Thoughts

[Haole]

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Hypothetical question: 🙄

Suppose someone was applying for a competitive fellowship and at the very beginning of the interview season, their home program offered a position before having had a chance to interview anywhere else. The home program is good, but the applicant was interested in seeing what else was out there and explore other institutions for differing perspectives. Problem is, home program wants an answer so they can move on and want a contract signed. Home program is unwilling to wait for the applicant to explore. Suppose the applicant realizing the competitive nature of the fellowship and thinks to self "a bird in the hand is worth two in the bush" and decides to accept the position. Would it be unethical for the applicant to continue interviewing at places they may be interested in? If the applicant ended up liking an away program better can a contract be withdrawn?

 

[smq123]

Hypothetical question: 🙄

Suppose someone was applying for a competitive fellowship and at the very beginning of the interview season, their home program offered a position before having had a chance to interview anywhere else. The home program is good, but the applicant was interested in seeing what else was out there and explore other institutions for differing perspectives. Problem is, home program wants an answer so they can move on and want a contract signed. Home program is unwilling to wait for the applicant to explore. Suppose the applicant realizing the competitive nature of the fellowship and thinks to self "a bird in the hand is worth two in the bush" and decides to accept the position. Would it be unethical for the applicant to continue interviewing at places they may be interested in? If the applicant ended up liking an away program better can a contract be withdrawn?

Not only do I think that this would be horribly unethical, but I think it could even blow up in that "hypothetical person's" face. Medicine is a small world, and everyone seems to know each other. What if your dream program's fellowship director found out that you were doing this (because he happened to talk to your home program's fellowship director) and spread it around? You'd never get a spot in a million years, and would effectively be blacklisted from all quality programs.

 

[gutonc]

Either accept and sign the contract or put your faith in the match. Playing both ends against the middle is a good way to find yourself looking for a job without anybody willing to be your reference come next spring.

 

[Haole]

Yeah, thats what I was thinking too. I'll have to let my friend know they shouldn't do that! 🙂 Thanks for the replies

 

[Groove]

If it's a competitive specialty/program, then it's a gamble both ways. Personally, I would take the offer if I did not have a large degree of confidence that I could match elsewhere and match in an equally desirable program. You already mentioned that it was a "good" program, and elude to a competitive nature of the specialty. I say... play it safe. The worst part about match? Having to wait until March to know if you matched period... and if you matched in a place where you could envision enjoying your training for 3-4 years. If you already know you can do that at your current location... why not take the position? It would save you a lot of money and travel expenses.

 

[neusu]

Not only do I think that this would be horribly unethical, but I think it could even blow up in that "hypothetical person's" face. Medicine is a small world, and everyone seems to know each other. What if your dream program's fellowship director found out that you were doing this (because he happened to talk to your home program's fellowship director) and spread it around? You'd never get a spot in a million years, and would effectively be blacklisted from all quality programs.

To OP. Read the contract. If it is binding, look at the terms of breach. Generally, this is very vague because it is expected that people have family issues along the way or change their mind and breach. If non-binding, continue your search.

It is neither unethical, nor immoral to accept a position yet continue looking as your program should not try to trap you in an agreement before you have had the opportunity to pursue other offers. While you and they may feel comfortable with one another, it is your prerogative, not the programs, to assure a best fit. To the program, you are just another warm body. If you feel uneasy about the situation, tell the program upfront with your acceptance that you are happy and flattered for the offer, yet will pursue further offers.

Alternatively, keep it on the DL. If a better offer arises, terminate your initial contract and be vague regarding your reasons. The only caveat is that you will be unable to solicit your home program to make contact with programs you wish to join.

 

[Law2Doc]

To OP. Read the contract. If it is binding, look at the terms of breach. Generally, this is very vague because it is expected that people have family issues along the way or change their mind and breach. If non-binding, continue your search.

It is neither unethical, nor immoral to accept a position yet continue looking as your program should not try to trap you in an agreement before you have had the opportunity to pursue other offers...

Um no. In general these contracts are binding and not unenforceably vague (from a legal perspective). Very few contracts (certainly none drafted by a lawyer) will leave an "out" for family issues or changing your mind. There will be rules allowing mutual termination, the employer will be allowed to terminate for cause,and sometimes will let parties terminate with a lengthy notice period. But they won't be terminable at will for being too vague. Once you sign a contract, it is, in fact, unethical in many people's eyes to continue to pursue other options. They aren't "trapping" you -- you do this to yourself by inking the contract. You are a grown up, and expected to weight your options of the "bird in the hand" versus "rolling the dice," on your own. Don't try to blame them (saying the contract is vague, or that they are trying to trap you) to justify your not playing by the rules, what you willingly signed on for. Will they sue you over it? Doubtful. But could they? Sure. You are technically in the wrong here.

 

[notdeadyet]

It is neither unethical, nor immoral to accept a position yet continue looking as your program should not try to trap you in an agreement before you have had the opportunity to pursue other offers.

Then you have odd viewpoints on the law and ethics.

The program is not "trapping" you into a position. It is offing a contract. If you are not ready to commit and honor said contract, don't sign. If you do, continuing to look for something better with the intent of breaking your contract is unethical.

 

[BolderNewfy]

Sorry to hijack this thread but i have a question as well that is sort of related. Im in PGY2 of IM and I told my PD last month I dont think Im am going to work in IM and would like to try and transfer to a psych program. He told me I was bound by contract to stick out my entire PGY2 year. I told him I would be fine sticking it out as long as he needed until he found a replacement but that I was really unhappy and wanted to leave. he didnt care. So im getting my app together for next year, and he said he will write a good LOR for me. So my question is would it be wrong of me to get the LOR from him, secure my eras application, and appy to programs for 2013, and then just tell him I am resigning, and he needs to find a replacement. What would be the potential repercussions? I still have to force myself to go to work everyday......

 

[DrAwsome]

Sorry to hijack this thread but i have a question as well that is sort of related. Im in PGY2 of IM and I told my PD last month I dont think Im am going to work in IM and would like to try and transfer to a psych program. He told me I was bound by contract to stick out my entire PGY2 year. I told him I would be fine sticking it out as long as he needed until he found a replacement but that I was really unhappy and wanted to leave. he didnt care. So im getting my app together for next year, and he said he will write a good LOR for me. So my question is would it be wrong of me to get the LOR from him, secure my eras application, and appy to programs for 2013, and then just tell him I am resigning, and he needs to find a replacement. What would be the potential repercussions? I still have to force myself to go to work everyday......

Well any new program will want to have a letter or talk to your current PD so it's not a good idea to make your PD upset. Also you may or may not match in psych so it's not a good idea to leave something without having something else in place. Further you'll be unemployed if you quit now, in addition to having a gap in training. So while technically you can quit at any time, I don't think it's recommended.

 

[mcl]

Well any new program will want to have a letter or talk to your current PD so it's not a good idea to make your PD upset. Also you may or may not match in psych so it's not a good idea to leave something without having something else in place. Further you'll be unemployed if you quit now, in addition to having a gap in training. So while technically you can quit at any time, I don't think it's recommended.

Agreed. It would absolutely be foolish to burn this bridge. For the rest of your professional career, the PD from your IM program* will be asked to complete credentialing paperwork regarding your performance as a resident in that training program whenever you request privileges at a new hospital or licensure in a new state. I know you don't think of it this way, but your PD is offering you a gift. He/She is going to support your decision to pursue a different residency, allowing you to keep your job and your paycheck, putting you in the best possible position to continue your career with no red flags on your application either for residency elsewhere, future licensure, or future (post residency) employment. I'd strongly advise taking a deep breath and finding a way to psych yourself into finishing the year as graciously as possible, giving your best effort every day.

*I don't mean to say that the person who is currently your PD will complete verification paperwork in perpetuity. I mean that the person in the role of PD at the time the residency verification request is made completes the paperwork. Once your current PD steps down, future PDs will have limited information about you. You don't want the last entry in the file that person sees to be a notification that you quit once you had secured a positive letter.

 

[Law2Doc]

Agreed. It would absolutely be foolish to burn this bridge. For the rest of your professional career, the PD from your IM program* will be asked to complete credentialing paperwork regarding your performance as a resident in that training program whenever you request privileges at a new hospital or licensure in a new state. I know you don't think of it this way, but your PD is offering you a gift. He/She is going to support your decision to pursue a different residency, allowing you to keep your job and your paycheck, putting you in the best possible position to continue your career with no red flags on your application either for residency elsewhere, future licensure, or future (post residency) employment. I'd strongly advise taking a deep breath and finding a way to psych yourself into finishing the year as graciously as possible, giving your best effort every day.

*I don't mean to say that the person who is currently your PD will complete verification paperwork in perpetuity. I mean that the person in the role of PD at the time the residency verification request is made completes the paperwork. Once your current PD steps down, future PDs will have limited information about you. You don't want the last entry in the file that person sees to be a notification that you quit once you had secured a positive letter.

Agreed. Your job now should be to load up on all the good will you can, because this won't be the last time your program gets to "weigh in" on future credentialing, licensure, character, etc questions. You want to maintain a reputation of "good guy, hard worker, but it just didn't work out". So you need to continue to work like you are a categorical, even though in the back of your head you perhaps are counting down the minutes. I suggest you save as much vacation as you can for the very end to get out of there a few days early.

 

[NotAProgDirector]

This is a complicated situation. You signed a contract for 1 year. Your program and your co-residents are counting on you to do that work. If you were to leave, it's not like there are 1000's of other people wanting PGY-2 spots, and unclear how many qualified applicants there would be. So, you made a legal promise to work for 1 year, and it can be argued that you should complete that commitment.

This would be similar to you hiring a contractor to work on your house. Let's say they get half done, and decide that they just don't want to finish. You could imagine how frustraing that would be -- you'd almost certainly have delays, it might cost you more to finish, and is a huge inconvenience at a minimum.

On the otherhand, this is training for you. You only get a certain amount of fully funded training time, so using it up on training that is of no value is a real negative. And, if you're not interested / committed to the work, I could imagine that it wouldn't be fun to work with you.

One would wonder why you signed a new contract if you were so unhappy. Likely, you decided that it was "safer" to have a job then to give it up -- and in that case, you really should complete your commitment.

As mentioned in this thread, you really have a few options. You can review your contract to see if it has any early termination clause. It should, and explain what you need to do to terminate. But, even if it has one, you have to realize that using it might make your program very unhappy. I'd like to believe that if your performance is fine and you resign, that programs wouldn't hold that against you in your final paperwork (although resigning early will also be considered some amount of a red flag -- would you hire a contractor who quit half way through their last job?)