Resignation process/advice

[Rad!0]

Currently in a specialty/malignant program with nonrenewal for this next academic year. Have a position in another specialty.

Is it advisable to stick out the remaining time with the malignant program or resign and prepare for the other specialty? There is sufficient coverage for the current program.

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[Shikima]

Stick it out.. complete your time and move on if you have something else lined up. Complete your duty with your head held high.

 

[Law2Doc]

It always looks better if you complete the term of your contract and have no gaps. This won't be the last time you apply for a job.

 

[Winged Scapula]

As others have said stick it out. For the rest of your professional career, every time you apply for a license or credential with the hospital or insurance company you have to document your time spent at this program.

Leaving early only puts you in a bad light which may be reflected on any future documentation.

 

[cabinbuilder]

I agree that you need to see your contract through. Don't want to have to explain red flags EVERY TIME you apply for a license or hospital privileges. It will haunt you forever.

 

[DermatoFIGHT]

I think the gap thing is over emphasized. Can someone please explain how you cannot practice because you left a program early and did research/something else before starting your new program? Doesn't make sense. It is the same thing as having a gap on your CV and this can be filled in very easily.

 

[22031 Alum]

I think the gap thing is over emphasized. Can someone please explain how you cannot practice because you left a program early and did research/something else before starting your new program? Doesn't make sense. It is the same thing as having a gap on your CV and this can be filled in very easily.

Every single job you apply to will have the prerogative of asking your old program about you. This is no longer the med school stage where "application boosts" like research help you look better. This is a job, and would be leaving a job without completely fulfilling the entirety of a binding contract. That can absolutely follow you forever.

 

[gutonc]

I think the gap thing is over emphasized. Can someone please explain how you cannot practice because you left a program early and did research/something else before starting your new program? Doesn't make sense. It is the same thing as having a gap on your CV and this can be filled in very easily.

It's not that you can't practice. It's just that every single state license and hospital privileging application you ever submit in the future will be delayed while the board scrutinizes your application more closely due to the gap. Unless the current program is a horror show and you're being beaten daily, sucking it up for the next 6 weeks to avoid this future hassle is a total no-brainer.

 

[cabinbuilder]

I think the gap thing is over emphasized. Can someone please explain how you cannot practice because you left a program early and did research/something else before starting your new program? Doesn't make sense. It is the same thing as having a gap on your CV and this can be filled in very easily.

Any time you have a greater than 3 month gap in your CV you have to "explain" why you were not working. It can add a lot of time to the credentialing process with every subsequent job.

 

[michaelrack]

Any time you have a greater than 3 month gap in your CV you have to "explain" why you were not working. It can add a lot of time to the credentialing process with every subsequent job.

Agree. Some hospital staff credentialers are anal and will ask a doc to explain even a one month gap. Most medical boards ask you to explain 3 month gaps or greater

 

[dannyboy1]

Sad that the state of medicine has come to this. OP is being forced out (with a non renewal) and has a new spot for July. why should they stick around? for the $hitty resident salary?

 

[psych72]

Sad that the state of medicine has come to this. OP is being forced out (with a non renewal) and has a new spot for July. why should they stick around? for the $hitty resident salary?

I think if you sign a contract for a year you are bound till July 1 regardless of what the cards hold for next year

 

[ThoracicGuy]

Sad that the state of medicine has come to this. OP is being forced out (with a non renewal) and has a new spot for July. why should they stick around? for the $hitty resident salary?

This isn't anything new and isn't reflective on the state of medicine. The OP is actually lucky in that he has a new spot already lined up for July. He's not in it necessarily for the salary, though that is important. He's in it for the continued experience and the ability to not have a gap in their CV. That matters to state and hospital credentialing as stated earlier. Maybe when you get out of med school and into the real world you'll understand some of this...

 

[dannyboy1]

This isn't anything new and isn't reflective on the state of medicine. The OP is actually lucky in that he has a new spot already lined up for July. He's not in it necessarily for the salary, though that is important. He's in it for the continued experience and the ability to not have a gap in their CV. That matters to state and hospital credentialing as stated earlier. Maybe when you get out of med school and into the real world you'll understand some of this...

Disagree. He is in it for the experience leading to board certification, without that you are just working for far less than you are worth. Besides, If OP is starting a residency in his new specialty this July that means that he will have at least 3 years of of uninterrupted experience. Will taking off six weeks in the transition from one residency to another really not allow him to get licensed or credentialed when he graduates ?

 

[so721]

This isn't anything new and isn't reflective on the state of medicine. The OP is actually lucky in that he has a new spot already lined up for July. He's not in it necessarily for the salary, though that is important. He's in it for the continued experience and the ability to not have a gap in their CV. That matters to state and hospital credentialing as stated earlier. Maybe when you get out of med school and into the real world you'll understand some of this...

I think that's the tricky part. I kind of wish a year ago someone had explained this to me. It's very tough for some of us to decide on a specialty we are 100% committed to at end of 3rd year, and then when we don't decide soon enough it seems like we're already out of the running come application season and you tend to spread yourself too thin. Sometimes combined with red flags, you end up in a disastrous situation of not matching or ending up at a place that's at the end of your list. Then you get committed for a year, and if you want to get out, there's not real way out without damaging your career permanently.

There are a lot of things you don't find out about a program until you've been there. Unfortunately medicine is an unforgiving field where if you have a red flag, or a gap, people see it as a big negative and a future risk--no one really gives you a chance afterwards unless you have the support of a your PD.

For the OP, there is a possibility of he/she getting sued by the hospital for not honoring the employment contract carefully, correct? Back when I was first unhappy with my match, I looked at my contract and it gave all the power to the PD to terminate me at any point in time, but it made no mention of my decision to leave at my will or how much notice. Regardless, having that gap is pretty annoying to explain anyways i bet.

At the end of the day, politics are very prevalent in this profession and your PD, faculty, even the ancillary staff and coordinator has all the power--while you are nothing more than underpaid servant who is expected to just agree.

 

[Winged Scapula]

Disagree. He is in it for the experience leading to board certification, without that you are just working for far less than you are worth. Besides, If OP is starting a residency in his new specialty this July that means that he will have at least 3 years of of uninterrupted experience. Will taking off six weeks in the transition from one residency to another really not allow him to get licensed or credentialed when he graduates ?

Was the answer from the FIVE licensed attendings (in different specialties and different states) above not clear enough for you?

No one said that it would prevent him wholesale from getting a license or credentialed. What we said that it will make it harder and will add unnecessary time (more than the 6 weeks he's got left), which could impact him professionally.

In addition, leaving on bad terms will impact him especially in smaller fields and when his former PD is asked to answer that licensing/credentialing question(s): "would you hire this individual again?", "is this individual eligible to be hired again?" It says a lot for maturity and professionalism as well as having the foresight to mitigate potential problems down the road if he were to stay.

 

[so721]

Was the answer from the FIVE licensed attendings (in different specialties and different states) above not clear enough for you?

No one said that it would prevent him wholesale from getting a license or credentialed. What we said that it will make it harder and will add unnecessary time (more than the 6 weeks he's got left), which could impact him professionally.

In addition, leaving on bad terms will impact him especially in smaller fields and when his former PD is asked to answer that licensing/credentialing question(s): "would you hire this individual again?", "is this individual eligible to be hired again?" It says a lot for maturity and professionalism as well as having the foresight to mitigate potential problems down the road if he were to stay.

Yikes, I didn't know it's that extensive. Heaven forbid anyone have a PD they rub the wrong way or a hostile one, they could really do you over!

 

[Winged Scapula]

Yikes, I didn't know it's that extensive. Heaven forbid anyone have a PD they rub the wrong way or a hostile one, they could really do you over!

For surgical fields the way it often works is as follows:

- initial licensing, hospital and insurance credentialing: records from residency and fellowship
- recredential usually every 2 years: for the first 5 years out in practice, they will still usually ask for your references to come from your training program. I find most hospitals and insurance plans here want 3 references.
- once you've been out in practice for 5 years or more, then you can use community colleagues as references (but not business partners)
- I fill these out for friends all the time, as they do for me. So I've seen the forms and these are the same ones that were sent to my residency and fellowship PD and they all include questions about moral/ethical character, would you hire this person again, is there any reason to believe they are not qualified to perform duties X, etc.

Since the OP is changing fields and programs, it won't likely come to that but some licensing boards want references from every place you've trained. Better safe than sorry in terms of burning bridges.

 

[so721]

For surgical fields the way it often works is as follows:

- initial licensing, hospital and insurance credentialing: records from residency and fellowship
- recredential usually every 2 years: for the first 5 years out in practice, they will still usually ask for your references to come from your training program. I find most hospitals and insurance plans here want 3 references.
- once you've been out in practice for 5 years or more, then you can use community colleagues as references (but not business partners)
- I fill these out for friends all the time, as they do for me. So I've seen the forms and these are the same ones that were sent to my residency and fellowship PD and they all include questions about moral/ethical character, would you hire this person again, is there any reason to believe they are not qualified to perform duties X, etc.

Since the OP is changing fields and programs, it won't likely come to that but some licensing boards want references from every place you've trained. Better safe than sorry in terms of burning bridges.

Thanks for the explanation. I hope these credentialing companies get input from actual Physicians who would know that a PD who you transfer from is unlikely to grant you a stellar reference. After all, they would love to see you for the duration of training. Albeit the majority are reasonable indivdiuals, there are some who are just downright controlling.

 

[ThoracicGuy]

Disagree. He is in it for the experience leading to board certification, without that you are just working for far less than you are worth. Besides, If OP is starting a residency in his new specialty this July that means that he will have at least 3 years of of uninterrupted experience. Will taking off six weeks in the transition from one residency to another really not allow him to get licensed or credentialed when he graduates ?

If he's changing to a different field, the things he can learn between now and the end of June can still apply to his new field. It's like I told my students back in residency - they may not want to go into surgery, but everyone can learn something from the rotation and use it in their future careers. Six weeks off won't mean the end of the world, but leaving his program without coverage suddenly will burn bridges that may already be in trouble. For the future credentialing at hospitals and getting licenses from state medical boards, he will need a document from all his past PDs stating that he trained with them during that time frame. If the PD doesn't like, he can drag his feet for quite a while and make it hard on you to move forward. Why do that to yourself?

As a student and resident, you guys don't think about these things but when you get out there in the real world, it will affect you.

 

[Gastrapathy]

It doesn't matter that this is a waste of time. Don't poke the bear. Finish.

 

[meerkat111]

Was the answer from the FIVE licensed attendings (in different specialties and different states) above not clear enough for you?

No one said that it would prevent him wholesale from getting a license or credentialed. What we said that it will make it harder and will add unnecessary time (more than the 6 weeks he's got left), which could impact him professionally.

In addition, leaving on bad terms will impact him especially in smaller fields and when his former PD is asked to answer that licensing/credentialing question(s): "would you hire this individual again?", "is this individual eligible to be hired again?" It says a lot for maturity and professionalism as well as having the foresight to mitigate potential problems down the road if he were to stay.

If OP stays, the malignant program could give bad evals and still give bad references. Remember, they are "malignant". Just saying. This happened to some one who agreed to complete the internship year initially upon finding another spot. She ended up leaving early anyways as she could not put up w increased levels of harrassment. Granted, in some cases perhaps the program wants the resident to go ?

Hospitals are run like big businesses now. They should get used to people leaving their jobs when they don't like it. No one expects a good reference from a supervisor whom you left because things didn't workout.

 

[Winged Scapula]

If OP stays, the malignant program could give bad evals and still give bad references. Remember, they are "malignant". Just saying. This happened to some one who agreed to complete the internship year initially upon finding another spot. She ended up leaving early anyways as she could not put up w increased levels of harrassment. Granted, in some cases perhaps the program wants the resident to go ?

Hospitals are run like big businesses now. They should get used to people leaving their jobs when they don't like it. No one expects a good reference from a supervisor whom you left because things didn't workout.

I never said that I expected his current program director to write a good reference. You've misunderstood that.

But by leaving early he is assuring that it least there will be some ADDITIONAL negative content in that reference.I'm not so naïve that I think that he is somehow going to get a good reference if he stays the extra six weeks. I've actually witnessed the exact same situation during my residency with a non designated pre-lim surgical resident who found a position outside the match and left a few days later. Our program director called her new program director who was reportedly not pleased about her actions

However you're missing the big picture. That is only one concern we have. By leaving early (6weeks!) even if it is a malignant program (whatever that means), he is behaving unprofessionally, leaving his fellow residents in a lurch with more work and more call, and as all of us have said, creating more problems for himself down the road in terms of licensing and credentialing because of the gap.

 

[killerleaf]

One other small thing to consider: is his new position dependent on completing the current year? For instance, if he is in Internal Medicine, and moving to Anesthesiology, does he have 12 months of medicine done? If not, then it may be difficult for him to move into a PGY-2 spot in Anesthesiology. Not impossible, but difficult. why make things harder than they have to be?

 

[psych72]

Could the OP be sued for breach of residency contract by the GME/Hospital? Contract is supposed to finish July 1st.

 

[Winged Scapula]

Could the OP be sued for breach of residency contract by the GME/Hospital? Contract is supposed to finish July 1st.

Could be, but most aren't going to go to that trouble.

 

[link2swim06]

Could the OP be sued for breach of residency contract by the GME/Hospital? Contract is supposed to finish July 1st.

You are allowed to quit a job. Most contracts require a few weeks or a month notice. Nobody is going to sue you.

They just aren't going to give you positive letters of recommendation and you likely burnt a bridge and will not get credit for the year if you randomly quit.

 

[psych72]

Currently in a specialty/malignant program with nonrenewal for this next academic year. Have a position in another specialty.

Is it advisable to stick out the remaining time with the malignant program or resign and prepare for the other specialty? There is sufficient coverage for the current program.

How did you manage to secure a position in another residency without a current positive LOR from your current PD?

 

[psych72]

You are allowed to quit a job. Most contracts require a few weeks or a month notice. Nobody is going to sue you.

They just aren't going to give you positive letters of recommendation and you likely burnt a bridge and will not get credit for the year if you randomly quit.

I read my contract, it doesn't mention anything of any notice being given---I'm sure what you are saying is correct though. Given how hard it is to match, its tough to imagine people just giving up on residency and abandoning ship.

 

[JGimpel]

If a program wants you gone, they will usually offer to let you out of your contract and some sort of letter with what you got credit for in that program so that the new one can figure out where you fall in their program. If they want to add any editorial to that, it definitely could happen. Leaving quickly could avoid termination, which they often make clear and is truly better for your record. They could also negotiate to have minimal to no adverse reports on what is released to other facilities for leaving quickly. With regard to credit given at your new program, assume the worst, no credit, and be pleasantly surprised if they offer you 6 months to 1 year of credit.

Every app for everything related to medicine will have some form of those "have you ever" questions on them. Answer them honestly, but you may want to consult an attorney to see what language you could use for the excuse. If you had a 2 month gap, you definitely could have been reviewing literature relevant to your field, or working at a job to pay the rent, so put that. As long as the first clerk sees an issue and a feasible explanation has been provided, you'll likely pass to the next round of scrutiny.

If not, your app gets escalated to an administrator to review and, yes, your time to reach credentialing may be extended and you'll have to push out your start date. It may take an extra week or two, but that should be it. Anything criminal is a whole other story. Make sure your program is aware of any possible delays, not necessarily why if they ask or say nothing and blame red tape. If they want you, they'll wait.

Resign with class, shaking hands and giving your support staff hugs if they're open to it and make sure that your contact information is up to date. They won't call, but it's a nice gesture. Giving 30 days notice is usually the goal for professionals, but you could play dumb and give two weeks and blame it on a rookie mistake if you're ever questioned about it. Still turn in the letter no matter what, since the people at the program may change and the next group can see that you properly resigned.

I take the above from others that have commiserated with myself about the quality of their programs, and bad outcomes have come to those not prepared to handle the circumstances. Residents talk, ask around.

 

[serimeri]

If a program wants you gone, they will usually offer to let you out of your contract and some sort of letter with what you got credit for in that program so that the new one can figure out where you fall in their program. If they want to add any editorial to that, it definitely could happen. Leaving quickly could avoid termination, which they often make clear and is truly better for your record. They could also negotiate to have minimal to no adverse reports on what is released to other facilities for leaving quickly. With regard to credit given at your new program, assume the worst, no credit, and be pleasantly surprised if they offer you 6 months to 1 year of credit.

Every app for everything related to medicine will have some form of those "have you ever" questions on them. Answer them honestly, but you may want to consult an attorney to see what language you could use for the excuse. If you had a 2 month gap, you definitely could have been reviewing literature relevant to your field, or working at a job to pay the rent, so put that. As long as the first clerk sees an issue and a feasible explanation has been provided, you'll likely pass to the next round of scrutiny.

If not, your app gets escalated to an administrator to review and, yes, your time to reach credentialing may be extended and you'll have to push out your start date. It may take an extra week or two, but that should be it. Anything criminal is a whole other story. Make sure your program is aware of any possible delays, not necessarily why if they ask or say nothing and blame red tape. If they want you, they'll wait.

Resign with class, shaking hands and giving your support staff hugs if they're open to it and make sure that your contact information is up to date. They won't call, but it's a nice gesture. Giving 30 days notice is usually the goal for professionals, but you could play dumb and give two weeks and blame it on a rookie mistake if you're ever questioned about it. Still turn in the letter no matter what, since the people at the program may change and the next group can see that you properly resigned.

I take the above from others that have commiserated with myself about the quality of their programs, and bad outcomes have come to those not prepared to handle the circumstances. Residents talk, ask around.

I totally agree with you about the being honest part.

 

[Law2Doc]

You are allowed to quit a job...

Sort of. Nobody is going to sue you but breaching a contract technically makes you liable for damages. So yes you can quit but it's not an automatic that you can quit without consequences when you are operating under a contract. Is it worth their while to sue you? No way. Could they ( and win)? You bet.

 

[serimeri]

It's really tough being a 3rd/4th year medical student. You really don't know what you want until you do a rotation. You could just as easily realize you made a mistake during residency.

 

[Law2Doc]

It's really tough being a 3rd/4th year medical student. You really don't know what you want until you do a rotation. You could just as easily realize you made a mistake during residency.

Yes and no. Sure some people decide there are fields that would be a better fit. But to a large extent residency is what you make of it, and the guy with the good mindset is going to do well in multiple paths while the guy whos miserable in his choice probably is unfairly putting some of the blame for his misery external to himself. You make the best selection you can but you at least play out the current year of your contract.

 

[link2swim06]

Sort of. Nobody is going to sue you but breaching a contract technically makes you liable for damages. So yes you can quit but it's not an automatic that you can quit without consequences when you are operating under a contract. Is it worth their while to sue you? No way. Could they ( and win)? You bet.

No. My contract literally says I can quit and terminate the contract with 30 days of written notice. I could quit by the middle of June and I would not have breached any contract.

I'd imagine many (most?) contracts have some similar procedures for quitting.

 

[Law2Doc]

No. My contract literally says I can quit and terminate the contract with 30 days of written notice. I could quit by the middle of June and I would not have breached any contract.

I'd imagine many (most?) contracts have some similar procedures for quitting.

Actually in residency contracts this is not common.

 

[serimeri]

Yes and no. Sure some people decide there are fields that would be a better fit. But to a large extent residency is what you make of it, and the guy with the good mindset is going to do well in multiple paths while the guy whos miserable in his choice probably is unfairly putting some of the blame for his misery external to himself. You make the best selection you can but you at least play out the current year of your contract.

I totally agree with you. It's just hard to be decisive and live life with no regrets.