I’m a PGY2 Internal medicine resident my program is not going to renew contract for next year and they asked me to start looking for PGY3 positions. I had 1 week of vacation and then 2 weeks with 3 working days in between. So, I called in sick for those 3 days. I previously bought this issue up and asked if they can rearrange schedule but they denied my request. So, I took it personally did this mistake. My program was pissed regarding the 3 days which I called in sick. I don’t know what to do now. They mentioned that my clinical skills are so good and it’s my professional behaviour that made them to take this decision. They told me that they are willing to write me good LORs. Can anyone please let me know about my chances of getting PGY3 spot. Can I swap? I was given option to appeal but I don’t think it’s going to make any difference as my current PD told that usually they don’t reverse the decisions. Is it wise to quit and go back to my country? What are the options I have? Does talking to my program again and requesting them is going to make any difference? Are there anyone that matched after having non renewal of the contract. Any input is highly appreciated, thank you
Contract non renewal
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First, it is not well looked upon unless you truly are sick to take sick days. Also if you asked for the time off but were told NO then it looks really really bad to call in *sick* - and for 3 days. Even at our program, after 2 days, a doctors note was required. Why would you risk this by doing something like this? I really don't understand, particularly if you are a foreign medical grad. Why wouldn't you simply stick it out for a few more years? I would consider that behavior unprofessional unfortunately. It also always bothered me when people in my program would call off sick for several days at a time. If they said no, it's no. As an attending that has recently finished residency, I can say that many things that i considered *silly* before now would bother me. I think it's highly unlikely that you could find a PGY-3 spot. I am not in IM but I believe you have to do 2 years at the same program?
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Were you unrenewed before you called in sick, or after?
After
It’s my bad, I realise this now. But don’t know how can I correct
So you took 1 week of vacation, but wanted 2 more? I'm confused.
Why would you call of sick when you weren't sick?
Were the 3 days you took off potentially never finding another residency and never working as a doc in the US?
I don't think you can unfortunately. Why would you do this? To me it comes across as immature. Where there issues before?
I had 3 weeks of vacation, but not in continuity there were 3 working days in between.
So you essentially wanted 3 weeks of vacation back to back?I'm sorry but this is silly. It is rare to get 3 weeks of vacation back to back. I know some programs do like 4 or something and that's all the vacaton the person gets a year. But I have never heard of 3 back to back. Why was it such a big deal to have 3 working days in between?
In our program we can get 4 weeks of vacation in continuity if we want. I went to my home country during that period
Was it worth it? You lied for one, which is a major unprofessional and unethical issue, and you did so without shame. I'm sorry but not sure how to counsel you.
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I totally get why you wanted those days off, and for all I know it prevented you from going home to see your sick dad with cancer
although I would think if that was the case they might have let you off the hook
that said, in my program residents did something similar, and it just went under the radar
meaning, it was a small program so in truth you were just inconveniencing the resident who had to cover for you, and we tended to be understanding about these sorts of things, provided that you weren't a dingus in any other regard
which leads me to think that it's highly unlikely they decided they would rather be short a PGY3 next year over this
I expect this didn't help your case, that they probably had other reasons for wanting to fire you, and that any inclination they might have had to show mercy was not helped by this
so none of this is surprising
however, what is surprising is that they would give you good LORs or help you find another position after this, that's a shocker
I would be worried that they would sabotage you for this, because all around they are saying this is a professionalism issue
they are not renewing you, which means you have like no recourse for trying to do anything to sway your LORs or an NDA, and appealing will likely not open that opportunity up for you, and it is likely to just make you even more enemies
so, buck up, I doubt this is the very reason you're being fired, thank your lucky stars if they are genuine in any way in helping you, and watch out for some passive aggressive backstabbing on that front, and don't antagonize them further with any more BS behaviour
the only avenue for appealing or negotiating would be if you had a leg to stand on regarding some sort of discrimination or health issues, and that does not sound like the case, and even then it sounds like they totally have your balls in a vice for professionalism
I'm sorry this happened. Wait, what was your question again?
although I would think if that was the case they might have let you off the hook
that said, in my program residents did something similar, and it just went under the radar
meaning, it was a small program so in truth you were just inconveniencing the resident who had to cover for you, and we tended to be understanding about these sorts of things, provided that you weren't a dingus in any other regard
which leads me to think that it's highly unlikely they decided they would rather be short a PGY3 next year over this
I expect this didn't help your case, that they probably had other reasons for wanting to fire you, and that any inclination they might have had to show mercy was not helped by this
so none of this is surprising
however, what is surprising is that they would give you good LORs or help you find another position after this, that's a shocker
I would be worried that they would sabotage you for this, because all around they are saying this is a professionalism issue
they are not renewing you, which means you have like no recourse for trying to do anything to sway your LORs or an NDA, and appealing will likely not open that opportunity up for you, and it is likely to just make you even more enemies
so, buck up, I doubt this is the very reason you're being fired, thank your lucky stars if they are genuine in any way in helping you, and watch out for some passive aggressive backstabbing on that front, and don't antagonize them further with any more BS behaviour
the only avenue for appealing or negotiating would be if you had a leg to stand on regarding some sort of discrimination or health issues, and that does not sound like the case, and even then it sounds like they totally have your balls in a vice for professionalism
I'm sorry this happened. Wait, what was your question again?
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The chances of another spot without heavy PD support is low. I don't know the rules on how many years you do at a program to be ABIM eligible. Although I don't know that means you wouldn't have medicare funding for PGY3 and that another program if they had an opening would not be amenable to having you fill a spot if it were vacant.
NO - it is not wise to quit and go home. I believe in some states if you are a foreign grad and have two years of training you may be eligible for a license.
Not to mention, if you are to ever hope for more US training, leaving your program short for the rest of the year will not do you any favours, and you're already pretty screwed here.
Not to mention, it is only by throwing yourself on the mercy of the program and doing all you can to make sweet love to them in every way that you can hope to wring any decent thing out of this situation.
Appealing will not help, if they want you gone they will get you gone, appealing will only anger them. Appealing only has benefit if you have lots of support to stay, or you have a legal case against them and grounds for a good appeal and need to appeal as part of checking the boxes in building such a case.
It would not make sense for you to go through the match again and redo intern year, and I doubt anyone would match you. You could look at advanced positions or starting as a PGY2 somewhere. For advanced positions that could be through the match. Otherwise you need to look for open positions. No matter what you need program support.
So nothing gets you out of talking to your program, kissing serious butt, and seeing what if any help they would give you. That's a whole nother post on how to talk to them about what could be done here, but none of it would be a discussion to stay. It would be talk about what your options would be elsewhere and what support could they give.
I would finish the year if that is an option. You could try to SOAP into something, but that's pretty soon, and again I think PGY1 positions make no sense and wouldn't happen. I would throw myself on their feet and I would do all I could to glean what the professionalism issues are and do my best to show contrition. Not with an eye of getting promoted because that won't happen, but hope that staying and atoning might predispose them to helping you get another spot somewhere.
So no, most people do not match again in this situation. Some people do manage to get another spot somewhere outside the match in the case of nonrenewal, as a general statement. Under this particular context of a professionalism issue like this? That I couldn't say.
I can't tell you that this will work out. I can only tell you what I think is the best course of action.
1) Finish the year.
2) Do not appeal.
3) Figure out what you did wrong, and try to fix yourself.
4) Hope that all of the above will predispose the program to helping you in some way.
5) See if the PD will help you get a job elsewhere.
6) In that discussion, see if it makes sense for you to SOAP, apply for an advanced spot, or find a PGY2 or 3 somewhere.
7) You cannot swap because there is nothing to swap. A transfer doesn't make sense.
Maybe you could find someone that wants your spot and arrange with them and the two PDs doing that, because it would allow each program to have a PGY3, maybe. Assuming that's how things work. That will need to be discussed. HOWEVER under no circumstances should you make it sound like you are wanting to leave the program or leave them shorthanded.
I don't see how they will support you in the same specialty to another program when you had professionalism issues in a swap, so I don't think that will work. But in any case it all belongs under #7 above where you see if there's any way to salvage continuing your training somewhere else.
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I think the only thing that would possibly work is is OP found a different specialty.
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If this is true, what was the issue with your two weeks that were interrupted? Why did they do that then?
I was asked to report early(1week before). I did
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Oh. That sucks.
This should be a lesson to anyone out there, that the next time a program asks you to do something, don't think it's a question, don't think they're asking, and don't think you can ever say no.
The only answer is, "Yes" "how high" and "how wide."
This should be a lesson to anyone out there, that the next time a program asks you to do something, don't think it's a question, don't think they're asking, and don't think you can ever say no.
The only answer is, "Yes" "how high" and "how wide."
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Just a gentle hint (and you KNOW that I am in your corner, and believe in you more than most ANYONE here), but, @Crayola227 , the book reply doesn't help. Even you say, "Wait, what was your question?"
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You are in big trouble. I'm not sure we have the whole story here, but it doesn't really matter for advice going forward. SOunds like you had two breaks (perhaps a holiday break and a vacation) that were separated by a few days of work, you tried to find a way to take them off, they declined to do so, and so you just "called in sick" anyway.
Not renewing you over behavior like this is completely reasonable in my view. In fact, if they had fired you on your return, that would be justified also. You didn't show up for work. This is a job, you don't get to just not show up when its inconvenient. I might have given you a second chance, if there had been no professionalism issues at all previously (of any sort).
What's done is done, so the question now is how to move forward. I'm not completely surprised that they are "supporting" you. I've done the same for residents I've had to terminate for professionalism problems -- if I think those problems are relatively easy to fix. I doubt you would do this again.
So, options:
1. Try to get reinstated. This is unlikely to work. But, there is a small chance that they notified you of non-renewal, and are waiting to see what you do about it. Come up with a suitable remediation plan yourself, and perhaps they would consider it. "I won't do it again" isn't good enough. The worst they can do is say no.
2. Try to switch to another IM program. You can look for a PGY-3, but many programs will not take PGY-3's. There's no rule about it like there is in FM, but many programs have lots of elective time and roles with minimal supervision, and I wouldn't be comfortable bringing a resident I don't know into a PGY-3. Therefore, you're probably going to need to look for PGY-2 positions. I think this also sends the message that you're willing to repeat an entire year to make up for this error that you've made.
3. Try to switch to a different field, presumably something that requires an IM PGY-1 which you already have done.
4. Appeal it. This is very different from option #1. You would need to make a legal/process argument that you should be renewed. An example is -- how did they know you were not sick for those three days? If they demanded a doc note, do they do so of everyone? If not, that's a process violation. Even if they were super suspicious that you just took the time off, if they don't require doc notes from everyone else, they can't require one of you. Chances are you've already admitted the issue, so I don't know that this would work at all. And you're likely to burn any good will you have with your program.
You haven't mentioned if you're on a visa. That complicates things.
Not renewing you over behavior like this is completely reasonable in my view. In fact, if they had fired you on your return, that would be justified also. You didn't show up for work. This is a job, you don't get to just not show up when its inconvenient. I might have given you a second chance, if there had been no professionalism issues at all previously (of any sort).
What's done is done, so the question now is how to move forward. I'm not completely surprised that they are "supporting" you. I've done the same for residents I've had to terminate for professionalism problems -- if I think those problems are relatively easy to fix. I doubt you would do this again.
So, options:
1. Try to get reinstated. This is unlikely to work. But, there is a small chance that they notified you of non-renewal, and are waiting to see what you do about it. Come up with a suitable remediation plan yourself, and perhaps they would consider it. "I won't do it again" isn't good enough. The worst they can do is say no.
2. Try to switch to another IM program. You can look for a PGY-3, but many programs will not take PGY-3's. There's no rule about it like there is in FM, but many programs have lots of elective time and roles with minimal supervision, and I wouldn't be comfortable bringing a resident I don't know into a PGY-3. Therefore, you're probably going to need to look for PGY-2 positions. I think this also sends the message that you're willing to repeat an entire year to make up for this error that you've made.
3. Try to switch to a different field, presumably something that requires an IM PGY-1 which you already have done.
4. Appeal it. This is very different from option #1. You would need to make a legal/process argument that you should be renewed. An example is -- how did they know you were not sick for those three days? If they demanded a doc note, do they do so of everyone? If not, that's a process violation. Even if they were super suspicious that you just took the time off, if they don't require doc notes from everyone else, they can't require one of you. Chances are you've already admitted the issue, so I don't know that this would work at all. And you're likely to burn any good will you have with your program.
You haven't mentioned if you're on a visa. That complicates things.
Thank you so much for the input. They didn’t yet gave me any paperwork and they didn’t ask me to sign any till now. I’m meeting with them on Monday. I will try to assure them that I’m not going to make mistakes again. I’m afraid that I’m going to loose their support in helping me to find another position if I appeal. I’m on J1
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just keep repeating how dumb and stupid you were and beg for mercy....I'm not joking. It's the best you approach at this point
I think that repeating that he's dumb and stupid would not be taken well. however I do agree that he should essentially beg for mercy and be apologetic, make amends, work those days taken off, etc. The problem here in my opinion is not that people make mistakes - maybe even if OP had say well I'm not really sick but I am calling off and had NOT asked before, meh, who knows. But OP asked and was told specifically NO. What if other residents were on medical leave? Who knows. It was asked, told no. and OP still did what he wanted to. it becomes dishonest. I have NEVER taken a day off that I Was told NO. Sometimes it made me upset, frequently I thought it was unfair, ridiculous, etc. but it's. a few years - not worth losing years of work over a few days - particularly if you are a foreign grad
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Tip of the iceberg syndrome is very real.
These are the types of stories that make me wish that a year of full time employment should be a pre-req for medical school.
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Ouch, but you can only control what you do going forward. Do not try to defend your behavior - everyone including you knows you made a poor decision. Grovel if you think there's any chance you can get reinstated.
Be grateful that they are offering to recommend you. I once had a mentor who did not care for me (told me as much in several unpleasant conversations) who nevertheless came through with a solid recommendation that helped me land a competitive position where I thrived. He told me he'd written an excellent recommendation tailored to the position and made it clear that I was never to ask him for anything again (at least that was my read) but by the time it didn't matter because I was in my new job and gave it my all so my bosses offered genuine mentorship, support, and recommendations. It seems that your program is offering you an olive branch - don't look a gift horse in the mouth and take them at their word. Work hard to show your better side in your next job (assuming you are not reinstated).
Be grateful that they are offering to recommend you. I once had a mentor who did not care for me (told me as much in several unpleasant conversations) who nevertheless came through with a solid recommendation that helped me land a competitive position where I thrived. He told me he'd written an excellent recommendation tailored to the position and made it clear that I was never to ask him for anything again (at least that was my read) but by the time it didn't matter because I was in my new job and gave it my all so my bosses offered genuine mentorship, support, and recommendations. It seems that your program is offering you an olive branch - don't look a gift horse in the mouth and take them at their word. Work hard to show your better side in your next job (assuming you are not reinstated).
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Doesn't sound like much of a "mentor".
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I seriously thought about switching, but when you have invested several years into a particular PhD project that can be hard to do without extending your studies (which I hoped to avoid). I consider myself extremely lucky that things worked out as well as they did afterwards. Don't lose hope/ sight of your goals, remember lessons learned, and move on.
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Oh, your research mentor. That's a big difference. I didn't realize you were speaking of your research advisor.
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I'm not going to comment on what you did because it seems you already know you were wrong. However, I would absolutely appeal. Your best shot at saving your career is the appeal. If you lose, you're no worse off than you are now and at that point, you can look for other PGY 3 slots.
Thank you, I’m worried that if I appeal I won’t get good LORs and will loose support from program in case if I find any spots
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Personally, I'd go in exactly the order that aProgDirector suggested, and don't get litigious unless you truly feel that is your only remaining option. I don't think you will lose any support from your program simply by apologizing again profusely, explain your remediation plan, and asking if there is anything you can do to be reinstated. You might lose support if you say you are contacting a lawyer.
OP doesn't have any legal ground to stand on. Apologizing and showing true remorse is the only thing to do.
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Well, seeing as the OP asked no less than 7 questions about something as complex as not being promoted and how to salvage their career... how long do you think it takes to address the pro/cons of the myriad pathways forward? My 2nd response is actually not much longer than aPD's, nor it is much different. I think I did my best to explain in both, because often residents are in the dark about why a program is doing what they do and how what they say is not always what they mean.
I think I realized I was doing more to muse about why the program took this action in the first post... which is somewhat pertinent to figuring out how to handle it.
Mostly, my first response was to offer some modicum of... comfort for what the OP is going through. My first responses tend to be that, and trying to clue them in on what is going on, because the #1 observation I have made about any resident in trouble, is limited insight into how they ended up where they are. Like, this is was an egregious mistake, but it actually isn't likely to be the sole reason they are not being promoted. So it's not a question of "if only I had not done this one thing..." which tends to haunt people to the end of their days.
That first post also focused on something ESSENTIAL for the OP to consider - why is this happening. It likely isn't the one error, and it likely is something more systemic that they need to figure out, not only to try to get as much support as they can from their current program, but moving forward in another spot should they get one, and basically any job they will do for the rest of their life.
Lastly, that response also clued them in - that whenever you have disappointed a program, whether it's being forced to resign for your cancer or you were derelict in your duty, what "support" will mean. What are they actually going to say to another program?
I had a friend that resigned for family reasons, which is simultaneously kinda selfish but also understandable, and they didn't have any kind of binding agreement with the program when they signed their resignation, a program that claimed would help them in the future. Guess what happened. Another friend that was in good standing and wanted to transfer to another specialty. They made it, but the program continually threatened to pull the rug out from under them with their "support." We've had entire threads on the subject of the importance of program support and that sometimes they say one thing and do another. And in both of those cases it might be reasonable to think that when the program says they will help you, that they actually will. Yet it wasn't like that. How do you think "support" might go when a program chooses not to promote you for professionalism?
Mostly, my first response was to offer some modicum of... comfort for what the OP is going through. My first responses tend to be that, and trying to clue them in on what is going on, because the #1 observation I have made about any resident in trouble, is limited insight into how they ended up where they are. Like, this is was an egregious mistake, but it actually isn't likely to be the sole reason they are not being promoted. So it's not a question of "if only I had not done this one thing..." which tends to haunt people to the end of their days.
That first post also focused on something ESSENTIAL for the OP to consider - why is this happening. It likely isn't the one error, and it likely is something more systemic that they need to figure out, not only to try to get as much support as they can from their current program, but moving forward in another spot should they get one, and basically any job they will do for the rest of their life.
Lastly, that response also clued them in - that whenever you have disappointed a program, whether it's being forced to resign for your cancer or you were derelict in your duty, what "support" will mean. What are they actually going to say to another program?
I had a friend that resigned for family reasons, which is simultaneously kinda selfish but also understandable, and they didn't have any kind of binding agreement with the program when they signed their resignation, a program that claimed would help them in the future. Guess what happened. Another friend that was in good standing and wanted to transfer to another specialty. They made it, but the program continually threatened to pull the rug out from under them with their "support." We've had entire threads on the subject of the importance of program support and that sometimes they say one thing and do another. And in both of those cases it might be reasonable to think that when the program says they will help you, that they actually will. Yet it wasn't like that. How do you think "support" might go when a program chooses not to promote you for professionalism?
I don't write these for those of you who have little to add but a short blurb how this was stupid and the OP needs to kiss up. I write them for the OPs and residents that come to my inbox, the ones that you never see, that need more than a swat on the butt or
pat on the head.
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@Crayola227 , fair enough, but, all I'm saying, and this only comes from 100% sincerity and support and friendship, is to tighten it up a little. The TL;DR crew is real.
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its like transitioning from residency to the real world...your notes need to be shorter.
I kind of agree with the other posters - while well intentioned, excessively long posts lead to others losing interest and your potentially good advice loses it effect. Kind of like HIT in terms of either training or learning, shorter is typically better. I agree with Rokshana too - as a resident one writes long verbose notes, as an attending, a few lines suffice.
Here I would agree - less is typically more.
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In defense of Crayola, if she would like to post long responses she is more than welcome to. I appreciate that you've been putting them under spoiler tags for people who are part of TL;DR crew (myself included) so that I'm not scrolling forever.
On topic - agree that groveling is your best option until they actually get rid of you. At that point you can start evaluating outside positions. I won't pile on further besides saying hopefully you've learned that this was a really, really bad idea.
On topic - agree that groveling is your best option until they actually get rid of you. At that point you can start evaluating outside positions. I won't pile on further besides saying hopefully you've learned that this was a really, really bad idea.
I’ve talked to my program yesterday and they told me that they discussed with their legal team how best to incorporate my request for a more lenient disciplinary action and they recommend me to go through formal appeal process. I’m thinking is it even worth appealing? as the one who took this decision of non renewal is going to be the chair of the appeal committee as per our program rules. Is it better for me to resign and look for PGY2 positions as I didn’t sign any paperwork till date.
Did you apologize profoundly and tell them what a poor decision it was, how you should have never done what you did, that you are willing to make up the days you took, did you come up with a remediation plan, etc?
I think the legal team and your program is making you go through the legal channels so that you don't create issues in the long term, which is the right thing to do.
If you did not do the above, you should have. Second I would appeal and show massive remorse, talk about how it won't happen again, make your plea. Again I think you went the wrong way - asking for a more lenient disciplinary action is like saying - yep I know i ddi this wrong but dont be so harsh on me. If I was the PD I would have done what they told you - appeal unless I saw massive remorse.
It does not seem like you feel awful about doing this, it seems you would have been ok with it if you had not been caught.
I am not trying to generalize but have seen this attitude with IMGs - the whole I want to do as I want, oh too bad if you odn't like it.
I remember when I was an intern, an IMG in the program had to do an admission . They wanted to leave, I was on call, and they said oh it's a transfer. I said fine I'll do the transfer. When I found out it was a whole admission. I was pissed. Behaviors like these lead to lack of trust.
You asked for leniency - wrong thing to do. You should have asked for forgiveness because you realized what you did WAS WRONG!
I’ve told them that I’m sorry for the things I’ve done and what I did was wrong. I’m accountable of my actions and asked them to give me a chance to prove myself. I told them that I can meet them every week to show my progress. I told that I’m willing to repeat 2nd year for the mistakes I’ve done
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I don't think you can just choose to repeat second year for something like this. There's limited funding for per resident.
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the trump card they have to play is their support of your application to other programs. don't do anything to jeopardize that. if you can appeal, there's a non-zero chance of success, and you can keep their support should you lose, then it's worth it.
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Apologize and ask for a lenient action. If this is the first time, and only wrong deed, should not be a career ending punishment.
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yeaah...thats a millennial thing...not to generalize...did you think maybe he was just a douche and being an IMG has nothing to do with it?
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lol
No I actually disagree. I have seen much more dishonesty and shadyness from IMGs than non-IMGs
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I am not sure what that means exactly. I was born in the 80's. But again I am not understanding your point. Ifyou'd like to clarify I am happy to listen. I don't like it when people make vague statements about others and generalize about others rather than being specific. And classifying millions upon milions of people (ie - people born in the 1980's) based on random statements is not wise. Individuals are individuals. Classifying people into *groups* and thinking their actions follow some sort of linear, non-logical, non thought out pattern just because they fall into *x* category is judgmental and outright silly.
It's like me saying oh yeah those baby boomers - they are destroying the economy those jerks! People are people. Realize that.
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no, its like you saying all IMGs are shady and dishonest...you didn't get that? Frankly classifying the hundreds upon thousands of people, many who will be your colleagues (and even your attending in that fellowship you are soon joining)as shady and dishonest is probably the unwise move.
and mine is that generation that CBS watch seemed to forget...which is actually kinda appropriate.
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