Texas physician intraining permit after termination

[Utdallas]

Hello All,

My question to all is regarding Physician In-training permit in texas.
My story basically is that I was a resident 22 months into training, when I made an honest yet detrimental mistake of allowing my husband, who is a resident at a different hospital to come on hospital campus. I was under the impression that he had some shadowing privelleges, however he did not, due to that he ended up observing two procedures. He wanted to attend a conference for which i lent him my ID, he only used it to attend the conference however when the hospital found out about this they terminated me due to the above reasons.

I was a very strong resident and my PDs have supported me from that aspect.

My question is that I have found a program which is interested in me but they are in texas, basically do you think this history will be an issue with obtaining a texas i training permit.

I had no license revocation and wasn’t reported to the state board. I have stellar evaluations and the interested program really likes me as well. Obviously I am very remorseful and didn’t have any malicious intention the first time, I understand where I was wrong and dont intent to repeat any of it

Please let me know what you guys think?

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[HemeOncHopeful19]

Do you have programs interested in you that aren’t in Texas?

You could also reach out to a lawyer that has experience with the Texas Medical Board and ask them (might cost a couple hundred dollars but you have a lot more to gain/lose than that).

Honestly you will probably be able to work it out in my non-expert opinion, but if I were you I would hire a lawyer for extra help. To be realistic, unfortunately you will probably have to be explaining this situation for the rest of your career every time you apply for a license or hospital privileges etc. so you might as well get a professional to help you draft your “official explanation” whether you need it for a Texas training permit or not

 

[Utdallas]

Most of the other programs are pgy1 and I would like to save a year.

Thank you for your answer.

 

[dozitgetchahi]

Hello All,

My question to all is regarding Physician In-training permit in texas.
My story basically is that I was a resident 22 months into training, when I made an honest yet detrimental mistake of allowing my husband, who is a resident at a different hospital to come on hospital campus. I was under the impression that he had some shadowing privelleges, however he did not, due to that he ended up observing two procedures. He wanted to attend a conference for which i lent him my ID, he only used it to attend the conference however when the hospital found out about this they terminated me due to the above reasons.

I was a very strong resident and my PDs have supported me from that aspect.

My question is that I have found a program which is interested in me but they are in texas, basically do you think this history will be an issue with obtaining a texas i training permit.

I had no license revocation and wasn’t reported to the state board. I have stellar evaluations and the interested program really likes me as well. Obviously I am very remorseful and didn’t have any malicious intention the first time, I understand where I was wrong and dont intent to repeat any of it

Please let me know what you guys think?

I’m slightly intrigued by this (especially with regards to what happened with the conference he attended) because my rheumatology program had open conferences where any fellow from any program in the city could come attend. It wasn’t unusual to see fellows from the programs across town at our morning conferences. I think this sort of thing is fairly common at many programs out there, so I could see how you might think that having your spouse resident from across town go to a conference etc isn’t a problem. (Lending your ID to them probably was the issue.)

Still, IMO, this seems like the sort of thing that shouldn’t have led to a termination.

As above, you need a lawyer. You probably should have had a lawyer when they were trying to fire you, too.

 

[rokshana]

I’m slightly intrigued by this (especially with regards to what happened with the conference he attended) because my rheumatology program had open conferences where any fellow from any program in the city could come attend. It wasn’t unusual to see fellows from the programs across town at our morning conferences. I think this sort of thing is fairly common at many programs out there, so I could see how you might think that having your spouse resident from across town go to a conference etc isn’t a problem. (Lending your ID to them probably was the issue.)

Still, IMO, this seems like the sort of thing that shouldn’t have led to a termination.

As above, you need a lawyer. You probably should have had a lawyer when they were trying to fire you, too.

Her husband came in observed procedures… under her ID? That’s a pretty big deal in this day and age of security…it was probably not just the one thing, but sometimes one thing can be a big enough deal.

 

[Utdallas]

Her husband came in observed procedures… under her ID? That’s a pretty big deal in this day and age of security…it was probably not just the one thing, but sometimes one thing can be a big enough deal.

My husband didn’t use my ID to observe the procedures. He only had it in his possession. He was escorted everywhere by somebody, the part where I was wrong not knowingly , and him knowingly was where he told people he has shadowing privileges when he did not. He always had his own id badge showing to show that he is from some place else.

Regardless all that is done, the truth is I am remorseful and obviously I have heard mixed things during this interview trail where some agree that it was too much specially when I was a pretty strong resident and hasn’t gotten in any sort of trouble before.

Biggest thing is if you think this will be too much for the TMB to deny a license? For all those who have seen license denials, is this something big enough in your opinion?

 

[Utdallas]

I’m slightly intrigued by this (especially with regards to what happened with the conference he attended) because my rheumatology program had open conferences where any fellow from any program in the city could come attend. It wasn’t unusual to see fellows from the programs across town at our morning conferences. I think this sort of thing is fairly common at many programs out there, so I could see how you might think that having your spouse resident from across town go to a conference etc isn’t a problem. (Lending your ID to them probably was the issue.)

Still, IMO, this seems like the sort of thing that shouldn’t have led to a termination.

As above, you need a lawyer. You probably should have had a lawyer when they were trying to fire you, too.

Exactly .. they just weren’t okay with him having my ID for this long. I can see if he was a crazy person and decided to do something bad with it, it can be an issue.

 

[wysdoc]

Exactly .. they just weren’t okay with him having my ID for this long. I can see if he was a crazy person and decided to do something bad with it, it can be an issue.

I’m wondering whether he will be reprimanded by his residency too

 

[HemeOncHopeful19]

I’m wondering whether he will be reprimanded by his residency too

I’m wondering whether he will be reprimanded by his wife!

 

[chessknt]

I'm not familiar with TX but states grant licenses to people who have operated while intoxicated. If you look through the TMB bulletins they have people still practicing (with restrictions) who had made sexual advances on patients, forged prescriptions, stolen drugs etc. Seems like it would be a stupid reason to deny a license and I have no idea what a lawyer would even add--you don't get to make a legal argument for licensure. I think you should just apply and have a coherent and well written explanation.

 

[Utdallas]

I’m wondering whether he will be reprimanded by his residency too

He came clean to his PD and he was fine thankfully.

 

[dozitgetchahi]

My husband didn’t use my ID to observe the procedures. He only had it in his possession. He was escorted everywhere by somebody, the part where I was wrong not knowingly , and him knowingly was where he told people he has shadowing privileges when he did not. He always had his own id badge showing to show that he is from some place else.

Regardless all that is done, the truth is I am remorseful and obviously I have heard mixed things during this interview trail where some agree that it was too much specially when I was a pretty strong resident and hasn’t gotten in any sort of trouble before.

Biggest thing is if you think this will be too much for the TMB to deny a license? For all those who have seen license denials, is this something big enough in your opinion?

In that case, I’d say it especially wasn’t a big deal. He didn’t use your ID to get in anywhere AND someone from the institution in question was leading him around? Whole thing seems a bit crazy, and more like a misunderstanding than a critical issue where someone should be fired.

How did anyone know he had your ID with him? Was he searched or something?

If I was the PD or hospital exec or whatever, this would have been a “give them a stern talking to and tell them not to do it again” situation, and then let the whole thing go. Tbh I have seen far crazier and more harmful things going on regularly in hospitals, with practically nobody caring about any of it.

 

[wysdoc]

In that case, I’d say it especially wasn’t a big deal. He didn’t use your ID to get in anywhere AND someone from the institution in question was leading him around? Whole thing seems a bit crazy, and more like a misunderstanding than a critical issue where someone should be fired.

How did anyone know he had your ID with him? Was he searched or something?

If I was the PD or hospital exec or whatever, this would have been a “give them a stern talking to and tell them not to do it again” situation, and then let the whole thing go. Tbh I have seen far crazier and more harmful things going on regularly in hospitals, with practically nobody caring about any of it.

The attending a conference was not a big deal. However observing procedures on patients where you have no official standing to be in that hospital is a breach in supervision and in patient privacy. You set this up to happen and that’s why they terminated you for your role.
If you have a new program willing to take you on to finish your residency that’s your second chance- they will be watching you closely to be sure you are professional in their program. I expect you will have to start your second year over from the beginning

 

[IMGASMD]

I think you should talk to a lawyer. They must have ran termination by their lawyer. This is not the time to cheap out. So the obtain your training license and move on from this, you should too.

Also, if someone were to take me on as a PGY-1 after “for cause” termination…. Regardless what the “reason” was, I would be very happy that they are welling to give me a second chance. I would absolutely just write off the “10 months” that you’ve already spent…. In grand scheme of things, a life time career as a fully licensed and trained physician is more than worth than those 10 months.

Welcome to the world that logic and reasoning is out the window, bottom line and cover your own a$$ trumps
everything else.

 

[chessknt]

I think you should talk to a lawyer. They must have ran termination by their lawyer. This is not the time to cheap out. So the obtain your training license and move on from this, you should too.

Also, if someone were to take me on as a PGY-1 after “for cause” termination…. Regardless what the “reason” was, I would be very happy that they are welling to give me a second chance. I would absolutely just write off the “10 months” that you’ve already spent…. In grand scheme of things, a life time career as a fully licensed and trained physician is more than worth than those 10 months.

Welcome to the world that logic and reasoning is out the window, bottom line and cover your own a$$ trumps
everything else.

What is the lawyer going to do exactly? Draft the response to the termination question for the TX medical board? It isn't like they are holding a hearing or need a special appeal for licensure--it is the same form literally everyone is using. Do people think a lawyer-worded letter is what they are looking for? Keep in mind these are often lay people, political appointees, and physicians serving, not other lawyers. Their duty is to make sure the person is not a threat to the public.

 

[IMGASMD]

What is the lawyer going to do exactly? Draft the response to the termination question for the TX medical board? It isn't like they are holding a hearing or need a special appeal for licensure--it is the same form literally everyone is using. Do people think a lawyer-worded letter is what they are looking for? Keep in mind these are often lay people, political appointees, and physicians serving, not other lawyers. Their duty is to make sure the person is not a threat to the public.

To speak “their” language? To buy myself a peace of mind?

I agree there are times hand shake and a good reason is enough. I also believe that the OP will have to explain why she was terminated, for the rest of her career…. It’s a good time to get her story straight from the get-go. Every time I read a story like this, there is always details that was not presented, that the OPs either conveniently left out, or just didn’t think they were important to include. Because they never make sense taken on face value.

Let me flip the question on you. Let’s say if I can arrange for the OP to talk to a lawyer to get all the advices for free, and draft a letter/statement for free. Would you still be opposed? What about for $100? 1000? Just trying to tease out, if you think the exercise of talking to a lawyer is worthless (too much $$$) or meaningless (because they add nothing to this discussion).

Certainly I am no longer a resident, and I have means to hire professionals to help me; however, looking back to some things that I may have diy’ed, the result may have been better if someone else did it. It also doesn’t hurt to know that you have someone in your corner, and you’re not fighting all alone.

(This part can be triggering to some). I am also a first generation immigrant and first doctor in the family. I don’t think the “system” is ever working against me, but I also don’t think it is on my side either….

Also if don’t know what’s happening in anesthesia world…, where I spent most of my time now… here’s a quick story about a group trust the system too much.

Story time. https://www.anesthesiologynews.com/PrintArticle/72202
I am definitely bias against any entities that aren’t heavily on our side.

 

[Utdallas]

In that case, I’d say it especially wasn’t a big deal. He didn’t use your ID to get in anywhere AND someone from the institution in question was leading him around? Whole thing seems a bit crazy, and more like a misunderstanding than a critical issue where someone should be fired.

How did anyone know he had your ID with him? Was he searched or something?

If I was the PD or hospital exec or whatever, this would have been a “give them a stern talking to and tell them not to do it again” situation, and then let the whole thing go. Tbh I have seen far crazier and more harmful things going on regularly in hospitals, with practically nobody caring about any of it.

I told them about it when they asked me about what had happened and why he was there. I didn’t think it was a mistake until I told them about it.

I guess every institution has their rules and regulations.

 

[chessknt]

To speak “their” language? To buy myself a peace of mind?

I agree there are times hand shake and a good reason is enough. I also believe that the OP will have to explain why she was terminated, for the rest of her career…. It’s a good time to get her story straight from the get-go. Every time I read a story like this, there is always details that was not presented, that the OPs either conveniently left out, or just didn’t think they were important to include. Because they never make sense taken on face value.

Let me flip the question on you. Let’s say if I can arrange for the OP to talk to a lawyer to get all the advices for free, and draft a letter/statement for free. Would you still be opposed? What about for $100? 1000? Just trying to tease out, if you think the exercise of talking to a lawyer is worthless (too much $$$) or meaningless (because they add nothing to this discussion).

Certainly I am no longer a resident, and I have means to hire professionals to help me; however, looking back to some things that I may have diy’ed, the result may have been better if someone else did it. It also doesn’t hurt to know that you have someone in your corner, and you’re not fighting all alone.

(This part can be triggering to some). I am also a first generation immigrant and first doctor in the family. I don’t think the “system” is ever working against me, but I also don’t think it is on my side either….

Also if don’t know what’s happening in anesthesia world…, where I spent most of my time now… here’s a quick story about a group trust the system too much.

Story time. https://www.anesthesiologynews.com/PrintArticle/72202
I am definitely bias against any entities that aren’t heavily on our side.

As someone who has applied for licenses in 7 states now I honestly don't think there is any role for a lawyer. Even a free one I would see it as a useless waste of time. 'They' are not lawyers on the medical board.

 

[dozitgetchahi]

As someone who has applied for licenses in 7 states now I honestly don't think there is any role for a lawyer. Even a free one I would see it as a useless waste of time. 'They' are not lawyers on the medical board.

As someone who has a physician friend who had a false board complaint filed against him by an angry ex, I think a *good* attorney in these situations is worth every single penny. Dealing with a medical board all by yourself is absolutely foolhardy, and can easily result in things going off the rails.

(That said, from what I can tell there are both good and bad attorneys out there in this arena, and the bad ones can potentially make things worse.)

 

[chessknt]

As someone who has a physician friend who had a false board complaint filed against him by an angry ex, I think a *good* attorney in these situations is worth every single penny. Dealing with a medical board all by yourself is absolutely foolhardy, and can easily result in things going off the rails.

(That said, from what I can tell there are both good and bad attorneys out there in this arena, and the bad ones can potentially make things worse.)

That is a different situation and absolutely warrants legal counsel. This person is applying for an initial license.

 

[NotAProgDirector]

The best people for advice may be your prospective program. They know all about this, and all about getting training permits from the TMB. They can probably answer this question -- and honestly, if the answer was no, then I expect they wouldn't consider you at all.

I can't actually see the PIT application, but in their eligibility criteria they list this: (the sample app is right on their website. As are most TMB applications, it's incredibly intrusive, including asking for confidential information).

If your prior training license (assuming you had one, not all states require them) wasn't restricted / suspended / canceled for cause, then you'll probably be OK. But you will need to disclose all this there. There is some chance that the program can contact the TMB and get some sense of whether this will be a problem or not.

 

[Utdallas]

The best people for advice may be your prospective program. They know all about this, and all about getting training permits from the TMB. They can probably answer this question -- and honestly, if the answer was no, then I expect they wouldn't consider you at all.

I can't actually see the PIT application, but in their eligibility criteria they list this: (the sample app is right on their website. As are most TMB applications, it's incredibly intrusive, including asking for confidential information).

View attachment 382359
If your prior training license (assuming you had one, not all states require them) wasn't restricted / suspended / canceled for cause, then you'll probably be OK. But you will need to disclose all this there. There is some chance that the program can contact the TMB and get some sense of whether this will be a problem or not.

From my convo with them, they aren’t too worried about this. They just want to start the process early to avoid delays as there is some paperwork to do.

 

[Utdallas]

Hi guys,

Thank you for all those who replied to me. I had another question regarding this situation. So I have signed my contract and I am
Waiting for my PIT at this time. However, there is a form L which my previous institute needs to fill out. I asked them to see if they can do it asap, however, they said that they need some approval from the hospital regarding the language they will use. This may take time and potentially delay the process.

How much do you think this delay could be from the board’s end, if they take “too much” time?

Thank you for your responses, any advice is appreciated.

 

[Crayola227]

To speak “their” language? To buy myself a peace of mind?

I agree there are times hand shake and a good reason is enough. I also believe that the OP will have to explain why she was terminated, for the rest of her career…. It’s a good time to get her story straight from the get-go. Every time I read a story like this, there is always details that was not presented, that the OPs either conveniently left out, or just didn’t think they were important to include. Because they never make sense taken on face value.

Let me flip the question on you. Let’s say if I can arrange for the OP to talk to a lawyer to get all the advices for free, and draft a letter/statement for free. Would you still be opposed? What about for $100? 1000? Just trying to tease out, if you think the exercise of talking to a lawyer is worthless (too much $$$) or meaningless (because they add nothing to this discussion).

Certainly I am no longer a resident, and I have means to hire professionals to help me; however, looking back to some things that I may have diy’ed, the result may have been better if someone else did it. It also doesn’t hurt to know that you have someone in your corner, and you’re not fighting all alone.

(This part can be triggering to some). I am also a first generation immigrant and first doctor in the family. I don’t think the “system” is ever working against me, but I also don’t think it is on my side either….

Also if don’t know what’s happening in anesthesia world…, where I spent most of my time now… here’s a quick story about a group trust the system too much.

Story time. https://www.anesthesiologynews.com/PrintArticle/72202
I am definitely bias against any entities that aren’t heavily on our side.

I agree. Often people don't know enough about law to know when they needed legal advice until it's too late. It never hurts to reach out to a lawyer. Many offer a free first consultation which can establish if you even can benefit from their expertise. Some only charge $100 for the first hour.

Better to let the attorney decide if you need an attorney than a physician...

Isn't this like when an auto mechanic decides if you need a doctor? So why let a doctor decide when you don't need an attorney?

 

[Crayola227]

As someone who has applied for licenses in 7 states now I honestly don't think there is any role for a lawyer. Even a free one I would see it as a useless waste of time. 'They' are not lawyers on the medical board.

Have you applied with negative things like this to report? Because the wrinkle isn't in the applying, it's in reporting the adverse action.

In Texas specifically, there is an attorney that claims he can get any number of things dismissed or waived by the board, including DUIs. So precisely, physicians are not lawyers so it frequently helps to have a lawyer familiar with the board in any state to work things out. For example that guy may have an idea how to approach this specific scenario for the most painless process.

I knew a resident who was once in a situation where explanations were demanded by the hospital and board, and damaging info could have been disclosed, but they talked to an attorney experienced with the board and they wrote up a wonderful sounding letter that said all that needed said and no more.

I've seen physicians in admin try several things they didn't know were not legal, until an attorney told them as much.

Always get an attorney when you are dealing with regulatory agencies, being disciplined, or beginning/ending a relationship with an employer like this situation

 

[Crayola227]

The best people for advice may be your prospective program. They know all about this, and all about getting training permits from the TMB. They can probably answer this question -- and honestly, if the answer was no, then I expect they wouldn't consider you at all.

I can't actually see the PIT application, but in their eligibility criteria they list this: (the sample app is right on their website. As are most TMB applications, it's incredibly intrusive, including asking for confidential information).

View attachment 382359
If your prior training license (assuming you had one, not all states require them) wasn't restricted / suspended / canceled for cause, then you'll probably be OK. But you will need to disclose all this there. There is some chance that the program can contact the TMB and get some sense of whether this will be a problem or not.

Just to be clear, this isn't always true. Some programs are quite clueless on the front of dealing with the board. Beyond the absolutely straightforward situation of initial licensure of a trainee.

 

[Crayola227]

Hi guys,

Thank you for all those who replied to me. I had another question regarding this situation. So I have signed my contract and I am
Waiting for my PIT at this time. However, there is a form L which my previous institute needs to fill out. I asked them to see if they can do it asap, however, they said that they need some approval from the hospital regarding the language they will use. This may take time and potentially delay the process.

How much do you think this delay could be from the board’s end, if they take “too much” time?

Thank you for your responses, any advice is appreciated.

I don't understand how this might be a delay from the board's end? You're waiting on the hospital, yes? Do you mean, how will the Texas board view any delay? Or, how much will this delay your license from the board?

The Texas board probably will have nothing to read into a delay of form from the hospital, delays are the name of the game. As for how much this delays your license, that is really hard to say because each board is different and their red tape varies in speed.

Someone with license experience in Texas specifically will hopefully chime in. Board attorneys often have some idea as well depending on your issue.

 

[chessknt]

Have you applied with negative things like this to report? Because the wrinkle isn't in the applying, it's in reporting the adverse action.

In Texas specifically, there is an attorney that claims he can get any number of things dismissed or waived by the board, including DUIs. So precisely, physicians are not lawyers so it frequently helps to have a lawyer familiar with the board in any state to work things out. For example that guy may have an idea how to approach this specific scenario for the most painless process.

I knew a resident who was once in a situation where explanations were demanded by the hospital and board, and damaging info could have been disclosed, but they talked to an attorney experienced with the board and they wrote up a wonderful sounding letter that said all that needed said and no more.

I've seen physicians in admin try several things they didn't know were not legal, until an attorney told them as much.

Always get an attorney when you are dealing with regulatory agencies, being disciplined, or beginning/ending a relationship with an employer like this situation

That was my point--if there is a hearing or some kind of response required absolutely get a lawyer. To hire a lawyer to fill out the initial application is beyond ridiculous. See if the board actually gives a **** first.

 

[Crayola227]

The best people for advice may be your prospective program. They know all about this, and all about getting training permits from the TMB. They can probably answer this question -- and honestly, if the answer was no, then I expect they wouldn't consider you at all.

I can't actually see the PIT application, but in their eligibility criteria they list this: (the sample app is right on their website. As are most TMB applications, it's incredibly intrusive, including asking for confidential information).

View attachment 382359
If your prior training license (assuming you had one, not all states require them) wasn't restricted / suspended / canceled for cause, then you'll probably be OK. But you will need to disclose all this there. There is some chance that the program can contact the TMB and get some sense of whether this will be a problem or not.

This is confusing. I would read this as they don't have to report this at all.

To be fair, not every adverse action from an employer or even professionalism concern is going to be a board issue or one that affects licensing in the state it happens in.

What is the basis of saying why the resident lost their job is something they have to report to this new board?

I mean, if there is a box to fill in that asks a question where it would be the answer... I'm not saying hide. Just wondering.

 

[Utdallas]

Thanks for the response guys.. so quick update is that my former program is refusing to send any evidence or even tel their side of the story to the board. All they are saying is that they will fill out the form L and then any evidence or documentation that the board is requesting they do not want to share as it is privelleged information.

How do you think the board will view this?

I feel like it would be unfair to deny me a license if I have been honest and my former program is not willing to talk.

 

[NotAProgDirector]

This is standard procedure. They will complete the form honestly. They will answer all of the questions. If the board then wants more information, they will usually request that the program "release the entire resident file". Which they will refuse to do, as it is QA protected. The TMB has no way to force some hospital in another state to do anything, and if their records are QA protected then there's nothing they can do anyway. Usually the board will need to make a decision based upon whatever is on Form L. But all this back-and-forth, even though we already know how it's going to play out, can take some time. The good news here is that your program is willing to advocate for you, and this is an in-training license which means you'll be supervised, and hence they are more likely to allow this to proceed. And, the issue at hand is on the more minor side.

At this point, there is nothing more you can do but wait, which I realize is one of the hardest things to do. Chances are you may have a late start because of all this.

 

[AlbinoHawk DO]

Considering they are HIPAA violations, this will be taken seriously. I don't think it's a scenario where you're "irredeemable" by the board, but it's also not an application I would fill out without an attorney