Wow this is one of the nastier of these threads I can remember in recent history.
The truth is that on a grieving time scale, this is actually pretty recent for the OP.
I want you all to consider what the death of one of your most dearly held life dreams, was like. Your first heartbreak, your first divorce, the untimely death of your father, being unable to bear children, losing a promising sports career to a knee injury. How long did it take to lose the sting? I admittedly don't move on quickly, I'll say for me it's 1-2 years before I've really put those things behind me to any real degree.
I'm trying to fathom what it would be like to be told that not only could I no longer practice medicine, but that I couldn't live in the US, but instead in another country. Don't know where OP is from, but many of us have been abroad, and there's few places elsewhere I would want to be. It says something that OP would even embark on being a stranger in a strange land, and be heartbroken over it.
What I see is that a lot of people either don't understand what this sort of loss of identity is like (all my above examples, or "dream deaths" embody this) or just don't factor it into how they speak to someone over the internet.
Imagine OP was one of those moms that did co-sleeping and rolled over and killed their infant in the night. Now they are discussing being a parent again. Even if you think they shouldn't be because they messed up, how do you talk to another human still processing this type of grief? Yes they need to understand where they went wrong. Frankly we didn't need to hash things the way we did in this thread.
In my mind, there's "clinic speak" and "work room speak." (Clinic: "I'm highly concerned about your high blood pressure and risk of stroke. Part of addressing that is your sleep apnea. Your weight is putting you at extreme risk of harm. I see that you mentioned drinking 2 liters of Pepsi daily. One good way of cutting calories...." Workroom speak: "JFC. This guy is going to stroke out as he dies choking under his own fat rolls, all because he can't give up vitamin P. Get a clue!"
On SDN we do a lot of the latter, and it's acerbic, brutal, and blunt. We understand with patients there's bedside manner, that we do more good delivering a given message with some sensitivity.
The truth is, outside character issues, it may not be unreasonable for someone to feel getting only one chance at residency is ridiculously unfair, whether we all feel that way or not.
More than anything, I see OP is highly invested, grieving, and responding very emotionally to many responses that at best are insensitive, at worst accusatory and cruel.
We're getting insight into someone's inner emotional life. The OP is showing some evidence of ability for introspection and understanding of the issues that were both under their control, and not. But we're also seeing a lot of emotional responses, right or wrong. Entitlement, feelings that it wasn't fair, externally locating control, blaming others, etc.
We're running into all sorts of knee jerk ego defenses, and understandably the instinct we have is to crush those ego defenses. Especially in medicine.
Believe me when I tell you that despite all evidence to the contrary, all the ego defenses and lack of insight, the terminated resident's ego is just about as crushed as it possibly can be, in every way. Hence the ego defenses.
I saw early on, that someone told the OP they were dangerous. All interns are dangerous, some more than others, certainly there's an unacceptable degree and then termination over it.
At the same time, I seriously doubt there was any benefit to that comment whatsoever. OP already knows this somewhere inside, they've already been told this in many ways before now, in all the little failures that led them to this day on SDN. They either know this already, so this is just another extremely blunt way to express in extreme terms the depth of OP's failures in this regard as a physician. If you give a damn, there is nothing more painful for a physician to process than that.
Perhaps there is a layer of denial you sensed that you wanted to strip away. Don't. It's there for a reason at this stage. If the OP truly doesn't understand that on any level, it doesn't matter because they're not in a position to be dangerous to patients - they've been removed.
I'm going through in my mind all the purposes and utilities one might argue for that statement. Just, it's not useful for the terminated resident, and it won't be useful in their interview, or in their restart to a residency. They will either have learned that that are dangerous and need to address it at this point, or never and it won't matter anyway. Hearing it from an anonymous internet stranger is unlikely to do any good anywhere. The person that cares and has insight doesn't need to hear it, but it can feel like a gut punch that stays with you, coming to you for days, at random moments, like sitting down to eat your lunch and losing your appetite. What a way to ruin someone's day. The person with no insight won't care beyond being upset you said so. So all you did was hurt someone as you said something that didn't need said or would fall on deaf ears. Congrats, you saved patient lives and a medical career today.
Something like this takes a very long time to process and eventually be able to see from an outside perspective, and take responsibility for.
Terminated residents, because of timeline, come to SDN in the absolute worst place they could be. Literally at the lowest they may have ever been in their entire lives, not ready to fully comprehend what happened, grieve, take full responsibility, introspect, improve. And the stakes are high, they are desperate personally, emotionally, financially, they aren't eating or sleeping. They are crushed, their self esteem gone with nothing to cushion it besides curling up in the fetal position with the thought "but it isn't fair" their only metaphorical pillow of comfort to the thought of what a failure they feel like.
Yet, time is if the essence and they must rebuild now or probably never. Where can they turn to? Who can help them not only salvage a dream of a lifetime, but avoid ruin and deportation?
So they come here, naked in shame, their ego and all sense of worth stripped, desperate.
Does OP need to be disabused of the notion that they will match IM? Sure. There are plenty of notions they need to shift gears on, despite the fact that in terms of grief processing this event, they're not in the best place to impartially evaluate anything.
I don't expect terminated residents to come off as well on SDN as they likely will be able to manage in their app, PS, and interview. It's true that we need to push OP and others to introspection and taking responsibility.
OP needs to be disabused of a lot of things to succeed, yes. That is different than abuse.
One argument is that OP will need to stand up to all of this to succeed. If they need kid gloves, they don't belong not only on SDN, but not in front of a PD either.
Eh, no.
Unless the thread is shut down, later I'll try to address this thread in more detail.
Tldr
Please approach terminated residents like someone who co-slept with their infant and accidentally rolled over in the night and killed it, and wants to start over as a parent. Whether you agree or not, understand that you are dealing with someone likely at a height of irrationality and pain, and adjust accordingly.
