Real life story

[mumbai]

---

Members do not see this ad.

Hi,
I just wanted to share my story with everyone. I was always a hard working student. I got 99 in all steps. I wanted to do either Radiology or cardiology. I did Transitional year and tried that year for Radiology but scrambled to an open Neurology program. I thought that I am going to save a year (in Neurology I joined as PGY2) and getting in radiology was difficult and getting in cardiology was tough.
Anyways I successfully finished TY and joined Neurology. In my 2nd month in VA rotation i had some problem with an attending and they put me under probation.
I was extremely disappointed and shock since it never happened to me in my life.I though it was extremely unfair hence I decided to fight against it and filed grievance. Once i filed it I got evaluation from Attending who I must have rounded 3-4 times.The grievance was disaster and i was put on probation not for month but for 3 months.
I was totally shattered. Anyways I was doing OK as my PD kept on insisting. Meantime I applied via ERAS and i did biggest mistake of telling one of my colleague about my interview trails.
Anyways suddenly after that my Program Director told me that i cannot attend VA clinic since they do not think I will be safe. I did not say anything as i thought that i am not going to be there anyways. After a week she called me in office and gave me option that either she fires me and i get 1 month salary or I resign and I would not get paid. I was given an hour to decide. I was totally shocked.I really needed money to pay my bills.I choose to get fired and choose money.
I did filed again grievance.So here I am sitting alone against bunch of people defending myself.I wanted them to let me finish my year but meeting was disaster.
Anyways meantime i got matched in a University program and currently doing extremely well.I gave my step 3 recently and got 99.Well scores does not matter but it just gave me little piece of mind.
I was one of good resident during TY and now too.I do not know what went wrong during neurology residency which is lot easier residency.

Bottom lines these grievance committee are no good and never ever go that route.

This experience has made me more sensitive.If some one would have told me that 3 yrs back that some resident was fired I would have automatically come to conclusion that he must be bad resident hence got fired.


Now that I am applying for License and I have to fill out that I was fired,it hurts so much.1 evil attending can ruin your life and this black spot can never ever be washed away.
Any advice while filing for license.

 

[glade]

After a week she called me in office and gave me option that either she fires me and i get 1 month salary or I resign and I would not get paid. I was given an hour to decide.

Things like this are why a lot of people who are in administrative positions overseeing residencies need to be beaten with baseball bats out in the parking lot.

 

[bronx43]

Things like this are why a lot of people who are in administrative positions overseeing residencies need to be beaten with baseball bats out in the parking lot.

[YOUTUBE]http://www.youtube.com/watch?v=egBTcedq7LU&feature=related[/YOUTUBE]

 

[NeurologyICU]

I am very sorry to hear your story and what happened to you. I don't have any advice for your question, but I wish that you have a successful future ahead.

 

[PharmaTope]

good god!!! that is an awful story. it is true. i have seen a resident get kicked out bc one attending didn't like him for some reason. the attending told other colleagues that the resident was terrible etc etc and tarnished their opinion of him.

the resident was ultimately fired. this was a psychiatry resident. i really felt bad for him. he had a wife and kids and now nothing....

why do people let their egos get in the way? this is just ridiculous

 

[C5toC9]

Why were you put on probation?

 

[sam1999]

Sorry to hear about your experience and any way you made it through.

Quick question. What difference does it make whether

1. you resign or
2. Fired
3. Asked to leave

Does fired and asked to leave are same 2 things?

 

[SouthernSurgeon]

I feel like there is a big something missing from this story...

 

[gutonc]

I feel like there is a big something missing from this story...

Like some semblance of the truth?

 

[bronx43]

Like some semblance of the truth?

Truth is all shades of grey. The OP probably wasn't the highest performing resident ever, and the administration probably don't go home to freshly cooked babies. Subjectivity and consequences of it are present in every field, industry, business, etc.
The difference with medicine, however, are the huge stakes for the student/resident. You simply don't have many options should you be victim to a "subjective" firing. Tack on the massive debt, and you have all the ingredients for a destroyed life.
In other industries, such as finance, corporate, or consulting, you always have other options (unless you single handedly ran a company into the ground, and even then you could probably land another decent gig). If your managing director or principal "screws" you over, it's not the end of the world. It may not even be a big dent on your career plans.

 

[glade]

The difference with medicine, however, are the huge stakes for the student/resident. You simply don't have many options should you be victim to a "subjective" firing.

The problem with medicine is that the people in charge are often as mature as a bunch of kindergarteners. I've said this before and it bears repeating: most people involved in residencies have little to no interest in actually teaching residents. They're there to take advantage of the perks of having residents as free help. Residents spend their time "learning the preferences of each attending" rather than learning medicine. It's a total joke. Meanwhile, these same little kids, if they decide they "have a problem" with a resident, will gang up on them and have no problem acting unethically. Repeat: NO PROBLEM ACTING UNETHICALLY, including lying about the situation. That's the galling part. The same *****s who preach ethics and morals are some of the least ethical people when it suits them and have no problem doing the wrong thing if it is politically expedient to them.

And you're right: I'd be way less outraged if the medical field was like, say, business. You get fired from one job, who cares? You'll find another one, maybe not as good, but so what? But from the medical field it's like you get fired or quit and that's it because there are really very few programs and they all think alike and blackball people. It's a true monopoly. Then you're there like a loser without a job, you're not qualified to even check blood pressures at a high school even though you're a "doctor," and you can have a few hundred thousand dollars of debt. So everyone is terrified of this occurring and therefore they allow themselves and other residents to be abused in almost every single way during residency. Good job, medical establishment, you suck ass.

 

[SouthernSurgeon]

Like some semblance of the truth?

Pretty much

 

[dragonfly99]

The OP may or may not have been a pretty good resident. We don't really have much info to know one way or the other, other than to think his knowledge base is probably fine due to the high step scores. I think the moral of the story is to understand that medicine is a hierarchy, is a lot like being in the military and you really can't go against the opinions of the people higher than you. If you do, you're likely to end up fired. For foreign medical grads, they have even fewer options, so need to keep their noses clean even more so than the rest of us. I also agree that filing grievances, etc. is unlikely to be effective 95% of the time or more. It is basically a "he said"/"she said" type of situation and unless there is obvious gross misconduct on the part of the faculty, like physical assault or something, I just don't see how the resident or intern would/will ever win. The hospital needs to protect itself and residents are expendable since there are always more where you/we came from. This is especially true for programs that take a lot of FMG/IMG's. The best defense is to try to get yourself into the best program you can (i.e. one with better teaching, few financial problems, hopefully more positive/helpful culture with decent relationships between the attendings and residents). Once you are there, you need to make it work, so choose wisely.

 

[bawer234]

Any advice while filing for license.

You have to learn who you can piss off and who you can't. Whether you're at fault or not, its usually not a good idea to start, continue, extend or finish *&%$ w/ people above you.

 

[dragonfly99]

You have to learn who you can piss off and who you can't. Whether you're at fault or not, its usually not a good idea to start, continue, extend or finish *&%$ w/ people above you.

quoted for truth.

 

[glade]

You have to learn who you can piss off and who you can't. Whether you're at fault or not, its usually not a good idea to start, continue, extend or finish *&%$ w/ people above you.

...and then you have to learn how to get back at them without them knowing it was you, which really isn't that difficult.

 

[Kosebamse]

...and then you have to learn how to get back at them without them knowing it was you, which really isn't that difficult.

How 😕

Is this just a pipe dream? Something tells me you have to wait until you are an attending, before you can start dishing out. If you act passively-aggressive, it will be transparent, and they will single you out. I can't see any way of getting even without just getting yourself expelled. Stealing from the department?

 

[glade]

Sorry, I don't do tutorial workshops. You'll have to figure it out on your own. Suffice it to say that people do it all the time, whether it's residents getting back at attendings or attendings getting back at attendings. As everyone says, it's all a game and the key is knowing how to play that game.

Also, in case anyone finds that "wrong," don't complain. After all, look at how everyone else acknowledges that it's a game where you have to know who you "can't" mess with even if you're the one who is right. So if you accept that it's a game in that regard, you accept that it's a game in the other regard. Play on, playas!

 

[southerndoc]

You quote USMLE scores to show that you have the knowledge base. That says nothing of how well you can apply it. I've seen the smartest residents in the world be the worst physicians because they can't make use of their knowledge.

As others have said, I feel like we are missing some of the story.

 

[Roofie]

Assuming that the story is true:

If you are scoring 99% on your boards, you know how to apply knowledge to clinical situations. Only in medicine can a 99% resident be classified as deficient academically. It is a legal fiction that needs to be changed for honor's sake. But then again, I do not think that this profession values honor. If it does not, then there are aspects of the profession that are dishonorable.

You are fortunate that you were able to go to another program. You are an example of many who switch programs because of illegitimate conduct by program leadership. The choice of choosing between termination or resignation in one hour is going way over the top. The program director should be disciplined. He or she demonstrated a true lack of integrity and compassion.

This scenario highlights an important problem in residency training. An attending complains about a resident and slanders his abilities. The PD is then forced to choose between a resident or an attending. Getting another resident is easy. Getting a qualified attending who will accept significantly lower pay to work in an academic environment is much tougher. Hence, many attendings in academic programs have significant deficiencies in that they could not succeed in a competitive private practice environment. There are a minority of attendings who choose academic practice not because they want to teach but because they could not cut it in private practice. These attendings become bitter and fustrated and lash out at their underlings. Misfortune befalls such an underling as he is then classified as academically deficient.

This scenario repeated many times over results in billions of dollars in expectation damages per year and demonstrates the importance of procedural and substantive safeguards. I suspect that the entire graduate education budget equals the amount of expectation damages per year caused by illegitimate dismissal, i.e. dismissal for anything other than true clinical incompetence.

Unfortunately, these procedural and substantive safeguards are not uniform nor robust. It will take victims of these abuses to learn the law and craft cases that could make these safeguards more substantive and robust.

A resident who is fluent in English and scores in the 90th percentile on the MCAT or boards will likely score well on the LSAT. He will likely be able to attend law school with a 50-100% scholarship if he chooses not to attend a highly ranked school.

Once done, he could help change the system by providing aggressive representation for residents and victims of medical malpractice. He could help increase the cost of malpractice insurance. Indeed change can only be brought by attaching significant liability for the abuses of GME.

 

[mdterps83]

Assuming that the story is true:

If you are scoring 99% on your boards, you know how to apply knowledge to clinical situations. Only in medicine can a 99% resident be classified as deficient academically.

Only in medicine would somebody make a two digit score not a percentile. The two digit score ISN'T A PERCENTILE. On step 1 a 99 is somewhere around a 245 which is about +1 std deviation, so a 99 is about 80 percentile, pretty good but not the 99th percentile.

 

[UserNameNeeded]

99 is the highest score you can get, so does it matter that it's not a percentile?

 

[glade]

Once done, he could help change the system by providing aggressive representation for residents and victims of medical malpractice. He could help increase the cost of malpractice insurance. Indeed change can only be brought by attaching significant liability for the abuses of GME.

I was with you right up to this point. Why do we always act like "the burden is on you to change the system; the rest of us are just going to watch"? I bet you that the majority, if not basically everyone, knows that there are unscrupulous things done by residencies and program directors and yet we're all like "oh, well, these things happen." So much for the integrity and ethics of medicine and those who practice it. That's why I always laugh when people get hard-ons about HIPAA or JCHAO. Who cares? What, someone will be ethical when it comes to patients and then throw other people under the bus using some pathetic "well, it's not me" excuse? If I'm going to be unethical when it comes to one, I'll be unethical when it comes to all. That's how I roll. 👍

 

[SouthernSurgeon]

99 is the highest score you can get, so does it matter that it's not a percentile?

I would argue that it "doesn't matter" either way. A high step score is not an entitlement. As Southerndoc stated above, we all know people who had the scores but were incompetent in the clinical setting. The OP's step scores don't in any way indicate how he/she did in residency.

 

[bawer234]

You quote USMLE scores to show that you have the knowledge base. That says nothing of how well you can apply it. I've seen the smartest residents in the world be the worst physicians because they can't make use of their knowledge.

As others have said, I feel like we are missing some of the story.

Guaranteed.