Reapplying to psych; what are the least selective, most forgiving programs? Thanks!

[Redsoxj64]

Hi everyone,
I would really appreciate some advice. I went to a top 30 Med school and graduated in 2021. I was a mediocre Med student. My step1 220 and step2 230... Mediocre I know.. I got really depressed during third year and my psychiatrist refused to prescribe antidepressants, which I desperately needed. I had to take a LOA. I came back and finished strong my fourth year (8/11 honors in rotations).
I applied for psychiatry in the 2020-2021 cycle and I didn’t match. After graduation, I had a HORRIBLE back injury and was in severe pain all year until June 2022, when I FINALLY got my PCP to give me a referral for surgery. For the past year I did a lot of volunteer work and also worked for my father’s finance company, but because of severe pain I was only able to work part-time.

I am now 100% pain-free and my depression is in complete remission. I'm ready to apply to residency! I'm now working as a medical interpreter (Spanish). It is very fulfilling to give patients a voice and connect them to care as well as keep up my medical knowledge.
I desperately need advice: I am going to reapply to psychiatry and apply to more programs, but I know I am very unlikely to match in psych, so I am probably gonna also apply to internal med and maybe family med as a backup. I don't have my heart set in these but maybe I can do one of them for a year and try reapply? Does anyone think that might actually work?

Does anyone know which psychiatry programs would be the LEAST selective and the most forgiving to someone like me with LOAs due to medical problems? I know with the time I’ve taken off it will be hard for me to find any psych spot. I'm trying to stay positive..I worked really hard in med school and I have overcome a lot of obstacles.

TLDR: what are the psych residency programs that are the least selective / most forgiving to applicants with LOAs due to medical problems ? Please list as many programs as you know because I need to apply very broadly.

Thank you so much for the help! I really appreciate it!

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[shoomer]

I don't know specific programs but general advice: look for newer programs (there's a list to track newly accredited programs that you can find online), and look for any programs that have had to SOAP in the past few years. Also look at programs that take IMGs, as that's another indicator of lower competitiveness.

Then in general, the least competitive places are going to be in undesirable locations and purely community-based. You will have a better chance within your region and perhaps if you look at your own school's previous match lists. Try to see if you have any faculty or attendings with connections that can help you out also.

I don't think it's impossible to match, it's harder as you state, but it is doable.

If you go the IM/FM backup route, look at places that have psych residencies within that institution. You can explore transferring out either in-house or elsewhere, and some places will give you PGY1 credit and let you start as a PGY2 with them. Obviously don't bring up your intentions while interviewing, but you would have to get approval from your PD if you were to match and work on transferring after.

 

[forchinet121]

Off topic but why would your psychiatrist refuse to prescribe you antidepressants? That seems very weird

 

[TexasPhysician]

I believe there are 1-2 programs in Texas along the Mexico border in undesirable locations.

 

[wolfvgang22]

Hi everyone,
I would really appreciate some advice. I went to a top 30 Med school and graduated in 2021. I was a mediocre Med student. My step1 220 and step2 230... Mediocre I know.. I got really depressed during third year and my psychiatrist refused to prescribe antidepressants, which I desperately needed. I had to take a LOA. I came back and finished strong my fourth year (8/11 honors in rotations).
I applied for psychiatry in the 2020-2021 cycle and I didn’t match. After graduation, I had a HORRIBLE back injury and was in severe pain all year until June 2022, when I FINALLY got my PCP to give me a referral for surgery. For the past year I did a lot of volunteer work and also worked for my father’s finance company, but because of severe pain I was only able to work part-time.

I am now 100% pain-free and my depression is in complete remission. I'm ready to apply to residency! I'm now working as a medical interpreter (Spanish). It is very fulfilling to give patients a voice and connect them to care as well as keep up my medical knowledge.
I desperately need advice: I am going to reapply to psychiatry and apply to more programs, but I know I am very unlikely to match in psych, so I am probably gonna also apply to internal med and maybe family med as a backup. I don't have my heart set in these but maybe I can do one of them for a year and try reapply? Does anyone think that might actually work?

Does anyone know which psychiatry programs would be the LEAST selective and the most forgiving to someone like me with LOAs due to medical problems? I know with the time I’ve taken off it will be hard for me to find any psych spot. I'm trying to stay positive..I worked really hard in med school and I have overcome a lot of obstacles.

TLDR: what are the psych residency programs that are the least selective / most forgiving to applicants with LOAs due to medical problems ? Please list as many programs as you know because I need to apply very broadly.

Thank you so much for the help! I really appreciate it!

Agree with previous posts. I would apply to every psychiatry program. Interview with anyone who invites you. It is worth spending a 2-3k on fees and travel compared to the cost of not matching.

 

[splik]

I'm not sure anyone is going to be able to tell you which programs are least selective since that is not something anyone is going to advertise. However, you might imagine that smaller, community based programs in less desirable areas, particularly if they are newer may be somewhat less competitive. However many such programs may be happier to take well qualified IMGs without any red flags. Since many of these programs may not interview you because they may consider you not really interested, make sure to use the supplemental application (this is new this yr) to emphasize geographic regions you would be interested in not evident in your application and to signal strategically programs you might have a chance of matching at (i.e. don't overshoot). You also want to emphasize your spanish interpreting experience and think about areas where they have a large spanish-speaking population and would value that.

You should definitely be applying this cycle since this may be your last chance to match. It's great that you are planning on applying to other specialties as well. I would recommend taking Step 3 as this may make you a bit more competitive (programs won't be worrying about whether you'll pass if you already have). You should also try to do some psych related activities during this time to bolster your application.

I would also strongly discourage you from discussing your depression and chronic pain in your application. Anything you mention is fair game to ask more about. You want to be highlighting your strengths and commitment to a career in psychiatry rather than any potential liabilities

 

[docksan]

Your step scores are not mediocre, especially not for psychiatry, but most psychiatrists are going to have the same question: why would your psychiatrist refuse to prescribe you medication?

 

[esob]

The accreditation list can be found here: ACGME - Accreditation Data System (ADS)

 

[wysdoc]

I believe there are 1-2 programs in Texas along the Mexico border in undesirable locations.

@Redsoxj64 If you are interested in Texas, there are newer programs at
-Texas A&M fairly new, features Army and Veteran work
-UT Tyler 6 positions a year (which has a well established teaching hospital and a psych residency that is just a few years old, and will now have a new medical school starting this year)
-UTRGV (psych residency has been running for 6 years and since you are fluent in Spanish they will be interested). There is an inpatient hospital as well as behavioral/developmental psych facility and community rotations. 6 positions a year in match. Caveat emptor - the organization of the medical school is chaotic and still at provisional accreditation after 6 years.

 

[G Sheb]

Hi everyone,
I would really appreciate some advice. I went to a top 30 Med school and graduated in 2021. I was a mediocre Med student. My step1 220 and step2 230... Mediocre I know.. I got really depressed during third year and my psychiatrist refused to prescribe antidepressants, which I desperately needed. I had to take a LOA. I came back and finished strong my fourth year (8/11 honors in rotations).
I applied for psychiatry in the 2020-2021 cycle and I didn’t match. After graduation, I had a HORRIBLE back injury and was in severe pain all year until June 2022, when I FINALLY got my PCP to give me a referral for surgery. For the past year I did a lot of volunteer work and also worked for my father’s finance company, but because of severe pain I was only able to work part-time.

I am now 100% pain-free and my depression is in complete remission. I'm ready to apply to residency! I'm now working as a medical interpreter (Spanish). It is very fulfilling to give patients a voice and connect them to care as well as keep up my medical knowledge.
I desperately need advice: I am going to reapply to psychiatry and apply to more programs, but I know I am very unlikely to match in psych, so I am probably gonna also apply to internal med and maybe family med as a backup. I don't have my heart set in these but maybe I can do one of them for a year and try reapply? Does anyone think that might actually work?

Does anyone know which psychiatry programs would be the LEAST selective and the most forgiving to someone like me with LOAs due to medical problems? I know with the time I’ve taken off it will be hard for me to find any psych spot. I'm trying to stay positive..I worked really hard in med school and I have overcome a lot of obstacles.

TLDR: what are the psych residency programs that are the least selective / most forgiving to applicants with LOAs due to medical problems ? Please list as many programs as you know because I need to apply very broadly.

Thank you so much for the help! I really appreciate it!

230 are solid scores in psychiatry. 8/11 honors is impressive. Don't undersell yourself. I've had colleagues who had 220s and made it to top programs.
You've had hickups and successes. You can turn that into a story you can sell especially if you can synthesize what you've learned from adversity. The key is how to properly 'market' yourself. You do not want to appear to shift blame on your psychiatrist or PCP. That's going to be a big red flag.
I would definitely recommend that you get some observerships or research with programs you're targeting. Nothing beats knowing a person upfront for at least a few weeks or ideally a few months. No 30 min interview can make up for that.

 

[Dharma]

Off topic but why would your psychiatrist refuse to prescribe you antidepressants? That seems very weird

I think any practicing psychiatrist here would be able to answer this question for him/herself.

 

[UTsksk]

I believe there are 1-2 programs in Texas along the Mexico border in undesirable locations.

Texas programs are tricky. They may be in less than desirable places (my hometown is one of them), but Texas people push for them. I couldn’t get one and got shipped off to a neighboring state.

 

[Monocles]

OP I don't think there's anything wrong with your stats or LOA. I would look into psych programs affiliated with academic programs in smaller "less exciting" college towns in the midwest (as they can still be very lovely and safe, have low cost of living, friendly locals, etc).

Do you mind if I ask why you didn't match last cycle? Did you only apply to top 10 programs? (Was there any specific feedback that might be helpful?)

 

[comp1]

We can guess why the OP wasn't prescribed antidepressants and programs certainly will if that is brought up as the OP did here. That's where the importance of marketing comes in. You don't technically have to explain or discuss the back injury. You may have to at least mention the medical leave of absence during residency. What did the OP say about their medical leave of absence at the past interviews? This is a situation where I think less detail is likely better. You had a medical condition, you left for treatment, it resolved and you finished your program with flying colors. Details will just raise eyebrows and questions. In terms of choosing programs, absolutely new programs have to be less selective. Community based programs, as opposed to academic affiliated programs also are less selective too. The less desirable a geographic location is, generally the less selective the program. These sort of guidelines should be enough. Apply broadly throughout the country.

 

[Redsoxj64]

I don't know specific programs but general advice: look for newer programs (there's a list to track newly accredited programs that you can find online), and look for any programs that have had to SOAP in the past few years. Also look at programs that take IMGs, as that's another indicator of lower competitiveness.

Then in general, the least competitive places are going to be in undesirable locations and purely community-based. You will have a better chance within your region and perhaps if you look at your own school's previous match lists. Try to see if you have any faculty or attendings with connections that can help you out also.

I don't think it's impossible to match, it's harder as you state, but it is doable.

If you go the IM/FM backup route, look at places that have psych residencies within that institution. You can explore transferring out either in-house or elsewhere, and some places will give you PGY1 credit and let you start as a PGY2 with them. Obviously don't bring up your intentions while interviewing, but you would have to get approval from your PD if you were to match and work on transferring after.

THANK YOU!

 

[Redsoxj64]

Off topic but why would your psychiatrist refuse to prescribe you antidepressants? That seems very weird

"You don't have depression, it's all SITUATIONAL"

 

[Redsoxj64]

I believe there are 1-2 programs in Texas along the Mexico border in undesirable locations.

GOOD IDEA!

 

[Redsoxj64]

Agree with previous posts. I would apply to every psychiatry program. Interview with anyone who invites you. It is worth spending a 2-3k on fees and travel compared to the cost of not matching.

Thanks for the advice!

 

[Redsoxj64]

I'm not sure anyone is going to be able to tell you which programs are least selective since that is not something anyone is going to advertise. However, you might imagine that smaller, community based programs in less desirable areas, particularly if they are newer may be somewhat less competitive. However many such programs may be happier to take well qualified IMGs without any red flags. Since many of these programs may not interview you because they may consider you not really interested, make sure to use the supplemental application (this is new this yr) to emphasize geographic regions you would be interested in not evident in your application and to signal strategically programs you might have a chance of matching at (i.e. don't overshoot). You also want to emphasize your spanish interpreting experience and think about areas where they have a large spanish-speaking population and would value that.

You should definitely be applying this cycle since this may be your last chance to match. It's great that you are planning on applying to other specialties as well. I would recommend taking Step 3 as this may make you a bit more competitive (programs won't be worrying about whether you'll pass if you already have). You should also try to do some psych related activities during this time to bolster your application.

I would also strongly discourage you from discussing your depression and chronic pain in your application. Anything you mention is fair game to ask more about. You want to be highlighting your strengths and commitment to a career in psychiatry rather than any potential liabilities

Thank you for your comments!

 

[Redsoxj64]

The accreditation list can be found here: ACGME - Accreditation Data System (ADS)

THANK YOU!

 

[Redsoxj64]

@Redsoxj64 If you are interested in Texas, there are newer programs at
-Texas A&M fairly new, features Army and Veteran work
-UT Tyler 6 positions a year (which has a well established teaching hospital and a psych residency that is just a few years old, and will now have a new medical school starting this year)
-UTRGV (psych residency has been running for 6 years and since you are fluent in Spanish they will be interested). There is an inpatient hospital as well as behavioral/developmental psych facility and community rotations. 6 positions a year in match. Caveat emptor - the organization of the medical school is chaotic and still at provisional accreditation after 6 years.

Thank you so much! Really appreciate this!

 

[Redsoxj64]

We can guess why the OP wasn't prescribed antidepressants and programs certainly will if that is brought up as the OP did here. That's where the importance of marketing comes in. You don't technically have to explain or discuss the back injury. You may have to at least mention the medical leave of absence during residency. What did the OP say about their medical leave of absence at the past interviews? This is a situation where I think less detail is likely better. You had a medical condition, you left for treatment, it resolved and you finished your program with flying colors. Details will just raise eyebrows and questions. In terms of choosing programs, absolutely new programs have to be less selective. Community based programs, as opposed to academic affiliated programs also are less selective too. The less desirable a geographic location is, generally the less selective the program. These sort of guidelines should be enough. Apply broadly throughout the country.

My medical school dean actually told me to be BRUTALLY honest on my applications, which I think was a BIG mistake looking back. I have my previous personal statement I used before, but I don't know what to write about all this time off without being honest. What am I supposed to say? just leave it at "I had some medical problems and I had to take a leave of absence, then I came back to rotations and finished with flying colors." ? But then what about my back injury? She had said that being honest would help me be more empathetic to patients so I wrote all about that. Could anyone give me some examples of what I can say instead of this? I would really appreciate it!

 

[Redsoxj64]

OP I don't think there's anything wrong with your stats or LOA. I would look into psych programs affiliated with academic programs in smaller "less exciting" college towns in the midwest (as they can still be very lovely and safe, have low cost of living, friendly locals, etc).

Do you mind if I ask why you didn't match last cycle? Did you only apply to top 10 programs? (Was there any specific feedback that might be helpful?)

I was in so much pain that I tried to apply last cycle but couldn't even get through the application, let alone interview. My PCP kept saying my back was going to get better "on its own." I saw my psychiatrist last october (different than the one who refused to prescribe me antidepressants) she saw me an IMMEDIATELY referred me to her hospital's pain clinic. I went to an appointment there and I couldn't even sit up on the exam table. Got emergent MRI which showed SEVERE foraminal stenosis. i should have had surgery in january but i had to wait until june. Yeah, last year sucked...

 

[FlowRate]

My medical school dean actually told me to be BRUTALLY honest on my applications, which I think was a BIG mistake looking back. I have my previous personal statement I used before, but I don't know what to write about all this time off without being honest. What am I supposed to say? just leave it at "I had some medical problems and I had to take a leave of absence, then I came back to rotations and finished with flying colors." ? But then what about my back injury? She had said that being honest would help me be more empathetic to patients so I wrote all about that. Could anyone give me some examples of what I can say instead of this? I would really appreciate it!

I don't know what you should do but I can say that, if you do talk about any sort of specifics, I'd personally leave out the depression piece. "I had a very painful condition which progressed to the point that I was not able to continue school, was surgically cured as of X date with no residual symptoms or limitations, and have excelled since my return." Or something. That gives a clear picture without getting bogged down in delays in care, withheld treatments, etc. etc. which, even if completely true, can come across as externalizing/whiny.

 

[Redsoxj64]

230 are solid scores in psychiatry. 8/11 honors is impressive. Don't undersell yourself. I've had colleagues who had 220s and made it to top programs.
You've had hickups and successes. You can turn that into a story you can sell especially if you can synthesize what you've learned from adversity. The key is how to properly 'market' yourself. You do not want to appear to shift blame on your psychiatrist or PCP. That's going to be a big red flag.
I would definitely recommend that you get some observerships or research with programs you're targeting. Nothing beats knowing a person upfront for at least a few weeks or ideally a few months. No 30 min interview can make up for that.

THIS. I have been trying so hard to do shadowing / a rotation at some residency programs that I am highly interested in and they will not respond to my emails /answer my calls! It is SO frustrating! How would you recommend I go about doing this? I did 2 rotations at a program in boston where I got honors in and I tried to "stop by" and drop off my resume. I saw one of the attendings I worked with and he was very happy to see me and he told me to email him (he then gave me his email address, and when I emailed him he never responded). I probably shouldn't have done this, but I really had nothing to lose... I would love to shadow at some programs but it is so hard as someone who has already graduated from med school...

 

[Redsoxj64]

I don't know what you should do but I can say that, if you do talk about any sort of specifics, I'd personally leave out the depression piece. "I had a very painful condition which progressed to the point that I was not able to continue school, was surgically cured as of X date with no residual symptoms or limitations, and have excelled since my return." Or something. That gives a clear picture without getting bogged down in delays in care, withheld treatments, etc. etc. which, even if completely true, can come across as externalizing/whiny.

THANK YOU!

 

[Redsoxj64]

Texas programs are tricky. They may be in less than desirable places (my hometown is one of them), but Texas people push for them. I couldn’t get one and got shipped off to a neighboring state.

I can NOT afford to be picky at all

 

[Redsoxj64]

I think any practicing psychiatrist here would be able to answer this question for him/herself.

Off topic but why would your psychiatrist refuse to prescribe you antidepressants? That seems very weird

"You don't have depression, it's SITUATIONAL" She was a resident psychiatrist. Looking back, I should have switched to an attending after a few months.

 

[G Sheb]

THIS. I have been trying so hard to do shadowing / a rotation at some residency programs that I am highly interested in and they will not respond to my emails /answer my calls! It is SO frustrating! How would you recommend I go about doing this? I did 2 rotations at a program in boston where I got honors in and I tried to "stop by" and drop off my resume. I saw one of the attendings I worked with and he was very happy to see me and he told me to email him (he then gave me his email address, and when I emailed him he never responded). I probably shouldn't have done this, but I really had nothing to lose... I would love to shadow at some programs but it is so hard as someone who has already graduated from med school...

Some programs have observerships in place where you can just apply.
Your best bet is to contact people in the educational system. I would try program coordinators who could then reroute your email to the director. Inpatient units are going to be the most open for this. I wouldn't say the response you're getting is surprising. Many would see this as a nuisance but others may be open.

 

[TexasPhysician]

Texas programs are tricky. They may be in less than desirable places (my hometown is one of them), but Texas people push for them. I couldn’t get one and got shipped off to a neighboring state.

They are tricky. One is so used to being rejected by US MD’s that they don’t interview them unless they get a phone call with a legit reason to interview there.

 

[docksan]

My medical school dean actually told me to be BRUTALLY honest on my applications, which I think was a BIG mistake looking back. I have my previous personal statement I used before, but I don't know what to write about all this time off without being honest. What am I supposed to say? just leave it at "I had some medical problems and I had to take a leave of absence, then I came back to rotations and finished with flying colors." ? But then what about my back injury? She had said that being honest would help me be more empathetic to patients so I wrote all about that. Could anyone give me some examples of what I can say instead of this? I would really appreciate it!

If something comes up in your interview, be honest. When you sell yourself to an employer you don't bring your weaknesses up. You let them do it then reflect it as a strength.

Edit: also be careful when talking about residents. Not a good look and they'll be attendings before you will.

 

[Candidate2017]

"You don't have depression, it's SITUATIONAL" She was a resident psychiatrist. Looking back, I should have switched to an attending after a few months.

Perhaps she meant adjustment disorder? It's more common in med school than MDD or other depressive disorders that require antidepressants.

Anyway, cut the resident some slack. Have some compassion. You will be in her position one day, if you make it into a psych residency. You will get to experience the thankless, difficult patients who want to argue about your opinion and demand a specific diagnosis or medication that is inappropriate.

Who knows? Maybe you're correct and the resident (and attending who agreed with the resident) should've diagnosed you with depression, and a handful of years from now you'd be complaining about how a psych resident misdiagnosed you, prescribed unneeded SSRIs that caused years of sexual dysfunction, ruined your chances of getting disability and life insurance, and made it inordinately difficult for you to obtain your medical license and hospital privileges.

 

[G Sheb]

My medical school dean actually told me to be BRUTALLY honest on my applications, which I think was a BIG mistake looking back. I have my previous personal statement I used before, but I don't know what to write about all this time off without being honest. What am I supposed to say? just leave it at "I had some medical problems and I had to take a leave of absence, then I came back to rotations and finished with flying colors." ? But then what about my back injury? She had said that being honest would help me be more empathetic to patients so I wrote all about that. Could anyone give me some examples of what I can say instead of this? I would really appreciate it!

I would leave the depression piece out of it.
There's a lot of stigma around mental illness unfortunately, even in psychiatry (or maybe even more so).
I do not know what would be the appropriate way to put it, but I would leave it to medical issues. Some people are going to very nosy, and inappropriately so imo (they should not really be asking about your medical condition), so be prepared for that. However I believe it's against the law to discriminate based on having a medical condition, so there's that as well, and they may be careful around this.
In any case, if you had to drop out of the match rather than 'failing to match', that's an entirely different thing. I would be very, very clear around that. The biggest flag I can see in your application is not your LOA but your 'failure' to match.
Your best bet is to present yourself with confidence (which isn't showing in your posts here, I have to say). At the end of the day, overcoming a medical illness is something to be proud of and you could turn that into a positive.

 

[Redsoxj64]

Perhaps she meant adjustment disorder? It's more common in med school than MDD or other depressive disorders that require antidepressants.

Anyway, cut the resident some slack. Have some compassion. You will be in her position one day, if you make it into a psych residency. You will get to experience the thankless, difficult patients who want to argue about your opinion and demand a specific diagnosis or medication that is inappropriate.

Who knows? Maybe you're correct and the resident (and attending who agreed with the resident) should've diagnosed you with depression, and a handful of years from now you'd be complaining about how a psych resident misdiagnosed you, prescribed unneeded SSRIs that caused years of sexual dysfunction, ruined your chances of getting disability and life insurance, and made it inordinately difficult for you to obtain your medical license and hospital privileges.

Ah, if you only you knew the full story... lets call my former psychiatrist Dr. D...My best friend is now a psych resident at the hospital where Dr. D is now an attending. As a resident, Dr. D never followed her plans up with an attending, she never took any notes during her two years of outpatient care. She recklessly prescribed stimulants and benzos to many of her patients, giving them early refills time and time again....this program has poor oversight of its residents.

 

[comp1]

DEFINITELY do not bring that up.

Ah, if you only you knew the full story... lets call my former psychiatrist Dr. D...My best friend is now a psych resident at the hospital where Dr. D is now an attending. As a resident, Dr. D never followed her plans up with an attending, she never took any notes during her two years of outpatient care. She recklessly prescribed stimulants and benzos to many of her patients, giving them early refills time and time again....this program has poor oversight of its residents.

DEFINITELY do not bring this up.

 

[docksan]

Ah, if you only you knew the full story... lets call my former psychiatrist Dr. D...My best friend is now a psych resident at the hospital where Dr. D is now an attending. As a resident, Dr. D never followed her plans up with an attending, she never took any notes during her two years of outpatient care. She recklessly prescribed stimulants and benzos to many of her patients, giving them early refills time and time again....this program has poor oversight of its residents.

Great, make sure nobody interviewing you comes close to knowing this story unless you want to be labeled before you even have a job and end up a statistic.

 

[ObsequiousAplomb]

Don't you find it a little odd that you're simultaneously accusing someone of overprescribing and underprescribing? That they jump to polypharmacy of controlled substances but "refuse" to prescribe an antidepressant? And that they somehow saw patients for 2 years without ever writing a note but didn't get in trouble for that? That nobody noticed a resident literally not writing any notes in 2 years? As a PGY-3 they were using their own DEA in a resident clinic? There are a lot of very peculiar aspects of what's being said here.

 

[docksan]

We're all thinking it. Best to move on.

 

[FlowRate]

Don't you find it a little odd that you're simultaneously accusing someone of overprescribing and underprescribing? That they jump to polypharmacy of controlled substances but "refuse" to prescribe an antidepressant? And that they somehow saw patients for 2 years without ever writing a note but didn't get in trouble for that? That nobody noticed a resident literally not writing any notes in 2 years? As a PGY-3 they were using their own DEA in a resident clinic? There are a lot of very peculiar aspects of what's being said here.

Honestly, the only part I find fishy is lack of notes. We had remote supervision in 3rd year (didn't staff every case) and used our institutional DEA numbers (vs attending's which is what you're implying?)

 

[clausewitz2]

Honestly, the only part I find fishy is lack of notes. We had remote supervision in 3rd year (didn't staff every case) and used our institutional DEA numbers (vs attending's which is what you're implying?)

And that's fishy only because I can't imagine the resident in question not being positively inundated with nastygrams from the billing and coding people about incomplete documentation. Hospital gots to get paid, yo.

 

[ObsequiousAplomb]

Yeah. Remote supervision would mean that the only contact the attending has with the case is signing the notes. So without a note they just assume the residents saw no patients the entire time?

I guess different programs handle DEAs somewhat differently. For our program only one site offered us an institutional DEA (the child outpatient clinic). The rest we had to put in draft for our attendings to sign and they would use their own DEA, or for schedule IV we could call in with the attending's DEA. But more likely we just sent an email, text, or EHR message asking them to send the Schedule II or schedule IV meds. They would do it only if there was a note ready for them to sign as well, because they weren't going to waste their time opening the same chart twice.

Most importantly - how did nobody notice that there were no notes for billing? Were all copays collected pre-visit but then the visit was never billed? Did the clinic / hospital really just let a resident and the supervising attending get away with providing services for free? Is this the same hospital that hired that resident afterwards?

 

[painballer27]

What program was this?

 

[ObsequiousAplomb]

If you value your career, please don't answer the person asking what program it was.

 

[painballer27]

I mean I really doubt the program was that bad. I know there are some bad ones but I resident can't just decide they aren't going to writ notes. But I do think this person should spill the beans of the sake of posterity.
But then again, if notes are optionally, may not be a bad deal. Note writing sucks especially when people want you to write an essay. 3-4 sentences is enough.

 

[docksan]

I mean I really doubt the program was that bad. I know there are some bad ones but I resident can't just decide they aren't going to writ notes. But I do think this person should spill the beans of the sake of posterity.
But then again, if notes are optionally, may not be a bad deal. Note writing sucks especially when people want you to write an essay. 3-4 sentences is enough.

You are wrong on multiple levels. Program directors do visit these forums and it's an easy way to black ball yourself.

In no program would notes be optional. It's a violation of several laws and ACGME standards.

 

[painballer27]

You are wrong on multiple levels. Program directors do visit these forums and it's an easy way to black ball yourself.

In no program would notes be optional. It's a violation of several laws and ACGME standards.

I never said PDs don't visit these forums. I agree that note writing is required, just threw the last bit in saying it would be nice if it wasn't. I don't see how I'm wrong on any levels.

 

[docksan]

If you match a residency perhaps you will.

 

[painballer27]

If you match a residency perhaps you will.

I don't think you follow. You said I was wrong on multiple levels, yet you haven't pointed to a statement that I made that is incorrect. There's really nothing to understand. I personally don't care if OP gets blackballed, if they're unwise enough to state the program then that's not my problem. I just want to know what program it was lol.

 

[docksan]

I mean I really doubt the program was that bad

What makes you doubt it was that bad?

But I do think this person should spill the beans of the sake of posterity.

No, you think they should spill the beans for your personal interest. They should probably remain anonymous until they actually have a residency spot unless they, you know, don't want one. Shaming a program and being identified as a shamer really gets you nowhere.

But then again, if notes are optionally, may not be a bad deal. Note writing sucks especially when people want you to write an essay. 3-4 sentences is enough.

I have seen notes where 3-4 sentences told me nothing and 30-40 sentences told me too much. I'd rather have a coherent note than care about the length. And note writing is like 70% of your job, so get used to it. Writing a note should never be optional and is probably the only means you have of avoiding a lawsuit.

I personally don't care if OP gets blackballed, if they're unwise enough to state the program then that's not my problem.

There's nothing unwise about it. Until you're a resident, and even then until you're an attending, your degree means nothing. Potentially jeopardizing your career this early is never wise.

I just want to know what program it was lol.

This accomplishes nothing.