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Said I'd make a post when I got around to it. I'm currently procrastinating against an article deadline so I figured this would be a good time lol.
What led me to leave was a combination of a serious medical issue, unsupportive training environment, and personality conflict with our PD.
Let me say, first off, that I did not handle my part at all well, and made lots of mistakes along the way. That said, my program could be directly antagonistic to an extreme degree.
As an intern, I didn't have the easiest start. 5 days into my first psych block, my attending took a month vacation. I was left with a series of random attendings covering who would come in, sign the notes, and leave. Chief wasn't any better. As my 'team' didn't have an attending, I got the most admits/discharges, the most pain in the butt patients, etc. It was hell. I routinely violated work hours, routinely took new patients post-call, and routinely broke the 30h rule. I fell behind on d/c summaries and got raked over the coals for it. PD wasn't interested in the hostile work environment or lack of support, didn't care that I was doing my best (coming in on off days to do d/c summaries), or that I had violated work hours consistently. In fact, that last point was raised as a lack of 'professionalism' on my part.
And at this point my back had deteriorated as I was unable to maintain my pretty time-consuming rehab adn recovery protocol throughout this period of my training. Not only that but I wasn't able to make appointments with my doctor due to the clinical demands and lack of cross-coverage, or make PT visits with any regularity. Not to downplay my own role in this, I find it difficult to ask for help or to admit to physical weakness. Because ultimately sheer bloody-mindedness is how I got through my physical disability to the extent that I had.
Pediatrics was even tougher in a lot of ways. While I loved working with the kids and never actually violated hours, my back had gotten even worse and I could barely think straight. On several occasions I actually passed out from the pain and was only brought back to consciousness by smacking into a wall as I fell over. Turns out that people with spinal stenosis at a high level don't stand so well for hours on end (attending rounds were a 3-5 hour ordeal). Asking for sit-down rounds was an exercise in futility. I even ran into resistance on wearing shoes that made standing more tolerable (which do admittedly look goofy). 'Go to the ADA office or take a medical leave of absence!' was the response I got. Hard to go to the ADA office when you--can't get cross-cover support!
My clinical performance was godawful. I didn't miss diagnoses or raise stupid treatment ideas, but I'd forget to put in orders and my h&ps were not exactly exemplary. I was--not doing well.
Turned it around the next 12 months, got great reviews from everyone involved, despite continued hell. Took more short-call on my medicine months than any other intern. At the VA I was the only resident for a full week and a half, and spent 120h one of those weeks at the hospital. Started getting my back under control, etc. Yet despite consistently 'superior' evals from my evaluators, my PD continued to insist that my performance was unsatisfactory, and continued to list issues from my first 6 months that hadn't come up again.
Only one problem, couldn't afford to take Step 3 by December of my 2nd year. Told the program in advance, and they said 'fine but it's still program policy that you go on probation for that'. I said, 'that's fine, I understand the rules'. And walk into a four page letter detailing any negative comment about me ever made but written as if they were all consistent issues.
'Has issues with support staff'. I had one negative eval from support staff from my first three months, but at that point had two certificates from Childrens' nurses, numerous positive evals, and the nights charge nurse had actually written an unsolicited letter to my supervisor and PD telling them that I was one of the best and most responsive residents they'd ever worked with.
'Doesn't finish documentation on time.' Hadn't had an issue since the first part of my intern year as I mentioned earlier.
'Frequently late.' Again, not an issue since my intern year with one exception--and related to my medical issue.
The list went on and on and basically implied that I was a corss between the spawn of satan and Gomer Pyle. And ran directly counter to what my evals were reading from my supervisors, who not only gave me good numerical evals but also specifically mentioned my dedication to patients, medical knowledge, and ability to work well with support staff. 'Above and beyond' appeared a number of times independently. Not to mention that at this point, I'd picked up an award for my PRITE performance, published two abstracts, was working on a clinical trial at a very involved level, and had twice gotten an honorable mention for medical student teaching.
I pretty much lost my crap after that and checked out. Up through then the whole atmosphere, not just my PD, had been so unsupportive that I felt like I had nowhere to turn. I'd spoken to lawyers, several attendings who empathized but couldn't tell me to do anything but 'push through it', the ombudsman, head of GME, and the head of the housestaff association with nothing in the way of practical change to be made. Overall, the environment was 'service first' and if you happened to get some training it was because that individual attending cared. Our institution seemed to have little use for actually emphasizing training or mentorship. I was busting my butt while I was in the hospital--still without recognition from my PD--but hadn't even applied for Step 3 until the last possible moment I could.
I finally found some supportive attendings with some clout, but by then I was too angry, too burned out, and too apathetic. It was affecting my medical health and my patient care. So. I left.
I've been burned out and could probably be diagnosed with PTSD since my first rotation at the program I was at. I'm a naturally oppositional person and that was more than triggered by the way my PD dealt with me. It was like throwing oil on a naked flame. At the same time, you can only tolerate so much before you throw in the towel.
I've always wanted to be a therapist, and I'll go back to training eventually. But for right now, I'm waiting on my full license, will moonlight at urgent care centers and what not, and will write freelance articles until I can catch my breath and recover.
P.S. No, I'm not going to name my institution. Feel free to PM me. I cleared out my inbox.
P.P.S. Resigning was my first vacation in over 10 months. Due to being placed on an understaffed rotation late in the year and after everyone else had requested vacation.
What led me to leave was a combination of a serious medical issue, unsupportive training environment, and personality conflict with our PD.
Let me say, first off, that I did not handle my part at all well, and made lots of mistakes along the way. That said, my program could be directly antagonistic to an extreme degree.
As an intern, I didn't have the easiest start. 5 days into my first psych block, my attending took a month vacation. I was left with a series of random attendings covering who would come in, sign the notes, and leave. Chief wasn't any better. As my 'team' didn't have an attending, I got the most admits/discharges, the most pain in the butt patients, etc. It was hell. I routinely violated work hours, routinely took new patients post-call, and routinely broke the 30h rule. I fell behind on d/c summaries and got raked over the coals for it. PD wasn't interested in the hostile work environment or lack of support, didn't care that I was doing my best (coming in on off days to do d/c summaries), or that I had violated work hours consistently. In fact, that last point was raised as a lack of 'professionalism' on my part.
And at this point my back had deteriorated as I was unable to maintain my pretty time-consuming rehab adn recovery protocol throughout this period of my training. Not only that but I wasn't able to make appointments with my doctor due to the clinical demands and lack of cross-coverage, or make PT visits with any regularity. Not to downplay my own role in this, I find it difficult to ask for help or to admit to physical weakness. Because ultimately sheer bloody-mindedness is how I got through my physical disability to the extent that I had.
Pediatrics was even tougher in a lot of ways. While I loved working with the kids and never actually violated hours, my back had gotten even worse and I could barely think straight. On several occasions I actually passed out from the pain and was only brought back to consciousness by smacking into a wall as I fell over. Turns out that people with spinal stenosis at a high level don't stand so well for hours on end (attending rounds were a 3-5 hour ordeal). Asking for sit-down rounds was an exercise in futility. I even ran into resistance on wearing shoes that made standing more tolerable (which do admittedly look goofy). 'Go to the ADA office or take a medical leave of absence!' was the response I got. Hard to go to the ADA office when you--can't get cross-cover support!
My clinical performance was godawful. I didn't miss diagnoses or raise stupid treatment ideas, but I'd forget to put in orders and my h&ps were not exactly exemplary. I was--not doing well.
Turned it around the next 12 months, got great reviews from everyone involved, despite continued hell. Took more short-call on my medicine months than any other intern. At the VA I was the only resident for a full week and a half, and spent 120h one of those weeks at the hospital. Started getting my back under control, etc. Yet despite consistently 'superior' evals from my evaluators, my PD continued to insist that my performance was unsatisfactory, and continued to list issues from my first 6 months that hadn't come up again.
Only one problem, couldn't afford to take Step 3 by December of my 2nd year. Told the program in advance, and they said 'fine but it's still program policy that you go on probation for that'. I said, 'that's fine, I understand the rules'. And walk into a four page letter detailing any negative comment about me ever made but written as if they were all consistent issues.
'Has issues with support staff'. I had one negative eval from support staff from my first three months, but at that point had two certificates from Childrens' nurses, numerous positive evals, and the nights charge nurse had actually written an unsolicited letter to my supervisor and PD telling them that I was one of the best and most responsive residents they'd ever worked with.
'Doesn't finish documentation on time.' Hadn't had an issue since the first part of my intern year as I mentioned earlier.
'Frequently late.' Again, not an issue since my intern year with one exception--and related to my medical issue.
The list went on and on and basically implied that I was a corss between the spawn of satan and Gomer Pyle. And ran directly counter to what my evals were reading from my supervisors, who not only gave me good numerical evals but also specifically mentioned my dedication to patients, medical knowledge, and ability to work well with support staff. 'Above and beyond' appeared a number of times independently. Not to mention that at this point, I'd picked up an award for my PRITE performance, published two abstracts, was working on a clinical trial at a very involved level, and had twice gotten an honorable mention for medical student teaching.
I pretty much lost my crap after that and checked out. Up through then the whole atmosphere, not just my PD, had been so unsupportive that I felt like I had nowhere to turn. I'd spoken to lawyers, several attendings who empathized but couldn't tell me to do anything but 'push through it', the ombudsman, head of GME, and the head of the housestaff association with nothing in the way of practical change to be made. Overall, the environment was 'service first' and if you happened to get some training it was because that individual attending cared. Our institution seemed to have little use for actually emphasizing training or mentorship. I was busting my butt while I was in the hospital--still without recognition from my PD--but hadn't even applied for Step 3 until the last possible moment I could.
I finally found some supportive attendings with some clout, but by then I was too angry, too burned out, and too apathetic. It was affecting my medical health and my patient care. So. I left.
I've been burned out and could probably be diagnosed with PTSD since my first rotation at the program I was at. I'm a naturally oppositional person and that was more than triggered by the way my PD dealt with me. It was like throwing oil on a naked flame. At the same time, you can only tolerate so much before you throw in the towel.
I've always wanted to be a therapist, and I'll go back to training eventually. But for right now, I'm waiting on my full license, will moonlight at urgent care centers and what not, and will write freelance articles until I can catch my breath and recover.
P.S. No, I'm not going to name my institution. Feel free to PM me. I cleared out my inbox.
P.P.S. Resigning was my first vacation in over 10 months. Due to being placed on an understaffed rotation late in the year and after everyone else had requested vacation.
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