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- Jul 1, 2008
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I am a PGY1 (US grad at a US residency) who just received a non-renewal of contract letter from my residency program. I did reasonably well in med school (no reprimands, no grades below a B, >220 on step 1 and 2 first time, etc etc) and I feel like I have what it takes to do well in residency. I would like some advice on this matter and have already searched a number of threads like it.
I will spare the gory details because everything you say on the internet exists forever, but I basically had a big miscommunication incident early in my residency with an attending and it majorly pissed him off. Nobody got hurt but I definitely lost his trust. After that I was put on a remediation plan which actually was going fine. I jumped through all their hoops, proved that it was just a one-off incident. Things were actually looking better at that point, but I noticed that the usual friendly social interaction that my PD and others had previously shown was stunted. I felt shunned almost from the get-go.
Halfway through the year, I received poor evaluations from the attendings on an internal-medicine-type of rotation (despite asking for feedback, working hard, etc) afterward and was told that I wouldn't be getting my contract renewed for next year. Some of the stuff in the medicine evals was true, some things were flat out lies. I attempted to explain this rationally and calmly to my PD but I was just perceived as being defensive. Yes, some of this is my fault, but every other intern I work with thinks that this response is way out of proportion to the actual problems. In fact, making matters worse, they pulled me off the medicine rotation – AND my future medicine rotations – for the rest of intern year because they don't trust me. Guess what that means – matching into a PGY2 position somewhere else is going to be virtually impossible and I have to start over.
I could protest it formally but I probably don't want to. I know that residents essentially have few rights, so making a stink about it is probably just going to piss-off the powers that be, and likely make any LORs worse in the future. I would rather finish the year, swallow my pride, go quietly and hope the LORs turn out ok. There are definitely some people in this program who will write on my behalf.
I am actually quite open to looking for an alternate career, such as working for an EMR tech company, or getting an MBA and doing something along those routes. My loan/debt load is far less than most residents and I would definitely be happy getting paid $70k/yr forever doing something non-medical. However, my primary goal right now is to finish my year and get into another residency program.
I was able to hustle and get all of my ERAS application stuff submitted to I can scramble/SOAP this year. My med school is aware of it and helped me out greatly, but all of my LORs, essay, etc etc are from MED SCHOOL not from this residency. It all happened too quickly and I didn't have time to get new letters. To make matters worse, my essay and LORs from med school are all program-type-specific, limiting my authenticity to that type of program (it's a very low-competition field thankfully). So, I feel like I could scramble/SOAP but I'm not sure how well it's going to work out. I feel like it would be too rushed.
My second idea would be to wrap up this year, find a job in something for a year, get some good references from that and actually hit the interview trail again next year – with a new personal statement, LORs, etc. I feel like I might get better prospects if I "take some time and learn from my mistakes" etc. I could even take Step 3 and pass it during that time, to "prove" that I am an ok risk for a program to take. Granted, I can always scramble next year too.
What do you all think? I'm not trying to save my position here, I am trying to exit gracefully and find a program that appreciates my effort and dedication.
I will spare the gory details because everything you say on the internet exists forever, but I basically had a big miscommunication incident early in my residency with an attending and it majorly pissed him off. Nobody got hurt but I definitely lost his trust. After that I was put on a remediation plan which actually was going fine. I jumped through all their hoops, proved that it was just a one-off incident. Things were actually looking better at that point, but I noticed that the usual friendly social interaction that my PD and others had previously shown was stunted. I felt shunned almost from the get-go.
Halfway through the year, I received poor evaluations from the attendings on an internal-medicine-type of rotation (despite asking for feedback, working hard, etc) afterward and was told that I wouldn't be getting my contract renewed for next year. Some of the stuff in the medicine evals was true, some things were flat out lies. I attempted to explain this rationally and calmly to my PD but I was just perceived as being defensive. Yes, some of this is my fault, but every other intern I work with thinks that this response is way out of proportion to the actual problems. In fact, making matters worse, they pulled me off the medicine rotation – AND my future medicine rotations – for the rest of intern year because they don't trust me. Guess what that means – matching into a PGY2 position somewhere else is going to be virtually impossible and I have to start over.
I could protest it formally but I probably don't want to. I know that residents essentially have few rights, so making a stink about it is probably just going to piss-off the powers that be, and likely make any LORs worse in the future. I would rather finish the year, swallow my pride, go quietly and hope the LORs turn out ok. There are definitely some people in this program who will write on my behalf.
I am actually quite open to looking for an alternate career, such as working for an EMR tech company, or getting an MBA and doing something along those routes. My loan/debt load is far less than most residents and I would definitely be happy getting paid $70k/yr forever doing something non-medical. However, my primary goal right now is to finish my year and get into another residency program.
I was able to hustle and get all of my ERAS application stuff submitted to I can scramble/SOAP this year. My med school is aware of it and helped me out greatly, but all of my LORs, essay, etc etc are from MED SCHOOL not from this residency. It all happened too quickly and I didn't have time to get new letters. To make matters worse, my essay and LORs from med school are all program-type-specific, limiting my authenticity to that type of program (it's a very low-competition field thankfully). So, I feel like I could scramble/SOAP but I'm not sure how well it's going to work out. I feel like it would be too rushed.
My second idea would be to wrap up this year, find a job in something for a year, get some good references from that and actually hit the interview trail again next year – with a new personal statement, LORs, etc. I feel like I might get better prospects if I "take some time and learn from my mistakes" etc. I could even take Step 3 and pass it during that time, to "prove" that I am an ok risk for a program to take. Granted, I can always scramble next year too.
What do you all think? I'm not trying to save my position here, I am trying to exit gracefully and find a program that appreciates my effort and dedication.