Residency Program Reporting Dismissal to State Licensing board

[Jas2188]

Hi All,

I am currently doing fellowship after completing residency. So its time to look for a job. I accepted an offer and its time to obtain a licence as the offer was contingent on obtaining a license. During my PGY1 year I had medical knowledge and inter personal skill incompetency according to my program/program director. I was eventually put on remedial and later contract was not renewed for the following year. I found a PGY2 position in another specialty and completed my residency (PGY2 and PGY3) and also got board certified. Currently I am doing a fellowship. I applied for a state license that need 24 months of ACGME approved residency. Still the state requested me to provide PGY1 verification. When I requested my past program to fill the verification form for PGY1 they sent me a letter from their legal department that basically give them consent to disclose my entire file to the board. Also, they specifically stated that they will attach the dismissal letter to the form which say that I didn't have the needed medical knowledge, skills or interpersonal skills to advance to the next year (PGY2). I got full credits for PGY1 and that's how I was able to start PGY2 in a program that was more suited to my learning style.

I do not know what to do at this point. If I do sign the release form there is a good possibility that my licence request will get denied and I will have to report to every other state the denial and reason for denial. If I don't sign they won't provide the verification form and I will be geographically restricted to the only state where I currently hold a license. What should I do?

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[DarkHorizon]

You will have to sign this release form. I am licensed in 3 states and they all asked for verification of every medical training I underwent. Omitting or lying about this will cause more trouble. In fact there was a question on every application that asked about any board exam failure or remediation or probation. You had to answer those questions, there was no option to omit this. They usually asked you to explain it if you answered yes.

Good news is that you shouldn’t worry too much, just explain that your contract was not renewed and you were able to find another position to continue. They have to verify that you completed PGY1 year, or else you couldn’t possibly continue your training. This should not be an issue, you should be able to obtain a license. If anything, they may ask you to come in and explain it personally.

You might have more trouble with credentialing, depending on what hospital system you join.... hospitals have their own unique credentialing requirements and some of them can be quite strict.... although I think most of them will credential you, given that you moved on and have since successfully completed your training and have no other red flags.

 

[Smurfette]

If you got full credit for your intern year, and full credit for all the following years, this shouldn't be an issue. They are verifying training, not looking to punish you. You ultimately turned things around and were allowed to finish; that's what they are looking for. When you apply for hospital privileges, this will be verified again at the institutional level and the worst case is that they ask for a bit more info. All you have to say if they ask for specifics is that you were non-renewed but ended up at another residency program that was a better fit for you.

 

[Jas2188]

Hi,
What is worrying is they wanting to attache my final dismissal/contract non-renewable letter to the verification form as an explanation. The letter is worded very poorly and negatively by the program and give an impression that I am not fit to be a physician or practice any where else. Also, it states that I won't be academically ready to move to PGY2. As stated I found a PGY2 position in another specialty and did very well. I am afraid that the board may consider that I failed PGY1 and over look the following successful years. I don't understand why they can't write a short explanation on a additional sheet instead as stated on the verification form.

 

[Piebaldi]

If you got full credit for your intern year, and full credit for all the following years, this shouldn't be an issue. They are verifying training, not looking to punish you. You ultimately turned things around and were allowed to finish; that's what they are looking for. When you apply for hospital privileges, this will be verified again at the institutional level and the worst case is that they ask for a bit more info. All you have to say if they ask for specifics is that you were non-renewed but ended up at another residency program that was a better fit for you.

Exactly. Not to mention that OP finished residency and also in process of completing fellowship, and is board certified. Clearly he/she was able to make it through whatever knowledge/interpersonal issues he/she had and allowed to complete training. So I wouldn't imagine it would be an issue but yes, he/she will have some additional explaining to do and should likely get an official "response statement" to attach to paperwork as he/she will have to explain this likely to every licensing body/hospital they apply to.

 

[Piebaldi]

Hi,
What is worrying is they wanting to attache my final dismissal/contract non-renewable letter to the verification form as an explanation. The letter is worded very poorly and negatively by the program and give an impression that I am not fit to be a physician or practice any where else. Also, it states that I won't be academically ready to move to PGY2. As stated I found a PGY2 position in another specialty and did very well. I am afraid that the board may consider that I failed PGY1 and over look the following successful years. I don't understand why they can't write a short explanation on a additional sheet instead as stated on the verification form.

You certainly can kindly request that. Again obviously you transferred, finished residency, now completing fellowship, so you have been deemed to be sufficiently qualified and passed boards too. So perhaps you might have to explain yourself, maybe have a person interview, etc but I doubt that the board wouldn't license you if you have graduated ultimately and have successfully completed your training. You will again likely have to jump through some hoops but would be surprised if you were denied a license based on something in your first year.

 

[DokterMom]

It might be worth consulting an attorney who specializes in medical licensing issues and/or employment law, but frankly, I don't imagine you have much leverage at this point. (Though there's some case law on negative references that might be worth exploring...)

It would be a 'goodwill thing' if they're willing to spend the time writing something small and new if they already have their original nastygram. That said, someone at your old program might be genuinely happy to hear that you were able to find a better-fit program and succeed there and might be willing to 'soften the tone' on their verification.

 

[Jas2188]

Hi,

Thank you all for your support.

I have decide to be proactive include a response statement in the paperwork that would address the contract non-renewal letter that talks poorly about my medical skills and knowledge. I don't plan to directly refute what the letter say but will like to point to the fact that I accepted their feedback and decision and didn't appeal their non-renewal as I realized that the program was not a right fit for me. Instead I completed 12 months and got full credit and moved to a new program and a different specialty. Since than I have completed PGY2 and PGY3 with excellent academic performance and have published multiple research papers at various conferences. Have been awarded "outstanding resident" as well as "best research" awards by the program and also was the only resident to be nominated by the program to be a member of a honorary medical society that year. Did server as a chief resident for a while and passed the specialty board on the first attempt and became board certified. Based on my excellent academic performance I was offed a fellowship at the same program and I am on the path to be dual board certified.

I would like to point to the fact that it was slightly above 6 months into the residency program that I was placed on remedial because of deficiencies in academic performance and interpersonal skills. I would like to highlight that there were no other disciplinary or professional issue that arised during my intern year. Also, I have been at my current program for more that 36 months without a single academic or professional issue.

I don't know how I should start the statement and what I should call it while including in the license package. Also, I am not sure if I should address each of the things raised in the dismissal letter like deficiencies in patient care, medical knowledge and inter-personal communication skills individually. Any insight in this matter or a sample letter will be greatly appreciated.

 

[evilbooyaa]

Just put a synopsis of the first paragraph. Keep it brief. Nobody cares you did research. You excelled at a different program, and passed your boards first attempt.

Don't put any of the stuff from paragraph 2.

 

[DoubleBogey]

Briefity is your friend when it comes to responses to “red flags” - keep short and don’t editorialize.
Personally, I would feel that the PGY1 institution should be slightly embarrassed (and be more self-reflective regarding this experience) as you have gone on to be successful and pursue fellowship. With that said, I wouldn’t go poking the bear on this.

I don’t see an issue with it, more of annoyance/nuisance to respond and provide additional information (if needed).