to resign or be fired

[studentdad]

Hello I am in such a mess I started a residency in july and have now been asked to resign as They say I am not progressing at the same speed as the other residents, which I must say are all AMGs. I am from AUC. I was put on remediation for 6 weeks which I felt was never fair. They had thier minds made up from the beginning.there were nver any concrete guidelines for me to improve. I would ask and they woul give vague examples of what needed to improve.They throughout kept going back to when i has first started and my speed on the computer system which there are 2 different ones .
My question is should I resign or let them fire me. I have 2 children and a wife and if I resign I will not get any unemployment and my loans will come due. I can put them in deferment if I get fired. Also I read that if I resign the program gets to keep the 140,000 they got for me and if they fire me they have to give it back is this true. They are trying to blackmail me by saying if I resign they will then see how they can help me and if they have to fire me It could be worse. The Director is more likely to giv me a good review if another program calls about me if I resign, not so if they have to fire me. I am so lost and don't know who to talk with to get advice or counsel. Any help Thanks

 

[medstudent87]

Hello I am in such a mess I started a residency in july and have now been asked to resign as They say I am not progressing at the same speed as the other residents, which I must say are all AMGs. I am from AUC. I was put on remediation for 6 weeks which I felt was never fair. They had thier minds made up from the beginning.there were nver any concrete guidelines for me to improve. I would ask and they woul give vague examples of what needed to improve.They throughout kept going back to when i has first started and my speed on the computer system which there are 2 different ones .
My question is should I resign or let them fire me. I have 2 children and a wife and if I resign I will not get any unemployment and my loans will come due. I can put them in deferment if I get fired. Also I read that if I resign the program gets to keep the 140,000 they got for me and if they fire me they have to give it back is this true. They are trying to blackmail me by saying if I resign they will then see how they can help me and if they have to fire me It could be worse. The Director is more likely to giv me a good review if another program calls about me if I resign, not so if they have to fire me. I am so lost and don't know who to talk with to get advice or counsel. Any help Thanks

Hello I am in such a mess I started a residency in july and have now been asked to resign as They say I am not progressing at the same speed as the other residents, which I must say are all AMGs. I am from AUC. I was put on remediation for 6 weeks which I felt was never fair. They had thier minds made up from the beginning.there were nver any concrete guidelines for me to improve. I would ask and they woul give vague examples of what needed to improve.They throughout kept going back to when i has first started and my speed on the computer system which there are 2 different ones .
My question is should I resign or let them fire me. I have 2 children and a wife and if I resign I will not get any unemployment and my loans will come due. I can put them in deferment if I get fired. Also I read that if I resign the program gets to keep the 140,000 they got for me and if they fire me they have to give it back is this true. They are trying to blackmail me by saying if I resign they will then see how they can help me and if they have to fire me It could be worse. The Director is more likely to giv me a good review if another program calls about me if I resign, not so if they have to fire me. I am so lost and don't know who to talk with to get advice or counsel. Any help Thanks

I ain't no expert but I'd assume that resign always look slightly better than getting fired. I just wanted to say that I'm really sorry this is happening to you 🙁

 

[JackADeli]

...started a residency in july and have now been asked to resign as They say I am not progressing at the same speed as the other residents...I am from AUC. I was put on remediation for 6 weeks...

My question is should I resign or let them fire me. I have 2 children and a wife and if I resign I will not get any unemployment and my loans will come due. I can put them in deferment if I get fired. Also I read that if I resign the program gets to keep the 140,000 they got for me and if they fire me they have to give it back is this true. They are trying to blackmail me by saying if I resign they will then see how they can help me and if they have to fire me It could be worse. The Director is more likely to giv me a good review if another program calls about me if I resign, not so if they have to fire me. I am so lost and don't know who to talk with to get advice or counsel. Any help Thanks...

First, I wish you the best. Times are hard and I am sure this is not easy.

Now to the question. IMHO, your best bet is to continue to work to the best of your ability until they formally terminate you. The resignation option really has no benefits for you and plenty of downside.

1. You have a family to think about and the real issue of unemployment benefits. Resigning is giving away money.... that you will need.
2. Given your description, it is going to be hard if not impossible for you to get into another program. Resigning from your current program is not going to get you a ~good letter from your PD. He/she will be asked to explain your performance and resignation. I don't know a program in the country that will view your "resignation" as anything less then "he was about to be fired so he resigned".

As to the program keeping money or not, that is irrelavent to the over all issue. I understand you are probably hurt, frightened, angry, and etc... You are crying out for help. But, at this point, much of what you put into your post about fairness or "blackmail" or large sums of money to your program do not matter. That stuff may be of interest to an attorney and jury if going to court (which, IMHO, I don't think will help you). But is useless to your current situation. What sounds like will be of greatest value is unemployment benefits and student loan deferments.

Finally, just to finish the above thought, if your program is so unfair and corrupt to seek resignation for a $140k financial benefit.... why in the world would you resign, give them the money, sacrifice unemployment rights/benefits, and go into student loan repayment?

that's my 0.05

 

[NotAProgDirector]

Resigning and being fired are very similar in this situation. As mentioned above, any letter from your current program is going to say that they either fired you, or that you resigned prior to being fired. Neither is really any better than the other. Some PD's feel that resigning is better, but honestly it seems to me that then they don't have to feel as bad about it. Also, some PD's equate "fired" residents who have contested the action, and that can certainly lead to bad feelings. You could simply tell your PD that you'd rather be fired for financial reasons.

It's not clear that you can collect unemployment, if you're fired for cause (which "unsatisfactory clinical performance" clearly is). Same with your loan forebearance -- if you're let go because a hospital closes you can collect unemployment, but if you're fired for a reason, not always.

I understand your frustration with the evaluation process. There are no good objective measurements of clinical performance. It can be very hard to catch up when you fall behind, as everyone else continues to make progress -- you don't just need to make progress, you need to make progress at a faster rate than everyone else and get caught up.

The financial issue is not true. Programs bill medicare for resident funds every month. Once they fire you (or you resign) they will stop collecting funds for you. They have already collected funds for the first 6 months of your residency, but that's reasonable since they paid your salary etc. Whether you're fired or resign, the fincancial situation is the same -- at least, that;s the way I think it works.

Your major focus now has to be on how to best get a new spot. It will not be easy, as an IMG who has failed out of one program, other programs may not be willing to take a chance on you. You'll need to decide whether you want to try to get a spot in the same field (arguing that your first program was a "bad match" and that a different program and a fresh start will make your performance better), or try switching to a new field (arguing that a new field will play to your strengths, and allow you to succeed).

Staying in your old program's good graces could help quite a bit. You should review whether getting fired would trigger unemployment benefits, and whether your loans will be put on pause. As above, it's not so straightforward. If not, then probably better to do what your program asks, and hope that they really help you get another spot. There is absolutely no guarantee you will get another spot, which would leave you in a tough spot indeed, as educational loans are not dischargable in bankruptcy (usually).

 

[NinerNiner999]

Ask yourself if you still want to practice medicine again, ever, in your life, in the United States. If the answer is yes, look for another program and try to salvage your career. If the answer is no, resign and look elsewhere for employment without looking back. Really, this is the only question you have to answer. The financial question has no bearing on you. Unemployment is a short-term benefit. You will always have your children - with or without income. Do what you think is right for your career. Only you have that answer.

 

[turquoiseblue]

sometimes resigning they give you credit, whereas with termination, they may not give you credit. credit won't matter in your case because it is not even enough to get licensed. i resigned and got credit and it didn't help me to get another position again. resignation and termination are both looked down on in terms of getting a residency position again.

the one thing you may want to consider is whether termination will affect your ability to be licensed. resignation usually won't do anything to your ability to get licensed as i have found out in my own situation. im not sure, but you may raise more red flags if you were terminated, whereas with resignation you could say it was for family reasons, etc. of course they may not buy it. good luck on making a decision.

 

[shopsteward]

The first thing to do is to look at the contract you signed when you entered residency. What does it say about remediation and termination? Has the program gone through all the proper steps it needs to, or has it missed something it should have done? It will be very difficult to challenge their opinion on your work, but it may be possible to challenge them on process. If the program has not gone through all the proper contractual steps prior to termination, it may be possible to stop them terminating you.

The next thing to do is to find someone to help you in person. Is there a residency adviser for your program? If so, you need to speak to them urgently to see what they can do for you. You need someone who can give you advice about your contractual position with the residency and about how to approach the people running the residency, and possibly even speak on your behalf. (The people in the residency hierarchy and the human resources dept won't necessarily be in a position to help you, or even want to help you. They will have information though, so if there is specific information you need, you could ask them for that.)

Finally, there is the question of whether there is still time for you to do anything about the way the program views your performance. You need to forget about whether or not their view of you is fair. (It is quite possibly your perception that that they are not being fair which has prevented you from being able to demonstrate that they are not being fair - this is the paradox which stops a lot of people from sorting things out before they get to the stage where there is no way back.) As to what might be done for you to stay in your current program, a further period of remediation seems unlikely, but not necessarily impossible if you can show the program that it would work. The other possibility might be starting the year again.

You will only be able to sort something out with your current program if they want to give you another chance, so you would need to present yourself as a person they want to help. Being a person the program wants to help means -

a) you are a person they like, or feel sympathy for, and would want to assist,
b) you are a person they think would make a good doctor when training is complete (ie the problems they think you have are termporary and resolveable),
c) you present them with a plan which has the most benefit and least downside for the program, and the most certainty of a successful outcome.

I can't emphasize too much how much you need to show that you understand and accept why these problems have arisen, that you understand how you need to change, and that you have started putting the steps in place to do it. Even if your existing program doesn't keep you on in some way, you would need to show these things to any other program that might take you.

I don't think things are necessarily hopeless for you. You did succeed in getting taken on by your program in the first place, which means they thought then that you had the qualifications and abilities needed. You need to get either your existing program, or a new program, to accept that you still have those qualifications and abilities and that the current problems can be explained and dealt with. Good luck.

 

[PharmaTope]

I ain't no expert but I'd assume that resign always look slightly better than getting fired. I just wanted to say that I'm really sorry this is happening to you 🙁

honestly, next time you are in the hospital and the floor is wet, a nice slip and fall workman's comp will delay any termination 🙂.

if you have a disability where an accomodation wasn't made they cannot terminate you without violating your rights.

what blows my mind is there are programs with horrible residents taht wont fire them. then there are programs with residents that really are not bad and will terminate them. baffles me.


but seriously, i would get a lawyer and i would examine to see if the program failed to follow proper procedure for all steps in terminating you to the T. if they failed to do so, you can make an argument of unjust termination and targetting. this could give you grounds to sue the hospital and program director directly for lost wages, emotional distress, etc.

trust me, EVERY doctor out there LOVES a lawsuit. your program director won't want the extra nightmare especially if you get a great lawyer that will go wild. if you sue him PERSONALLY not just the hospital, he will have to retain counsel. keep that in mind, it is more headaches. you can easily have the problem solved in that manner.

What you need to do, is if you can get documentation of your peers to show that your work is up to par with theirs. if they have SPECIFIC examples where you are deficient makes sure you obtain copies of the PROOF, not their typed up eval. you want the actual proof so you know what is being brought against you. without knowing the specifics of what they are saying your problems are, it is hard to say where it lays.

If the termination is found to be unfounded, guess what, the hospital would be HAPPY to settle on the case and sign paperwork saying you were NOT deficient.

LAWYER UP!!! There are so many lawyers out there now starving for a lawsuit in this economy. give them the work to do BUT have them work on a percentage basis vs paying a retainer and up front.

you could also make a deal with the program. give them an extra year of work later on for free by working with you. there a lot fo ways around this. people terminate when you are GROSSLY BAD, i mean SCARY SCARY SCARY DANGEROUS. Then there are programs that terminate bc they just don't like you. that is how it goes in all jobs and places. some are malignant like that.

if you are in a malignant place, just lawyer up.

while i am not advocating violence, you would be amazed how people's "hold over you" changes when they see you don't care and are willing to lay a smack down on them.

 

[PharmaTope]

Resigning and being fired are very similar in this situation. As mentioned above, any letter from your current program is going to say that they either fired you, or that you resigned prior to being fired. Neither is really any better than the other. Some PD's feel that resigning is better, but honestly it seems to me that then they don't have to feel as bad about it. Also, some PD's equate "fired" residents who have contested the action, and that can certainly lead to bad feelings. You could simply tell your PD that you'd rather be fired for financial reasons.

It's not clear that you can collect unemployment, if you're fired for cause (which "unsatisfactory clinical performance" clearly is). Same with your loan forebearance -- if you're let go because a hospital closes you can collect unemployment, but if you're fired for a reason, not always.

I understand your frustration with the evaluation process. There are no good objective measurements of clinical performance. It can be very hard to catch up when you fall behind, as everyone else continues to make progress -- you don't just need to make progress, you need to make progress at a faster rate than everyone else and get caught up.

The financial issue is not true. Programs bill medicare for resident funds every month. Once they fire you (or you resign) they will stop collecting funds for you. They have already collected funds for the first 6 months of your residency, but that's reasonable since they paid your salary etc. Whether you're fired or resign, the fincancial situation is the same -- at least, that;s the way I think it works.

Your major focus now has to be on how to best get a new spot. It will not be easy, as an IMG who has failed out of one program, other programs may not be willing to take a chance on you. You'll need to decide whether you want to try to get a spot in the same field (arguing that your first program was a "bad match" and that a different program and a fresh start will make your performance better), or try switching to a new field (arguing that a new field will play to your strengths, and allow you to succeed).

Staying in your old program's good graces could help quite a bit. You should review whether getting fired would trigger unemployment benefits, and whether your loans will be put on pause. As above, it's not so straightforward. If not, then probably better to do what your program asks, and hope that they really help you get another spot. There is absolutely no guarantee you will get another spot, which would leave you in a tough spot indeed, as educational loans are not dischargable in bankruptcy (usually).

depends on the laws for unemployment in his state. you can be fired and still collect unemployment in a number of states. they would have to show GROSS negligence on your job by you and breaking major rules of the hospital.

i doubt that you just failed to show up for work, so you could get unemployment. call the local office and speak with someone at length.

 

[dragonfly99]

I don't know the answer to the question about unemployment benefits.

I think if you ever want to practice medicine again in the U.S., it is probably better to resign. If you make the program fire you, the program director and dept. chair will be mad and they are guaranteed to say and write bad things about you in the future. This would likely make it very hard for you to get a new residency, and may make it difficult or impossible to get a license later, even if you do finish another residency. Basically, the program has most of the power in this situation. I would like one of these people who is advising the OP to just get a lawyer to provide an example of a resident who has done this (an IMG with only few months of internship) and successfully got either a lot of money or got back into the program. If you are a fired Johns Hopkins upper level surgical resident, former AOA and from a prestigious US med school, you might come out ahead by getting a lawyer, but I don't see how the OP will. It's a bitter pill to swallow, but I think that starting anew, perhaps next year, at another program is the best bet. It sucks royally for the OP, though.

I guess my idea is try to make nice with your current program director. I know you hate his guts right now, but the reality is he has about 99% of the power in this situation, and the OP has 1% or less. My other idea is if he's at some sort of residency that has a university, research labs, etc. that are associated with it, maybe he can see whether the program is willing to help him get a job in someone's lab or something, and in the mean time do some hospital volunteer work or shadowing. Then he can say that he got more clinical experience when he goes looking for another spot next year.

This is going to be really hard. I think this post is kind of another warning to people going down to the Caribbean schools. Make sure the school is going to prepare you to work clinically as a doctor, not just past the Step 1/2 because there is more to it than that. Also, if you can only match into a crappy program(s) from the school maybe it would be better not to go to med school down there. Don't know if that was the case with the OP, but I know the rate of matching into crappier residencies that don't treat their residents very well has got to be higher at these schools.

 

[Grace34]

I'm not sure which program would want to take on the resident that sued the pants off their last PD...

 

[snowbank]

As you can see, lots of different opinions, and the answer is clearly not easy. I agree with most things posted here, so much so that its hard to keep track - as I was reading, I'd day spot on! or yes! to so many posts....and wanted to mention them, but lost track in the end. I've been in your shoes bud, and its tough, and I'm still searching....

The biggest thing that Id want to say is that others are correct about malignant process and malignant places vs places that are more understanding and give residents a chance. Many have negligent residents that are allowed to finish, and others have mediocre or slightly less than average residents who are let go. Also 2nd biggest thing - only you in your heart know your performance and training level - and whether you are competent and comparable to your peers in the program, or if you are deficient. THink hard, and dont go easy on yourself.

I'm type A, and always pushing himself. I went through what you went through. Initally my opinion was I'm below the others, but now looking back at the other residents (and faculty I must say) who were let go from my former program - I'm not so sure. Look whether these things are mentioned in your contract and what the process is for them. Probation? Contesting the decisions? Appeals process? YOu can go to your local GME and ask them to investigate, or to the ACGME if you think you're comparable and not grossly deficient. That's what I'd have done for myself if I knew then, looking back as I believe in my heart they were unfair (cleared remediation, and afterwards was asked to resign!)

I was also told the resign vs. fired bit by my PD, and asked to resign as it'll be better for me and we'll do whatever we can do find you another position and this happens all the time and the best 'if you resigned for personal and family reasons - thats what the record will show - and no more' . Well, it DOESNT happen all the time, and they have NOT helped me find a position, more so have actually hurt my chances when PDs called to ask. Have tried the personal/family line, have also tried the not a good fit for me line, want to go to another program.
Result - zero calls in my original specialty, and a few calls in different specialties, lets see what happens. DO consult a lawyer. There are several other users here who have posted their stories here, search for them. One deferred like you said, and was successful for a time, but then ultimately resigned. There was a case of 1 girl I think in 08 or 09 (do google search) who sued her FM program in virginia somewhere- shannon valley or similar I think was the program , and the court threw out some of her arguments and agreed with others. Never found out the ultimate answer....
DO figure out if your rotation schedule was different from the other interns. For example, I was the only one with 2 back to back floor rotations in July and August, the first 2 months. No other intern had back to back floors for the whole year!
If it were me again, I'd say in the end stick it out with the program, show them you want to change, ask for evidence of your deficiencies, ask for written evals and progress, let them put you on probation if they want (DONT be scared of that word like I was) - and then you can 'transfer' to another program after you finish the year. That's what some do (I know personally someone from my program who did that).

Hope this helps...I know this is a lot, and may have been disjointed....but good luck to you...

Now for some humor - had no clue my century post would be with a bang and would bring back memories...

 

[MJB]

How often does this sort of thing happen, and what exactly do you have to do (or not do?) to be considered too bad to work with?

I've got to believe if a program fires/forces resignations it doesn't exactly speak well for that residency program.

 

[snowbank]

Additional Points to be Considered

Disclaimer: these are entirely my own (to the best of my knowledge!) thoughts, considerations and ruminations and are simply food for thought. I dont know the legal language/validity, so I'd welcome other opinions on these, esp. from aPD.

- Every program has an 'attrition rate' --- how many residents 'leave' (for whatever reason) every year. My program had at least 1/year for the last 3 years since the leadership changed. Some, who matched, weren't even allowed to start for whatever reason. I dont know if that goes against the 'binding contract' by NRMP and is a match violation, but other posts here suggested that you at least have to join or start, be it even for a day, in the program you match, but I digress....

I dont know where an applicant would find these stats, or even if they're published somewhere (aPD?) but would behoove each applicant to know. Plus, they aren't exactly advertised during the interview day! I guess the only way you can find out is by speaking to other residents....

That may (or may not) give you 1 indication of malignancy (there are many others, there's a thread by that name on SDN) --- but then again, genuine life events happen, and people move....but consider how many, and how often, and if there's a pattern from year to year....

- There is a similar rate for faculty leaving (dont know what its called). When I was interviewing, the PD listed on the website and on the invite letter was no longer there, and a replacement interviewed us. Should've been a red flag (leaving in the midst of interview season?) but hey - things happen - people move - family stuff or whatever - and I thought no more of it. Only after I started did I realize that other faculty also 'left'....

- Big red flag for me: time frame of events. I was put on remediation in the 2nd week of residency (July), others after the end of month 1. aPD - comments? Shouldn't residents be given some time to 'settle in' and learn systems-based practice and practice-based learning (ACGME competencies)? I can say with utter confidence here that there were no untoward events/hard events (below)/patient endangerment etc. I know many SDNers will post a reply mentioning that 'something MUST have gone wrong' - and the point here is not to argue, or discuss my case, but to help the OP. For his sake, and that of intelligent conversation, let's 'assume' nothing happened....

- 'Soft' vs. 'hard' events (again, this is my own term, and way of thinking, dont know how valid it is). I define hard events as provable, verifiable, non-discussable events of gross negligence/misconduct/harming pateints/endangering lives/etc. Anyone who reviews the records should be able to document and see this. Can give countless examples, but I think the SDN readers are knowledgable enough to know what I mean.

Soft events are unprovable, things that 2 people may make different opinions/judgements about, often verbal, and non-documented, and nothing that directly harms patients or the hospital. Perhaps may even be personality related. Examples -- asking too many questions vs. not asking questions, smiling a lot vs. being too serious and stone faced, having an 'attitude', having a 'blank look' etc.

Whatever events the OP is facing --- which category do they fall into?

- Whether the lawyer you consult is 'familiar' or 'has heard of' certain faculty, or the program before hearing your story. Most will tell you this straight off (ours did).

- Paper trail. Why I have not researched this issue in detail, in speaking with other attendings I have realized that for termination/being fired/let go/resign (whatever the case) the program has to have documented the deficiencies/discrepancies/misdoings/negligence/malpractice/unprofessional behavior/lack of performance etc of the resident.
There is hierarachy of sorts that has to be followed (and your program's contract may mention this) - starting with verbal warning - to written warning - to remediation - and with a clear list of goals/competencies/follow up items/weaknesses/areas of achievement - with a specific time frame (written before the start of remediation) - by which progress is going to be measured. Then probation. Each program may be slightly different though.

Without the basic minimum of remediation and probation, a resident cannot be let go. ACGME has a rule relating to this I think.
Is this correct aPD?
If at least these 2 have not occurred - then the resident may raise an issue with GME, ACGME or the legal system. Is this correct aPD?

In my case, I was asked to resign, on soft factors, after remediation (which I unanimously cleared), and before probation (I was given the probation will be very bad for your future career and license, we like you, we're telling you for your own good to resign and NOT go on probation) --- which now, in retrospect, I think scared me into resignation.

Has the paper trail been established in the OP's case?

I think considering these factors, and of course your own self evaluation as suggested in my last post, will help you decide how much ground you're standing on. Then, decide what action you'd like to take per the posts here and elsewhere. You need to figure out for yourself whether you have certain deficiencies (and all of us do to some extent - no-one's perfect) OR whether there is an element of bias @ being an IMG or otherwise, and whether the program truly is malignant.

Good luck to all currently in (or who were) in this situation. It's not the first, nor will it be the last of such events. Best to all....

 

[NotAProgDirector]

- Every program has an 'attrition rate' --- how many residents 'leave' (for whatever reason) every year. My program had at least 1/year for the last 3 years since the leadership changed. Some, who matched, weren't even allowed to start for whatever reason. I dont know if that goes against the 'binding contract' by NRMP and is a match violation, but other posts here suggested that you at least have to join or start, be it even for a day, in the program you match, but I digress....

The NRMP match is binding on all parties. The only case where students would not start in their matched residency is if they failed to meet the criteria for being hired by the hospital. If they failed to graduate from medical school, for example. Of if they fail a pre-employment drug test.

I dont know where an applicant would find these stats, or even if they're published somewhere (aPD?) but would behoove each applicant to know. Plus, they aren't exactly advertised during the interview day! I guess the only way you can find out is by speaking to other residents....

They are not published. The only way to know is to ask the program / residents. Some attrition is "normal" -- resident's lives change and some need to change programs, some change their specialty willingly, etc. I do agree that you're likely to get a more honest response from poor performing programs from the residents rather than from administration.

- Big red flag for me: time frame of events. I was put on remediation in the 2nd week of residency (July), others after the end of month 1. aPD - comments? Shouldn't residents be given some time to 'settle in' and learn systems-based practice and practice-based learning (ACGME competencies)?

There isn't a clear right or wrong answer. One can argue that it's best not to intervene in the first 6-8 weeks as some interns who start out "behind the pack" catch up without additional support. Then again, if someone fails out at month 3-4 and you didn't do anything at week 2, that's not the best either. Also our interns directly supervise medical students -- if an intern is struggling then the students can have a poor experience, and that may sometimes force me to intervene.

Without the basic minimum of remediation and probation, a resident cannot be let go. ACGME has a rule relating to this I think.
Is this correct aPD?
If at least these 2 have not occurred - then the resident may raise an issue with GME, ACGME or the legal system. Is this correct aPD?

Programs are held to a standard of academic due process. The basics are that residents are given notice of their deficiencies, and a chance to remediate. Note that the law does not require programs to actually help in that remediation, but simply tell residents what needs to be fixed. There is no legal definition of a timeframe.

As you point out, programs are held to whatever their written policies are. This usually requires some sort of stepwise process, and usually some sort of appeals process.

You are incorrect that the ACGME get's mixed up in this. The ACGME reviews and accredits programs in general. It does not get involved with individual resident complaints. It does have an anonymous reporting system for resident abuses (mainly duty hours issues), but that's not going to help an individual resident.

 

[studentdad]

Thank you all so much for your well-thought out answers to my" get fired or resign post". I have moved toward making the decision to resign, thinking it may make it easier to get a position in the future.

Now, I am asking for Scramble. I am going to ask my program director and program coordinator for assistance in the scramble. They may do this, we shall see. The PD seemed willing to help me find another position, at least to some degree.

Please, any help in the Scramble process, that may make me successful would be appreciated. I plan on only applying for Family Medicine, but I would take anything for a year. Thanks

 

[NotAProgDirector]

There's a stickied "Scramble" thread at the top of the NRMP forum you should review.

"I would take anything for a year" is a dangerous statement. A poor program in any field could be a nightmare, and all would consume your funding making it more difficult to find yet another program in the future.

 

[medpsych1]

Thank you all so much for your well-thought out answers to my" get fired or resign post". I have moved toward making the decision to resign, thinking it may make it easier to get a position in the future.

Now, I am asking for Scramble. I am going to ask my program director and program coordinator for assistance in the scramble. They may do this, we shall see. The PD seemed willing to help me find another position, at least to some degree.

Please, any help in the Scramble process, that may make me successful would be appreciated. I plan on only applying for Family Medicine, but I would take anything for a year. Thanks

Basically it seems to me your program is saying:
If you resign we will help you get a position.
If you do not resign then we will not help you get a position.
This is extortion plain and simple.
Extortion is a criminal activity and your PD is therefore acting like a criminal IMO.
Criminals generally cannot be trusted.
I think you should go through whatever appeals process they have and refuse to resign. The idea that resigning is better than getting fired is laughable in this circumstance IMO.
If they fire you then I think you should file for unemployment, mass email other programs to find open spots, maybe go through the scramble, and do what is best for you and your family.
If you want to play the same game you can tell them you will only resign after they have helped you get a spot elsewhere.
P.S. If you are a member of a racial minority, female, over the age of 40, of foreign origin, or member of any other protected class then I would consider mentioning the possibility of filing an EEOC complaint against the program. http://www.eeoc.gov/employees/charge.cfm
The program director will not be happy at the thought of an EEOC investigation.

In addition as the program director seems willing to extort you I wonder how he/she would feel if you told him that if they do not help you get another position you will out the program on SDN. I am sure they will love the idea of getting publicity over how they are trying to terminate a resident with two children in the middle of the holiday season.

Maybe aprogdirector can weigh in again on this.

 

[JackADeli]

Basically it seems to me...
your PD is ...IMO.
...generally cannot be trusted.
...I think you should...

I appreciate you would like to help and all; other then the "cannot be trusted", I do not see you providing great advice. If you are a pre-med, I am hesitant to even consider you have much of an idea what you are talking about.

The reality I have seen is most pre-meds are idealistic and still to close to their parents and buddies talking about fairness. Through med-school, a percentage start to mature and get a better understanding, though not all. Hopefully, by the end of residency, most will have had enough servings of life to get a clue that life isn't fair.

Is it wonderful that any employer offers option a. resign or b. get fired? Probably not. Is it a crime for ANY employer to make these offers and make one ~better then the other? Probably not. This scenario by the OP is not unique to medicine. It can be, "we will write you a letter of recommendation if you leave quietly" or "we will continue your benefits for three months and give you two weeks pay if you leave quietly". It doesn't matter, that is the cold harsh reality of life.

...I think you should ...do what is best for you and your family...

Probably the only real advice that has been echoed by many in here. But, the rest of your advice may very well be just the oposite.

 

[medpsych1]

I appreciate you would like to help and all; other then the "cannot be trusted", I do not see you providing great advice. If you are a pre-med, I am hesitant to even consider you have much of an idea what you are talking about.

The reality I have seen is most pre-meds are idealistic and still to close to their parents and buddies talking about fairness. Through med-school, a percentage start to mature and get a better understanding, though not all. Hopefully, by the end of residency, most will have had enough servings of life to get a clue that life isn't fair.

Is it wonderful that any employer offers option a. resign or b. get fired? Probably not. Is it a crime for ANY employer to make these offers and make one ~better then the other? Probably not. This scenario by the OP is not unique to medicine. It can be, "we will write you a letter of recommendation if you leave quietly" or "we will continue your benefits for three months and give you two weeks pay if you leave quietly". It doesn't matter, that is the cold harsh reality of life.Probably the only real advice that has been echoed by many in here. But, the rest of your advice may very well be just the oposite.

Many opinions in your post here.
Can you answer two questions:
1. Is the offer the PD is making not equivalent to extortion?
2. Do you consider extortion to be acceptable conduct?

P.S. Your equating of age and maturity is faulty. Everyone is different. There are many young immature drunk fools who grow up to be old immature drunk fools. Age does not automatically confer wisdom.

 

[JackADeli]

Many opinions in your post here.
Can you answer two questions:
1. Is the offer the PD is making not equivalent to extortion?
2. Do you consider extortion to be acceptable conduct?

I wasn't there for the conversation nor were you. I have seen numerous occasions on which the representation by the resident was not exactly as it occurred.

I could ask you similar questions, i.e. will answering your questions in any way at all assist the OP? This thread is not about your moral high point or picking a fight. Again, as a pre-med, I don't know what your knowledge or understanding is. However, if you think picking a fight or declining the PD's choices and then attempting to scramble is feasible.... you clearly lack a real understanding.

Based on what was described by the OP, he/she is DONE where they are now. The questions are can any additional future in an alternate program be salvaged and what is best for the individual and their family? Not necessarily in that order. Additional training opportunity will prove to be difficult. Best for the family? Only the OP can answer that question. To my knowledge, resignation will definately preclude unemployment benefits.

...P.S. Your equating of age and maturity is faulty. Everyone is different. ...Age does not automatically confer wisdom.

Pretty sure I did not equate "age" as you say.....

 

[Taurus]

I would wait for them to drag my cold ass out the hospital doors before I would voluntarily resign. I support consulting a lawyer -- secretly without your program knowing. You need to know your rights and make sure that the program followed all procedures. If you can find any areas where they screwed up big time, you got yourself a real case.

You have to understand that you're in an extremely poor predicament. Even if you play nice with them and do everything they say like resign, there's a very good chance that you will never get another US residency again. Being an FMG and being let go of a program is as big of a red flag as it gets. If you're an optimist, it may be 2 more years at the earliest before you can restart your residency.

So if this was me, I would proceed with this case assuming that my medical career is over. This is your last stand. This is your LAST chance. Don't throw it down the toilet. You essentially give up your fight by resigning. It's like how companies make you sign a contract agreeing not to badmouth or sue the company to get a severance package during layoffs. Know your rights and make sure that your program followed all procedures. If you find that they did in fact screw up, give the program an ultimatum: help me transfer out of here successfully or see me in court. As always, be professional and courteous in your dealings with your program, but don't be a fool.

 

[medpsych1]

I wasn't there for the conversation nor were you. I have seen numerous occasions on which the representation by the resident was not exactly as it occurred.

I could ask you similar questions, i.e. will answering your questions in any way at all assist the OP? This thread is not about your moral high point or picking a fight. Again, as a pre-med, I don't know what your knowledge or understanding is. However, if you think picking a fight or declining the PD's choices and then attempting to scramble is feasible.... you clearly lack a real understanding.

Based on what was described by the OP, he/she is DONE where they are now. The questions are can any additional future in an alternate program be salvaged and what is best for the individual and their family? Not necessarily in that order. Additional training opportunity will prove to be difficult. Best for the family? Only the OP can answer that question. To my knowledge, resignation will definately preclude unemployment benefits.
Pretty sure I did not equate "age" as you say.....

Pathetic attempt IMO at answering my two questions. Let us assume the OP is not lying. Will you answer the two questions or are you preparing for a career in politics?

I would wait for them to drag my cold ass out the hospital doors before I would voluntarily resign. I support consulting a lawyer -- secretly without your program knowing. You need to know your rights and make sure that the program followed all procedures. If you can find any areas where they screwed up big time, you got yourself a real case.

You have to understand that you're in an extremely poor predicament. Even if you play nice with them and do everything they say like resign, there's a very good chance that you will never get another US residency again. Being an FMG and being let go of a program is as big of a red flag as it gets. If you're an optimist, it may be 2 more years at the earliest before you can restart your residency.

So if this was me, I would proceed with this case assuming that my medical career is over. This is your last stand. This is your LAST chance. Don't throw it down the toilet. You essentially give up your fight by resigning. It's like how companies make you sign a contract agreeing not to badmouth or sue the company to get a severance package during layoffs. Know your rights and make sure that your program followed all procedures. If you find that they did in fact screw up, give the program an ultimatum: help me transfer out of here successfully or see me in court. As always, be professional and courteous in your dealings with your program, but don't be a fool.

👍👍👍👍👍

 

[JackADeli]

Pathetic attempt IMO at answering my two questions. Let us assume the OP is not lying. Will you answer the two questions or are you preparing for a career in politics?

No. This thread is not about satisfying your need for some sort of morality debate. My feelings are irrelevant. The issue at hand is what is best for the OP and his/her family. Is unemployment best? Is the pursuit of further rsidency training? I am not going to get into a side debate on your hypothetical presumption of what the conversation was or if it was moral/ethical/legal/etc..... Absolutely no interest in it.

And, you can keep score and decide I have failed to answer your two questions... they don't matter. But, your insistance does indirectly support my perception of pre-meds/undergrads. Thank you for not dissapointing.😀

 

[medpsych1]

No. This thread is not about satisfying your need for some sort of morality debate. My feelings are irrelevant. The issue at hand is what is best for the OP and his/her family. Is unemployment best? Is the pursuit of further rsidency training? I am not going to get into a side debate on your hypothetical presumption of what the conversation was or if it was moral/ethical/legal/etc..... Absolutely no interest in it.

And, you can keep score and decide I have failed to answer your two questions... they don't matter. But, your insistance does indirectly support my perception of pre-meds/undergrads. Thank you for not dissapointing.😀

Do you precept or advise any pre-meds/undergrads?
If so are you up front to them about your preconceptions and biases or are you a closet stereotyper?

 

[JackADeli]

Do you precept or advise any pre-meds/undergrads?
If so are you up front to them about your preconceptions and biases or are you a closest stereotyper?

Good luck to you.

 

[NotAProgDirector]

Basically it seems to me your program is saying:
If you resign we will help you get a position.
If you do not resign then we will not help you get a position.
This is extortion plain and simple.
Extortion is a criminal activity and your PD is therefore acting like a criminal IMO.

I honestly don't see this as extortion. And, it happens in many different fields. Your boss has no responsibility to help you get a new job if you resign / are fired. He/she does have a responsibility to be honest about the details regarding your performance when asked. Dealing with an appeals process is time and energy consuming -- so offering a resident to spend that time on helping them get a new spot instead does make some sense. Also, as mentioned, programs could offer continuing benefits or other "sweeteners" to resigning rather than being fired.

It's only extortion if the thing you threaten someone with would not otherwise happen.

Criminals generally cannot be trusted.

I agree with this.

I think you should go through whatever appeals process they have and refuse to resign. The idea that resigning is better than getting fired is laughable in this circumstance IMO.

There is only a point to appealing if you think that 1) your termination was somehow unfair, and 2) you would want to continue training there.

If they fire you then I think you should file for unemployment, mass email other programs to find open spots, maybe go through the scramble, and do what is best for you and your family.

It might be best for yourself and family to resign, as that might lead to another position. Or it may not. Unemployment has been discussed in prior threads, and would be state specific (and depend on why you were fired).

If you want to play the same game you can tell them you will only resign after they have helped you get a spot elsewhere.

You could try this plan, but it could easily backfire and they could just fire you.

P.S. If you are a member of a racial minority, female, over the age of 40, of foreign origin, or member of any other protected class then I would consider mentioning the possibility of filing an EEOC complaint against the program. http://www.eeoc.gov/employees/charge.cfm
The program director will not be happy at the thought of an EEOC investigation.

You only have an EEOC complaint if your termination was because of one of these issues. You'd need to prove that you were fired because you were a woman, or a minority. Otherwise, you're only creating more problems for yourself. Most PD's would fight a bogus complaint.

In addition as the program director seems willing to extort you I wonder how he/she would feel if you told him that if they do not help you get another position you will out the program on SDN. I am sure they will love the idea of getting publicity over how they are trying to terminate a resident with two children in the middle of the holiday season.

It's a free country, and you can certainly do this. Needless to say, there's no anonymity here. If the PD hears about it, there is no question they would know it was you. When you're looking for a new program, that might affect their opinion of you.

 

[snowbank]

This is turning to be a WONDERFUL source of discussion and ideas. I've read some other threads on similar topics here, now and in the previous years, but I think this thread takes the cake for the sheer # of opinions posted....

To the OP - I would definitely consider medpsych's analysis. To jackadeli - I have been in a similar situation earlier this year. I appreciate your helping and posting, but only after having been through such a situation can you say if hindsight was 20/20....I woulda done xyz, which is what I am trying to do here in writing and advising. I'm not even commenting/opinion-ating at his advice or plan of action --and will leave that to the OP to figure out ---- all I'm saying is that that his predictions turns out to be correct, at least as they related to my subsequent experience after resigning.

I, too naively, 'trusted' the program/PD in their comments at helping me find a position if I resigned and doing everything in their power to help and giving me an explanation letter. As detailed above, turns out when I did resign, they refused to give me the said letter (when I requested it the next day!). Moreover, the PD specifically FORBADE me from even asking for LoRs from other faculty. Complete 180 turnaround! Then, and only then, did I realize that it was perhaps best that I left that program (realiziing why so many residents and even faculty had left too). I had no idea about EEOC then, but I fit into those protected categories. Didn't know a fraction of what I know now, didnt even know my rights, but your prediction, based on similar statements, turned out to be 100% true in my case, and I urge the OP to consider this becoming reality in his own situation.

Wish that, I knew then, what I know now...when I was younger (as a popular song goes)

 

[Taurus]

I, too naively, 'trusted' the program/PD in their comments at helping me find a position if I resigned and doing everything in their power to help and giving me an explanation letter. As detailed above, turns out when I did resign, they refused to give me the said letter (when I requested it the next day!). Moreover, the PD specifically FORBADE me from even asking for LoRs from other faculty. Complete 180 turnaround!

Here's a valuable 'rule of thumb' for now and the rest of your life.

Never, ever trust anyone in a position of authority when you find yourself in trouble. They will act like they are concerned about you and your future. WRONG! They are only worried about not looking bad themselves and trying to push this 'problem' out the door as fast as possible. They don't genuinely care about you. If you stay or go, does it matter to them? Not really. It's just less headache for them if you go.

The only people you can trust during this period are 1) your family (don't even trust your friends) 2) your own lawyer who is fighting for you.

I've seen how this process works from those who find themselves in similar position as you. I can't say how much it completely disgusts me how the system works. This is one of the ugliest little secrets of medicine (that and how abusive the training is) and one reason why I regret going into medicine. We end the medical careers of promising physicians while we let freaking NP's with just two years of training to work unsupervised? How jacked up is that?

Here's another very valuable tidbit. If you decide to stay and fight, they will recommend that you go see a psychologist. DON'T FALL FOR THE TRAP. The psychologist is working for them and helping to build a case against you.

Before you do anything else, go see a lawyer. Most lawyers work on a contingency basis so it won't cost you anything unless you win a settlement at which time they will take like a 35% cut. It's worth it if it keeps a medical career for you.

 

[michaelrack]

Go ahead and see a lawyer, but the truth is that you have few rights. If you went nuclear and threatened a lawsuit etc, you may be able to get up to a year's salary (probably less than that). But no judge is going to give you credit for successful completion of a rotation/residency year. A lawyer can protect your right temporarily to the pitiful salary of a resident, but he can't get you credit for the year or advance you to the next PG year.

 

[JackADeli]

Go ahead and see a lawyer, but the truth is that you have few rights. If you went nuclear and threatened a lawsuit etc, you may be able to get up to a year's salary (probably less than that). But no judge is going to give you credit for successful completion of a rotation/residency year. A lawyer can protect your right temporarily to the pitiful salary of a resident, but he can't get you credit for the year or advance you to the next PG year.

IMHO, I must agree.

To add, those that have stated that you can not trust the PD are correct. However, you likely do not need to trust the PD. Because you trusting or not does not make a difference. You have two choices,

1. get fired, and iff elegible, take unemployment and accept 100% assuridity you will probably not get additional residency training. Further be assured by filing a suit that will not get you more training, limited funds, take a long time (or until your attorney chooses to quit spinning the clock), etc.... Attorney taking this case will require retainer and may possibly want more then contingency. An attorney going purely on contingency probably does not understand the reality, likely not so good, but honest. Attorney that goes by some billing and clock turning, possibly good but at least not naive, though probably dishonest.
2. resign, accept 100% assuridity you will be ineligible for unemployment, know you may or may not get help from your PD but still possibly leave the door for additional training just a sliver open.

Neither choice is good. One choice assures end to your medical career and one leaves at the very least a fantasy of possible future. Keep in mind DrSerrano was Stanford grad, ~prodigy, on television, highly published, NIH grant/s, elected by the residents to the GME council and still JH fired him. I am not sure the OP has any juice of that caliber to hold up to this.

 

[nitemagi]

Go ahead and see a lawyer, but the truth is that you have few rights. If you went nuclear and threatened a lawsuit etc, you may be able to get up to a year's salary (probably less than that). But no judge is going to give you credit for successful completion of a rotation/residency year. A lawyer can protect your right temporarily to the pitiful salary of a resident, but he can't get you credit for the year or advance you to the next PG year.

Agreed, unless you have a case for a wrongful termination and could get yourself reinstated.

 

[LADoc00]

I can concur with some thoughts above: see a lawyer and file suit.

If you are a competent physician intern (and if you have doubts about that than you probably arent...sorry), then refuse to be railroaded. Ask for every possible mediation/arbitration.

At the end of the day any employee not accused of an outright crime can fight their way to a standstill with ANY employer (who isnt engaging in mass layoffs for financial reasons). You can make life sooo difficult for the faculty in charge, trust me they will relent.

Ive been on the receiving end of this of employees doing this to me, so Im 100% certain it works...

 

[Negrodamus]

This thread scares the crap out of me.

If you're fired/resign is it possible to get a residency or practice in another country like Canada, Australia or Brittion?

I don't understand how anyone could be that malicious. Without IBR firing someone from residency would doom them to several decades of poverty. Is this a common occurrence?

 

[Winged Scapula]

This thread scares the crap out of me.

If you're fired/resign is it possible to get a residency or practice in another country like Canada, Australia or Brittion?

Possible but difficult. The US medical degree is somewhat transferable, but its not like you can just show up to these countries and expect to work. Most give preference to their own citizens and those who have trained in their country. Australia for example, triages specialty placement positions based on citizenship and where you trained. Non-citizens trained outside the country are at the bottom of the list...you can still get a spot but generally the less desirable places and specialties.

I don't understand how anyone could be that malicious. Without IBR firing someone from residency would doom them to several decades of poverty. Is this a common occurrence?

Poverty? That's a bit hyperbolic. You are still intelligent, with a college degree and presumably physically fit enough to take a job. While I agree that it would be horrible to be terminated from residency and to have student loans to pay off, you are not unemployable.

 

[JackADeli]

This thread scares the crap out of me.

If you're fired/resign...

I don't understand how anyone could be that malicious. ...firing someone from residency would doom them to several decades of poverty. Is this a common occurrence?

So, yes, some people are formally terminated from residency. I have found this to be a rare exception. There is plenty of transferring and/or changing specialties/residency. IMHO, more people should be fired and/or encouraged to transfer to a different field far sooner then actually occurs. I have watched too many programs attempt to "remediate" residents for far too long.

Not everyone is cut out to be a physician or to practice a specific specialty. I have watched as marginal individuals have been promoted through medical school, because it was their dream and nobody wanted to be "malicious" and shatter that dream. Then, individuals get into certain specialty residencies, flounder, and are still continually warned and promoted because, because it was their dream and nobody wanted to be "malicious" and shatter that dream....

There is no reason to be doomed "to several decades of poverty". Medical school students should not be anticipating getting fired. They should be anticipating a fundamental need to be adults, take ownership, and assume responsibility. It is time to stop fantasy level dreaming. You need to seriously analyze yourself and set realistic goals. If your realistic goals do not match to the requirements for a career in medicine, you need to recognize that early. If your realistic goals do not match with the requirements of a particular specialty residency, you need to look for a different specialty. That is life. It is not, in general, malicious to terminate a resident that fails to perform. It is malicious and irresponsible to improperly continue to promote someone.... Your debt level and/or fantasy dreams of a career are not my consideration in terminating someone not qualified and/or repeatedly failing to meet standard. There is no place for "social promotion" in any field, but especialy in medicine.

...Poverty? That's a bit hyperbolic. You are still ...with a college degree and presumably physically fit enough to take a job. While I agree that it would be horrible to be terminated from residency and to have student loans to pay off, you are not unemployable.

👍

PS: Yes, there are exceptions in which rotten programs terminate on ~political/improper grounds. That is not, IMHO the majority of circumstances.

 

[QofQuimica]

OP, I'm going to argue against the majority here, and say that you should just walk away. Resign ASAP, forget about getting a lawyer/otherwise trying to retaliate against the program/PD, and move on with your life. I say this for several reasons. First, if you were targeted for failure as you say, then these people clearly want to get rid of you. Why would you want to continue subjecting yourself to a toxic work environment full of hostile people who are out to get you? That can't be good for your psychological well-being. Second, even if you did fight The Man by refusing to quit or even bringing a lawsuit, it would be a Pyrrhic victory. If you lose the lawsuit, you obviously lose. But even if you win the lawsuit, you still lose. Lawsuits drag on for years. That's a lot of time, money, and soul to give up just so you can "prove a point." Third, you are a young parent with a family. They need you to be there for them, not to immerse yourself in a protracted battle that isn't even winnable. Finally, the best revenge isn't obtained by duking it out with an implacable enemy who has all the power. The best revenge is when you succeed without them.

It's not immediately clear where you should go from here, but wherever you go will almost certainly be a heck of a lot better than where you're at now! My advice would be to try a multi-pronged approach. Apply for other specialties/programs, and if the PD keeps his promise to help you, swallow your pride and accept the help. But also look for alternative avenues. Someone already mentioned research as a possibility. But there are many others, depending on your talents and interests. If you hadn't gone to medical school, what would you have done instead? Now is a good time to look into those options at the same time that you look into changing programs.

Hope this helps, and best of luck to you. 🙂

 

[satakay]

Sorry for yet another victim of malicious residency programs. These people are bastards they wont give a 2nd thought destroying your life. They are like barbaric animals, their personal egos are all what to kill a another person..You kill a person by destroying his whole career.
And they are all connected especially if it is a small town. the Judge will not even considering taking ur case..
in Majority of case if not all they are immuned.
so as one of the poster said..act like Vendita or then just walk away..there is nothign for you..this is a grim reality..

 

[chocomorsel]

It is easy for people on here to tell you to just "walk away" because they have no idea what it's like for you. Getting another residency is difficult and sometimes impossible. Because where ever you go, the new potential employers will always want to chat with the PD and get a letter to find out what these people thought of you. It sucks but that's how medicine works.

I say if you still have a job fight until security drags you out. Swallow your pride, change your personality and ask for constant feed back. It ain't pretty but residency is unlike the real world and some of these people think nothing about ruining someone's life and livelihood. They will tell you all kinds of stuff in order to earn your trust and believe that they are truly trying to help you. In reality, if they think you suck and want you out for whatever reason, then they will dig, and spy and attempt to find any kind of dirt on you in order to kick you out. I say don't leave voluntarily. Let the security guards drag your ass out fighting and screaming.

In the mean time, change what you can, read more, be more "professional" and just take it day by day. It will pass eventually and either things will get better or they wont. But at least, you can say you gave it a good try and fought. Don't give up man, don't walk out. If you still have a position, keep it as long as you can.

 

[QofQuimica]

It is easy for people on here to tell you to just "walk away" because they have no idea what it's like for you. Getting another residency is difficult and sometimes impossible. Because where ever you go, the new potential employers will always want to chat with the PD and get a letter to find out what these people thought of you. It sucks but that's how medicine works.

I say if you still have a job fight until security drags you out. Swallow your pride, change your personality and ask for constant feed back. It ain't pretty but residency is unlike the real world and some of these people think nothing about ruining someone's life and livelihood. They will tell you all kinds of stuff in order to earn your trust and believe that they are truly trying to help you. In reality, if they think you suck and want you out for whatever reason, then they will dig, and spy and attempt to find any kind of dirt on you in order to kick you out. I say don't leave voluntarily. Let the security guards drag your ass out fighting and screaming.

In the mean time, change what you can, read more, be more "professional" and just take it day by day. It will pass eventually and either things will get better or they wont. But at least, you can say you gave it a good try and fought. Don't give up man, don't walk out. If you still have a position, keep it as long as you can.

One could just as easily argue that it's easy for you to tell the OP to stay and fight, when you're not the one who is going to have your rear end handed to you on a daily basis over the next several weeks, months, or years. The mental stress of working in an openly hostile environment like that should not be underestimated.

I think we all agree that the situation the OP is in is lamentable, even if he really is progressing more slowly than the other residents. Discounting the people who just want the OP to try to get revenge on the program, the disagreement we're seeing in this thread seems to stem from how optimistic each of us is that he can turn the situation around. To my mind, if the OP has already been put on remediation, and if the PD is already telling him that his choice is to either resign or be fired, it doesn't sound like there's much room for compromise where he can hope to better his position within the program. Based on what he's told us, it appears that the OP *is* going to be leaving the program, either voluntarily by resigning, or involuntarily by being fired. And if they've already made up their minds to give him the boot, there isn't much point in trying to get back into the program's good graces.

Although the repercussions are particularly severe for a resident who gets forced out, this is not just something that happens in medicine. Before going back to graduate school, I spent some time managing an office. When my bosses wanted to get rid of an employee whom we perceived to be a problem, we didn't just fire them without cause, because then they could collect unemployment at our expense. Instead, we scrutinized their every move for any verifiable slip-up, and we documented *everything*, including getting other employees to write signed statements if applicable. Over a period of a few weeks to months, we built up a file to show that the problem employee was repeatedly violating the rules, willfully not taking direction, and so on. Sometimes the employee would get fed up with all of the reprimands and quit on their own. Sometimes we'd build up a big enough file and then fire them for cause. If they tried to apply for unemployment after being fired for cause, we'd fight it, and while I was working there at least, no employee whom we fired *ever* got awarded unemployment.

My bosses were not malignant people, and I think they would have given someone another chance if they saw the person making a real effort to change. But sometimes you reach a point where your mind is made up that this employee is more trouble than they're worth and needs to go by hook or crook. At that point, it's just a question of when and how they'll be departing, not whether. I believe the OP is already there based on what he's said, and if so, there's no benefit to sticking around longer while they continue to build up their file on him before inevitably getting rid of him anyway.

Hope this makes my position clearer.

 

[JackADeli]

Sorry for yet another victim of malicious residency programs. These people are bastards they wont give a 2nd thought destroying your life. They are like barbaric animals, their personal egos are all what to kill a another person..You kill a person by destroying his whole career...

I am all for support and being positive. But, there are at least two sides to every story and none of us are in any position to believe the OP is just an innocent victim or the program is some evil and malicious organization taking sick pleasure in destroying the future of medical school grads.

...they have no idea what it's like for you...

True, I think many of us have said as much.

...I say if you still have a job fight until security drags you out. ...It will pass eventually and either things will get better or they wont. ...If you still have a position, keep it as long as you can.

Individuals continue to comment as if the "fight" will some how prolong the situation and/or enable continued training. The fight may be prolonged but there is little to say the program will be forced to allow continued training during any attempt at fighting.

...Neither choice is good. ...Keep in mind DrSerrano was Stanford grad, ~prodigy, on television, highly published, NIH grant/s, elected by the residents to the GME council and still JH fired him. I am not sure the OP has any juice of that caliber to hold up to this.

 

[satakay]

I am all for support and being positive. But, there are at least two sides to every story and none of us are in any position to believe the OP is just an innocent victim or the program is some evil and malicious organization taking sick pleasure in destroying the future of medical school grads.True, I think many of us have said as much.Individuals continue to comment as if the "fight" will some how prolong the situation and/or enable continued training. The fight may be prolonged but there is little to say the program will be forced to allow continued training during any attempt at fighting.

I am the Victim of the same situation. No one deserve to be fired from Residency. Its like you killed somebody,s whole career and hence the life, because a physician very rarely will be able to do another job.

I wish him a good luck and my sincere prayers for him, it is just a horrible Nightmare for the whole family, nothing else..

These residency programs are very inhuman. if somebody just dont like you for whatever reason. then believe me you are dead. Just dead..

 

[oldfatman]

I am the Victim of the same situation. No one deserve to be fired from Residency. Its like you killed somebody,s whole career and hence the life, because a physician very rarely will be able to do another job.

I wish him a good luck and my sincere prayers for him, it is just a horrible Nightmare for the whole family, nothing else..

These residency programs are very inhuman. if somebody just dont like you for whatever reason. then believe me you are dead. Just dead..

You're not dead until you're dead. There's a lot of things you can do with your life besides be a doctor. Bottom line, I think you need to get out of this situtation as soon as possible.

 

[JackADeli]

I am the Victim of the same situation. No one deserve to be fired from Residency. Its like you killed somebody,s whole career and hence the life, because a physician very rarely will be able to do another job...

I agree there are some circumstances in which people suffer injustice and are improperly terminated. I do not know the specific circumstances of the OP or you. I do not know your specific circumstances either.

However, yes, there are circumstances in which students should be and are expelled from college, medical students should be and are expelled from medical school, and residents should be and are fired. The fact that termination can and often does mark the end to a medical career is not justification to perpetuate someone in the field of medicine. There are individuals that may not be suited for a career in medicine or are incompetent.

Often the real crime was allowing/enabling individuals to get that far down the road when they should have been terminated or redirected to another career sooner. The fact that one dreams of being a great physician does not mean it will happen or they are capable of achieving it. The fact that you have debt or some other sad story does not mean you should be continually promoted forward despite continued failure to demonstrate competency (which equates safety in medical practice). Being a physician and/or practicing medicine is not a right or entitlement. It is something that is earned through rigorous training. There is no place for social promotion.

As an attending physician or PD, you have a serious responsibility. It goes far beyond the individual resident/s. Not only do you need to consider the patients and families you and your residents are taking care of during the residency program. But, you need to be confident that those you are promoting and ultimately graduate are competent and safe. If you promote and/or graduate a resident that poses a threat to the safety & lives of future patients, it doesn't matter what a resident spent on their education.

...I wish him a good luck and my sincere prayers for him, it is just a horrible Nightmare for the whole family, nothing else...

With that, I think I and others agree, we wish nothing but the best.

I am all for support and being positive. But, there are at least two sides to every story and none of us are in any position to believe the OP is just an innocent victim or the program is some evil and malicious organization taking sick pleasure in destroying the future of medical school grads...

 

[satakay]

We can argue as much as possible, and we can bring numerous exceptional cases too. But I find it extremly unfair and extremely difficult situation for a fired resident to have a different career.

You can say one can be fired from college or School, even in the ist yr of residency let me say which is again very unfair.

But if someone had internship, 2nd year and in the end you fire him or her , and telling ,,that you are not a good fit for medicine is not true and not fair by any circumstances, unless the patient care or negligence is involved and you expect a resident as superhuman. so in that case you may justify firing someone.
But terminating someone.. it is definetly with intension to kill his or her carreer..and these people do not care. Someone has to act to bring them to justice one way or another.
Dr. Wang did it the wrong way and may be the wrong person. But still had the courage to bring someone to justice.
All of us know very well, how easy it is in the Residency programs for superiors to bring someone down.

 

[JackADeli]

We can argue as much as possible, and we can bring numerous exceptional cases too. But I find it extremly unfair and extremely difficult situation for a fired resident to have a different career.

You can say one can be fired from college or School, even in the ist yr of residency let me say which is again very unfair...

And, I will again say, "fair" depends completely on the circumstances. A resident that fails to meet standards, fails to remediate, etc and is fired, that is real grown up world of accountability for one's actions.

...if someone had internship, 2nd year and in the end you fire him or her , and telling ,,that you are not a good fit for medicine is not true and not fair by any circumstances, unless the patient care or negligence is involved and you expect a resident as superhuman...

And, as I stated earlier, too many allow emotion to influence them. They give too many chances and opportunities. Often, the resident should have been terminated far sooner but people felt sorry for them and allowed promotion to go too far. But, if they didn't give too many chances, we would be having just the opposite argument, i.e. "they didn't give him/her enough chances". Then they are given 1, 2, 3 years of chances and the argument is "it's not fair to allow them to go that far and then fire them...". When it comes to incompetence, it isn't about fair and it isn't about the resident. It is about the patients and allowing someone to possibly make victims out of patients. That would be unfair.

If someone is failing to meet standards, failing to remediate, it is not the termination that kills their career. It is the individual's own incompetence. The termination just puts an end to the facade/fantasy/illusion.

But, as I have stated, this is generalization and not directed to the OP or anyone else as I have no personal knowledge on their specific situation/s.

 

[nitemagi]

I find it fascinating the idea that no other career is possible after leaving residency for a doctor. I routinely see extremely smart foreign medical grads, who finished residency, working in research labs here in the US as a job. They're quite employable. Given, their salary is substantially lower. And that's the big difference. The likelihood of a medical student or resident finding an equally paying job to a physician straight out of training if they didn't finish is low, which means debt drags for potentially a long time.

 

[michaelrack]

The fight may be prolonged but there is little to say the program will be forced to allow continued training during any attempt at fighting.

👍

Fighting may temporarily preserve your $12-15 per hr job, but it's not going to get you academic credit and will not move you any closer to your goal of becoming a licensed physician

 

[Taurus]

I said to consult a lawyer immediately, not filing a suit. There's a big difference. People need to know their rights and what the program can and cannot do. What's so radical about that concept? Don't let anyone run you over. If and only if you think you have a case with hard irrefutable evidence, then let the cat out of the bag and file a suit if necessary. However, the chances that you have a winning case is extremely miniscule. Don't think that simply hiring a lawyer or filing a lawsuit will scare your program into keeping you. Most likely the program has the data to support firing you or you can't prove that there was wrong-doing or the program didn't follow procedures. That's why it's very important that you keep it extremely secret from anyone except your family and those that need to know that you are consulting a lawyer. You will destroy any good will with the program if they find out that you're seeing a lawyer. People get very defensive when they find out they may be a target of a lawsuit. Simultaneously, you need to work hard to be in your program's good graces so that they either decide to retain you or at least support you finding another program. Most people who go into medicine have some sense of compassion and don't want to be responsible for ending another person's career.

Schools and programs are not invincible. Besides Oscar Serano case, here's a recent case of a former dental student who successfully sued the University of Michigan for wrongful dismissal.

In the tiny chance you do have a real case, a program can be held liable for your future earnings as a physician if they prematurely end your career. That's why the lawsuits are usually for $20 million. They obviously don't want to be held liable for that. It would be far less headache for them to help you to transfer out successfully.

 

[Taurus]

As an attending physician or PD, you have a serious responsibility. It goes far beyond the individual resident/s. Not only do you need to consider the patients and families you and your residents are taking care of during the residency program. But, you need to be confident that those you are promoting and ultimately graduate are competent and safe. If you promote and/or graduate a resident that poses a threat to the safety & lives of future patients, it doesn't matter what a resident spent on their education.With that, I think I and others agree, we wish nothing but the best.

That's the ideal but we all know that there are some very malignant and vindictive even deceptive personalities in medicine who can hardly care if they destroy other people's careers for their own personal reasons and nothing to do with your performance. You're kidding yourself if you think otherwise.

Here's someone's experience with such PD.

http://forums.studentdoctor.net/showpost.php?p=10433679&postcount=183