What's my options?

[SadNutellaGirl]

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I am not quite following your situation. You were in remediation but you failed the remediation? I would try to make your case and plead nicely for them to allow you to make up the 2 months somehow and say you are going nonclinical.

Yes that is correct. I was in 5 months remediation, but I failed two of the rotations. So I am trying to request to be given a chance to re-mediate the failed months due to underlying circumstances I was facing ( and I have previously given a letter of consideration saying I want to go non clinical). It seems like they can possibly allow me to do it, but I still have to finish my core months.....so either a) they allow me to re mediate the two inpatient months and I have to do my 1 remaining rotation at another hospital or b) I finish my 1rotation and do my remediation at another hospital c) get only 10 months of credit . Idk if option A or B is even possible

 

[Piebaldi]

Yes that is correct. I was in 5 months remediation, but I failed two of the rotations. So I am trying to request to be given a chance to re-mediate the failed months due to underlying circumstances I was facing ( and I have previously given a letter of consideration saying I want to go non clinical). It seems like they can possibly allow me to do it, but I still have to finish my core months.....so either a) they allow me to re mediate the two inpatient months and I have to do my 1 remaining rotation at another hospital or b) I finish my 1rotation and do my remediation at another hospital c) get only 10 months of credit . Idk if option A or B is even possible

I am not an expert on this but I don't think you can remediate at a different hospital nor do random rotations at a hospital as a resident. 5months of remediation> that seems like a lot? It's typically 2-3.

 

[Ironheme]

I know of a situation similar to OPs where a friend was getting dismissed after failing one rotation then failing remediation of that rotation. They managed to snag a position at another program and get credit for everything except those 2 months. I'm not too sure of the details - but I imagine the residency would be extended. Program director would have to chime in on this.

 

[rokshana]

I am not quite following your situation. You were in remediation but you failed the remediation? I would try to make your case and plead nicely for them to allow you to make up the 2 months somehow and say you are going nonclinical.

How? There are but so many months in a year...even if they allowed her to do 2 inpt months she still failed 2 months...the number of inpt months go up but she still will only have 10 months of passed rotations... if the program was going to exist after June, then yeah, she could stay an extra 2 months but that can’t happen...

 

[SadNutellaGirl]

I know of a situation similar to OPs where a friend was getting dismissed after failing one rotation then failing remediation of that rotation. They managed to snag a position at another program and get credit for everything except those 2 months. I'm not too sure of the details - but I imagine the residency would be extended. Program director would have to chime in on this.

So are you saying that your friend was able to successfully start PGY2 at another residency with those 10 months credits and just have to do two months of extra time? I was told that I need to apply as a PGY1 and maybe some would be transferred

 

[NotAProgDirector]

If you started in July 2018 and failed 2 months, there is no way to remediate it if your program is closing in June. Your program decided that those two months did not count for credit. Trading elective months for inpatient months won't actually get you caught up -- if you finish out the year at the end of June without failing anything else, you'll have 10 months of credit. Getting more inpatient time might help you with the next step of your career (perhaps), but it won't remediate your failed months. Since the program is closing, they can't extend you by 2 months to make up the gap.

You will need 2 more months of training time to finish your PGY-1. However, realistically no program is going to take you for just 2 months and then certify that you're trained. You're either going to need to find an FM program that is willing to accept you at the PGY-1 level for several months and then willing to promote you to PGY-2, or find some other PGY-1 level program that's willing to take you. I expect that most programs would insist upon at least 6 months so they can evaluate you. PGY-1 months are not like college credits where you just collect enough of them and you graduate -- your last program needs to certify a satisfactory level of performance, and they are going to want to see some period of time to do that.

A program could take you as a PGY-1 for two months and then promote you. Or they could have you repeat 6 months and promote you. or they could have you repeat the full 12 months. It's completely up to them.

 

[Piebaldi]

If you started in July 2018 and failed 2 months, there is no way to remediate it if your program is closing in June. Your program decided that those two months did not count for credit. Trading elective months for inpatient months won't actually get you caught up -- if you finish out the year at the end of June without failing anything else, you'll have 10 months of credit. Getting more inpatient time might help you with the next step of your career (perhaps), but it won't remediate your failed months. Since the program is closing, they can't extend you by 2 months to make up the gap.

You will need 2 more months of training time to finish your PGY-1. However, realistically no program is going to take you for just 2 months and then certify that you're trained. You're either going to need to find an FM program that is willing to accept you at the PGY-1 level for several months and then willing to promote you to PGY-2, or find some other PGY-1 level program that's willing to take you. I expect that most programs would insist upon at least 6 months so they can evaluate you. PGY-1 months are not like college credits where you just collect enough of them and you graduate -- your last program needs to certify a satisfactory level of performance, and they are going to want to see some period of time to do that.

A program could take you as a PGY-1 for two months and then promote you. Or they could have you repeat 6 months and promote you. or they could have you repeat the full 12 months. It's completely up to them.

I think OP wants to go into a nonclinical direction. Can't she do another PGY-1? I get the impression that unless she wants to start all over, she would have to repeat PGY-1. But you are the expert.

 

[gutonc]

I think OP wants to go into a nonclinical direction. Can't she do another PGY-1? I get the impression that unless she wants to start all over, she would have to repeat PGY-1. But you are the expert.

Repeating PGY-1 is starting all over again. And it's quite frankly the OP's only real option at this point.

 

[gutonc]

I think OP wants to go into a nonclinical direction. Can't she do another PGY-1? I get the impression that unless she wants to start all over, she would have to repeat PGY-1. But you are the expert.

Repeating PGY-1 is starting all over again. And it's quite frankly the OP's only real option at this point.

 

[Piebaldi]

Repeating PGY-1 is starting all over again. And it's quite frankly the OP's only real option at this point.

Yes, but the PGY-1 is a requirement not a choice.

 

[rokshana]

Yes, but the PGY-1 is a requirement not a choice.

What does this mean?
Frankly I think gut onc is being optimistic...finding another pgy 1 spot this late in the game is slim...OP needs to make a concerted effort to contact anyobw and everyone to find an unexpected opening and try to get support from her PD to help get her a spot somewhere
If psych is still an interest OP , you may want to consider a Psy.D program and work to becoming a clinical psychologist...would still give you the chance to work with pts and in some places you may even be able to prescribe.

 

[clausewitz2]

What does this mean?
Frankly I think gut onc is being optimistic...finding another pgy 1 spot this late in the game is slim...OP needs to make a concerted effort to contact anyobw and everyone to find an unexpected opening and try to get support from her PD to help get her a spot somewhere
If psych is still an interest OP , you may want to consider a Psy.D program and work to becoming a clinical psychologist...would still give you the chance to work with pts and in some places you may even be able to prescribe.

This is not a good back up plan.

Psy.D programs are either a) legitimate and fully-funded but brutally competitive, i.e. without significant psychology-related research don't hold your breath or b) not as hard to get in to but aren't funded and will add an extra mountain of debt with significantly lower future earnings.

Don't try to solve this problem with a fresh round of loans, whatever you do.

EDIT: Most clinical psychologists are PhDs, regardless. The skill sets for successfully pursuing a PhD and what are rewarded in most medical training are not very similar. I would not assume you would do very well in that environment just because you managed to make it through medical school.

 

[rokshana]

This is not a good back up plan.

Psy.D programs are either a) legitimate and fully-funded but brutally competitive, i.e. without significant psychology-related research don't hold your breath or b) not as hard to get in to but aren't funded and will add an extra mountain of debt with significantly lower future earnings.

Don't try to solve this problem with a fresh round of loans, whatever you do.

EDIT: Most clinical psychologists are PhDs, regardless. The skill sets for successfully pursuing a PhD and what are rewarded in most medical training are not very similar. I would not assume you would do very well in that environment just because you managed to make it through medical school.

While it may take longer, it is a possibility ...only the OP knows if she has a skill set to get through a PhD program...getting another residency spot will be an uphill climb.

 

[clausewitz2]

While it may take longer, it is a possibility ...only the OP knows if she has a skill set to get through a PhD program...getting another residency spot will be an uphill climb.

It is only a possibility in the sense that OP could also go to law school or become a plumber.

It is basically the same as walking away and just starting a whole different career path. Clinical psychology is especially bad as it will require 4+ years and very possibly taking on more debt to go through yet another match process at the end of it. It is not a realistic or advisable option.

 

[rokshana]

It is only a possibility in the sense that OP could also go to law school or become a plumber.

It is basically the same as walking away and just starting a whole different career path. Clinical psychology is especially bad as it will require 4+ years and very possibly taking on more debt to go through yet another match process at the end of it. It is not a realistic or advisable option.

The OP didn’t voice an interest in bro g a lawyer or plumber...
That is your opinion as whether it’s viable option bit it is certainly o e that someone one can advise...just because you disagree with it doesn’t make it wrong.

 

[clausewitz2]

The OP didn’t voice an interest in bro g a lawyer or plumber...
That is your opinion as whether it’s viable option bit it is certainly o e that someone one can advise...just because you disagree with it doesn’t make it wrong.

Sure, this is all a matter of opinion. Tell me this, though: if OP had expressed interest in emergency medicine, do you think it would be reasonable or unreasonable to say "well, you can just apply for a PGY-1 EM position next match"?

Would you have a problem with someone else saying "that's not a great idea"?

 

[rokshana]

Sure, this is all a matter of opinion. Tell me this, though: if OP had expressed interest in emergency medicine, do you think it would be reasonable or unreasonable to say "well, you can just apply for a PGY-1 EM position next match"?

Would you have a problem with someone else saying "that's not a great idea"?

No, I would have said there are no real options since EM is even more competitive than psych.

Frankly, I don’t think she has many options to be able to stay in medicine... but who knows...if she applies broadly and is able to get a supportive letter from her PD, she may get another pgy1 spot...if she is proactive, maybe she can scramble into something that will give her a year’s credit and she could then move on , but the unfortunate circumstance of her needing 2 more months and her program is closing makes it harder to get those credits...hopefully her PD will feel for her and help out.

 

[clausewitz2]

No, I would have said there are no real options since EM is even more competitive than psych.

It is probably fair to say that non-exploitative clinical psychology doctoral programs are as competitive or more competitive than matching in psych as a US MD, so lets leave it at that. This is why I suggested it is not a real option.

 

[Piebaldi]

What does this mean?
Frankly I think gut onc is being optimistic...finding another pgy 1 spot this late in the game is slim...OP needs to make a concerted effort to contact anyobw and everyone to find an unexpected opening and try to get support from her PD to help get her a spot somewhere
If psych is still an interest OP , you may want to consider a Psy.D program and work to becoming a clinical psychologist...would still give you the chance to work with pts and in some places you may even be able to prescribe.

What does it mean? It simply means that OP HAS to do a PGY-1 in order for her to even pursue preventive med which is less clinical than say FM or IM. Doing a PGY-1 is not a choice that she is making - she's aPGY1 year is clinical but OP has no choice to do it if she was to continue any type of residency. Pursuing a less clinical route like Preventive med vs FM/IM is a CHOICE. Pretty simply.

AndI agree with the poster below - advising OP to do a clinical psych program is not a good idea. Not only does the PsyD require far more schooling and debt, but they are also competitive programs. OP should find a PGY1 somewhere. She won't be the first or last person to be able to land one even if she is dismissed.

 

[SadNutellaGirl]

If you started in July 2018 and failed 2 months, there is no way to remediate it if your program is closing in June. Your program decided that those two months did not count for credit. Trading elective months for inpatient months won't actually get you caught up -- if you finish out the year at the end of June without failing anything else, you'll have 10 months of credit. Getting more inpatient time might help you with the next step of your career (perhaps), but it won't remediate your failed months. Since the program is closing, they can't extend you by 2 months to make up the gap.

You will need 2 more months of training time to finish your PGY-1. However, realistically no program is going to take you for just 2 months and then certify that you're trained. You're either going to need to find an FM program that is willing to accept you at the PGY-1 level for several months and then willing to promote you to PGY-2, or find some other PGY-1 level program that's willing to take you. I expect that most programs would insist upon at least 6 months so they can evaluate you. PGY-1 months are not like college credits where you just collect enough of them and you graduate -- your last program needs to certify a satisfactory level of performance, and they are going to want to see some period of time to do that.

A program could take you as a PGY-1 for two months and then promote you. Or they could have you repeat 6 months and promote you. or they could have you repeat the full 12 months. It's completely up to them.

Thank you

If you started in July 2018 and failed 2 months, there is no way to remediate it if your program is closing in June. Your program decided that those two months did not count for credit. Trading elective months for inpatient months won't actually get you caught up -- if you finish out the year at the end of June without failing anything else, you'll have 10 months of credit. Getting more inpatient time might help you with the next step of your career (perhaps), but it won't remediate your failed months. Since the program is closing, they can't extend you by 2 months to make up the gap.

You will need 2 more months of training time to finish your PGY-1. However, realistically no program is going to take you for just 2 months and then certify that you're trained. You're either going to need to find an FM program that is willing to accept you at the PGY-1 level for several months and then willing to promote you to PGY-2, or find some other PGY-1 level program that's willing to take you. I expect that most programs would insist upon at least 6 months so they can evaluate you. PGY-1 months are not like college credits where you just collect enough of them and you graduate -- your last program needs to certify a satisfactory level of performance, and they are going to want to see some period of time to do that.

A program could take you as a PGY-1 for two months and then promote you. Or they could have you repeat 6 months and promote you. or they could have you repeat the full 12 months. It's completely up to them.

Thank you for the clarification - you are right, realistically, I don't think I'll be able to find a program to take me for just 2 months. It make sense that they would want to evaluate me for a period of time before giving certification . I just wonder though - if this program didn't end and my year was counted - what would it be counted as? A prelim year? I didn't get to do several of the FM rotations like peds, surg,ob that most FM interns do....

 

[SadNutellaGirl]

What does this mean?
Frankly I think gut onc is being optimistic...finding another pgy 1 spot this late in the game is slim...OP needs to make a concerted effort to contact anyobw and everyone to find an unexpected opening and try to get support from her PD to help get her a spot somewhere
If psych is still an interest OP , you may want to consider a Psy.D program and work to becoming a clinical psychologist...would still give you the chance to work with pts and in some places you may even be able to prescribe.

Yeah like 3 months ago I considered it....it's not entirely crazy to do.....but maybe if I was like 7 years younger lol. Just don't think I have the energy to do 5 years of schooling with build up of tuition. The other option is Phd which are fully funded ,but very competitive to get into...but again , 5-7 years. I think in retrospect I should've done either of those rather than med school. But at that time, I never even considered psychiatry/ psychology. I actually wanted to FM or IM....funny now how I realize how much I don't want it now

And you are right, finding a pgy1 is very difficult now : /

 

[SadNutellaGirl]

What does it mean? It simply means that OP HAS to do a PGY-1 in order for her to even pursue preventive med which is less clinical than say FM or IM. Doing a PGY-1 is not a choice that she is making - she's aPGY1 year is clinical but OP has no choice to do it if she was to continue any type of residency. Pursuing a less clinical route like Preventive med vs FM/IM is a CHOICE. Pretty simply.

AndI agree with the poster below - advising OP to do a clinical psych program is not a good idea. Not only does the PsyD require far more schooling and debt, but they are also competitive programs. OP should find a PGY1 somewhere. She won't be the first or last person to be able to land one even if she is dismissed.

Yeah the situation kinda sucks - because I'm already without a residency after june.....and then there is the option to apply to an FM PGY1 for the following year and maybe they might transfer some of my credits and advance me to PGY2 if im lucky.....but then I'm locked into an FM program again. It would be nice if I could just finish up at a TRI - but I don't think it works that way

All I wanted was credit for this year so I could apply for preventive medicine

 

[ThoracicGuy]

Yeah like 3 months ago I considered it....it's not entirely crazy to do.....but maybe if I was like 7 years younger lol. Just don't think I have the energy to do 5 years of schooling with build up of tuition. The other option is Phd which are fully funded ,but very competitive to get into...but again , 5-7 years. I think in retrospect I should've done either of those rather than med school. But at that time, I never even considered psychiatry/ psychology. I actually wanted to FM or IM....funny now how I realize how much I don't want it now

And you are right, finding a pgy1 is very difficult now : /

You should be looking for any spots that might open up anywhere in the country pretty much every day. I would also talk to some faculty that you believe will give you a GOOD LOR to write something for you.

 

[rokshana]

Position Available - New Psychiatry Program Accreditation Announcement - Las Vegas, Nevada

Sunrise Health GME Consortium at Southern Hills Hospital in Las Vegas, Nevada has just been granted initial accreditation by ACGME for the Psychiatry Residency as of 4/26/19. We are now on an expedited track to welcome our first class of PGY-1s psychiatry residents to start July 1st, 2019...

forums.studentdoctor.net

 

[Raryn]

Yeah the situation kinda sucks - because I'm already without a residency after june.....and then there is the option to apply to an FM PGY1 for the following year and maybe they might transfer some of my credits and advance me to PGY2 if im lucky.....but then I'm locked into an FM program again. It would be nice if I could just finish up at a TRI - but I don't think it works that way

All I wanted was credit for this year so I could apply for preventive medicine

You can theoretically start *any* program as a PGY1 without credit. FM may (but probably wouldn't) give you enough credit to bump you up to PGY2 quickly. IM might (but probably wouldn't) give you up to 6 months of credit.

In addition, psychiatry programs can give you significant amount of credit - as much as they want - they are uniquely flexible with huge amounts of elective time, particularly in the fourth year. If you can find a psychiatry program desperate for a PGY2, they could promote you after 2 months if they wanted.

The most important factor in all this is honestly going to be finishing out this year as strongly as possible and getting a good letter from your soon-to-be-former PD. Then apply broadly both inside and outside the match and hope for the best.

You are not eligible for a license without your program signing off on a full year of training, so you have no other chance to stay within medicine.

 

[NotAProgDirector]

if this program didn't end and my year was counted - what would it be counted as? A prelim year? I didn't get to do several of the FM rotations like peds, surg,ob that most FM interns do....

Some boards will allow for an FM PGY-1 to count as the base year, some will not. In any case, it would count as a PGY-1 FM year.

All I wanted was credit for this year so I could apply for preventive medicine

Your best bet is to apply to PM programs. If you can find one interested in taking you, then maybe they could convince the IM (or FM) program there to take you for 2-3 months to finish your PGY-1.

 

[SadNutellaGirl]

Position Available - New Psychiatry Program Accreditation Announcement - Las Vegas, Nevada

Sunrise Health GME Consortium at Southern Hills Hospital in Las Vegas, Nevada has just been granted initial accreditation by ACGME for the Psychiatry Residency as of 4/26/19. We are now on an expedited track to welcome our first class of PGY-1s psychiatry residents to start July 1st, 2019...

forums.studentdoctor.net

Thank you! 🙂

 

[SadNutellaGirl]

You can theoretically start *any* program as a PGY1 without credit. FM may (but probably wouldn't) give you enough credit to bump you up to PGY2 quickly. IM might (but probably wouldn't) give you up to 6 months of credit.

In addition, psychiatry programs can give you significant amount of credit - as much as they want - they are uniquely flexible with huge amounts of elective time, particularly in the fourth year. If you can find a psychiatry program desperate for a PGY2, they could promote you after 2 months if they wanted.

The most important factor in all this is honestly going to be finishing out this year as strongly as possible and getting a good letter from your soon-to-be-former PD. Then apply broadly both inside and outside the match and hope for the best.

You are not eligible for a license without your program signing off on a full year of training, so you have no other chance to stay within medicine.

I was wondering about that - even if I don't get completion of the year certificate, could I still apply as PGY2 for psych and have my credits transferred over? Or are you saying that I have to apply as PGY1 psych and if they are desperate for PGY2 , they might promote me?

 

[SadNutellaGirl]

Some boards will allow for an FM PGY-1 to count as the base year, some will not. In any case, it would count as a PGY-1 FM year.



Your best bet is to apply to PM programs. If you can find one interested in taking you, then maybe they could convince the IM (or FM) program there to take you for 2-3 months to finish your PGY-1.

Oh you mean a FM and IM program at the same hospital ,right? Since a requirement for PM is to have a completed internship...I didn't think of that as an option, but I guess that is something to think about

 

[Raryn]

I was wondering about that - even if I don't get completion of the year certificate, could I still apply as PGY2 for psych and have my credits transferred over? Or are you saying that I have to apply as PGY1 psych and if they are desperate for PGY2 , they might promote me?

If you don't have credit for PGY1, I don't see how they could take you as a PGY2 flat out. You could apply for PGY2 Psych spots and then say you need 2 months before you "count" as a PGY1. You're in a unique enough situation there's no clear answer.

 

[NotAProgDirector]

I was wondering about that - even if I don't get completion of the year certificate, could I still apply as PGY2 for psych and have my credits transferred over? Or are you saying that I have to apply as PGY1 psych and if they are desperate for PGY2 , they might promote me?

How much credit you get is 100% dependent on your new program. For example, a psych internship is usually 6 months of psych and 6 months of IM. If your program feels your FM rotations "count", then you could get 6 months of credit and have 6 months of psych PGY-1 to finish. An IM program will give you zero credit for FM rotations unless your original program also had an IM program and the rotations you completed were identical to what an IM intern would do.

Oh you mean a FM and IM program at the same hospital ,right? Since a requirement for PM is to have a completed internship...I didn't think of that as an option, but I guess that is something to think about

I mean a PM and IM program at the same hospital.

 

[deleted480308]

I was wondering about that - even if I don't get completion of the year certificate, could I still apply as PGY2 for psych and have my credits transferred over? Or are you saying that I have to apply as PGY1 psych and if they are desperate for PGY2 , they might promote me?

You aren’t a pgy2 in july. You just aren’t. It would be best to largely forget that if you are thinking about other specialties

 

[SadNutellaGirl]

How much credit you get is 100% dependent on your new program. For example, a psych internship is usually 6 months of psych and 6 months of IM. If your program feels your FM rotations "count", then you could get 6 months of credit and have 6 months of psych PGY-1 to finish. An IM program will give you zero credit for FM rotations unless your original program also had an IM program and the rotations you completed were identical to what an IM intern would do.


I mean a PM and IM program at the same hospital.

Okay that make sense. What I don't understand is how credit is given for each rotation in the first place. Originally my PD told me that I'll be getting 10 months of credit. But today he told me he went through the evaluations again and he is unsure if it really be 10 months..... Is there no standardized numerical value that totaled up for each rotation ? Or is it - lets total how many negative subjective evaluations vs the positive subjective evaluations for each rotation? I'm just confused if he told me I failed two inpatient rotations....how suddenly there could be more failures....especially being told this a week after I already met him....

 

[NotAProgDirector]

It is completely, absolutely, and non-appealably up to your current and any future PD how much credit you are given. Your current PD will report to the ABFM how much credit you get. Any future PD could decide to give you less, theoretically (but unrealistically) could give you more.

 

[mvenus929]

Okay that make sense. What I don't understand is how credit is given for each rotation in the first place. Originally my PD told me that I'll be getting 10 months of credit. But today he told me he went through the evaluations again and he is unsure if it really be 10 months..... Is there no standardized numerical value that totaled up for each rotation ? Or is it - lets total how many negative subjective evaluations vs the positive subjective evaluations for each rotation? I'm just confused if he told me I failed two inpatient rotations....how suddenly there could be more failures....especially being told this a week after I already met him....

Your current PD goes through and decides how many rotations you “passed” and what they were (wards, elective in x, elective in y, etc).

Your new PD and possibly the board of the specialty you are in will decide how many of those rotations count towards board certification and thus getting through residency. Could be all the ones you passed, could be none.

 

[SadNutellaGirl]

I met my PD today and he said he went through the entire evaluations again. He said made a mistake and I actually failed the entire remediation - so 5 months total!! 😱 I was really surprised especially since last week's meeting he said it was only 2 rotations...and this after going through my file....T

If this would've been told me at the dismissal meeting ,It would've saved me the trouble of bothering asking for for even a remediation if I knew I failed half the year! My only options are 2 more 2 week elective rotations or just end the contract early if I want to go and focus on Comlex

He gave me a copy of my evals - this is the first time I'm seeing it....and it is....BAD....like really negative stuff . Is this going to follow me wherever I apply to residencies? I honestly don't know how it will ever be possible for me to get into a residency again with this. I was recommended by someone to appeal the decision of remediation which I think with psych evals I have enough to win it . Heck one faculty member is avoiding me since thinks im gonna sue - someone who thinks that def knows they did something wrong . But I don't see any point since residency is closing down soon anyway....

 

[deleted480308]

I met my PD today and he said he went through the entire evaluations again. He said made a mistake and I actually failed the entire remediation - so 5 months total!! 😱 I was really surprised especially since last week's meeting he said it was only 2 rotations...and this after going through my file....T

If this would've been told me at the dismissal meeting ,It would've saved me the trouble of bothering asking for for even a remediation if I knew I failed half the year! My only options are 2 more 2 week elective rotations or just end the contract early if I want to go and focus on Comlex

He gave me a copy of my evals - this is the first time I'm seeing it....and it is....BAD....like really negative stuff . Is this going to follow me wherever I apply to residencies? I honestly don't know how it will ever be possible for me to get into a residency again with this. I was recommended by someone to appeal the decision of remediation which I think with psych evals I have enough to win it . Heck one faculty member is avoiding me since thinks im gonna sue - someone who thinks that def knows they did something wrong . But I don't see any point since residency is closing down soon anyway....

Sometimes thinking someone is going to sue is because they seem emotionally irrational and disconnected with reality

You failed 5 rotations with extremely negative evals and few weeks ago you thought you had a full year of passing as likely.

This sucks hard. Even if you legitimately did that poorly, it sucks and I’m sorry

But your self-assessment skills and ability to read your interactions with staff are deeply flawed. I would caution against having a lawyer burn bridges and certainly hope you haven’t mentioned lawyers to your PD

 

[deleted171991]

I agree with this. I would try to SOAP or get one of the FM residencies in less desirable states. I think you CAN make a case that the 3 year gap was a big problem. I think most of us would atrophy 3 years away from medicine.

Not necessarily true. I had a big gap as an FMG and still performed well in a good IM internship. I used those years to go from somebody who was 200 (in today's scores) to 260 (by the time I took my USMLE) on every single step (and not because of test-taking "skills" - never took a similar exam before coming to the US - but sheer knowledge). I also had some fantastic physiology, pathology, and clinical diagnosis foundations from medical school, and I built my palace on those foundations. After just 2 months of American observerships (which actually led to that internship), I ran circles around many of my fresh grad FMG/IMG PGY-1 peers and was pretty close to my AMG colleagues.

Especially in IM-related fields, knowledge is king, IQ is king, logic is king, The best internists I know have "beautiful minds". Even without having read this thread in detail, I would bet my money that the OP's problem is knowledge-related and diagnostic (i.e. thinking) skills-related, and everything else stems from there. I can see it in my residents: above-average knowledge leads to confidence and all kinds of good stuff. Between an "empathetic" know-nothing and an Asperger's high scorer, I would take the latter 10 out of 10 times (of course, most patients choose the former, hence the great number of weak doctors who can still make a living).

Internship is not for learning medicine, it's for getting experience, for learning how to apply the theory. One can be out of medical school for years and it wouldn't matter (if constantly reading and re-reading the right stuff), especially with the current lack of emphasis on physical exam skills. (Why do some smart APRNs/PAs rise to the level of some physicians, if medicine cannot be learned from books?) No remediation will fix lack of knowledge, except for intensive study; for an intern, I would recommend mastering the best study materials people currently use for the USMLE steps, starting from Step 1. It's hard (I remember reading and re-reading and re-reading about 1200 pages of highly-digested review material before my Step 2, including like 600 pages of IM, and then the same material again and again while studying for Step 3, and again before my internship), but there is a reason not everybody can/should become a physician. To the day, as a double board-certified attending, I read 30-60 minutes of medicine every day, just to keep up (and I consider myself below average in knowledge when compared to my IM intensivist colleagues).

Sorry for the tough love, but generations Y and Z have a chronic insufficiency of it, stemming from their so-called "education", and it shows. Real life does not award participation trophies. It's a jungle out there...

P.S. Many people have medical/psych problems. Learn to cope with them, stop using them as excuses. If life gives you lemons, make lemonade. Also, everybody makes mistakes; that's how we learn. What matters is what one does with the mistake, how one turns it into a learning and personal improvement opportunity, and rises like a phoenix from its ashes. That could include recognizing that one doesn't have the right central processing unit and software for medicine, and switching to a profession with lighter intellectual requirements where one can actually shine and be happy. Walking away is very hard with the millstone of educational loans around one's neck, I'll give you that.

 

[NotAProgDirector]

It's very unfortunate, and unacceptable, that this is the first time you're seeing you're seeing your evaluations. The whole point of evaluations is to help you improve, how are you supposed to improve if you don't get feedback? If you were going to appeal your termination, this would be a very solid argument. But as you say, not clear that would be terribly effective since they are closing the program, there's nothing to appeal into.

As far as "what follows you", they should write up a summary of your training. Only that summary document would be shared in the future.

 

[SadNutellaGirl]

Sometimes thinking someone is going to sue is because they seem emotionally irrational and disconnected with reality

You failed 5 rotations with extremely negative evals and few weeks ago you thought you had a full year of passing as likely.

This sucks hard. Even if you legitimately did that poorly, it sucks and I’m sorry

But your self-assessment skills and ability to read your interactions with staff are deeply flawed. I would caution against having a lawyer burn bridges and certainly hope you haven’t mentioned lawyers to your PD

I'm a bit unsure if you are are talking about the faculty member being emotionally irrational and disconnected with reality or me being that. If it is the latter, all I can tell you that despite the constant harassment I faced from her and enduring being the only resident to be constantly humiliated in front my peers ( many of the residents and med students noticed and told me they felt I was targeted ) , I had a very good professional relationship her and although felt I was being unfairly treated, I never spoke ill of her to the residency committee. When it was not medicine related, we were on friendly terms and she often said she felt bad about how hard she is on because she likes me as person. I even wrote positive things about her in my letter of consideration ( since she recommended me to a good psychologist who led to my diagnoses). I never threatened legal action against her or anybody. All the attendings agreed to give me a second chance and take me on for the remediation except her ( this is before the PD realized it is more than 2 rotations). She told my PD she doesn't want to take me on in case it does not work out again and that she will be one who is "targeted." She told my co-resident that she is afraid I am going to sue her. So that's what I am saying, someone who thinks that must feel either guilty or afraid because of their something they done.

I knew I was not doing well on my rotations. It was not clear from dismissal meeting, but i thought maybe 3 max. He took a verbal eval from EM director and decided to fail me for that too even though both dismissal meeting and last week meeting he said I passed 2 months of EM. It seems like it was negative consequence of expressing my dissatisfaction with how they handled the remediation.

 

[SadNutellaGirl]

It's very unfortunate, and unacceptable, that this is the first time you're seeing you're seeing your evaluations. The whole point of evaluations is to help you improve, how are you supposed to improve if you don't get feedback? If you were going to appeal your termination, this would be a very solid argument. But as you say, not clear that would be terribly effective since they are closing the program, there's nothing to appeal into.

As far as "what follows you", they should write up a summary of your training. Only that summary document would be shared in the future.

My PD said he did not know nobody can see their evals online. I did not know I was allowed to see it and neither did any of other resident's until he asked them. I was only verbally told in some meetings that they evals were negative and vaguely about the comments but they never went into details about it. I was also not ever informed of my right to appeal and the reasons of dismissal which was to be in writing as per resident manual. I honestly think he is incompetent since he did not even know how many rotations I failed. I think I do have a strong appeals case, and wish I could so at least there can be some justice....but it's unfortunate that nothing can be done . I wonder if AOA can assist me in some manner to help me in some way. If there was at least a TRI available this year, I could maybe redeem myself.

Although I was not improving to their standards, I was not getting proper feedback either. One of attending, kept telling me that I need more improvement but then say, it will work out and talk about me being a second year and my plans for the future. She said just keep going. I did not appreciate this false deluded encouragement. We both clearly knew this remediation was not improving, and she would not listen to my suggestions on how to make it go better. I knew most of remediation is supposed to be my responsibility but I expected a little more support. My PD when I asked how I am doing and what to improve, also said just said keep going and read the book he told me to read - except he never went over it when it was part of remediation plan.

The resident evals were probably worse than the attending evals - they were all very friendly to me, I even asked sometimes how I am doing and they would list a few points and say you are doing fine. It seems they had a very strong opinion of me in their eval, and it's pretty unfortunate that they did not decide to tell me this in person so I could work on those issues. Almost all the attendings agreed to the remediation. Most residents it seemed did not.

I really think honesty is very important especially if it will help someone improve . I rather tell a resident if you don't make drastic improvements in one to 2 month, you are going to fail than say "just keep going." If I was in residency faculty , and I don't see significant improvement after a few months - I would one more time sit with resident and find out if there is way to better address these deficiencies, including taking the resident's suggestions so a and have a modification of remediation plan. I made suggestions, nothing was changed. These plans I feel to be very individualized and should have some degree of flexibility - what works for one resident won't always works for another.

I am glad to hear that these evals won't follow me though. There is not point in applying again if it did. In this summary of training - the PD would write something like that I was placed on remediation, failed it and got credit for 5 months, right ?

 

[evilbooyaa]

With you not being able to see your evaluations (a major sticking point for ACGME accreditation of programs) and no knowledge of a remediation plan, you would have a very good chance at appealing this entire situation and basically saying that the program did not follow the extremely well-described rules and regulations of remediation, probation, etc. defined by the ACGME...... if your program was not closing down.

I would focus on what you can do going forward. You know the program is closing down per external sources, right? You have not passed PGY-1. You need to discuss with your PD whether they can write you a good LoR for continuing in the same field (or even if they think you'd be better in a different field). Regardless, there needs to be some sort of letter from them explaining that the program closed, is not allowing you to be orphaned with your funding and therefore you are available. Whether you were on remediation or not is moot, because you did not get a chance to properly complete it. You need to be ready to re-apply for the match from scratch this year if you cannot find any last minute open spots.

This is not an attack on you, but your posts read like somebody who is in some element of denial or not willing to accept personal responsibility in this matter. For example, how were you told you were on remediation without assessing what previous evaluations were saying about you? Perhaps it's just naivete of someone who believed a PD's verbal description of remediation. Regardless, it doesn't matter because your program is closing. Don't piss off the PD. Try and get good LoRs from whichever attendings you work with that would be willing to do so. While there's no benefit of burning bridges with consideration of litigation, there's no significant benefit of you being overtly friendly with anyone besides the basic minimum in the program (PD and whoever writes you LoRs). The program was so incompetent at an operational level that it was closed down. It is time for you to be selfish, get things in writing that espouse you in the best possible light, and get the hell off the sinking ship.

 

[SadNutellaGirl]

With you not being able to see your evaluations (a major sticking point for ACGME accreditation of programs) and no knowledge of a remediation plan, you would have a very good chance at appealing this entire situation and basically saying that the program did not follow the extremely well-described rules and regulations of remediation, probation, etc. defined by the ACGME...... if your program was not closing down.

I would focus on what you can do going forward. You know the program is closing down per external sources, right? You have not passed PGY-1. You need to discuss with your PD whether they can write you a good LoR for continuing in the same field (or even if they think you'd be better in a different field). Regardless, there needs to be some sort of letter from them explaining that the program closed, is not allowing you to be orphaned with your funding and therefore you are available. Whether you were on remediation or not is moot, because you did not get a chance to properly complete it. You need to be ready to re-apply for the match from scratch this year if you cannot find any last minute open spots.

This is not an attack on you, but your posts read like somebody who is in some element of denial or not willing to accept personal responsibility in this matter. For example, how were you told you were on remediation without assessing what previous evaluations were saying about you? Perhaps it's just naivete of someone who believed a PD's verbal description of remediation. Regardless, it doesn't matter because your program is closing. Don't piss off the PD. Try and get good LoRs from whichever attendings you work with that would be willing to do so. While there's no benefit of burning bridges with consideration of litigation, there's no significant benefit of you being overtly friendly with anyone besides the basic minimum in the program (PD and whoever writes you LoRs). The program was so incompetent at an operational level that it was closed down. It is time for you to be selfish, get things in writing that espouse you in the best possible light, and get the hell off the sinking ship.

I did ask my PD for LOR and he's like yeah you will get a summary of what was completed. I'm like no I mean a "Letter" and he stared at me blankly and said yeah...I do not take that as a good sign. In all honesty, I think most of the bridge has already been burnt. He said I failed remediation so it was completed. I requested for another remediation due to underlying circumstances I was under. With an appeal, that is what is usually granted if successful ( 2-3 months of second remediation). Another attending who was present at meeting, said if this program wasn't closing down, he said most likely we could have done something for you - probably a second remediation re-evaluation with a whole different set of residents who have an unbiased opinion of me.

I was told I was placed on remediation based on attendings evals. I believed PD, because I knew I deserved to placed on remediation. I never felt it was unfair for them to place me on it. But they definitely did not follow proper protocols. I did not see them until now and did not know I am allowed to see them - so yes that is my naivete.

 

[SadNutellaGirl]

I was thinking of resigning so I can focus full time on COMLEX. I have about a month left and I wanna do well on it, with no more distractions. My lease will be up next month too and then I have to move home . Would future residencies care if I left 6 weeks early? I honestly just wanna be done with them and move on with my life.

 

[Raryn]

I was thinking of resigning so I can focus full time on COMLEX. I have about a month left and I wanna do well on it, with no more distractions. My lease will be up next month too and then I have to move home . Would future residencies care if I left 6 weeks early? I honestly just wanna be done with them and move on with my life.

Do you really want to give another reason for this program to write you a worse summary for your year with them?

 

[SadNutellaGirl]

Do you really want to give another reason for this program to write you a worse summary for your year with them?

I think they'll be pretty happy if I leave so they don't have to deal with me anymore. They said if you wanna end contract now, that's fine. They forgot about even looking for rotations until I was pressing them for what rotation is gonna be next ( this was about 2 weeks). It's an elective rotation anyways , so does it matter? But yeah, if this is going to have an even negative more consequence, I would stay. I honesty don't think any of these elective rotation will transfer over since it's gonna be a gap year - im expecting that i will be repeating an entire year if i ever get a pgy 1 spot.

 

[ThoracicGuy]

I think they'll be pretty happy if I leave so they don't have to deal with me anymore. They said if you wanna end contract now, that's fine. They forgot about even looking for rotations until I was pressing them for what rotation is gonna be next ( this was about 2 weeks). It's an elective rotation anyways , so does it matter? But yeah, if this is going to have an even negative more consequence, I would stay. I honesty don't think any of these elective rotation will transfer over since it's gonna be a gap year - im expecting that i will be repeating an entire year if i ever get a pgy 1 spot.

It's only a few weeks. Finish your year. Use it to try and get better.

 

[GoSpursGo]

I think they'll be pretty happy if I leave so they don't have to deal with me anymore. They said if you wanna end contract now, that's fine. They forgot about even looking for rotations until I was pressing them for what rotation is gonna be next ( this was about 2 weeks). It's an elective rotation anyways , so does it matter? But yeah, if this is going to have an even negative more consequence, I would stay. I honesty don't think any of these elective rotation will transfer over since it's gonna be a gap year - im expecting that i will be repeating an entire year if i ever get a pgy 1 spot.

I think you should get as many months of credit as you can. Yes, chances are that you are going to have to start over at the start of PGY-1, but the more months you can say that you successfully completed, the better your chances of getting another program to take a chance on you.

If you have an elective rotation, you should have plenty of time to get studying in anyways.

 

[SadNutellaGirl]

I think you should get as many months of credit as you can. Yes, chances are that you are going to have to start over at the start of PGY-1, but the more months you can say that you successfully completed, the better your chances of getting another program to take a chance on you.

If you have an elective rotation, you should have plenty of time to get studying in anyways.

ok you have a point...I just wanted to be done with them, le sigh.... but if it's a few more weeks, might as well as do it. maybe if it's a good experience i can get a LOR

 

[GoSpursGo]

ok you have a point...I just wanted to be done with them, le sigh.... but if it's a few more weeks, might as well as do it. maybe if it's a good experience i can get a LOR

You absolutely want to get an LOR if possible. I think you need to end on SOMETHING of a positive note that can convince a prospective program that you're no longer the same resident who failed multiple months earlier in the year. This summary document that you're going to get from your PD sounds like it's going to be extremely negative, and at least if you get an LOR from your last rotation you can maybe argue that you were finally improving toward the end of your time there and would have successfully passed a second remediation.