What's my options?

[SadNutellaGirl]

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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.

I think the summary document is something that is sent to AOA and to residencies when I apply...I asked my coordinator what it is exactly, and basically saying what rotations are completed so far. Nothing even about probation and failing that or any comments - just a straightforward document. I do think if I actually keep inquiring about a real LOR from him , it will be very negative or lukewarm. I honestly think getting a LOR from my PD will hurt my chances more and I don't think I should ask any more for it.

 

[GoSpursGo]

I think the summary document is something that is sent to AOA and to residencies when I apply...I asked my coordinator what it is exactly, and basically saying what rotations are completed so far. Nothing even about probation and failing that or any comments - just a straightforward document. I do think if I actually keep inquiring about a real LOR from him , it will be very negative or lukewarm. I honestly think getting a LOR from my PD will hurt my chances more and I don't think I should ask any more for it. The next time up are substance abuse clinic and neuro...I don't think it will really show that i would've been great with inpatient , but it can show maybe my other strengths - especially if I continue to try pursue psych field

Others may be able to comment better than me, but most threads that I have seen from someone in your shoes have agreed that one needs an LOR from their prior PD giving an honest assessment of where you stand. If in your case that takes the form of this "summary document" that literally only lists the time you were there and the amount of months of credit you received, that's pretty negative even if there are no explicit comments--anyone will be able to see you were there for 12 months and only got ~1/2 year of credit, and the fact that they would be unwilling to even say something like "we think she showed substantial progress toward the end of her remediation and could be successful in another, less-clinical field" will be noticed even if there are no comments at all. Either way, you will want an LOR which at least tries to convince the reader that you have made significant strides toward the end of your time there and may be successful in a new program/field.

As aPD said, I think your most realistic scenario going forward is finding your way into a PM-type field. To put it as delicately as possible, I don't think you should spend time considering a competitive field like psychiatry, except perhaps that program that rokshana suggested.

 

[Raryn]

Others may be able to comment better than me, but most threads that I have seen from someone in your shoes have agreed that one needs an LOR from their prior PD giving an honest assessment of where you stand. If in your case that takes the form of this "summary document" that literally only lists the time you were there and the amount of months of credit you received, that's pretty negative even if there are no explicit comments--anyone will be able to see you were there for 12 months and only got ~1/2 year of credit, and the fact that they would be unwilling to even say something like "we think she showed substantial progress toward the end of her remediation and could be successful in another, less-clinical field" will be noticed even if there are no comments at all. Either way, you will want an LOR which at least tries to convince the reader that you have made significant strides toward the end of your time there and may be successful in a new program/field.

As aPD said, I think your most realistic scenario going forward is finding your way into a PM-type field. To put it as delicately as possible, I don't think you should spend time considering a competitive field like psychiatry, except perhaps that program that rokshana suggested.

aPD had a phenomenal post that summarized what these letters *can* look like

Best: abc2019's performance was outstanding. Unfortunately, they had a family emergency which required their full attention and had to resign from the program. We would have happily continued their training and fully expected them to promote on cycle to the next PGY year. If we had an open position, we would happily continue their training. We expect they will succeed in any similar competitive training program and have our full support.

OK: abc2019's performance was excellent. Unfortunately, they had a family emergency during training which ultimately resulted in their resignation. Due to this serious distraction, abc2019's performance level suffered and evaluations at the time of his/her resignation suggested a below average performance. However, we feel that their performance and trajectory prior to this problem was excellent, and now that the situation is resolved we expect their performance would return to being fully satisfactory. If we had an open position, we would happily consider continuing their training.

Not so great: abc2019's worked hard in his/her training year. Their performance was below average, but they were making some steady improvements. Unfortunately, they had a family emergency during training which impacted their performance and resulted in an unsatisfactory performance level. After reviewing their options, they decided to resign from our program. We expect that he/she can be successful in the right environment and have encouaged them to apply to programs where the level of acuity and workload are not as intense.

Ug: abc2019's performance was marginal, with repeated professionalism concerns. They resigned in lieu of termination proceedings. We recommend that further training include close observation and mentoring to help prevent similar issues from occurring.

Worst: We have been directed to refer all requests for information to our office of legal council.

 

[NotAProgDirector]

Your program might decide to only write a summary document that states what rotations you received credit for, and nothing more than that. Personally I think that's a pretty crappy way to do things, but it's their choice. The good news is that it lets you tell your story -- their story is just a list of rotations. The bad news is that some programs might look at that, decide that you might not be worth any risk at all. Regardless, there isn't much you can do about the situation. Make the most of the time you have left. If you're interested in PM and there's any chance of doing an elective in it with the time you have left, you should do that.

 

[SadNutellaGirl]

As aPD said, I think your most realistic scenario going forward is finding your way into a PM-type field. To put it as delicately as possible, I don't think you should spend time considering a competitive field like psychiatry, except perhaps that program that rokshana suggested.

Believe me I know 🙁

 

[SadNutellaGirl]

aPD had a phenomenal post that summarized what these letters *can* look like

my letter would probably be in between not so great and ugh. is it really still worth to get something like that?

 

[rokshana]

my letter would probably be in between not so great and ugh. is it really still worth to get something like that?

Really? You think “not so great” is really in the realms of reality?

 

[Piebaldi]

my letter would probably be in between not so great and ugh. is it really still worth to get something like that?

I don't know it seems your program is set on making your life miserable. If they are shutting down as we've talked about clearly there were issues with the program. It would be easier and kinder to at least provide a neutralish letter. I would try to get the best letters from other attendings so that at least that blow could be lessened a bit. I transferred to a different program with a PD letter from internship, but not from advanced position and not a single program asked me about it. So you never know.

 

[SadNutellaGirl]

Really? You think “not so great” is really in the realms of reality?

They said they would "help me" when I want to apply for other programs ( they instead decided to keep me out of the hospital and not have any contact with me except for 2 quick phone calls.) When I asked for LOR during dismissal meeting - he said you will get "a letter" explaining what happened here. I don't take it as a good sign.

 

[SadNutellaGirl]

I don't know it seems your program is set on making your life miserable. If they are shutting down as we've talked about clearly there were issues with the program. It would be easier and kinder to at least provide a neutralish letter. I would try to get the best letters from other attendings so that at least that blow could be lessened a bit. I transferred to a different program with a PD letter from internship, but not from advanced position and not a single program asked me about it. So you never know.

They are making my life miserable. And due to incompetence, they didn't even do the dismissal correctly that led to a lot of confusion and unanswered questions which was finally answered 3 months later. My coordinator hinted PD never even read the evals before dismissing. I was so angry and appalled by the laziness and incompetence of this program but there is nothing I can do about it.

I put this is all past me and was finally do relatively well for the past month and a half - no more depression, lot more energy, exercirsing again and eating healthy....studying was going well too. But now I just feel like **** again. Reading a year's worth of negative evals was just pure awfulness. I think I may have to postpone exam since this was such a huge distraction. I will try to ask other attending for LORs, but unfortunately they aren't many to ask - I only pretty much been on inpatient - most of them were nice, but it is clear from the evals that they were not happy with my performance. It seems like PD never had plans to write me a LOR and when I asked, it didn't seem like it would even be a neutralish one...