seeking advice: Appealing a Dismissal

[M3RedemptionArc]

Fall: Civil lawsuit; couldn’t afford an attorney right away and had to scramble to represent myself. (Should have asked for a leave of absence, hindsight is 20/20). Missed 4 days of a rotation (policy limit = 2 days) and was late multiple times. Failed on rotation for professionalism concerns/absences/tardiness. Placed on academic & professionalism probation.
Winter/Spring: Rebounded and did well on the next rotation, despite two back-to-back family health emergencies leading up to break. Was taking care of family members entire break & didn't invest enough time in studying (medicine shelf). Came back exhausted. (Should have asked for a leave of absence, again hindsight is 20/20). Missed a didactic session while sick, didn’t notify faculty until late that day. Slept through alarm for shelf exam retake (while on trauma surgery), Owned up immediately, was totally transparent, but failed by a small margin. Took medicine shelf one week later and failed by just small margin. Referred back to the student progress committee, recommended for dismissal.

Additional context: Ongoing mental health struggles due to the stress (now getting help). Scheduled in-lab sleep study; suspect undiagnosed sleep apnea may be contributing to constant fatigue and sleeping through alarms. currently off rotations, in appeal process, studying hard for my medicine shelf retake, must prove I can still meet the academic standard. Was planning for a research/gap year between M3/M4. (if given opportunity). I have been/was VERY involved in leadership, community service, research - within institution (had to give all of this up when put on probation according to contract). Never had any issues during pre-clerkship.

Questions:
- What can I say or do in my appeal meeting (1-1 in person w Dean) to give myself the best chance of overturning this dismissal recommendation?
- How can I demonstrate improved professionalism while off clinical rotations?
- Are there any specific documents or strategies (e.g., remediation plans, physician letters, timelines, etc.) that have helped in similar appeals?

Thanks for reading, i know it's cliche but this is my passion I've just been stuck on autopilot (probably a trauma response). I know I can do this I just have to show that I deserve another chance (actions > words). any actionable advice or insight would be MUCH appreciated

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[Goro]

Very sorry to see this, OP, but what I read in your post are a lot of excuses and poor judgement.

Failing by a small margin is the same as failing by a large margin; you failed to display minimal competence, much less mastery of the subject.

For starters, you're going to have to own everything.

two back-to-back family health emergencies leading up to break. Was taking care of family members entire break & didn't invest enough time in studying (medicine shelf).

Once you put on that White Coat, that was the time to become somewhat selfish, as being a med student means that you can't always be at home for emergencies. Those are for extended family and/or neighbors.

You may have to not only appeal to the Dean, but go up the chain of command to University President/CEO/Provost/Chancellor.

But also be prepared for the eventuality that your medical career is over.

@gyngyn @Med Ed thoughts???

 

[mistafab]

Just keep in mind you are appealing to doctors.

Doctors like people who take full responsibility, and identify what can be done different.

Take goro's advice. Flip this to be entirely in your control. Be someone who they want to help. Here's my general train of consciousness below - generally just taking 100% ownership and beg for sympathy:

I should have asked for help sooner. I should have done less external activities to focus on my studies. I am really invested in helping people but I should have focused on learning to be a doctor first, because I did not have enough bandwidth to do all this at once. I did not have the skills to balance the academics with the leadership roles and the community service and research while these personal problems were going on. I should have reached out to my attending on that rotation and let them know what was going on. When some family emergencies happened, I should have requested time off to come back when I was ready, and actually deal with these problems.

I want to make any changes that you all recommend that will make me a successful student. I have also been working with my doctors to help me with some medical illnesses that I should have worked up and dealt with long ago, including possibly sleep apnea. I know I can do this, I just did not make this enough of a priority and did not realize when my performance was slipping. I did not do what I knew I needed to do to make sure I'd be successful in clinicals, and unfortunately, I ignored the signs that things weren't working. I take full responsibility for my failures here and am still 100% invested on doing anything it takes to move forward in this career. I am willing to do anything to get back on track and follow any recommendations you all have for me to succeed from here on out.

 

[Med Ed]

Sometimes life is difficult but it's not complicated. The job of a medical student on clinical rotations is twofold: show up when you're supposed to, and pass your exams. That's it. That's all you have to do. Everything else is gravy.

I'm guessing you have never struggled before, at least not really. The behavioral pattern you have exhibited is pretty common. Unexpected stressful event happens, mild panic ensues, leading to a bad decision. The bad decision begets more stress, which in turn leads to more bad decisions. This establishes a vicious cycle which is exceedingly painful to watch.

I personally wouldn't invoke the sleep apnea thing. Undiagnosed medical conditions are blamed for practically every student shortcoming nowadays (looking at you, ADHD), so it just reads like another weak excuse. The simple fact is that you have failed to perform your most basic duties. You have failed to show up (repeatedly), and failed your exams (repeatedly). The reasons are irrelevant. The only thing I think you can do is accept these failures, express that you understand their gravity and the precariousness of your current situation, and resolve to get back on track by whatever means necessary.

 

[Goro]

Sometimes life is difficult but it's not complicated. The job of a medical student on clinical rotations is twofold: show up when you're supposed to, and pass your exams. That's it. That's all you have to do. Everything else is gravy.

I'm guessing you have never struggled before, at least not really. The behavioral pattern you have exhibited is pretty common. Unexpected stressful event happens, mild panic ensues, leading to a bad decision. The bad decision begets more stress, which in turn leads to more bad decisions. This establishes a vicious cycle which is exceedingly painful to watch.

I personally wouldn't invoke the sleep apnea thing. Undiagnosed medical conditions are blamed for practically every student shortcoming nowadays (looking at you, ADHD), so it just reads like another weak excuse. The simple fact is that you have failed to perform your most basic duties. You have failed to show up (repeatedly), and failed your exams (repeatedly). The reasons are irrelevant. The only thing I think you can do is accept these failures, express that you understand their gravity and the precariousness of your current situation, and resolve to get back on track by whatever means necessary.

And develop a remediation plan so ypu can demonstrate that you are being proactive towards getting back on the straight path

 

[GoSpursGo]

Agree with Med Ed and Goro. Less important is the why of your prior failure, and more important is the answer to why you will be successful going forward

 

[Rachapkis]

I understand why I was dismissed. I excercised poor judgment when . . .

I am in a different place now and have learned from my mistakes. For example . . .

Here is what I am doing differently and what I plan to do differently going forward to make sure that I succeed . . .

 

[operaman]

Lots of excellent advice here already. Definitely gotta take ownership and don’t bother with sleep apnea or other undiagnosed issues. The fact is that you would have had that during preclinical but apparently were able to perform quite well. Focus on your poor decision making and how you plan to change things going forward.

I read your tale and it seems you were involved in a legal action - arguably one of the most stressful experiences and why I always roll my eyes when someone says “you should sue!” I’ve never met anyone walk away from a legal action saying they felt justice was done and that they feel whole again. No, just a ball of stress and misery and only the lawyers walk away happy.

So that part I can see leading to the professionalism failure. It’s the part after that I don’t understand. Was the break in the middle of your medicine clerkship? If so, then you failed despite having extra time to study than your classmates who rotated at other times. Maybe im reading it wrong - just tossing out ideas of how others might interpret your situation.

My read is that you dug a hole during the civil suit and never quite recovered. Being busy and tired during Christmas break didn’t help, but you continued the same pattern of poor coping into the next semester with predictable consequences.

Thoughts on structuring appeal:

1) definitely take ownership and drop all the qualifiers. The passing cutoff for shelf exams is laughably low, so failing even by a small margin suggests your mastery of the material is woefully sub par.

2) would not make much of the family health stuff unless it was something really big. Grandma had a stroke and I had to pitch in to help around the house - not that big a deal. Brother got in a car accident and you were sleeping at his bedside in the hospital every day - maybe relevant. The generic family health excuse is another tired one though and to be effective needs both detail of severity and detail of why you were so personally involved. Even so - it’s still a break that other students didn’t have during that rotation so the fact you didn’t study much doesn’t explain much.

3) the big issue is the spring spiral. My sense is that you were mentally burned out and probably never recovered from the first rotation failure. Then more stressors hit like they always do and you had nothing left in the tank. You should have asked for help and a LOA when you got back from the break exhausted. You tried to push through because you’ve been able to in the past because you’re a smart person, but the dual didactic and clinical demands of clerkships were too much and you underestimated the challenge, especially since it sounds like you had medicine and surgery shelves to contend with, arguably the most difficult ones and the more grueling rotations.

4) what you needed then and probably still need now is a nice long break to get your head straight again. In lieu of dismissal, I would ask to repeat all of M3 starting this summer. Use the intervening weeks to dial in whatever you can from a medical standpoint, meet with academic support staff and develop some plans to incorporate shelf study with your clinical duties, etc.

5) if you have any faculty you’re close to, now’s a great time to get their help. A letter where they would offer to serve as an ongoing mentor with frequent check ins about your progress would be helpful. Ditto for academic support staff.

Focus on your poor decisions, that you now recognize the spiral you got in to, and how you plan to make different decisions going forward. You need a little time off still to get your head straight. And you have put in place some additional checkpoints and mentor support to make sure you don’t have a similar spiral next time around. If you were a solid student before, this may be enough to convince people you will do much better with a second chance.

 

[Drjc1977]

Fall: Civil lawsuit; couldn’t afford an attorney right away and had to scramble to represent myself. (Should have asked for a leave of absence, hindsight is 20/20). Missed 4 days of a rotation (policy limit = 2 days) and was late multiple times. Failed on rotation for professionalism concerns/absences/tardiness. Placed on academic & professionalism probation.
Winter/Spring: Rebounded and did well on the next rotation, despite two back-to-back family health emergencies leading up to break. Was taking care of family members entire break & didn't invest enough time in studying (medicine shelf). Came back exhausted. (Should have asked for a leave of absence, again hindsight is 20/20). Missed a didactic session while sick, didn’t notify faculty until late that day. Slept through alarm for shelf exam retake (while on trauma surgery), Owned up immediately, was totally transparent, but failed by a small margin. Took medicine shelf one week later and failed by just small margin. Referred back to the student progress committee, recommended for dismissal.

Additional context: Ongoing mental health struggles due to the stress (now getting help). Scheduled in-lab sleep study; suspect undiagnosed sleep apnea may be contributing to constant fatigue and sleeping through alarms. currently off rotations, in appeal process, studying hard for my medicine shelf retake, must prove I can still meet the academic standard. Was planning for a research/gap year between M3/M4. (if given opportunity). I have been/was VERY involved in leadership, community service, research - within institution (had to give all of this up when put on probation according to contract). Never had any issues during pre-clerkship.

Questions:
- What can I say or do in my appeal meeting (1-1 in person w Dean) to give myself the best chance of overturning this dismissal recommendation?
- How can I demonstrate improved professionalism while off clinical rotations?
- Are there any specific documents or strategies (e.g., remediation plans, physician letters, timelines, etc.) that have helped in similar appeals?

Thanks for reading, i know it's cliche but this is my passion I've just been stuck on autopilot (probably a trauma response). I know I can do this I just have to show that I deserve another chance (actions > words). any actionable advice or insight would be MUCH appreciated

Lets say everything you said is true and has not been embellished intentionally or unintentionally. As I read your words, lets pretend I am a person in authority, perhaps the Dean, perhaps an employer, or even a spouse. What I am hearing, as I take that viewpoint, are excuses. There were a whole bunch of excuses but no real apparent learning from mistakes made. If I were the dean facing a student with constant issues and a failure to truly resolve those issues by actions and not by words, I would be reluctant for you to continue your medical education. More importantly, is this an unfortunately series of bad events, or is this a life pattern of making excuses. If that is the case, only you can fix that. I do not know what you should during your meeting with the dean other than being honest, open and what you plan to do about this mess. I do wish you well.