Racism in residency programs.

[HemeOncHopeful19]

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And you seem to think there are not like minded people in medicine. They will get rid of you if you come in with a Trump Ultra Maga Hat

As they should. Politics has no place in the workplace.

 

[Iamnew2]

My contract does have a "no cause" loophole stating I can be fired whenever. However, in my case, that would nullify my noncompete and I believe they have to pay me out 90 days even if they want me out sooner than that. My employer walks you out same-day if you are fired. Otherwise I have reasons listed in my contract that are fireable and the caveats that go with each.

ok. As someone else said, no one cares what some other doctor/admin person says as an attending. As long as no malpractice issues or serious allegation is made, no harm done really. Residency firings etc are career ending. Apples and oranges that's my point.

So if your employer says Smurfette we don't like your scrubs today, you are gone now! You say ok whatever, and then in like 2 weeks you can likely have a job elsewhere. Other than some mildly hurt pride no big deal. If you are a resident and you are fired most people are done.

 

[MDMechEngr]

As they should. Politics has no place in the workplace.

yes and it goes both ways. No creepy/sleepy Joe Bejing Biden support bottons in the workplace also.

 

[anonperson]

ok. As someone else said, no one cares what some other doctor/admin person says as an attending. As long as no malpractice issues or serious allegation is made, no harm done really. Residency firings etc are career ending. Apples and oranges that's my point.

So if your employer says Smurfette we don't like your scrubs today, you are gone now! You say ok whatever, and then in like 2 weeks you can likely have a job elsewhere. Other than some mildly hurt pride no big deal. If you are a resident and you are fired most people are done.

No procedural specialist can just walk into a new job in 2 weeks.

Hospital privileging can take months. Getting on insurance panels takes awhile as well.

It is vastly easier to be fired as an attending. My contract states I can fired without cause. Most employment contracts state the same thing. Not to mention if you are on a claims made policy, you may be responsible for the tail as well.

Are the stakes higher if you are fired as a resident? Yes, but it is a much longer process with more documentation needed.

There seems to be this thought that no resident should ever be fired and if they were fired it was completely unfair.

In a perfect world, I would agree.

In the real world, some residents are not capable of being independent physicians. It's unfortunate but it happens. If the residency wants to cut their losses, that seems reasonable.

 

[Emmet2301]

So would you suggest grading them on something… objective… such as… exam scores?

I feel like this thread is about to come full circle.

Depends on how the exams are structured, created, implemented.

Didn't someone mention the racial/economic bias of the SAT?

(It's also interesting to note the looking at candidates from a "holistic" viewpoint that would give preference to white candidates vs. looking solely at test scores that might give preferences to Asian candidates. But that might be a conversation for another day.)

 

[guytakingboards]

And you seem to think there are not like minded people in medicine. They will get rid of you if you come in with a Trump Ultra Maga Hat

I think there's some goal-post shifting here. If you wanna say all roads are possible to someone getting railroaded out of residency, fine, I don't agree with that. But your tone is kinda implying you don't understand that that could literally happen in any job, big or small.

This seems to be touching on something completely different. The absolute frustration with the power dynamic and the inherent vulnerability of the residency position. Yes, it sucks. No question. Probably a substantial amount of resident's general unhappiness during residency is due this fact. They have no ownership of their training. They are at the whims of everyone else.

God knows I thought the process was insane as I was going through it as well, but in retrospect, it's really "your first job". Learning the harsh reality of the job environment for the first time in your late 20's/early 30's, while completely contrasting your perception of medicine as a noble/enlightened profession, is jarring. But really, most jobs suck. That's why they're "jobs" and you get paid for it.

 

[Goro]

That was my point. All they have to say is youre not professional in your interactions we are concerned about the safety of this resident. It's a joke. Having said that and knowing all this as a resident your job is to attempt to win an academy award on how good of an actor you are.

You seem to like picking the data points that confirm your prejudices

 

[NITRAS]

All jobs have subjective evaluations. This is seen in every field.

Unless you're in solo practice, you will still be evaluated subjectively by others who theoretically could be racist.

I work at a FQHC and the site director (a physician) and the Women's health director periodically review me and the other physicians based on subjective measures.

As a solo practitioner, you are subjectively evaluated by your patients.

One of the biggest issues of firing a resident is the hole in the schedule and the pool of replacement residents is usually limited and have often times have red flags.

EDITED: spelling. . .

 

[mvenus929]

As a solo practitioner, you are subjectively evaluated by your patients.

One of the biggest issues of firing a resident is the whole in the schedule and the pool of replacement residents is usually limited and have often times have red flags.

And the impact on the next few recruitment cycles if prospective applicants find out.

 

[OptionOffense]

You seem to like picking the data points that confirm your prejudices

There is no data points and I am not prejudice. Im calling it like it is. The entire thing is subjective. How can it not fail?

 

[JKinSC]

Anyone who has been here for a while has seen ridiculous stories. One fired resident posted on here about how they were unfairly targeted and someone just hated them... Then three pages into the thread it came out they were fired for hiding a camera in a bathroom and the fired resident kept trying to justify their actions...

I'd completely forgotten about that guy. The news articles were unreal.

 

[voxveritatisetlucis]

Wonder where the guy is now. IIRC, his fiancé was a resident at same place

 

[Raryn]

Wonder where the guy is now. IIRC, his fiancé was a resident at same place

Pretty sure if someone gets caught putting cameras in the bathrooms at work, they won't typically have a fiancée for long.

 

[smq123]

Pretty sure if someone gets caught putting cameras in the bathrooms at work, they won't typically have a fiancée for long.

You'd think so, but people never fail to surprise me...

 

[voxveritatisetlucis]

Pretty sure if someone gets caught putting cameras in the bathrooms at work, they won't typically have a fiancée for long.

Lol according to the article it was because he thought somebody stole his adderall and wanted to catch the perp. Sounds like ampetamine induced paranoia

 

[hallowmann]

As a solo practitioner, you are subjectively evaluated by your patients.

One of the biggest issues of firing a resident is the hole in the schedule and the pool of replacement residents is usually limited and have often times have red flags.

EDITED: spelling. .

Everyone always says this. It really depends on the program. One program I'm familiar with fired (or "non-renewed") 5 residents in 3.5 yrs (about 12 in 10 yrs), in fact one academic year saw 3 residents dismissed. The remaining residents were basically pulled off of electives and off service rotations to fill in the missed clinic, inpatient, and call shifts. The residents were simply expected to absorb the remaining work and leadership basically made the chiefs "fix" the schedule with barely any notice that residents were being dismissed. Witnessing this firsthand put a pretty bad taste in my mouth about the entire residency system. No autonomy, no power, and incredibly high stakes for the residents involved. About half of those residents that were dismissed went on to complete residency elsewhere (granted a year late) and some even went on to fellowships.

The 3 in one year led to torching of the program in the ACGME survey, multiple attendings in the psych department filed complaints (residents sought a lot of mental health care around this time), and ultimately the GME department came down with some pretty big admin changes. Magically the program hasn't lost a graduate for years. I say all this to point out that all it takes is a specific type of culture and a willingness to dump on the remaining residents. You don't need to replace a resident if you make the others work more.

Pretty sure if someone gets caught putting cameras in the bathrooms at work, they won't typically have a fiancée for long.

He was plotting to catch someone he thought stole his stimulant. Completely no insight as well. Kept trying to defend the action when others pointed out how problematic it was to be recording in the bathroom. IIRC, he was even interrogated and confronted, tried to make up a story, and then said, "whelp, you got me!".

 

[voxveritatisetlucis]

lol ya I’m pretty sure he was only caught because there was footage of his apartment on the camera

Everyone always says this. It really depends on the program. One program I'm familiar with fired (or "non-renewed") 5 residents in 3.5 yrs (about 12 in 10 yrs), in fact one academic year saw 3 residents dismissed. The remaining residents were basically pulled off of electives and off service rotations to fill in the missed clinic, inpatient, and call shifts. The residents were simply expected to absorb the remaining work and leadership basically made the chiefs "fix" the schedule with barely any notice that residents were being dismissed. Witnessing this firsthand put a pretty bad taste in my mouth about the entire residency system. No autonomy, no power, and incredibly high stakes for the residents involved. About half of those residents that were dismissed went on to complete residency elsewhere (granted a year late) and some even went on to fellowships.

The 3 in one year led to torching of the program in the ACGME survey, multiple attendings in the psych department filed complaints (residents sought a lot of mental health care around this time), and ultimately the GME department came down with some pretty big admin changes. Magically the program hasn't lost a graduate for years. I say all this to point out that all it takes is a specific type of culture and a willingness to dump on the remaining residents. You don't need to replace a resident if you make the others work more.


He was plotting to catch someone he thought stole his stimulant. Completely no insight as well. Kept trying to defend the action when others pointed out how problematic it was to be recording in the bathroom. IIRC, he was even interrogated and confronted, tried to make up a story, and then said, "whelp, you got me!".