taking legal action in a program

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docu

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What if you felt that you were unfairly dismissed from a program or left a program where you felt you were treated unfairly? Lets say you got ill and they didn't let you finish what you missed? Has anyone ever taken legal action? and if so, what did you do? What are the consequences of taking legal action? Do residents ever win?
 
Disclaimer: I am not a lawyer.

Legal action is complicated. Remember that legal action is not predicated on what is "fair". Being treated "unfairly" is not necessarily against the law. A legal action will usually only help if the other party actually broke the law.

So:

1. If you think you were terminated illegally, then you might have a case. Illegal forms of termination would be those based on race, gender, etc. If the program terminated you for "doing a bad job" but you disagree, that's NOT usually a legal argument. The courts can't really decide whom is competent in medicine, and defer such decisions to medical training programs.

2. Getting ill and missing time is unfortunate. However, I expect your contract was for 1 year. There is nothing illegal about not extending your contract beyond that. I agree it may be "unfair", but it's not illegal. As I think I may have mentioned in prior threads, usually most programs will extend you by a few months if needed if your performance was fine. If your performance was not fine, they will simply end your contract and be done.

3. Legal action takes time and money. And lots of each. You should not expect a resolution for several years. And you could easily lose. And even if you win, what then? You might have a long break in your training that could prevent you from getting a new position. And, I doubt you will win millions -- you might simply force the program to take you back, and that could be miserable for all.

4. You certainly burn any bridges at that program should you do this. Those bridges may be burnt already, so perhaps you have little to lose.

5. Other programs may be even less excited about taking you should they discover that you're suing another program. The thought process goes: "Docu is suing their prior program. Perhaps they treated him badly/illegally. Perhaps not, and he's just someone with poor insight and a low threshold to instigate legal action. Let's not risk it, and choose someone else".

6. How could you win in court? Really, there are several options:

A. They actually broke a law. Firing you for being a whistleblower, for example. (Although, these types of cases are notoriously difficult to prove, as often someone who is underperforming then blames the "system" and claims whistleblower status)

B. They didn't follow their own internal rules. This is the most likely way you can "win". See the threads on SJB's accreditation status. The LCME pulled SJB's accreditation, but in the process of doing so they broke their own rules. Therefore, the court reinstated SJB and forced the LCME to do it again. Note that the court specifically did not address whether SJB should retain it's accreditation, and stated that they left that expert decision up to the LCME. In the end, the LCME is likely to come to the same decision, this time closely following their own internal rules. That's the problem with winning a case this way -- usually all it does is force the program to reprocess your situation. But sometimes you can get some sort of a mutual agreement to separate.

C. You sue them to the point that they decide to settle to stop the madness. We see this in the legal system all the time -- that it's cheaper and easier to settle. I doubt this happens much in GME, since the cases aren't that "big".
 
thanks for the insight aprogdirector. i feel i have nothing to lose. im not getting any interviews. i was told i was doing okay in the program without problems as written in the letter, so he has no reason to say i wasn't a good resident, he even told me that i was a good resident. so this whole, 'im not letting you finish because we don't accommodate for that', im not buying. i saw him letting someone finish a couple months of what they missed, so why is it different with me?
 
thanks for the insight aprogdirector. i feel i have nothing to lose. im not getting any interviews. i was told i was doing okay in the program without problems as written in the letter, so he has no reason to say i wasn't a good resident, he even told me that i was a good resident. so this whole, 'im not letting you finish because we don't accommodate for that', im not buying. i saw him letting someone finish a couple months of what they missed, so why is it different with me?

Why not talk to your PD and finding out what he/she has to say before seeking legal counsel? You could end up having a lawsuit like the USFL vs NFL (http://sportsillustrated.cnn.com/vault/article/magazine/MAG1065099/index.htm).
 
Why not talk to your PD and finding out what he/she has to say before seeking legal counsel? You could end up having a lawsuit like the USFL vs NFL (http://sportsillustrated.cnn.com/vault/article/magazine/MAG1065099/index.htm).

I asked him several times and he says 'we do not accommodate for that' each time, so that's why I'm seeking legal counsel as a last resort. i saw him accommodate for one guy in the past though. i really don't feel like doing this though. i feel like it may bring me trouble. i think i'll do this after the match and scramble, if i don't get anything.
 
Sadly, I agree with the above!
I am sorry for what you have to go through, accept my sympathy!
I had a friend of mine run through comparable experience, sounded very logical to sue her program. Guess what:
ACGME, Court and Legal system are ALL in cahoot with the residency programs and they are regarded as "The Educators" they are above errors!
That why some PDs act like "The Sun comes up because of me" and "You stepped on my toes,,Get out of here"
If you take that route, going to the mattresses, expect lots of distress, financial and emotional drain and zero yield. Try to move on with your career and let go to this negative energy. GOD will provide better outcome.
Bottom line DO NOT sue them
 
get a lawyer and take their advice. if the residency program continues to harass you more, you should probably sue first, and ask questions later. it's time to apply and utilize the good old american value of litigation as an appropriate course action to obtain justice. this is a civilized society and if you think that you have been wronged, threatened your livelihood, the "educators" neglect their duty of care, sit on 200k per resident per year, and you feel intimidated all the time and you have enough to prove yourself in court or with the jury - sue them for every penny. this will eventually force a change. being a resident does not mean that you no longer have rights or that all your rights are determined by the hospital. do whatever you have to do to protect yourself and your right to a livelihood. let these issues play out in court or before a jury. let the american public determine if the hospital system is screwed up or fair. get a lawyer and don't feel bad about it. this is your career and everything that it means to you. i can tell you that most people who you work with hang up a lot on that alone and as should you. do you really want to be a doctor or not?
 
get a lawyer and take their advice. if the residency program continues to harass you more, you should probably sue first, and ask questions later. it's time to apply and utilize the good old american value of litigation as an appropriate course action to obtain justice.

Agree with the above but this lawyer will need money for the run, most malpractice lawyers take the case on contingency bases, if you can find one like that go for it and save your money. I will be interested to hear their response. Lawyers want money, if you are willing to spent some on them do it but do not forget your goal is the outcome!
 
Tread cautiously. Do have a lawyer evaluate your case, carefully and make sure
Any lawyer you choose knows the nuances of litigation in residency/medical staff cases. These cases are not the usual. There are several cases yogi need to be aware of which make a successful suit much more difficult, even if the pd was hitting you in a public corridor at high noon. Look at schulman v Washington Hospital Center which the court ruled that these cases are too complex for mere judges. Contrast this with Feyz v. Mercy Memorial which the Michigan Supreme Court rejected this philosophy. This is a highly specialized legal arena. Make darn sure your lawyer knows this. My thought: you'll not gain anything but grief, cost a lot of money andq spend a bunch of time.

Better to look for back doors back in.
 
Tread cautiously. Do have a lawyer evaluate your case, carefully and make sure
Any lawyer you choose knows the nuances of litigation in residency/medical staff cases. These cases are not the usual. There are several cases yogi need to be aware of which make a successful suit much more difficult, even if the pd was hitting you in a public corridor at high noon. Look at schulman v Washington Hospital Center which the court ruled that these cases are too complex for mere judges. Contrast this with Feyz v. Mercy Memorial which the Michigan Supreme Court rejected this philosophy. This is a highly specialized legal arena. Make darn sure your lawyer knows this. My thought: you'll not gain anything but grief, cost a lot of money andq spend a bunch of time.

Better to look for back doors back in.


Any particular resident vs. program cases in the NYC area?
Anyone know any good lawyers that are residency savvy in NY that would possibly win a case? what about some probono lawyers that would work for cheap?

Cant i just take it to small claims court? or if not, get a free case with the supreme court?
Wonder if judge judy would be on my side.
 
Will your PD support you in finding another position?
If not, what is the reason?

Sometimes work arrangements just don't work out for the parties involved.
That doesn't mean the employer should blackball you from future work opportunities.

I'd exhaust all of my options with getting support from your program before I go down the lawsuit route.

I was a manager in my previous career. If I knew a prospective employee was suing a former employer for wrongful termination, I wouldn't touch them with a ten foot pole.

Even if you "win" your case, you still might lose.

:luck:
 
Will your PD support you in finding another position?
If not, what is the reason?

Sometimes work arrangements just don't work out for the parties involved.
That doesn't mean the employer should blackball you from future work opportunities.

I'd exhaust all of my options with getting support from your program before I go down the lawsuit route.

I was a manager in my previous career. If I knew a prospective employee was suing a former employer for wrongful termination, I wouldn't touch them with a ten foot pole.

Even if you "win" your case, you still might lose.

:luck:

even without suing no program is going to touch me with a 10 foot pole. i just want to finish residency, or even restart and finish, that's all.

i don't have any money at this time to file a suit, unless i can do it for free or cheap somehow.
 
i don't have any money at this time to file a suit, unless i can do it for free or cheap somehow.

(1) I thought you were a practicing GP? You can't afford even a basic lawyer?

(2) What's also hurting your chances at landing another interview is the fact that you are a Caribbean grad who graduated 8 years ago, and have low USMLE Step scores (with multiple attempts).

(3) If you improved your app and decided to apply, PLEASE do so with the less-competitive fields and apply very widely and broadly. A previous post of yours stated you were applying to Gen Surg and Neurosurgery (in addition to IM). Why would you do this?

(4) As mentioned earlier, how strongly your previous program director is advocating for you will make all the difference in you obtaining a second residency.
 
First, to the OP, I'm sorry about your predicament. It truly is unfortunate and I hope that you are able to work things out. I think legal action in these cases is almost always a lost cause and almost never the best route and history seems to have proven that. Your best bet is to squeeze as many concessions and as much help as you can from your former PD and try and move on.

...being a resident does not mean that you no longer have rights or that all your rights are determined by the hospital.

I'm afraid that's exactly what it means to be a resident. All your rights are determined by your institutional GME policies, and, thanks to the impotence, willful negligence, or downright collusion of the ACGME, those rights can vary widely from one institution to another. There is no standardization of the process to reduce the likelihood of disparities across institutions. They never intervene or second-guess resident disciplinary matters and never involve themselves with individual cases. This lack of independent oversight means program directors are given extremely powerful mandates with essentially no checks-and-balances. A perfect combination for abuse of their discretion.

Sure, as part of the required "due process" residents are supposedly entitled too, an appeals process is usually included within GME policy. I can only imagine what a joke that is at most places. It's the program director's word against the lowly resident's. Medicine is already a small world, but within an institution, it is incredibly smaller. Those involved in the appeals process, even if they are from different departments and had no involvement with any of the involved parties, likely know the PD on a personal level, and even if they didn't, would almost certainly place greater weight on the PD's opinion than the facts of the matter. Some PDs have appointments beyond program director and have extensive institutional ties which would bring them into contact with many faculty and administration members.

I'd be curious to know the percentage of cases upheld on appeal vs. in the judicial system. I'm sure it would be embarassingly higher, and, I'm sure that's not because the programs always get it right.

Abuse of discretion is a real thing. It's not some conspiracy theory pushed by the disenfranchised in medical education. Just one example off the top of my head involved a resident who was arrested for physical battery involving another employee in the hospital. This particular resident ended up pleading out and serving a very short term in jail but was allowed to remain in the program. I was told of another resident in that same institution but in a different program who was terminated--despite performing well clinically and having high ITE scores--for the good 'ole "personality conflict" with an attending.

Now, I don't know the specifics of either case, but I do know if the guy with the "personality conflict" had to go then the guy with the criminal record should have to go as well. I was told of other examples at that particular hospital as well. I'm sure if greater transparency were required, the disparities and abuse of discretion uncovered would be egregious and astounding. I believe that greater transparency is the only thing that will keep this process in check since there's no real hope the ACGME will step up. In terms of absolute numbers, it doesn't affect enough residents at this point for any true reform to occur but it's a travesty nonetheless to those whose lives are affected and careers disrupted. At present, the iron curtain that most program directors operate behind allows them more discretion than any one person should ever have and with no true oversight.
 
Will your PD support you in finding another position?
If not, what is the reason?

I'm guessing if their former PD was truly making an effort to help them they wouldn't feel the need to be on this forum seeking advice about a lawsuit. Just guessin'.

Sometimes work arrangements just don't work out for the parties involved.
That doesn't mean the employer should blackball you from future work opportunities.

This I suppose becomes a logical fallacy in the world of medicine. Yes, sometimes certain work relationships just don't work and both parties would probably be fine with a different arrangement and do well in a different environment. However, medicine, especially medical education, doesn't work like that. It's probably the exception in medicine where both parties amicably part ways. When do you ever hear a program say , "You know, that resident just wasn't right for us but maybe they are for someone else?" No, they usually want to be rid of them and attempt to portray them as incompetent to justify the expulsion, because they can't simply say we just didn't like the guy and we're getting rid of them. In the world of graduate medical education, being labeled as "incompetent" or subpar is akin to being blackballed, and for all practical purposes has the same effect.
 
thanks for the insight aprogdirector. i feel i have nothing to lose. im not getting any interviews. i was told i was doing okay in the program without problems as written in the letter, so he has no reason to say i wasn't a good resident, he even told me that i was a good resident. so this whole, 'im not letting you finish because we don't accommodate for that', im not buying. i saw him letting someone finish a couple months of what they missed, so why is it different with me?

Do you have any other documentation regarding your performance in the program, such as copies of evaluations? Have they been satisfactory? If this is the case, you may have some grounds to say that your termination was unfair.
 
I agree that it can become complicated but you have to stand up for your rights and hold hospitals accountable. They have a duty to you that is funded thru taxpayers and they have high fallootted ideals about stuff ...just read the house staff manual or so on which, they use to convince people they have integrity and serve some purpose. Sure sure all these places do some good and there are good good people there but there are also bad people who will harass an individual and single them out, try to make them quit, they will engage in subversive and outright illegal behavior that is ok'ed by their legal team. If you are the victim of this sorta harassment, it's tough to keep perspective and know what the right thing to do is.

Find yourself and find people who like you. Get a good and competent lawyer, let them help you navigate the wacko world of egotistical and self-important folks in power. I can tell, from experience, once they dislike you and have decided to harass you on any level, you are on their radar and you are screwed.

For ex, if pd hates you, go to gme. If they don't assist, assume the hospital doesn't want you there. Prepare to help yourself and be ready for Gestapo-like mind games and nonsense. not everyone hates you either... Trust people who you know. Get a lawyer to rationally narrate and put your situation in perspective. Have them contact the hospital, if you have a case. Otherwise, put up with the crappy place and do your reasonable best to work there. When they get crazy, stay calm, call lawyer. Be smart. Know what they are trying to do.

Acgme is quite helpful for residency and hospitals as a collective. They do not adjudicate for you and between you and the residency and for very good reasons. However, they will handle grossly unacceptable issues that affect training for most residents at any given program etc. So they are not your friend but they do serve an important role and have likely decreased a lot of class action law suits against residency programs.

What you should be thinking about instead is your right to organize, ie. Labor unions. Check out CIR on wiki etc... Try to get one for your hospital... It will help you with having a lawyer thru union and cheaper to handle problems for both parties.

So coming back, don't be afraid, be appropriately indignant when people try to screw you over. Move to parents or sleep at the hospital 24/7 if that's what it takes for you to be able to afford a lawyer. Don't be despondent and be defeated. Dont get angry at people or any individual or make threats to people, it will always come and bite you in the butt. Be politic and engage them nicely and with respect. Be calm. You have the right to a career and continue forward to pursue your dreams like all those goofballs in power.
 
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I don't think it's a good idea at all to try to sue.
Even on the miniscule chance that you win, it will take years and years, and I think the chances of winning are vanishingly small, particularly if you are an FMG or IMG with low board scores, as others have stated. The program will just say you were incompetent and you won't be able to disprove that.

If you want to ever be board certified, then pick an easy to get specialty (fp, psych or IM) and then go back to your old PD, tell him you have work experience now but you really realize that the only thing you really want is to finish your training. It doesn't matter if you hate his guts...just be conciliatory and then if you have to, go outside and vomit later. Consider trying to get back into your old program, or get a research job at a new institution for a year or two, maybe somewhere where you can make connections to get into a new residency. Be willing to start at a lower level, like PGY2 or even PGY1. It may be tough to swallow but that's the best advice I can think of. Sometimes life kicks you in the teeth but for myself I find success sometimes because I just keep coming back...and back...and back...and then try to learn from previous mistakes that I made, and somehow at the same time stay true to myself.
 
Don't list to the above idiot's comments. . . fight for your future.
 
Be careful what you wish for as you will be sorry you ever started with the legal route that will have you spinning your wheels as you go nowhere. It will become a devasting emotional nightmare that will only cost and not help you in the slightest. Move on with your life as best you can.
 
Only enagage these locos if you are a solid post-graduate trainee... if you are worried, then chances are you got something between those ears.
 
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file paperwork for FMLA asap. This will protect you from getting screwed by your program due to you being out for "illness". your rights are protected. any negative treatment and action against you for that would be against the law. do this now.
 
file paperwork for FMLA asap. This will protect you from getting screwed by your program due to you being out for "illness". your rights are protected. any negative treatment and action against you for that would be against the law. do this now.

This is good advice, but flawed. First, if the resident is already terminated, it's likely to be too late to claim FMLA (but for others reading this, it's a very good choice if you have to go out sick for an extended period of time).

Second, FMLA only applies to employees with 12 months of experience. Hence, most interns would not qualify for FMLA -- however some employers decide to offer FMLA in this case.

However, it is an interesting legal question: If your position is contractually scheduled to end and you take FMLA leave at the end, is your employeer legally required to extend your position. I doubt this is the case.
 
Second, FMLA only applies to employees with 12 months of experience. Hence, most interns would not qualify for FMLA -- however some employers decide to offer FMLA in this case.

This is also be state-dependent. My state offers a version of FMLA that kicks in after 6 months. But the federal law is definitely 12 months. I also never thought about doing this, but it's a great idea.
 
What if you felt that you were unfairly dismissed from a program or left a program where you felt you were treated unfairly? Lets say you got ill and they didn't let you finish what you missed? Has anyone ever taken legal action? and if so, what did you do? What are the consequences of taking legal action? Do residents ever win?


You will never be able to go back to that program. Move on with your life and work to get your career back on track.

Cambie
 
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