Terminated (voluntary resignation) for unprofessional behavior, should I let PD know I'm an addict?

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First...this will probably get closed because they don't like things cross-posted. I don't think your addiction is going to be any secret when you reapply. Therefore, I think it is fine to let your PD know.

You have a quite a lot of difficult battles both personal and professional in your future. I think getting back into residency could be tough. Ethically you shouldn't even consider applying to the match until you have your addiction under control. The only good thing I see is that theoretically EtOH addiction is treatable while a personality defect isn't.
 
First...this will probably get closed because they don't like things cross-posted. I don't think your addiction is going to be any secret when you reapply. Therefore, I think it is fine to let your PD know.

You have a quite a lot of difficult battles both personal and professional in your future. I think getting back into residency could be tough. Ethically you shouldn't even consider applying to the match until you have your addiction under control. The only good thing I see is that theoretically EtOH addiction is treatable while a personality defect isn't.


They don't know I'm an addict.
 
Right...but when you reapply you are going to have to disclose this. Were you in a physician substance abuse program while in residency?

Why would I have to disclose it? Nobody there knew. I'm not being smart, I'm just asking why I would have to disclose it when I didn't get caught.
 
Well they are going to want to know why you left. If you just tell them you lied a bunch and were continuously unprofessional with no reversible cause you stand zero chance of getting back into a residency program imo.

But more importantly I am guessing they are going to ask you what you did in between quitting and reappyling. Are you just going to omit all the time you plan to spend in rehab? I think you need to be honest when you reapply. Additionally you need to get plugged into the physician alcohol abuse program through your state medical board.

Finally you quitting "voluntarily" seems like just semantics to me. You were going to be fired if you didn't resign, right?

There are a few program directors on this forum...try contacting them and getting their perspective.
 
Well they are going to want to know why you left. If you just tell them you lied a bunch and were continuously unprofessional with no reversible cause you stand zero chance of getting back into a residency program imo.

But more importantly I am guessing they are going to ask you what you did in between quitting and reappyling. Are you just going to omit all the time you plan to spend in rehab? I think you need to be honest when you reapply. Additionally you need to get plugged into the physician alcohol abuse program through your state medical board.

Finally you quitting "voluntarily" seems like just semantics to me. You were going to be fired if you didn't resign, right?

There are a few program directors on this forum...try contacting them and getting their perspective.

First of all, thank you for being straightforward and honest. I will contact some PD's. As far as the voluntary resignation, that's what it says on my paperwork. I am not making that up. Concerning me needing to disclose the time I spent away, I am more than happy to mention it was in rehab. My question is whether disclosing it will be helpful or harmful.
 
First of all, thank you for being straightforward and honest. I will contact some PD's. As far as the voluntary resignation, that's what it says on my paperwork. I am not making that up. Concerning me needing to disclose the time I spent away, I am more than happy to mention it was in rehab. My question is whether disclosing it will be helpful or harmful.

I would think that if you could get through rehab and show that you are clean since then and got your act back together, that should help. A program might be willing to give you a chance if they know what the problem was at your first program and that you addressed it honestly and worked to fix it and improve yourself. You still have a tough road ahead and no guarantees. @aProgDirector and @IMPD are two of the PDs on here and they probably would have more insight that alot of people on this sort of situation. I agree that you should probably get hooked up with your medical board physician substance abuse program. They can be an advocate for you IF you clean up and stay clean.
 
Well they are going to want to know why you left. If you just tell them you lied a bunch and were continuously unprofessional with no reversible cause you stand zero chance of getting back into a residency program imo.

But more importantly I am guessing they are going to ask you what you did in between quitting and reappyling. Are you just going to omit all the time you plan to spend in rehab? I think you need to be honest when you reapply. Additionally you need to get plugged into the physician alcohol abuse program through your state medical board.

Finally you quitting "voluntarily" seems like just semantics to me. You were going to be fired if you didn't resign, right?

There are a few program directors on this forum...try contacting them and getting their perspective.

Yeah, this is probably the one situation where freely admitting to being an addict and having been in rehab makes you look "better" then keeping it quiet. Nobody is ever going to hire someone with such a history of unprofessional behavior like lying about what physical exam or imaging or labs showed without ever having looked. Those are cardinal sins in residency and professionalism, can kill patients, and I would never want someone in my hospital who would do such a thing. However if you can say it wasn't me, it was the disease, you might get another shot someplace. I agree with those who say focus on your sobriety/rehab first. Most 12 step programs expect you to make amends, so at that stage it might be appropriate to contact your PD.
 
As I'm sure you've heard from fellow physicians who have struggled with addiction (and others), addiction is otherwise known as the Liar's Disease. (I first read this from Stephen King, actually).

Complete honesty in all matters is a cornerstone to recovery. As long as this honesty does not unnecessarily damage other people. If you don't have a sponsor, an experienced one can help you sort through this question.

As for when and how to disclose all this to your previous PD or future PDs, it's probably too early. You should have some sobriety under your belt before doing all that. Otherwise, you risk sounding like the victim or justifying or blaming other people/circumstances. I don't know that to be true, but it is what I've observed in other people.
 
I see what you mean as far as explaining what went on, I am just scared about admitting my problem out loud to anyone.I will focus on my sobriety first. Not only for medicine but all life in general. Thank you for being honest but yet also non judgmental.
 
I'll agree with the advice given so far. The first thing to address is your own health. Many sober alcoholics state that they needed to hit "rock bottom" before they could get their drinking under control. Perhaps this is your bottom, and if so this may be one of the best things that's happened to you in some time. You need to get into rehab, AA, get a sponsor, etc. The 12 steps include making amends to those you have harmed in the past, and your prior PD is one of those people -- but this is in the late part of the steps, the early steps around self healing need to come first. You'll start by admitting your problem to other alcoholics, and it will get better from there. Ultimately your biggest fear won't be disclosing your alcoholism to others as you'll learn to accept that it's just part of you and something you can overcome. Hiding your alcoholism is part of your disease.

From a career standpoint, I agree that being an alcoholic is a "good" explanation for your prior behavior. If any program is going to give you a second chance, they are going to want to see that you've changed and "fixed" the problems from earlier and you'll have a clear explanation of that. As mentioned you'll have ongoing monitoring from the state board's impaired physician program. Once you're ready for this, you'll see it as a good thing.

Denial and secrecy are part of the illness. It's unfortunate, as had you admitted your problem and asked for help earlier you would have had a different path -- a medical leave from your residency program (which sometimes includes continuing your salary), and return to your job afterwards. I point this out not to make you feel badly, but as a signpost for others in a similar situation. You are not alone.
 
At a chief resident retreat for my institution, one of the speakers was an addict. She admitted and got help. She even had a major relapse iirc. She is now chief in one of our residency programs.

She was honest and forthcoming with everyone. Eventually, I think it will be in your best interest to do the same.
 
You should have been upfront with your PD earlier, as pointed out above. There are a ton of support mechanisms for you in a residency program, including potentially having your rehab paid for, and a spot being held. At this point, I would say you are in a tough spot. Obviously you would need to take care of your issues first before reapplying. Do not in any circumstance go into a specialty with easy access to bigger drugs, you will be a high risk to die from addiction, even after rehab. Relapse is unfortunately quite common.

Sorry for being harsh, but there is not a chance in hell that you would have been admitted into a residency program where I trained. You have a lot of strikes against you, and frankly, unless you find someone very kind hearted you are very unlikely to find a position.
You have low step 1
You are an IMG
You have a history of lying, fraud, etc.

The fraud is going to be the worst one for you to overcome, I know as an attending I would never trust you with a patient, even after you have become trustworthy again.

That is a ton of liability for a program to take on, while there is very little to gain by getting you over some other guy, and there is more risk than benefit to matching you. You will need to look very low tier. Honesty is your only chance now lying to get back in will only bring more problems in the future. I also would become involved in something in a position where a program can get to know you, so they can potentially look past all of this. Your former program may actually be one of your best bets.

There is probably some rule against discriminating against you for this, but we all know that it will occur, just not openly.
 
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