Switching Residencies - Timing and Consequences

[RothIRA]

I'm a first year resident in a surgical subspecialty that I am unhappy with. I figured this out early and reapplied to ERAS and rematched as a PGY1 at a new program in another specialty that is completely unrelated. My program was initially very supportive of this decision, but now it is toward the end of my intern year and the hazing and nastiness has started. Call was heaped onto my schedule. Nasty comments are made on a daily basis. Scutwork has become the norm and I haven't set foot in an OR in 6 months. I am subject to derogatory comments daily about how I am a traitor. I can't do my job properly. I'm more miserable than I have ever been and on medications, but I told my program I would stay until the end out of obligation.

The only problem is, I have used up all my vacation during interview season and now I can't leave this current program before my new one starts. My PD is threatening me and saying I can't leave a single day early, otherwise there will be a mark on my record. My initial thought was, "Who cares? I could disappear and consider the year a wash. I applied like any other M4, and they're off doing god-knows-what." My reviews are above-average and I've never been in any disciplinary action. He said that my licensure and future employment would be jeopardized because he would have to disclose that I didn't finish the year (48 weeks out of 52). I'm going to complete another residency, so what's the big deal? Thew new residency is fine with me leaving the current one, by the way--they were surprised I stayed at all.

My question is, has anyone ever been in the same situation? Has declaring that you did not finish a program in an unrelated field affected your licensure, promotions, employment, fellowship opportunities, or anything at all?

PS. For those who say, "Suck it up and just finish! It's just a few weeks!" --I am potentially jeopardizing my position in my new program by not starting on time. I will not be practicing in this speciality. They have NO bearing on each other and are as different as occupational medicine and neurosurgery.

---

Members don't see this ad.

 

[rokshana]

I'm a first year resident in a surgical subspecialty that I am unhappy with. I figured this out early and reapplied to ERAS and rematched as a PGY1 at a new program in another specialty that is completely unrelated. My program was initially very supportive of this decision, but now it is toward the end of my intern year and the hazing and nastiness has started. Call was heaped onto my schedule. Nasty comments are made on a daily basis. Scutwork has become the norm and I haven't set foot in an OR in 6 months. I am subject to derogatory comments daily about how I am a traitor. I can't do my job properly. I'm more miserable than I have ever been and on medications, but I told my program I would stay until the end out of obligation.

The only problem is, I have used up all my vacation during interview season and now I can't leave this current program before my new one starts. My PD is threatening me and saying I can't leave a single day early, otherwise there will be a mark on my record. My initial thought was, "Who cares? I could disappear and consider the year a wash. I applied like any other M4, and they're off doing god-knows-what." My reviews are above-average and I've never been in any disciplinary action. He said that my licensure and future employment would be jeopardized because he would have to disclose that I didn't finish the year (48 weeks out of 52). I'm going to complete another residency, so what's the big deal? Thew new residency is fine with me leaving the current one, by the way--they were surprised I stayed at all.

My question is, has anyone ever been in the same situation? Has declaring that you did not finish a program in an unrelated field affected your licensure, promotions, employment, fellowship opportunities, or anything at all?

PS. For those who say, "Suck it up and just finish! It's just a few weeks!" --I am potentially jeopardizing my position in my new program by not starting on time. I will not be practicing in this speciality. They have NO bearing on each other and are as different as occupational medicine and neurosurgery.

are you off cycle? is there a reason you have to stay beyond july 1st?

you will m/l have to explain leaving the residency, but you left voluntarily and were not dismissed so unlikely will keep you from getting licenses and credentials...give whatever many days or weeks notice and leave if it is not going to affect your next residency.

or you can tell them you will stay until the date that you need to move and start your new residency to be able to help with work, but if they are being douchey about it, then leave as soon as you can.

 

[el_duderino]

If your new program doesn't care, why do you? What's the downside here?

 

[mcl]

If your new program doesn't care, why do you? What's the downside here?

Keep in mind for the rest of your professional career, your original residency program will be contacted to verify your residency training, and whether or not you remained in good standing while there. You can't leave it off your CV, and the program director's comments could potentially affect future employment--although the impact of statements from this original program will certainly decrease as time progresses. My opinion is that it will make your future life better if you make yourself get through this year as you indicated that you would. I'm not surprised that they aren't giving you OR time anymore, or that they are giving you more menial responsibilities--now that you are no longer invested in their specialty, they are no longer invested in your education. From the program's perspective, they are concentrating resources where most appropriate. The negative comments directed toward you are, of course, hurtful, unprofessional, and unnecessary. Do you think your new PD would consider contacting the current one to negotiate an ending date that would enable you to start the new program on time?

 

[NotAProgDirector]

Your old PD probably won't be able to stop you from getting licensed / credentialed, but they can seriously slow the process down depending upon how they complete your paperwork, and how timely they are with responding to requests.

Your program had plenty of notice that you would be leaving, and should have known that you would need to leave early.

You should review your contract and see what it says. Unfortunately, it probably says you need to give 90 days notice, which you should have done on match day. Best option is to do what your contract says. But, if they are making your life hell, I'd talk to the PD and ask nicely for a reasonable schedule, and if they refuse, you quit immediately.

The happy middle is to tell them you are leaving on June XX. Also tell them that if they make your schedule any worse (or don't make it better), you'll leave immediately.

If in the long run they do try to make your life miserable with poor recommendations, you'll have a good lawsuit on your hands. But that's not fun.

You should save copies of all emails and communications between you and your PD, somewhere at home. Your access to email could be terminated instantly.

 

[RothIRA]

Thanks for all the replies so far.

As for my contract, I read through it probably 20 times with the help of the Graduate Medical Education office. It doesn't really say anything about being fired if I leave early, or any sort of consequence. It basically says it's up to the PD whether they consider I had completed the year or not. I don't mind if I don't "get credit" for the year, as long as future employment prospects etc. don't seem to care either. And I know that's impossible to say...

Fortunately, I sent my letter of resignation last Fall, when they requested it. I stupidly put the end date as June 30 without taking into account transition time, although I want to revise it to be June 1 (not sure I can do this). I have considered asking my new PD for help, and he seems very responsive and willing to. I'm just not sure what the old PD will do in terms of the summative evaluation they supposedly write. I guess he could say something nasty about my attitude or being a quitter or something to that effect.

I had a colleague who quit after 45 days and successfully rematched through ERAS into another specialty of her choice. I guess I took it as a positive sign that it was possible even with that "red mark" on her record.

If leaving even one day early means my entire year doesn't count, part of me feels like I should just quit now to maximize my free time and get my life together before I move. It's hard to pack when you're on Q2 call and working over 100 hours a week.

 

[LucidSplash]

Thanks for all the replies so far.

As for my contract, I read through it probably 20 times with the help of the Graduate Medical Education office. It doesn't really say anything about being fired if I leave early, or any sort of consequence. It basically says it's up to the PD whether they consider I had completed the year or not. I don't mind if I don't "get credit" for the year, as long as future employment prospects etc. don't seem to care either. And I know that's impossible to say...

Fortunately, I sent my letter of resignation last Fall, when they requested it. I stupidly put the end date as June 30 without taking into account transition time, although I want to revise it to be June 1 (not sure I can do this). I have considered asking my new PD for help, and he seems very responsive and willing to. I'm just not sure what the old PD will do in terms of the summative evaluation they supposedly write. I guess he could say something nasty about my attitude or being a quitter or something to that effect.

I had a colleague who quit after 45 days and successfully rematched through ERAS into another specialty of her choice. I guess I took it as a positive sign that it was possible even with that "red mark" on her record.

If leaving even one day early means my entire year doesn't count, part of me feels like I should just quit now to maximize my free time and get my life together before I move. It's hard to pack when you're on Q2 call and working over 100 hours a week.

It’s less about a red mark than it is about having to depend on this program to verify your training everytime you apply for a license in the next 40 years. Every single application will need their verification.

 

[rokshana]

"It's hard to pack when you're on Q2 call and working over 100 hours a week.

if this is true and documented, then you need to use that info in the ACGME survey that you will do...and if not, start documenting it...I'm sure that your program will quickly find a way to work with you to let you out early...

 

[RothIRA]

if this is true and documented, then you need to use that info in the ACGME survey that you will do...and if not, start documenting it...I'm sure that your program will quickly find a way to work with you to let you out early...

We always lie about our hours. We were taught to do so on day 1 of orientation. I've never documented an hour over 80. I don't think my program would care, to be honest...

 

[rokshana]

We always lie about our hours. We were taught to do so on day 1 of orientation. I've never documented an hour over 80. I don't think my program would care, to be honest...

of course they do...think about it...why would they have you lie?

 

[Raryn]

We always lie about our hours. We were taught to do so on day 1 of orientation. I've never documented an hour over 80. I don't think my program would care, to be honest...

If I logged hours above 80, two shifts with less than 8 hours in between, a shift longer than 28 hours, etc... It triggered an immediate notification to the program and a semi-immediate one to GME.

Logging duty hour violations was taken seriously on an institutional level both where I did residency (and this had the rare one to lie about) and fellowship (easy specialty, hard to break hours).

So log your hours honestly. If they ask whats going on, you can mention the changes in schedule they've imposed on you.

It will get someone's attention for sure.

 

[evilbooyaa]

You have nothing to lose by logging your hours appropriately. So do it.

 

[AdmiralChz]

You have nothing to lose by logging your hours appropriately. So do it.

This is a great way to Be passive-aggressive to them over the situation. Log your hours honestly, they cannot force you to remedy them.

The common refrain from them will probably be along the lines of “were you scheduled to work more than 80?” Your answer needs to be that you logged actual hours in the hospital worked.

Know that if you do this it very well might intensify nastiness towards you at the end. Thankfully you only have 6 weeks left then you can trash them all you want and be done with them!!

 

[RothIRA]

So the reason why no one has ever written a thread about this (that I could find) was because none of this matters.

I talked to some university higher ups (who oversee the accreditation of the entire hospital) and they basically said, "You're free to leave whenever. Your pay and benefits would stop, yes. But it won't have any bearing on your future employment. And if your PD is an a**hole about it, we want to know."

Thanks for all your input. I think I just stressed myself out. For no reason. Sure, I wanted to do the right thing and help out the call schedule, but at the end of the day I have to take care of myself. I am a mere pawn in their game, and if one day is the same as one month to them, I'm outta here!!!!

TL;DR:
I'm leaving my residency program effective whenever I want and it won't have any lasting negative consequences.

 

[ThoracicGuy]

So the reason why no one has ever written a thread about this (that I could find) was because none of this matters.

I talked to some university higher ups (who oversee the accreditation of the entire hospital) and they basically said, "You're free to leave whenever. Your pay and benefits would stop, yes. But it won't have any bearing on your future employment. And if your PD is an a**hole about it, we want to know."

Thanks for all your input. I think I just stressed myself out. For no reason. Sure, I wanted to do the right thing and help out the call schedule, but at the end of the day I have to take care of myself. I am a mere pawn in their game, and if one day is the same as one month to them, I'm outta here!!!!

TL;DR:
I'm leaving my residency program effective whenever I want and it won't have any lasting negative consequences.

One thing to consider with this is in regards to health insurance. You can use COBRA coverage from residency 1 before you start on residency 2. You have up to 60 days to decide to take it or not.

If you don't need the paycheck and are ready, tell em bye. Otherwise, end it when you need to end it.

 

[KHE88]

So the reason why no one has ever written a thread about this (that I could find) was because none of this matters.

I talked to some university higher ups (who oversee the accreditation of the entire hospital) and they basically said, "You're free to leave whenever. Your pay and benefits would stop, yes. But it won't have any bearing on your future employment. And if your PD is an a**hole about it, we want to know."

Thanks for all your input. I think I just stressed myself out. For no reason. Sure, I wanted to do the right thing and help out the call schedule, but at the end of the day I have to take care of myself. I am a mere pawn in their game, and if one day is the same as one month to them, I'm outta here!!!!

TL;DR:
I'm leaving my residency program effective whenever I want and it won't have any lasting negative consequences.

Screw em. In the real world, people quit jobs all the time when they are overworked, underpaid, treated poorly, and harassed. In residency, your boss knows he can get away with it because you have no other employment option in medicine. You are in the unique scenario where you can do what any normal person in any other line of work would do. They were foolish to treat you so poorly as they should have known you could leave with no consequences. When you leave, you should do it with cause and cite the abuse you encountered. And then there's always this line: "I just have to do what's right for my family."

There is always the small chance they will be vindictive and contact your new boss and tell them you are insubordinate and lie about what happened.

Also, once you leave, you have nothing to lose by publicly calling the program out by name on this forum as a warning to med students regarding the abuse you received and illegal reporting of hours.

 

[RothIRA]

Screw em. In the real world, people quit jobs all the time when they are overworked, underpaid, treated poorly, and harassed. In residency, your boss knows he can get away with it because you have no other employment option in medicine. You are in the unique scenario where you can do what any normal person in any other line of work would do. They were foolish to treat you so poorly as they should have known you could leave with no consequences. When you leave, you should do it with cause and cite the abuse you encountered. And then there's always this line: "I just have to do what's right for my family."

There is always the small chance they will be vindictive and contact your new boss and tell them you are insubordinate and lie about what happened.

Also, once you leave, you have nothing to lose by publicly calling the program out by name on this forum as a warning to med students regarding the abuse you received and illegal reporting of hours.

True words. I was worried about the contacting my new boss thing, but I had written to my new residency several times that my program was giving me a hard time transitioning. They knew the circumstances. My GME said if my current PD contacts my new one and says anything negative, that they would want to know so they intervene on my behalf. It pays off to do a good job, not burn bridges, and to have a record that speaks for itself!

Thanks for all the input guys. I hope that someone else ever finds themselves in my situation (matched categorical, rematched after a few months through ERAS, stuck out the program for no reason) that they would feel empowered and NOT stressed. I wasted far too much of my life worrying and trying to walk between very fine lines that were set for me for no reason.

If I could do it all over again I would not have canceled so many interviews. They told me I had very few days off and I had to cancel all my vacations as well. So, I never took any vacation days and I could have ALL ALONG.