Hey folks Help wanted please.
Currently I'm am under a remediation which is next to termination. In the past 3 months I was handed down 2 remediations. My in house training exam was poor both of my years of residency(currently a PGY2). Now I feel the PD is treating me unfairly and scrutinizing every little thing I do. He is magnifying my areas to improve on and trying to make me look incompetent. I have good-great evaluations from attendings. I have one poor evaluation which he seems to always bring up. The PD even went to to extent to make a good evaluation sound poor, all he did was mention a area to improve. Overall he wants to make me look bad with low in-house training exam scores and magnify my areas-to-work on in my clinical skills.
Any advice on what to do?
Go over his head to the Chair?
Talk to the directors at the hospitals?
The story doesn't make sense to anybody I tell it to.
Please help, I am being a helpless victim on this PD's unfair emotional decisions.
Some questions:
1) When you say you have good/great evals, what do they actually say? Where do they advise you to improve? What do they say your strengths are? What kind of scores are you getting? What did the one bad eval say?
2) I am not clear what remediation means for you. Does that mean you have to actually repeat the month? Or are you just recieving poor scores on evals? Who decides that you have to remediate, the PD or the attending on that service?
3) Is this the first time you have been in residency or have you been terminated before? What specialty are you in?
4) Have you had any complaints filed against you by nursing/RT/techs/any other non physicians?
5) What's your personal relationship with other members of your residency class like?
6) Do you have an legal history? Any psychiatric history? Has a patient you followed ever initiated litigation against you or against the hospial? A yes or no is OK if you don't want to go into revealing details
7) Have you ever filed a formal complaint of any kind against either you PD or your residency program? Maybe with the ACGME, with HR, or with the department chair? Have you ever formally or informally complained that you'd been sexually harassed at your residency program? Have you ever initiated or threatened to initiate any kind of lawsuit?
8) Are you an American medical grad, IMG, or FMG? If you're not an American grad, what percentage of the residents in your program are? Do you speak English as a first language?
9) How many residents did you program terminate from each of the last two residency classes? Out of how many total?
Some preliminary advice:
Do you have a mentor assigned to you, or failing that do you have an attending that you particularly look up to? If you do ask for a meeting, lay your concerns out, and ask how you can remedy your deficiencies. You might get some insight into how you can fix your deficienceis (you might not be seeing them), and when you partner with a more senior physician to fix them you'll also have a advocate who will argue that you are TRYING to get better. They might listen to him/her where they would ignore you.
Similary, work hard to partner with the attendings and senior residents on each of your rotations to improve your performance. Ask for formal feedback at the end of every week: set a meeting early in the day. If they try to give you a quick 'I think you're doing fine' ask them for at least one thing you can improve on and then, if you're on service the next week, ask them 'am I improving?' in whatever they said to improve. You will be a lot less likely to be caught by surprise by their comments, you'll have time to fix deficiencies before you're reviewed, and you'll probably be seen in a drastically better light just because you asked.
I would agree with others who have said not to treat this as a fight. Unless you're related to the department head/dean by blood there's no point to going over anyone's head, or of calling the PD unfair. That's not to say that you're wrong, but you have absolutely no leverage and there's no way to argue your way out of this. Similarly don't post your grievances on facebook, and don't talk about them at work. Limit your anger to SDN and conversations with loved ones.
That beign said, don't let the accumulate evidence against you unncessarily. A common tactic of residencies wishing to pursuie an unfair termination is to try to bully you into seeing their pet psychiatrist and then opening your medical records to them. They can then cite your now official record of whatever they chose to make him diagnose you with as a major reason for your termination ('of course we couldn't renew his contract, he's an ADHD schizophrenic alcoholic who hates his mother!'). If they try to force it, politely refuse or at least insist that that you see your own practitioner and keep your medical record closed.
Finally, do try to fix whatever your PD hates about you. It sounds like you went to a program that cares deeply about inservice score and you had problems with the inservice. Are you subscribed to a Qbank? Do you have a study plan? How are you going to make sure this doesn't happen again next year?
BTW, this is coming from an Intern who hasn't been through remdiation, so value this advice as you will
