Co-fellow fired

[Piebaldi]

Hey all,

Wanting some thoughts on this.
My co-fellow was recently fired.

I don't know what's going to be done in terms of finding a replacement or not. So now my call suddenly increased ridiculously from every 3 weeks to every other week. I am not ok with this. I didn't sign up for this. I believe he was let go for something that was not that unforgivable (he made a medication error, but patient was ultimately ok).
Additionally I don't feel I am getting enough procedure time - I am not getting to do the US, attending does many of the thoracic/cervical procedures.
I am not happy with the situation. I was not even informed personally (other than by my co-resident) that he was let go.
Attending is good procedurally but not an easy person to get along with. Also gets upset a lot over menial things.
Not sure what to do?
Not ok with this.

Please advice.

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[lobelsteve]

Minute by minute, hour by hour, day by day.
8 months to go?
Head down, do your best. No complaints. Stay positive.
Do the opposite? I can write a great book about what happens if you ignore the above.

2000-04 EVMS. PMR.

 

[willabeast]

At Duke they used to say the problem with every other night call is that you miss half the interesting cases. Look at it this way - they will find someone else to replace the guy who left, maybe on this bulletin board. Ask if you can help find someone.

 

[slippery_when_wet]

why did you rank this place? sounds like a horrible place to train.

 

[ED50]

That really sucks, sorry to hear you are in this situation. Hopefully they will find another fellow and you can consider advertising the open spot on this site if they will let you. Strong recommendation to not quit, get your fellowship stamp and move on, at the worst it is only 7 more months.

 

[Ronin1]

Hey all,

Wanting some thoughts on this.
My co-fellow was recently fired.

I don't know what's going to be done in terms of finding a replacement or not. So now my call suddenly increased ridiculously from every 3 weeks to every other week. I am not ok with this. I didn't sign up for this. I believe he was let go for something that was not that unforgivable (he made a medication error, but patient was ultimately ok).
Additionally I don't feel I am getting enough procedure time - I am not getting to do the US, attending does many of the thoracic/cervical procedures.
I am not happy with the situation. I was not even informed personally (other than by my co-resident) that he was let go.
Attending is good procedurally but not an easy person to get along with. Also gets upset a lot over menial things.
Not sure what to do?
Not ok with this.

Please advice.

I would just suck it up honestly. I thought about quitting mid year of my fellowship due to personal conflict with my attending but just rode it out to get the certificate. And that was 20 years ago. Regarding procedures there is never enough during training, you will rapidly eclipse that in your first year out. Carry On!!

 

[SommeRiver]

Just suck it up and train. You'll find in your first year out the worse the misery as a fellow the more prepared you are as an attending. You're making an investment right now.

 

[BobBarker]

If it is a acgme fellowship you absolutely have to stay. But I don’t think a acgme fellowship would have fired someone over something trivial. It is a one year fellowship and it takes time to fire people in large institutions.

 

[slippery_when_wet]

If it is a acgme fellowship you absolutely have to stay. But I don’t think a acgme fellowship would have fired someone over something trivial. It is a one year fellowship and it takes time to fire people in large institutions.

Can you explain why if it's acgme fellowship you would absolutely need to stay?

 

[BobBarker]

She will never get a 2nd chance at one.

 

[slippery_when_wet]

She will never get a 2nd chance at one.

But if it was a non-acgme fellowship, she may get another one?

 

[BobBarker]

Certainly. They just want a cheap worker bee.

 

[Merely]

Hey all,

Wanting some thoughts on this.
My co-fellow was recently fired.

I don't know what's going to be done in terms of finding a replacement or not. So now my call suddenly increased ridiculously from every 3 weeks to every other week. I am not ok with this. I didn't sign up for this. I believe he was let go for something that was not that unforgivable (he made a medication error, but patient was ultimately ok).
Additionally I don't feel I am getting enough procedure time - I am not getting to do the US, attending does many of the thoracic/cervical procedures.
I am not happy with the situation. I was not even informed personally (other than by my co-resident) that he was let go.
Attending is good procedurally but not an easy person to get along with. Also gets upset a lot over menial things.
Not sure what to do?
Not ok with this.

Please advice.

cant you just quit to be an attending and make 300k?

 

[sdnuser001]

Hey all,

Wanting some thoughts on this.
My co-fellow was recently fired.

I don't know what's going to be done in terms of finding a replacement or not. So now my call suddenly increased ridiculously from every 3 weeks to every other week. I am not ok with this. I didn't sign up for this. I believe he was let go for something that was not that unforgivable (he made a medication error, but patient was ultimately ok).
Additionally I don't feel I am getting enough procedure time - I am not getting to do the US, attending does many of the thoracic/cervical procedures.
I am not happy with the situation. I was not even informed personally (other than by my co-resident) that he was let go.
Attending is good procedurally but not an easy person to get along with. Also gets upset a lot over menial things.
Not sure what to do?
Not ok with this.

Please advice.

Could you private mssg what fellowship you are in? Would be nice for future pain applicants to know what programs to avoid!

 

[Baron Samedi]

Put your head down and day dream about that sweet attending money you'll soon be making.

 

[Paingas]

Must be more to the story than just a medication error.
Keep head down mouth shut remember every day is one day closer to being done.

 

[wysdoc]

Hey all,

Wanting some thoughts on this.
My co-fellow was recently fired.

I don't know what's going to be done in terms of finding a replacement or not. So now my call suddenly increased ridiculously from every 3 weeks to every other week. I am not ok with this. I didn't sign up for this. I believe he was let go for something that was not that unforgivable (he made a medication error, but patient was ultimately ok).
Additionally I don't feel I am getting enough procedure time - I am not getting to do the US, attending does many of the thoracic/cervical procedures.
I am not happy with the situation. I was not even informed personally (other than by my co-resident) that he was let go.
Attending is good procedurally but not an easy person to get along with. Also gets upset a lot over menial things.
Not sure what to do?
Not ok with this.

Please advice.

You know, this is your chance to get more procedures.

I know it's upsetting, and suddenly being on call every 2 weeks is a way to burn out.
If you stop and look back at what you said, though, if you were the one being let go, I don't think you would like it if your boss talked to your coworkers all about it. You heard it from your co-fellow first. He told you what he wanted to about it.
The boss may never discuss the exact reasons with others, as it is a personal and a personnel issue and as such is confidential.

Show your boss that you got this. You can get though the rest of your fellowship.

 

[10KHertz]

If you are in an ACGME and ABMS program , you have resident/fellow Work hour restrictions. If they violate that , their certification can be subject to sanctions. Just sayin’....

 

[Piebaldi]

Minute by minute, hour by hour, day by day.
8 months to go?
Head down, do your best. No complaints. Stay positive.
Do the opposite? I can write a great book about what happens if you ignore the above.

2000-04 EVMS. PMR.

Well there is no way I can absorb the entire workload of another fellow. Just no way. Even at maximal efficiency there is simply no human way I can do this.

 

[Piebaldi]

But if it was a non-acgme fellowship, she may get another one?

Well it is non-ACGME and technically I have been offered another one that has a decent track record of training fellows. However I coulndt start until a number of months from now. Not sure what to do.

 

[deleted480308]

Well there is no way I can absorb the entire workload of another fellow. Just no way. Even at maximal efficiency there is simply no human way I can do this.

Show up for your 80hrs and do what you can. Keep your head down

 

[Piebaldi]

Must be more to the story than just a medication error.
Keep head down mouth shut remember every day is one day closer to being done.

Nope just a medication error - and a minor one at that. However what if I just don't get enough procedures and I am pitiful at the end of this training? I am concerned that while I have been doing more lately, attending is very protective - it's a private practice and patients are coddled. So he gives very little leeway. Ugh frustrated.

 

[Piebaldi]

Show up for your 80hrs and do what you can. Keep your head down

The hours per se are not terrible - roughly 8 to 5/5:30. But during the work day it is very busy. Also the bar is set very high.

 

[Piebaldi]

Put your head down and day dream about that sweet attending money you'll soon be making.

Yes I figure that I still work 8-5ish and most weekends even when on call are free. However I am very scared - I'm certain I'll make a mistake at one point or another, will I get fired too? I don't work to put in like 8-10 months and then get canned over a mistake. Mistkaes happen. That's one of my main fears honestly.

 

[DOctorJay]

Are you in clinic all day while you’re attending is doing all the procedures?


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[Piebaldi]

Are you in clinic all day while you’re attending is doing all the procedures?


Sent from my iPhone using SDN

No no. We have clinic 3 days, 2 procedure days. He's in clinic with us and in procedures as well. But he won't let us do cervical/thoracic stuff right now at all (I started off cycle), recently started doing lumbar/SI/caudals, etc. He'll do the US procedures. He gets frequently upset - even at minor things. He's very good procedurally, but short fused. And very protective of the private practice. I don't know whether to have a conversation and say - hey I want to do more or what. I mean the whole point of doing this is to gain procedural experience. Ugh.

 

[paingamechanger]

If it’s a non accredited fellowship just leave but agree if it’s accredited ride it out

 

[BobBarker]

If you started off cycle, then you have been there only 2 months or so?

Sounds like he is bringing you along appropriately. Also, what is the call like? I am on call every day. But it doesn’t affect my life at all.

 

[Piebaldi]

If it’s a non accredited fellowship just leave but agree if it’s accredited ride it out

it's not accredited, but that doesn't bother me. i do want to do pain but not sureif i should go back to my job and just wait until the next fellowship would start- although i really wanted tofinish training sooner rather than later.

 

[Piebaldi]

If you started off cycle, then you have been there only 2 months or so?

Sounds like he is bringing you along appropriately. Also, what is the call like? I am on call every day. But it doesn’t affect my life at all.

Can you elaborate on the whole "he is bringing you along appropriately?" Yes I have been there less than 2 months. But again only doing lumbar stuff, caudals, SIJ, lumbar RFA. Wont let me touch cervical or thoracic at this time. Don't fellows in other programs do all procedures from the get go? How do you get experience if u don't do the procedures> can't master something if you don't do procedure after procedure after procedure.
Call is from home. I guess technically can be called for a consult or something but not frequent per what other fellows say.

 

[BobBarker]

He has a good business model though. He works hard, but has 3 fellows to work hard, divide the pill count with, work up more procedures up with, take call.

 

[BobBarker]

He just met you and these are private patients. He is making sure you can safely drive a needle without skewering the cord. This is not unusual.

 

[Piebaldi]

He has a good business model though. He works hard, but has 3 fellows to work hard, divide the pill count with, work up more procedures up with, take call.

2 fellows. No med management.

 

[Piebaldi]

He just met you and these are private patients. He is making sure you can safely drive a needle without skewering the cord. This is not unusual.

Yes I understand that, but can't get better without practice.

 

[BobBarker]

If there is no med mgmt, what kind of calls are you expecting? Should be rare to be called at all.

 

[BobBarker]

he is making sure you know what LOR feels like before letting you do a CESI. This is all normal progression stuff in the private practice setting.

 

[slippery_when_wet]

Yes I understand that, but can't get better without practice.

What are the other fellows saying? are they experiencing or have similar concerns as you?

 

[Piebaldi]

If there is no med mgmt, what kind of calls are you expecting? Should be rare to be called at all.

Patient concerns, the rare consult, etc. Again it's not frequent - but it's the "you never know" situation, being cooped up in your house every other weekend since you never know issue.

 

[Piebaldi]

What are the other fellows saying? are they experiencing or have similar concerns as you?

Well I have met some of the other fellows - obviously now they are graduated and employed elsewhere - but most have gotten a few thousand procedures. Obviously I don't know how much he let them do at the beginning. The other fellow who is no longer there had a similar initial experience as me. Again I can only go by what I was told by the departing fellows really - that they had a few thousand procedures by the time they graduated.

 

[BobBarker]

why would you be cooped up? There are no pain emergencies and you aren’t going to get any esi consults on the weekend. Go enjoy and do whatever you want without leaving the state.

 

[Piebaldi]

why would you be cooped up? There are no pain emergencies and you aren’t going to get any esi consults on the weekend. Go enjoy and do whatever you want without leaving the state.

Well there is an "expectation" that we are within 30 minutes of the hospitals -again it's rare to be called in (the last fellow that graduated said he got called twice in the entire year and he never had to go in) but if for whatever reason they did call, you couldn't be more than 30 minutes away. Also since I moved from out of state I tend to travel to see family, etc so it would be problematic.

 

[slippery_when_wet]

Well there is an "expectation" that we are within 30 minutes of the hospitals -again it's rare to be called in (the last fellow that graduated said he got called twice in the entire year and he never had to go in) but if for whatever reason they did call, you couldn't be more than 30 minutes away. Also since I moved from out of state I tend to travel to see family, etc so it would be problematic.

Is the fellowship in a city? are there nothing to do downtown, nightlife, bars, etc

 

[Doctodd]

Embrace your situation so you aren’t miserable. As was said, you get all the cases now. And that saying of missing half the cases when on call every other night was from Debakey at Baylor.

On the surface it looks like a better situation is opening up at the accredited fellowship. You have time to decide if you jump ship or not. Hit the gym and get through this as that fixed point that is unflustered every day.

 

[Orin]

The problem here primarily is of your expectations.

In a PP setup, if you screw up, there's no ivory tower to back you or the practice up. You don't fly until everyone is confident there. You'll get a lot of reps of easy and safe things until you've earned the right to do more.

Still, you can learn a lot by actually watching someone. Watch their hands and learn their cadence. Watch the fluoro/ultrasound and ask about the anatomy. You don't need your hands on things right now. Assuming it's a 12 month fellowship and you're a 1/6th of the way through it, you gotta realize that you're going to be on a short leash.

You're still going to get a lot more volume it sounds like than most academic places, but there's a lot more to this than just procedural skills.

 

[clubdeac]

These non ACGME fellowships seriously need to be shut down. We need to do a better job off limiting who does these procedures. I mean any Tom Dick and Harry off the streets can set up shop and bill for these procedures. It’s insane and sad to say the least. I mean what makes you any better than “Dr.” Nevills

Our Team

Clinic specializing in traditional and alternative pain management techniques. The team of physicians and chiropractors does not only treat the pain but eliminate the cause and provide relief.

www.flinthillspainmanagement.com

 

[Piebaldi]

The problem here primarily is of your expectations.

In a PP setup, if you screw up, there's no ivory tower to back you or the practice up. You don't fly until everyone is confident there. You'll get a lot of reps of easy and safe things until you've earned the right to do more.

Still, you can learn a lot by actually watching someone. Watch their hands and learn their cadence. Watch the fluoro/ultrasound and ask about the anatomy. You don't need your hands on things right now. Assuming it's a 12 month fellowship and you're a 1/6th of the way through it, you gotta realize that you're going to be on a short leash.

You're still going to get a lot more volume it sounds like than most academic places, but there's a lot more to this than just procedural skills.

There is a very high volume yes. And yes it's 12 months. Yes I don'texpect to be doing kyphos and discograms and cervicalspine stuff the day I come in. Just would like to do more.

 

[Piebaldi]

These non ACGME fellowships seriously need to be shut down. We need to do a better job off limiting who does these procedures. I mean any Tom Dick and Harry off the streets can set up shop and bill for these procedures. It’s insane and sad to say the least. I mean what makes you any better than “Dr.” Nevills

Our Team

Clinic specializing in traditional and alternative pain management techniques. The team of physicians and chiropractors does not only treat the pain but eliminate the cause and provide relief.

www.flinthillspainmanagement.com

That is a nurse - aka - CRNA. Very different. It is scary that CRNAs are allowed to "practice" independently. I went to a cosmetic course recently and one of the instructor type people was an NP who had her own "practice." Many of the attendees were NPs. Very very different.

 

[chudat]

These non ACGME fellowships seriously need to be shut down. We need to do a better job off limiting who does these procedures. I mean any Tom Dick and Harry off the streets can set up shop and bill for these procedures. It’s insane and sad to say the least. I mean what makes you any better than “Dr.” Nevills

Our Team

Clinic specializing in traditional and alternative pain management techniques. The team of physicians and chiropractors does not only treat the pain but eliminate the cause and provide relief.

www.flinthillspainmanagement.com

Not the point of the thread though. Also even nonacredited fellowships require completion in a primary residency first, so theres definite legitimacy to them.

 

[Piebaldi]

These non ACGME fellowships seriously need to be shut down. We need to do a better job off limiting who does these procedures. I mean any Tom Dick and Harry off the streets can set up shop and bill for these procedures. It’s insane and sad to say the least. I mean what makes you any better than “Dr.” Nevills

Our Team

Clinic specializing in traditional and alternative pain management techniques. The team of physicians and chiropractors does not only treat the pain but eliminate the cause and provide relief.

www.flinthillspainmanagement.com

I'm a physician - I'm not a CRNA. What makes you any better than anyone else? In the end I will probably graduate with more procedural experience than most fellows at most programs. So not sure why you'd make an offensive comment like that. Get off your high horse - not sure what special knowledge you think most fellows get in other programs.

 

[Piebaldi]

Not the point of the thread though. Also even nonacredited fellowships require completion in a primary residency first, so theres definite legitimacy to them.

Precisely. I went to an excellent residency program. I will be board certified in a few months. I have done a significant and diverse number of procedures throughout residency. I get the same procedures as everyone else in other programs. There is legitimacy - yes obviously as others have pointed out there is less "protection" in terms of something going wrong or work hours. But otherwise not much difference. Even the chair of our PM&R program was practicing pain (he was in his 70's) and never did a fellowship. There is a big big difference between nurses - NPs, CRNAs and physicians doing this. Not sure why the other poster is trying to instigate.