Title IX

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rambo91

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rambo91 said:
Hey guys, so here is my situation. I was PGY2 resident and my wife a PGY1. Things have never been okay between us. We would always argue and have huge blow outs( nothing at work) So during one of these arguments things got physical, she hit me I shoved her back and eventually cops were called. Nobody went to the jail, no charges were filed. Cops realized we both were the aggressors and victims. They made a report and left. Things were never good between us. However, the local police department ended up informing this to my program. Long story short, my program did an extended investigation where they interviewed both of us individually which unfolded all the problems that we been having in our marriage. The final report came out to be we both violated a title IX law or something. Once I sat down with the higher ups they suggested that I should resign even though we both were found to be in violation this very specific TITLE IX. According to program I can still apply to different programs and 'hopefully' get a spot since some states might not even accept me and this will stay in my permanent file. So, what do you guys think? any suggestions? what should be my next step, have you guys heard anyone in this situation? Otherwise I am a decent resident, have gotten mostly good evaluations, passed steps with decent scores and ITEs show improvement year over year.
PS: I am an IMG. and safe to say we are getting a divorce :(
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Sorry to hear it OP. :( Did they also ask your wife to resign though?
 
Thankfully NO!! since we have a 4 year old child.
 
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I've been here on SDN for many years, and this is the first time I've heard of Title IX issues and residency programs.

First of all, let's get something out of the way. You and your wife need help, immediately. Having blow out fights, even if it doesn't escalate to physical violence, is not good for a marriage and certainly not good for kids. Physical altercations can quickly get out of hand, mistakes can be made, and people can be seriously injured. You need to decide whether this marriage is going to last, and if so you need immediate help to find a way forward. If you think you're somehow "hiding" this from your kids, or that it won't affect them because they are so young, you are very wrong. You mention at the end of your description that you're getting a divorce, and that's certainly one part of a solution, but you still have to find a way to deal with each other if you're going to share custody of your kid.

OK, on to the topic at hand, Title IX. This is the first I've heard of it in residency, and that's not surprising because this was just recently litigated. In March 2017 the 3rd Circuit ruled that a private hospital running a residency program, but affiliated with a university, is subject to Title IX. The "affiliated with a university" part was only a part of the decision, and hence even programs with no univ affiliation may be affected. The Circuit found that there was a clear educational mission to the residency program, that there were lectures / conferences etc, and that the hospital clearly advertised it as an educational experience. And since hospitals get federal funds for resident education, Title IX applies. Didn't make a splash in my world. Will now.

Programs affiliated with a University are probably already gunshy about Title IX issues. Title IX is very interesting -- the law itself is very vaguely worded, and has left it to the DoE (and others) to determine how to implement. This has resulted in a lot of controversy, as the gov't departments who implement the law can just decide how they plan to implement, announce, and there's no check-and-balance. As in this thread (and for residency programs in general), Title IX now includes sexual harrassment and sexual violence. And as an example of controversy, any investigation of either is held to "the preponderance of the evidence" rather than "beyond a reasonable doubt". Whether this is "justice" or "a travesty" depends upon your point of view. Programs are required to investigate all issues of which they become aware, even if no one officially complains. And if they find a problem, they must intervene.

So, to the OP's situation. They both are residents at the same program, and hence are basically both students of the same educational system per Title IX. Since there was some violence in a relationship between 2 people who have a sexual relationship, they must investigate and do something to protect all parties. What the two of you may want is not really part of the discussion. If the institution doesn't find a way to address the situation, they can be fined large penalties, or forfeit all federal dollars.

There have been multiple high profile cases on college campuses like this. Student A and B have a sexual relationship, and it gets ugly. A accuses B of sexual misconduct. B says A consented and is now having second thoughts / lying. The truth is probably somewhere in between. There usually is little evidence. The situation is investigated by the school -- not the courts. There is no trial, just a committee that reviews all of the findings. There's no right to counsel, or to face your accuser. The committee determines an outcome based upon "preponderance of the evidence" -- which is a much lower bar than "reasonable doubt". If they find there was a problem, then the accused is often expelled, as their presence on campus creates ongoing trauma for the other party.

This is what's happening here. The program will probably force one of you out, to comply with Title IX. And it's much more likely that the male will be forced out.

From a program leadership viewpoint, it's a new twist. It's an extra risk when I take couple matches, even if in two different programs. Or if two residents "hook up" and it turns ugly.

On the practical side, I agree with the advice above that you might need a lawyer to help. I don't think a lawyer will be able to stop this. But ideally you'd like to leave this out of your credentialing documents if possible. If your program offers you a graceful exit, no mention in your paperwork, and help finding a new spot -- I'd probably take that offer and move on, it's the best you're going to get. if they offer you anything less than that, then (perhaps) a lawyer will help you get to that point.

Best of luck. This is going to be tough. Even if it all goes well, you may end up moving away from your young child.
 
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There goes my life's 6 years
 
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rambo91 said:
There goes my life's 10 years
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No, get a lawyer. I'm wondering if it might be possible for you to work out another solution if your wife agrees. For example, maybe you both agree to get counseling, have no rotations in common, live separately or something and you both sign off that you are okay with this, that might take the institution of the hook enough they let you finish.
 
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Just jumped in to say I'm so sorry you're going through this, OP. Good luck.


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aProgDirector said:
I've been here on SDN for many years, and this is the first time I've heard of Title IX issues and residency programs.

First of all, let's get something out of the way. You and your wife need help, immediately. Having blow out fights, even if it doesn't escalate to physical violence, is not good for a marriage and certainly not good for kids. Physical altercations can quickly get out of hand, mistakes can be made, and people can be seriously injured. You need to decide whether this marriage is going to last, and if so you need immediate help to find a way forward. If you think you're somehow "hiding" this from your kids, or that it won't affect them because they are so young, you are very wrong. You mention at the end of your description that you're getting a divorce, and that's certainly one part of a solution, but you still have to find a way to deal with each other if you're going to share custody of your kid.

OK, on to the topic at hand, Title IX. This is the first I've heard of it in residency, and that's not surprising because this was just recently litigated. In March 2017 the 3rd Circuit ruled that a private hospital running a residency program, but affiliated with a university, is subject to Title IX. The "affiliated with a university" part was only a part of the decision, and hence even programs with no univ affiliation may be affected. The Circuit found that there was a clear educational mission to the residency program, that there were lectures / conferences etc, and that the hospital clearly advertised it as an educational experience. And since hospitals get federal funds for resident education, Title IX applies. Didn't make a splash in my world. Will now.

Programs affiliated with a University are probably already gunshy about Title IX issues. Title IX is very interesting -- the law itself is very vaguely worded, and has left it to the DoE (and others) to determine how to implement. This has resulted in a lot of controversy, as the gov't departments who implement the law can just decide how they plan to implement, announce, and there's no check-and-balance. As in this thread (and for residency programs in general), Title IX now includes sexual harrassment and sexual violence. And as an example of controversy, any investigation of either is held to "the preponderance of the evidence" rather than "beyond a reasonable doubt". Whether this is "justice" or "a travesty" depends upon your point of view. Programs are required to investigate all issues of which they become aware, even if no one officially complains. And if they find a problem, they must intervene.

So, to the OP's situation. They both are residents at the same program, and hence are basically both students of the same educational system per Title IX. Since there was some violence in a relationship between 2 people who have a sexual relationship, they must investigate and do something to protect all parties. What the two of you may want is not really part of the discussion. If the institution doesn't find a way to address the situation, they can be fined large penalties, or forfeit all federal dollars.

There have been multiple high profile cases on college campuses like this. Student A and B have a sexual relationship, and it gets ugly. A accuses B of sexual misconduct. B says A consented and is now having second thoughts / lying. The truth is probably somewhere in between. There usually is little evidence. The situation is investigated by the school -- not the courts. There is no trial, just a committee that reviews all of the findings. There's no right to counsel, or to face your accuser. The committee determines an outcome based upon "preponderance of the evidence" -- which is a much lower bar than "reasonable doubt". If they find there was a problem, then the accused is often expelled, as their presence on campus creates ongoing trauma for the other party.

This is what's happening here. The program will probably force one of you out, to comply with Title IX. And it's much more likely that the male will be forced out.

From a program leadership viewpoint, it's a new twist. It's an extra risk when I take couple matches, even if in two different programs. Or if two residents "hook up" and it turns ugly.

On the practical side, I agree with the advice above that you might need a lawyer to help. I don't think a lawyer will be able to stop this. But ideally you'd like to leave this out of your credentialing documents if possible. If your program offers you a graceful exit, no mention in your paperwork, and help finding a new spot -- I'd probably take that offer and move on, it's the best you're going to get. if they offer you anything less than that, then (perhaps) a lawyer will help you get to that point.

Best of luck. This is going to be tough. Even if it all goes well, you may end up moving away from your young child.
Click to expand...

Y
 
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rambo91 said:
Yea, all u said makes sense but what I am not able to understand is even if fights happened at home how the hell is this impacting workplace.
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My understanding of this area of the law is imperfect at best. However, schools appear to be on the hook regardless of where the behavior occurs. A good example is Frats. At many schools, Frats may be private -- on private land, privately owned. But it's clear that schools are responsible under Title IX for what happens at Frat parties.

Here is a nice summary of off campus issues: http://www.higheredcompliance.org/resources/resources/BarranJones_2013URMIAJournal2.pdf

rambo91 said:
Thats what I am asking. But to be honest if it comes to down to someone getting fired, better me than her since is has the kid right now.
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Unfortunately, the way Title IX works currently, it's almost always the male who faces the consequences.

---

Universities are terrified of Title IX actions. Hence, they are likely to be very aggressive in addressing any situation that might trigger a Title IX complaint. I agree that this situation, while clearly unfortunate, has little to do with the program. But if both residents are in the same field, it may be impossible to separate them adequately. If one of the two says "I can't be near this person any more and feel safe", that's not a request I could make work in my program. As mentioned already, even if the OP and other resident don't complain, a resident in the future could point to this example as evidence that the institution willfully ignored the problem. The penalties that follow are severe enough that programs must protect themselves.
 
Boy, this is a tough situation. I am sorry you are going through it.

I actually had to take Title IX training for my fellowship through a medical school that doesn't have an undergraduate arm, so I thought it was a little strange having to do it since it was a lot about dorms and domestic violence. But Given the above, it makes so much more sense. It seems to apply to just about anything with an educational focus, including residencies.

Baylor University in Texas appears to be bracing for the prospect of getting absolutely hammered with Title IX violations - they had rampant sexual abuse from the football team that was suppressed from the coaching staff, to the school administration and even possibly the student health centers from what I read. That's more the intent of that law, but I can see an extension into residency issues. It's a shame this happened this way, but having physical arguments often with your spouse (with kids around) is an alarming fact that should be addressed immediately.
 
yea! I understand that, but the other viable option would be to let me go to another program, just a decent LOR and not have title IX in permanent file. Because to an institution who is not well versed in TITLE IX would assume there was sexual misconduct on campus and won't even interview me. And IF WE BOTH WERE IN VIOLATION then why am I the only one getting screwed.
 
A reasonable compromise in a situation like this would be to separate you (one of you is forced to leave), but with no adverse action in your file, as the issues involved didn't affect the work environment. This assumes that there was no impact on work -- something of which you may not be aware. Perhaps everyone saw how uncomfortable your relationship was, and there was significant spillover to work.
 
You laid your hands on your spouse, spin it anyway you like but that's domestic violence. Get yourself some professional help, and until that's solved I think a break from medicine isn't a bad idea. From an administration prospective you broke the law and got off VERY easy, but that kind of instability is a liability. Call me old fashioned but if you lay your hands on a woman I'm not going to be in your corner.


Sent from my iPhone using SDN mobile app
 
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chicagochildpsych said:
You laid your hands on your spouse, spin it anyway you like but that's domestic violence. Get yourself some professional help, and until that's solved I think a break from medicine isn't a bad idea. From an administration prospective you broke the law and got off VERY easy, but that kind of instability is a liability. Call me old fashioned but if you lay your hands on a woman I'm not going to be in your corner.


?
Click to expand...
 
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This sounds ridiculous that she hit you first and you retaliated but you are the only one getting fired???

Can someone please tell me I am not reading this wrong?

Just what is wrong with this world?
 
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Apollyon said:
Dude - seriously. SDN is NOT the answer. EVER. You need a lawyer. ASAP, or sooner.

Remember, one measure of the value of advice is how much it costs.
Click to expand...

Back off my line, bro.

Also: how does one act sooner than ASAP?
 
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??
 
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rambo91 said:
YES!!! thats exactly what happened here. We both are found guilty but I am the only one without a job. As mentioned before TITLE IX is usually reserved for sexual misconduct on campus. This did not even take place. With stain on my file no prog will touch me a 10 foot pole.
Click to expand...


So are you going to get that lawyer?
 
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wholeheartedly said:
So are you going to get that lawyer?
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This.

And with the attitude you have towards losing your job like it is no big deal as long as she keep hers. That is abhorrent and makes me think twice about your entire story.
There are many more people out there who would die to have your job.
 
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rambo91 said:
yup
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Doubt it would work. but a last dit
bannie22 said:
This.

And with the attitude you have towards losing your job like it is no big deal as long as she keep hers. That is abhorrent and makes me think twice about your entire story.
There are many more people out there who would die to have your job.
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Correct!!but here I am talking as a father. I know we made mistakes, things were really bad and we were not able divorce sooner. But everyone here knows that child stays with mother. So it will be better for him if atleast one person has a proper job and better her than me.
 
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rambo91 said:
YES!!! thats exactly what happened here. We both are found guilty but I am the only one without a job. As mentioned before TITLE IX is usually reserved for sexual misconduct on campus. This did not even take place. With stain on my file no prog will touch me a 10 foot pole.
Click to expand...

Atta boy, on getting a lawyer. This is the only way that doesn't end up casting all of the blame on you no matter the circumstances, and maximally protecting the hospital or the "man."

It has become abundantly clear lately that we put way too much faith in the "process." Fool me once, or a million times, shame on you. Fool me twice, and we all lawyer up.
 
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chicagochildpsych said:
You laid your hands on your spouse, spin it anyway you like but that's domestic violence. Get yourself some professional help, and until that's solved I think a break from medicine isn't a bad idea. From an administration prospective you broke the law and got off VERY easy, but that kind of instability is a liability. Call me old fashioned but if you lay your hands on a woman I'm not going to be in your corner.


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Click to expand...

Dude gtfo of here, she hit him first he has the right to retaliate/defend himself...it's called feminism at its finest. Also I love that she hits him first but you say he needs help and don't even mention her...very fair
 
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Merely said:
Dude gtfo of here, she hit him first he has the right to retaliate/defend himself...it's called feminism at its finest. Also I love that she hits him first but you say he needs help and don't even mention her...very fair
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You may be 100 percent correct, but rarely does the right thing = the legal thing. If it were as easy as doing the right thing, there would be no need for departments like HR.

The reality is that in such situations (and all imageineable situations really) the hospital/school is always going to do the thing that exposes it to the least amount of liability possible, hence kicking the dude out. Because as we all know, women are considered minorities in the medical profession, so if they fired her, they would have a gender discrimination issue on their hands. So why not just blame him and ask him to leave...which is exactly what they are doing. Not the right thing, but definitely the best legal option they have.

They have to kick someone out based on that paper trail. It doesn't even matter who did what, it's gonna be the dude 99/100 times. The "facts" are a mere after thought, and they can change based on who is observing and recording them.

Decisions like this are virtually always pre-determined categorically regardless. The facts somehow always support the final decision, and not the other way around.

And no, it isn't a conspiracy, its business/employment law 101.
 
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Light at end of tunnel said:
You may be 100 percent correct, but rarely does the right thing = the legal thing. If it were as easy as doing the right thing, there would be no need for departments like HR.

The reality is that in such situations (and all imageineable situations really) the hospital/school is always going to the thing that exposes it to the least amount of liability possible, hence kicking the dude out. Because as we all know, women are considered minorities in the medical profession, so if they fired her, they would have a gender discrimination issue on their hands. So why not just blame him and ask him to leave...which is exactly what they are doing. Not the right thing, but definitely the best legal option they have.

They have to kick someone out based on that paper trail. It doesn't even matter who did what, it's gonna be the dude 99/100 times. The "facts" are a mere after thought, and they can change based on who is observing and recording them.

Decisions like this are virtually always pre-determined categorically regardless. The facts somehow always support the final decision, and not the other way around.

And no, it isn't a conspiracy, its business/employment law 101.
Click to expand...
Yea man, you're right. I was ready to 'go away' but what they're saying just leave and no LOR no support to get me in different program. So either ways I am done. As mentioned before, more likely a last ditch effort.
 
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rambo91 said:
Yea man, you're right. I was ready to 'go away' but what they're saying just leave and no LOR no support to get me in different program. So either ways I am done. As mentioned before, more likely a last ditch effort.
Click to expand...

You need a lawyer, probably a strong employment lawyer - STAT. Nothing else will do you any good at this point.

You need to fight their decision, which on its face looks like it could have gone either way but conveniently hosed you because (I may be presuming, but work with me here), you have an XY genotype.
 
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chicagochildpsych said:
You laid your hands on your spouse, spin it anyway you like but that's domestic violence. Get yourself some professional help, and until that's solved I think a break from medicine isn't a bad idea. From an administration prospective you broke the law and got off VERY easy, but that kind of instability is a liability. Call me old fashioned but if you lay your hands on a woman I'm not going to be in your corner.


Sent from my iPhone using SDN mobile app
Click to expand...
What if something like this happened -- would he be wrong to push her away or "shove" her?
 
chicagochildpsych said:
You laid your hands on your spouse, spin it anyway you like but that's domestic violence. Get yourself some professional help, and until that's solved I think a break from medicine isn't a bad idea. From an administration prospective you broke the law and got off VERY easy, but that kind of instability is a liability. Call me old fashioned but if you lay your hands on a woman I'm not going to be in your corner.


Sent from my iPhone using SDN mobile app
Click to expand...
Uh she laid hands on him too... that is domestic violence as well...
 
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bannie22 said:
This sounds ridiculous that she hit you first and you retaliated but you are the only one getting fired???

Can someone please tell me I am not reading this wrong?

Just what is wrong with this world?
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Right? It's a reasonable question to ask in the age of the Modern Woman but courts/legal system/laws/general institutional governance has not kept up with the "muh independence" and "muh equality"

I guess Orwell was right though.

animalfarm1.jpg
 
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Light at end of tunnel said:
You may be 100 percent correct, but rarely does the right thing = the legal thing. If it were as easy as doing the right thing, there would be no need for departments like HR.
Click to expand...
Did you actually read what post that post was replying to? That thread of discussion is not about the law or what the school will do. It's about what's right in a more ideal sense.
 
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hamstergang said:
Did you actually read what post that post was replying to? That thread of discussion is not about the law or what the school will do. It's about what's right in a more ideal sense.
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Yes!! To be honest it seems more and more I won't get another spot. Likely be going back to motherland :(
 
chicagochildpsych said:
I have had an ex hit me, I've had a patient try to assault me. But I value my medical career and freedom, so I walked away.


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Click to expand...

I respect that and I want to be like you.
 
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chicagochildpsych said:
I have had an ex hit me, I've had a patient try to assault me. But I value my medical career and freedom, so I walked away.


Sent from my iPhone using SDN mobile app
Click to expand...
Of course, any sensible person would agree with this statement. If you don't want to mess up your career or worse, then restraint is highly advised! That's obvious.

However, that's not exactly the same as what you originally said, which was a bit harsher. What you originally said only blamed OP, not his wife, even though she was to blame as well, and even though the cops on the scene believed that both were at fault too. In other words, why wouldn't your words ("But I value my medical career and freedom, so I walked away") apply to OP's wife too, not just OP? Maybe she could have walked away too, but she didn't, so isn't she at fault too? I just think it's unfair to blame one side without blaming the other too.

(Note I'm not referring to what is/isn't legal and ethical. Rather I'm referring to what ought/ought not to be legal and ethical.)
 
Apollyon said:
Dude - seriously. SDN is NOT the answer. EVER. You need a lawyer. ASAP, or sooner.

Remember, one measure of the value of advice is how much it costs.
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You know, I think this forum makes this call prematurely 99% of the time. A lawyer is almost never the answer.

Except now. Now it is the answer. You need to get legal on board here. There is no other option. Period. Full stop. The law is f--ked up, particularly in regards to gender biases, but none of us are going to fix that. You need to get yourself to some kind of salvagable situation here. I doubt reinstatement is in the cards, but the best you can probably ask for is for everything to be sealed and you to be able to apply to a different program without the details of *why* you left your program coming out. "I got fired because I got in a fist fight with my wife" kills your career vs "I left the program b/c I was in it with my wife, whom I was in the process of divorcing, and we couldn't continue to work together" gives you a possible out.
 
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?????
 
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rambo91 said:
Got a lawyer involved, doesn't like would do much though since most of the lawyers and not super familiar with TITILE IX and its implication on residency. Just FYI this is one of the better lawyers in the whole state. Comes highly recommended.
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I don't think Title IX is the biggest issue you need your lawyer to address. I think at this point, disputing the actual accusation and getting your job back is pretty much impossible. Mind you, I'm *not* a lawyer, so I could easily be wrong.

In my opinion, the issues you need your lawyer to address is

A) Did you resign or were you fired? Your original post says resign. This would be good. You want this to be perfectly clear.

B) What exactly is your program going to write about why you resigned (or were fired)? If it's something generic, great. If they plan on explaining the situation and mentioning Title IX (etc), that's a problem. What you'd want in that situation is the lawyer to discuss, in legalese, that the best way for this to go quietly without further drama would be if the program seals the details and the PD writes you a neutral reference. If you truly were a resident in good standing before this, that should be doable. The comments about the "permanent file" are irrelevant. There does exist a permanent file of all your evals and whatnot, but the only things that matter to you are the summative evaluation your PD puts in the front of that file and the letter of recommendation your PD writes you for a new program. You want the details of this to not go into either of those documents.

What you get out of that happening is a reasonable chance to find a new program. I don't know what field you're in, but you can probably start looking for PGY2 spots once you've gotten your neutral letter (yes, you'll probably lose a year applying and probably have to repeat your PGY2 residency year. It sucks).
 
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chicagochildpsych said:
I have had an ex hit me, I've had a patient try to assault me. But I value my medical career and freedom, so I walked away.


Sent from my iPhone using SDN mobile app
Click to expand...

R u a guy or girl?
 
Yea turns out nothing can be done now. Heard ex- wife is applying for an appeal and still continues to work. No LOR either, they wont even take my call. lawyer says he doesn't know what else to do since they pretty much hold all the power. Basically done with medicine. Guess this was a fun ride while it lasted. NOW, any suggestions what I can do with an international MD degree?
 
rambo91 said:
Yea turns out nothing can be done now. Heard ex- wife is applying for an appeal and still continues to work. No LOR either, they wont even take my call. lawyer says he doesn't know what else to do since they pretty much hold all the power. Basically done with medicine. Guess this was a fun ride while it lasted. NOW, any suggestions what I can do with an international MD degree?
Click to expand...

That is heartbreaking. I'm sorry, OP.
 
rambo91 said:
Yea turns out nothing can be done now. Heard ex- wife is applying for an appeal and still continues to work. No LOR either, they wont even take my call. lawyer says he doesn't know what else to do since they pretty much hold all the power. Basically done with medicine. Guess this was a fun ride while it lasted. NOW, any suggestions what I can do with an international MD degree?
Click to expand...
So you've completed one year of residency? Many states will give you a license after one year right? Work in an icc?
 
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