Residency termination/resignation (long post, really struggling)

Started by dawgs55
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dawgs55

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Resignation/termination from residency (long post, really struggling here)

USMD grad class of 2024 here. In late 2024/early 2025 I was dealing with some very difficult life circumstances. My dad was diagnosed with multiple myeloma which has invaded his skull and spine. And then about a month later my longtime girlfriend, who was pregnant with our child and I was hoping to marry, was killed in a motor vehicle accident. Our child was killed instantly—she initially survived but passed about 3 weeks later.

To be honest, I just started to struggle enormously during her time in the ICU and in the aftermath of these events. Although I tried not to show it and still showed up to work each day, my program had to have noticed a change/decline in my demeanor and performance and were I think at a loss. For months, I did not tell any of them what was going on, not wanting to look weak/make excuses, and now I totally regret this. They drug tested me like 4+ times (all of which were negative), placed me on a PIP, and then referred me to the state health board in April. It was here that I finally began to open up somewhat about what I was going through.

They placed me a leave of absence for 90 days, most of which I spent at MD Anderson with my father who was receiving cancer treatment. However, during this time, while I was not even on rotations, they went ahead and placed me on probation. My progression to PGY2 was obviously delayed, and I know that I really messed up their call schedule, etc. I came back, completed 4 extra months of PGY 1 rotations, and then was given notice of termination/resignation option instead of termination.

I know that when a resident is fired, it is an enormous red flag. Other program directors have consistently asked me if there is something else I am not telling them—such as an arrest, substance abuse, an inappropriate relationship with patients/staff, HIPAA violations, killing a patient, etc. Although I am far from perfect, there is not anything like that. Even my old program has offered to attest to that. I almost think they are skeptical that something else didn’t happen. I have even, as morbid as it sounds, offered to provide medical records and death certificates to prove I am not making up a sob story.

None of this is to say it isn’t my fault. It is absolutely my fault—I let outside life events affect my work, my demeanor, my performance. And I know that is unacceptable, and 100% on me. I was just going through an enormously difficult time and quite frankly having difficulty focusing. That’s on me.

My life is now ruined. I put all these years and all this money into this, and now it’s just over. Does anyone have any type of advice? I have no interest in suing my old program or anything like that, I’m not like that. I would be so grateful to get a new program, maybe a place that is a little more compassionate, and work my ass off to show I can be a kind, caring, competent physician.
 
First, your life is not ruined. You have a chance to come back from this. It may not be what you initially pictured for yourself, but the door isn't always going to be shut to you.

Second, make sure you are in a good place now. If you aren't, get help.

What specialty are you currently doing/trying for. That can help to guide any advice. Looking at prior posts, you do have an IA for drinking in the past, so I suspect that may play a role in some of the questions that you're getting. Make sure that you and your prior program are completely on the same page as far as your first try at training.
 
I wouldn't jump back into residency right now. I know you want to feel "normal" again ASAP, but you need to take time to digest what has happened. It is a lot.

The only thing you did wrong was not tell your program as things were starting to fall apart. And you should absolutely not feel guilty about "messing up their call schedule."

Take some time. Figure out where your life goes from here. And then start to apply. But make sure you're in a good headspace before trying to dive back in.
 
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Sorry all this happened - it’s definitely a tricky spot to be in but you can come back from this.

Sounds like you have some measure of support from your old program, or at least a letter offering the facts from their perspective. My guess is you weren’t at your best on those 4 rotations after the loa and that’s probably what got you bounced. Anyone with a brain also knows that you were under increased scrutiny during those rotations as well, and even good trainees can look bad when they’re under the microscope.

Agree with the other that you need some time, just like you probably needed more time between the loa and the makeup rotations. Couple key data points we don’t have:

1) what field? Can also be broad if you don’t want to specify - ie a primary care field, surgical subspecialty, highly competitive, etc.

2) were you given credit for the pgy1 year? I’m guessing not, but your options are slightly different


Either way, going to need some time but not too much time. Enough to get your headspace to where you can handle training again, but not so much that you’re too rusty and will struggle for other reasons.
 
You can definitely recover from this. This all represents a fairly good explanation for what happened, assuming you're describing everything accurately. I second that your big mistake was not letting your program know immediately followed by an extended leave. "Showing up to work" right after your child is killed is a frank use of a maladaptive coping skill, not something to be commended. I also agree you need to be focusing on your mental health right now. Even someone with excellent support and who was clearly aware of their own adaptive coping skills would struggle mightily with what you went through. With a good explanation of what happened AND what you did about it to work on yourself, you can reapply to several specialties with likely success.
 
Resignation/termination from residency (long post, really struggling here)

USMD grad class of 2024 here. In late 2024/early 2025 I was dealing with some very difficult life circumstances. My dad was diagnosed with multiple myeloma which has invaded his skull and spine. And then about a month later my longtime girlfriend, who was pregnant with our child and I was hoping to marry, was killed in a motor vehicle accident. Our child was killed instantly—she initially survived but passed about 3 weeks later.

To be honest, I just started to struggle enormously during her time in the ICU and in the aftermath of these events. Although I tried not to show it and still showed up to work each day, my program had to have noticed a change/decline in my demeanor and performance and were I think at a loss. For months, I did not tell any of them what was going on, not wanting to look weak/make excuses, and now I totally regret this. They drug tested me like 4+ times (all of which were negative), placed me on a PIP, and then referred me to the state health board in April. It was here that I finally began to open up somewhat about what I was going through.

They placed me a leave of absence for 90 days, most of which I spent at MD Anderson with my father who was receiving cancer treatment. However, during this time, while I was not even on rotations, they went ahead and placed me on probation. My progression to PGY2 was obviously delayed, and I know that I really messed up their call schedule, etc. I came back, completed 4 extra months of PGY 1 rotations, and then was given notice of termination/resignation option instead of termination.

I know that when a resident is fired, it is an enormous red flag. Other program directors have consistently asked me if there is something else I am not telling them—such as an arrest, substance abuse, an inappropriate relationship with patients/staff, HIPAA violations, killing a patient, etc. Although I am far from perfect, there is not anything like that. Even my old program has offered to attest to that. I almost think they are skeptical that something else didn’t happen. I have even, as morbid as it sounds, offered to provide medical records and death certificates to prove I am not making up a sob story.

None of this is to say it isn’t my fault. It is absolutely my fault—I let outside life events affect my work, my demeanor, my performance. And I know that is unacceptable, and 100% on me. I was just going through an enormously difficult time and quite frankly having difficulty focusing. That’s on me.

My life is now ruined. I put all these years and all this money into this, and now it’s just over. Does anyone have any type of advice? I have no interest in suing my old program or anything like that, I’m not like that. I would be so grateful to get a new program, maybe a place that is a little more compassionate, and work my ass off to show I can be a kind, caring, competent physician.
Bro, what? This is outrageous, you're a human being struggling immensely with frankly horrible circumstances. Your biggest failing as you said is not telling anyone what happened and taking a leave at the time. It's not about not being professional or any of that, it's about believing in the twisted view that physicians are somehow not allowed to be human and not allowed to be affected by the stuff that life hits us with.

Anyway, all this to say, I agree take a minute. Get yourself back together and make a plan of attack. Theres still plenty of options for you. Your career is not over, and certainly your life is not ruined.

If you haven't already, get lots of LORs from your old program, try to build connections with mediocre programs that struggle to fill locally, and reapply broadly. Call your med school friends and see if they can put out feelers for open programs at their institutions. Go to conferences if you can, make connections. If you completed PGY1, which I hope they let you do and have the completion certificate, take Step 3, get licensed, etc. There is a way through this, and I know plenty of people fired for worse reasons that were more in their control that have recovered from termination.