs to be regarding every single criticism lobbed your way:

Remember, no one is your friend.
Anyone including co-residents can me made a witness.
Dot all your i's and t's when it comes to work, like in your notes, reported work hours, etc.
Even the pissy notes from nurses, "MD called. Assessment still not made," when you didn't go bedside for bull****, and they are just RN-ass covering, can look bad. "Dr. Sos and So is not responsive to staff concerns."
Some of it you can't do much about. Just be aware of what a sweetheart you need to be to everyone, including the janitor.
Likeability is the only thing that can "save" you, or at least let you leave this program with some decent LORs.

Victim of malignant PD, dismissed yet reinstated.
Good guide on how to document what happens.

Always make it clear you are willing to do whatever it takes to complete the program, you just want to see if there's any way to work together to balance program scheduling with your physician's recommendations for your health. You just want reasonable accommodations for your medical conditions.

Please please please get yourself an attorney and say very little overall. The link above says how to document, this will help your attorney.

When it comes to ANY criticism, DO NOT SAY ANYTHING that can even appear to deflect responsibility in any way. Trust me, it can be tempting to try to defend yourself, but this will just be used against you. "Lacks insight into deficiencies," "unable to take responsibility," "blames other for mistakes," etc etc

"I realize that my performance needs to improve in X ways. I would appreciate a remediation plan to help me address/develop those skills."
"I am willing to repeat any amount of time, including the year, if that is possible and felt to be the best way for me to continue my training here."
"If an extension of my training time or additional nightfloat is necessary, I am willing to do that."

You might worry that agreeing with every nasty thing they have said is just helping/feeding into the nasty case they are building about you that says you are the worst resident on Earth, but they can do this despite anything you say.

The only thing you can control is what comes out of your mouth, and that it doesn't just add fire to the flame. That's why you don't want a single quote that out of context sounds like anything other than a totally committed resident that accepts all responsibility. A resident that sounds REMEDIATABLE. Issues that could get better with pointed feedback and training.

If something is due to your medical condition, you can say, "I feel that my medical condition has contributed to that aspect of my performance. I would like to keep working on my condition in conjunction with my medical providers and the program to address that and improve."

If it is something that is related to character, "Your seniors and attendings have felt that you are not receptive to feedback." You could say, "I apologize if I have come across that way, that was never my intent. Intent aside, I recognize part of being a team player is how you come across to others. I would like to work on that with feedback."

"Character" issues like insight, willingness to take feedback, honesty, it is hard to make a case that those are "remediatable," (somewhere I have a long post on what to say/not say and discusses how to seem remediatable.)

So never never lie. If a case is made, "well, what you said wasn't true, as evidenced by ___ in the notes, or what your senior/attending said,"

You can say, "I apologize, misrepresentation was never my intent. To the best of my ability at the time, I believed what I documented was true, but I must have made an error. I recognize that documenting with accuracy is necessary skill to work on." "I fully acknowledge I may have remembered that incorrectly, I never intended dishonesty. It was miscommunication, which I need to work on."

DO NOT bring up that now you feel you are subject to the negative halo effect.
Don't talk about the microscope.
This next bit, is extremely difficult, because on some level you want documentation that you are worried that discrimination is taking place.

You can say that, "I recognize that all of the program's efforts have been aimed at improving my performance. I think that I might benefit from accommodations for my health condition. I would like to work with my physicians, the program, and HR to put in place the best plan for all involved. I have some concerns that in addition to how my performance is impacted by my condition, for which I take full responsibility, and need to improve on from a personal medical and professional standpoint, that under the current plan, I'm having difficulty in determining what aspects of the feedback I am given is due solely to my performance, or if there are some perceptions about my illness that is affecting that. I think a plan that is specific and actionable, with guidelines about feedback, might address this by making things more clear. While I recognize several areas in which I need to improve, I am concerned about discrimination due to my condition."

If they say you are a danger to patients, "It's possible my condition may be affecting my performance. I am committed to working with my healthcare providers to continue to get my health under control, and the program in order to practice safely with my condition. If the program does not feel that with adequate or increased supervision that I can continue to work safely for patients and myself, than I would ask for an immediate leave of absence as an accommodation for my medical condition that the program is aware of. I would ask that no further disciplinary actions be taken against me during this time while I recover so that I can return safely. I would ask for 2 weeks while I meet with my providers and the program to determine the conditions for my safe return. I put patient safety first and foremost."

The italics would need to be in writing.

The italics are verbatim for invoking your ADA rights for your health condition that were given to someone I know from an ADA attorney. Do not let them terminate or dismiss you. As long as you are officially an employee, you have a lot of rights. The second they terminate you, then this becomes a wrongful termination suit, is ugly, you have no rights, not likely to win. As long you stay an employee, even if you're toast at this program, you have leverage to negotiate a better release.

I have more ideas, but I hope this gives you an idea for the flavor you want at your meeting.

TLDR:
DO NOT TRY TO DEFEND YOURSELF OR EXPLAIN AWAY ANY DEFICIENCIES NO MATTER HOW BULL****
"Not my intent, will work on"
"Due to my illness, will work on"

The only thing you should "fight," are things that make you seem unremediatable - and I don't mean when they say you're too slow, too ___ to be trained/accommodated, I mean if they try to make it sound like you're willfully being bad or a liar. Bad character stuff.

If you must, you can invoke leave for your condition if:
you condition meets the ADA definition - you need an attorney
it is currently impacting your work

When it comes to ANY criticism, DO NOT SAY ANYTHING that can even appear to deflect responsibility in any way. Trust me, it can be tempting to try to defend yourself, but this will just be used against you. "Lacks insight into deficiencies," "unable to take responsibility," "blames other for mistakes," etc etc

You might worry that agreeing with every nasty thing they have said is just helping/feeding into the nasty case they are building about you that says you are the worst resident on Earth, but they can do this despite anything you say anyway.

The only thing you can control is what comes out of your mouth, and that it doesn't just add fire to the flame. That's why you don't want a single quote that out of context sounds like anything other than a totally committed resident that accepts all responsibility. A resident that sounds REMEDIATABLE. Issues that could get better with pointed feedback and training.

DO NOT bring up that now you feel you are subject to the negative halo effect.
Don't talk about the microscope.

You need to be totally contrite, don't say a word against anyone else. Your attitude must me that YOU are the problem. I don't care if you think that's true or not. That's the only reality that matters here.

If you do have anger/emotional problems, yeah, get on that hardcore.

My next favorite sayings: if you have the chance to open your mouth and say 1 of 2 things, one will make you sound smarter, the other makes you seem more likeable, go with likeable every single goddamn time. Being liked is gonna trump being right. Learn to like the taste of blood from your bit tongue.

What sort of loans have you? Did you complete an intern year that can get your an unlimited license? Because without one....

Your survival and livelihood rests on this. If you wash out of this program for these reasons, and you haven't won everyone over as a sweetheart that made one helluva an effort AND a got a confidentiality agreement and neutral to positive LOR from the PD playing this smart with attorney, you are toast. Even if you get let go nicely, you are still likely toast. Take this seriously. Your career has a knife to its throat right now.

I am a doctor, I cannot give you medical advice on SDN, against the TOS. I am NOT a lawyer, so I can offer you laymen information that you can use at your own risk, or not.

 

[Stingarov]

um, if you still want to practice clinical medicine like, ever, why are we even talking about resigning right now?

Sure, I can tell you right now what i's and t's to cross to try to poise yourself for a nice resignation, but that's only a good idea if you can't make probation work for you.

Sometimes probation is a necessary formality before you get terminated, and you want to avoid termination at all costs. After termination you have no rights. While you are still an employee you have rights and you are in a position to negotiate a resignation.

But if the probation is in good faith, you want to make it work. Still, play smart. Look out for yourself. I guarantee the program is looking out for itself.

I don't know if you have any psych dx.

I would:

1) consult an attorney familiar with employment law, possibly ADA NOOOOOOOWOWWWWWW!

FACT: such an attorney can help protect your personal medical information. You are free to sign over as much of your HIPAA rights as you want to your employer and HR.... but.... sometimes it's best if your attorney helps you control the flow of this information. Especially since the program can tell the Medical Board whatever they want that you've revealed, and that can follow you forever.

How complicit in building a case against you to not only terminate you, but ruin you forever to any Medical Board, do you want to be?

However, for now, it's best if any legal advice you get right now stays a super secret. Remember anyone can be made a witness, including your personal medical providers (the Board can subpoena!!!), any co-residents, your friends... So watch your words and don't talk to anyone about your attorney, and talk to your attorney about what's OK to say. Trust me, people love to talk in programs.

You want to be cooperative to fix things and not antagonize the program, you also need to protect yourself by not making it too easy to fire you. If they are looking to fire you, badmouth you, build a terrible case against you, share it with the Board, and any reference that should ever call them, then you want to be poised to negotiate a resignation package that includes a confidentiality agreement on both sides. However, the more dirt the program gets on you that makes a case for firing, and the less of a counter-case you have with the help of an attorney, the less they're going to have any reason to have to work with you.

2) get your own psychiatrist, NOWOOWOOWOWOW (this is not as medical advice)
@Perrotfish has mentioned before you really want to think long and hard before you give your employer, through HR or PD, access to your psych info.

3) if this was the type of probation reported to the Medical Board, or you're having dealings with them, I would get an attorney that specializes in board dealings.

4) Use the SDN search function in the upper right corner, search all forums, member crayola227, for the following terms

probation
remediation
resignation
termination
ADA
attorney
discrimination

5) By doing so, you'll learn some tips and tricks for how to document things that are happening and lay the groundwork for a graceful exit, should it come to that. I also have in there advice on navigating the politics as you try to get along at this program. You'll end up in threads were you can read a lot about being in hot water at a program.

Basically,
1) You want to make things work here. On the off chance this probation is for real a chance for you to get better, stay, succeed, you need to pursue that 100%. However, in case it isn't, and it's just formality to fire you, you need to protect yourself medicolegally and be poised for an exit.
2) Here is a post where I detail what your attitude needs to be regarding every single criticism lobbed your way:



When it comes to ANY criticism, DO NOT SAY ANYTHING that can even appear to deflect responsibility in any way. Trust me, it can be tempting to try to defend yourself, but this will just be used against you. "Lacks insight into deficiencies," "unable to take responsibility," "blames other for mistakes," etc etc

You might worry that agreeing with every nasty thing they have said is just helping/feeding into the nasty case they are building about you that says you are the worst resident on Earth, but they can do this despite anything you say anyway.

The only thing you can control is what comes out of your mouth, and that it doesn't just add fire to the flame. That's why you don't want a single quote that out of context sounds like anything other than a totally committed resident that accepts all responsibility. A resident that sounds REMEDIATABLE. Issues that could get better with pointed feedback and training.

DO NOT bring up that now you feel you are subject to the negative halo effect.
Don't talk about the microscope.

You need to be totally contrite, don't say a word against anyone else. Your attitude must be that YOU are the problem. I don't care if you think that's true or not. That's the only reality that matters here.

If you do have anger/emotional problems, yeah, get on that hardcore.

My next favorite sayings: if you have the change to open your mouth and say 1 of 2 things, one will make you sound smarter, the other makes you seem more likeable, go with likeable every single goddamn time. Being liked is gonna trump being right. Learn to like the taste of blood from your bit tongue.

What sort of loans have you? Did you complete an intern year that can get your an unlimited license? Because without one....

Your survival and livelihood rests on this. If you wash out of this program for these reasons, and you haven't won everyone over as a sweetheart that made one helluva an effort AND a got a confidentiality agreement and neutral to positive LOR from the PD playing this smart with attorney, you are toast. Even if you get let go nicely, you are still likely toast. Take this seriously. Your career has a knife to its throat right now.

I am a doctor, I cannot give you medical advice on SDN, against the TOS. I am NOT a lawyer, so I can offer you laymen information that you can use at your own risk, or not.

This is extremely helpful. I've already given them ample reason to cover their arse unfortunately after some poor initial advice. We will see. I did complete intern year, but an integrated internship year.

All of your advice is sound and probably something I will read daily. I just have to do my part and in good faith.

Why would it not be good to say "full disclosure that I wish to discuss this with an attorney?" That isn't saying "I'm suing you." Wouldn't that assure good faith approach? Help my naivete out here.

 

[ThoracicGuy]

This is extremely helpful. I've already given them ample reason to cover their arse unfortunately after some poor initial advice. We will see. I did complete intern year, but an integrated internship year.

All of your advice is sound and probably something I will read daily. I just have to do my part and assume it's good faith, which I hope it to be based on past interactions.

Why would it not be good to say "full disclosure that I wish to discuss this with an attorney?" That isn't saying "I'm suing you." Help my naivete out here.

You may say it not meaning that you're planning litigation, but all the program will hear is litigation.

 

[Stingarov]

You may say it not meaning that you're planning litigation, but all the program will hear is litigation.

The advice that was given to me was to "let them know you have an attorney." Oof.

 

[Crayola227]

yes people forget that one can consult an attorney for advice and be guided that way without anyone ever being any the wiser

except for when they have you in the office and want to put forms in front of you to sign right then and there, you can usually put off such things long enough to run it by your attorney

for example, say they want you to sign a form that gives over access to all of your personal psych records

You can say, "I want to do whatever it takes to help the program help me, but I'd just like a few days to consider this and contact my provider personally first, given the personal nature of all this." Will the program love this? Probably not, but it's not likely to cause much damage. It's actually illegal for them to pressure you too much for certain types of information. Then you see what your attorney says. If they do employment law, employers wanting your personal medical info will not be a new thing to them, it's not their first rodeo. They can likely help you figure out how to turn down giving them everything they want and how to phrase it smart.

Then basically you sign something that your attorney can talk to your healthcare providers. Your attorney can be trusted this way. They can help coordinate the flow of information to protect you.

 

[ThoracicGuy]

The advice that was given to me was to "let them know you have an attorney." Oof. So now does resignation sound more enticing? Heh.

Resignation is NOT the answer. Why are you wanting to resign because of a probation??? Do you think that resigning will make things better?

 

[Crayola227]

The advice that was given to me was to "let them know you have an attorney." Oof. So now does resignation sound more enticing? Heh.

Resignation never sounds enticing. I don't know what you mean. You mean to them? Or to you?
Because I'm starting to wonder if you want to be canned, given your behavior from start to finish as you have described....
If you have a career death wish, I can't help you.

Yeah, telling them you have an attorney before you've thrown in the towel at this program, that's what we call going nuclear.

Are you training in the US? I'm just wondering based on how you've phrased some things. My advice won't be as useful outside the States.

Like I said, I'm not sure why people aren't aware that you can get attorney advice and no one has to know. It's not like when you go to the doctor for advice on your AIDS or go to the car mechanic you have to announce it to the world.

The very very crappy advice to announce to a program that you have an attorney is to try to scare them. You will never scare a program into keeping you. If they want you gone, you will be gone. Attempting to scare them can just backfire.

If you time it wrong.... say they wanted to help you and the probation was for real to try to keep you.... then you said "attorney," they heard "litigation," and now they're terminating you just to limit what a legal liability you've made yourself look like.

If you're convinced it's all over at the program and they are getting closer and closer to termination (often they tell you they will be having a meeting to decide your fate, and if termination is one of the menu options....)

You can scare them into whipping their attorney out and having them hash out a nice little resignation package with yours. It can be rather painless if you accept that you are going out the door and all you're looking to do is shut it well behind you.

The key to not antagonizing the program with an attorney is to not tell them, have the attorney tell you how to play smart, and just tell the program you have one when you just have to. You can let them know you got one just to make the resignation process easier, you trust the program is looking out for you, it's just hard for you to be objective about leaving because it's not something you want to do, although you understand it must be done. As such, you thought the most professional way to handle this for the benefit of all was to be represented.

 

[Stingarov]

Training inside the US. I see I've already made enough missteps...

Fair assessment re: death wish. Not sure how to recover...a bit in shock.

 

[Crayola227]

get an attorney, get a psychiatrist, do it FAST

get with the program!

I would talk to the program, and tell them that you know you really messed up, you're terrified of being terminated, and you're willing to do whatever it takes to save your career, because being a practicing doctor means everything to you. You were really worried if probation was a real chance for you to prove yourself or just a pitstop on the road to termination as a foregone conclusion. That fear drove you to consider advice about how an attorney might help you, but you see now how this could come off. You were just scared and didn't know where to turn for help. You're not trying to deflect responsibility doing this. Really, you want to take full responsibility for what you have done, are looking to stay and make things right.

Ask them if they know any psychiatrists that have experience with residents. They may suggest names. If they are inside your system, I wouldn't go there. Find your health insurance company's info. There's usually a way to contact some psychiatrists that way.

You can contact by googling an attorney that specializes in board dealings, such attorneys tend to be very used to representing physicians with mental/physical health issues, and they tend to know of psychiatrists that work with physicians in trouble! You can ask for some names, even if you don't need the help of that kind of attorney.

You can let these psychiatrists know that you are a resident and you're in hot water with your program and you need help ASAP. Seriously, you can leave that as a message even if their practice is otherwise closed. Many of us docs feel an urge to help one of our own when they get into hot water, and if these are the sort of docs that do this as a matter of course.... you'd be surprised the strings pulled or the referrals made, and how quick they might get you in.

You never want the only psychiatrist involved to be one of the hospital's or medical board's choosing.

Even if you find one of your own and establish (do it ASAP so you can start to build a rapport) you want your attorney to talk to them, they can gauge how sympathetic and helpful to you they will be.

 

[Stingarov]

get an attorney, get a psychiatrist, do it FAST

get with the program!

I would talk to the program, and tell them that you know you really messed up, you're terrified of being terminated, and you're willing to do whatever it takes to save your career, because being a practicing doctor means everything to you. You were really worried if probation was a real chance for you to prove yourself or just a pitstop on the road to termination as a foregone conclusion. That fear drove you to consider advice about how an attorney might help you, but you see now how this could come off. You were just scared and didn't know where to turn for help. You're not trying to deflect responsibility doing this. Really, you want to take full responsibility for what you have done, are looking to stay and make things right.

Ask them if they know any psychiatrists that have experience with residents. They may suggest names. If they are inside your system, I wouldn't go there. Find your health insurance company's info. There's usually a way to contact some psychiatrists that way.

You can contact by googling an attorney that specializes in board dealings, such attorneys tend to be very used to representing physicians with mental/physical health issues, and they tend to know of psychiatrists that work with physicians in trouble! You can ask for some names, even if you don't need the help of that kind of attorney.

You can let these psychiatrists know that you are a resident and you're in hot water with your program and you need help ASAP. Seriously, you can leave that as a message even if their practice is otherwise closed. Many of us docs feel an urge to help one of our own when they get into hot water, and if these are the sort of docs that do this as a matter of course.... you'd be surprised the strings pulled or the referrals made, and how quick they might get you in.

You never want the only psychiatrist involved to be one of the hospital's or medical board's choosing.

Even if you find one of your own and establish (do it ASAP so you can start to build a rapport) you want your attorney to talk to them, they can gauge how sympathetic and helpful to you they will be.

Done and done. Thank you for the patience to provide all of the information. I read your old threads too. Yourself, Law2Doc, aPD, ThoracicGuy...thanks for the past info too.

I will also draft a careful but honest "I was worried" mea culpa, as that is fact.

 

[Smurfette]

Do what they ask of you. Seeing a counselor is an excellent idea even if you don't resign. What you are going through is stressful, and you implied that stress has also resulted in some irrational behavior at work; a counselor can help you find some coping mechanisms and develop better ways to react in stressful situations. It also may show your program you are going above and beyond what they ask and are truly trying to change.

I personally saw a colleague with erratic behavior (in practice, not in residency) be put through a FFDE, drug screens, etc. as the hospital wanted to rule out any ADA qualifying conditions before finalizing any decisions about her. The FFDE was a big deal to get arranged as she was sent out of the system to do it and it took a few days to get the results, but it sounded pretty straightforward and not like they were trying to trick her. I'm not saying your program is trying to fire you---this may be their protocol based on the nature of the complaints against you---but it sounds like they are covering their bases from all angles and trying to sort out how to best handle your perceived deficiencies. You are pretty much stuck, as it's not in your interest to refuse to do what they ask, and passing those tests may prove to them you are safe to return to work.

 

[Stingarov]

Do what they ask of you. Seeing a counselor is an excellent idea even if you don't resign. What you are going through is stressful, and you implied that stress has also resulted in some irrational behavior at work; a counselor can help you find some coping mechanisms and develop better ways to react in stressful situations. It also may show your program you are going above and beyond what they ask and are truly trying to change.

I personally saw a colleague with erratic behavior (in practice, not in residency) be put through a FFDE, drug screens, etc. as the hospital wanted to rule out any ADA qualifying conditions before finalizing any decisions about her. The FFDE was a big deal to get arranged as she was sent out of the system to do it and it took a few days to get the results, but it sounded pretty straightforward and not like they were trying to trick her. I'm not saying your program is trying to fire you---this may be their protocol based on the nature of the complaints against you---but it sounds like they are covering their bases from all angles and trying to sort out how to best handle your perceived deficiencies. You are pretty much stuck, as it's not in your interest to refuse to do what they ask, and passing those tests may prove to them you are safe to return to work.

Reading the university bylaws it does appear as protocol. Did your friend end up okay? Are they okay now?

 

[Smurfette]

Reading the university bylaws it does appear as protocol. Did your friend end up okay? Are they okay now?

She found a long-term locums assignment and quit soon after the hospital put her through all that.

 

[bannie22]

TLDR but Crayola has some solid advice here.

 

[NotAProgDirector]

I agree that the advice on this thread is good. My thoughts:

1. Your employer can require a fit for duty exam, including a drug test. Most likely, they can require a drug test for absolutely no reason at all -- that should be in your institution's policies. In any case, with an "event" they can certainly require one. If they "do this right", the Fit For Duty exam is completed and all your PD gets is a report that says that you are fit for duty, or not, or that you'll need some modification. I'm going to assume from your posts above that this is not a substance problem, as failing a drug test will complicate matters quite a bit. If they do this right, they don't see anything in your medical record, even if you're "not fit for duty".

2. There's complicated language re: remediation vs probation. Probation is usually reportable to outside entities, so this will go on your "permanent record". You should clarify with your program whether this will be disclosed to the Board of Medicine, or to licensing / credentialing bodies in the future. It probably will be, but best to know now.

3. The only thing that sounds fishy to me is that you go on probation and if there are further problems you can be fired "without review". I'm not sure what that refers to. You shouldn't have to waive your right to a fair hearing should you be terminated. If they mean that they can just fire you without warning and further assessment should there be more issues, that's fine.

4. ADA is complicated stuff. But you only have ADA protections if your report your disability to your employer and request reasonable accommodations. If your illness makes you perform poorly at work, such that your performance is unacceptable and you are fired, you can't then claim ADA protections -- I don't have to accommodate your problem if I don't know about it. (The exception is if it's obvious. If you have both legs amputated, then I need to accommodate that without you asking or at least I should ask you if there are accommodations that you might need).

This sounds very similar to what I might do in the same situation. If a resident had a major professionalism event that made me worry that they were unsafe to care for patients, I'd put them on paid leave, require a Fit For Duty eval, and then return them to duty once cleared (or stay on leave if not). If this was the last in a series of prior problems for which I had met with the resident, discussed, and made clear that they needed to stop, then remediation or probation would be appropriate. if the event is severe enough, direct probation is a reasonable plan.

Needless to say, your entire career is in the balance here. If you lose this job over this, you're going to find it very hard to get a new one. No one wants professionalism problems. You need to own this, and do whatever it takes to fix it.