i am put on probation in my reisdency and HR is not helping me..what i can do?

[BoardingDoc]

Its true that residency is probably one of the occupations most akin to slavery in modern civilization

I am tired all the time, I frequently don't want to go to work, I put in awful hours.... but I sure as hell am not operating under the delusion that my career is akin to slavery.

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[Belleza156]

You really need to schedule a meeting with your program director. Pretty much now your head and ask how to rectify the situation you are currently in. Usually PD want to work with you because getting a new resident to fill an already taken spot is not an easy task. Remember he needs you, maybe not as much as you need him but you are not disposable. Whether you are FMG or not. Do exceptionally well on your in training exams, get along as best you can with everyone, be on top of your assignment. Offer to help your co-resident, show you have a good attitude and not a woe is me everyone is against me attitude. People especially PD want you to succeed. That is their job.

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[Belleza156]

You really need to schedule a meeting with your program director. Pretty much now your head and ask how to rectify the situation you are currently in. Usually PD want to work with you because getting a new resident to fill an already taken spot is not an easy task. Remember he needs you, maybe not as much as you need him but you are not disposable. Whether you are FMG or not. Do exceptionally well on your in training exams, get along as best you can with everyone, be on top of your assignment. Offer to help your co-resident, show you have a good attitude and not a woe is me everyone is against me attitude. People especially PD want you to succeed. That is their job.

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Sent from my Nexus 6 using SDN mobile

 

[Neopolymath]

One of the first things you learn in real life business is that HR is not your friend and is not there for you as an employee. They represent the organizations interests both directly and indirectly over anything else. That is a universal truth. Live and learn.

 

[bannie22]

One of the first things you learn in real life business is that HR is not your friend and is not there for you as an employee. They represent the organizations interests both directly and indirectly over anything else. That is a universal truth. Live and learn.

Yeah its like saying ACGME is your friend haha

 

[ssttrrbbk]

One of the first things you learn in real life business is that HR is not your friend and is not there for you as an employee. They represent the organizations interests both directly and indirectly over anything else. That is a universal truth. Live and learn.

Someone I know (a nurse) was having an issue with her immediate supervisor and her husband kept telling her to go to HR. I thought that was odd. I guess they are called Human Resources but I don't think they would be someone I'd go to for help on any real situation as its not even really their job. Pretty much all they did for me was screw up my health insurance and retirement.

"oh we've been taking out your money every month for health insurance but forgot to enroll you"


Anyway I've read this thread a few times now but was staying away as I think you already got a lot of good advise but haven't taken it.
I'm not sure if you have a shot at this point based on your timeline you stated you have already been asked to leave. If you can you really need to go to your PD and discuss what deficiencies they wanted you to address. Maybe in writing. I always recommend asking for help on specific things. Don't let anyone vaguely say that you aren't operating at the level of whatever PGY ___ you are at. I think that's a cop out complaint. Have them state discrete deficiencies. Have the PD along with yourself come up with solutions and things to work on to fix those very specific things. Make a roadmap as you likely can't fix everything at once. Show that your willing to address issues and try to work with them. All these he said, she said, other residents lied defenses won't help you. If they lied then it should be very easy for you to address the problems because they wouldn't really exist. I don't think you could really be asked to leave based on unsubstantiated complaints by other residents.

I'm not sure if its too late from what you said though. Also if the concern is professionalism addressing and showing that you are willing to fix the concerns could be harder unless you can really show that it was an honest mistake.

 

[Top Gun]

One of the first things you learn in real life business is that HR is not your friend and is not there for you as an employee. They represent the organizations interests both directly and indirectly over anything else. That is a universal truth. Live and learn.

This. Sorry, but human resources does not represent your interests, but rather those of the hospital. They couldn't give two &hits about you and your situation. I agree with the others that you need to find out what your deficiencies are and come up with a solid plan to correct them. How have your clinical evaluations been? What about inservice scores? Has there been any pattern of negative interactions with nurses, other residents, attendings, etc..? Also, I have been reading some of your posts and you do tend to come across as defensive when other posters try to give you advice. I wonder if you reacted the same way when attendings attempted to give you feedback? If this is the case, its probably a big part of the reason that you are now on probation. Part of being a good resident is learning to take criticism from higher-ups, no matter how "mean" or "rude" it appears to be, and then using it to improve. Just an observation, but I think this might be something you may want to work on.

 

[Buzz Me]

You are trying to proof the wrong .. I have very high English scoring tests. I was born in the state and grew up her and I graduated from Caribbean medical school because my family were not able to get me into Allopathic or DO school. So i dont know from where you trying to post the wrong message! do you sympathize with them

I think you're losing sympathy in this thread when you post things like this - it may not be as evident to you, but to native English speakers from this country your posts clearly do not sound like those of someone "born in the state."

You'll find it's always better to be honest when asking for advice. People here truly want to help. If you feel uncomfortable giving out too many details, that's understandable, but when you start to make statements that just don't sound true it completely changes the tone of the thread.

Best of luck to you.

 

[Psai]

I think you're losing sympathy in this thread when you post things like this - it may not be as evident to you, but to native English speakers from this country your posts clearly do not sound like those of someone "born in the state."

You'll find it's always better to be honest when asking for advice. People here truly want to help. If you feel uncomfortable giving out too many details, that's understandable, but when you start to make statements that just don't sound true it completely changes the tone of the thread.

Best of luck to you.

Stop trying to proof the wrong

 

[shoal007]

Thanks very much for your insightful share, you literally have said what i felt over this form as well as in real work station.

I love my work station. I'm sorry you do no fell the way I do about the couching I get forum my mentors. Best of lucks


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[Shorin-Ryu]

You are attaching me all the way since we started the conversation
Please leave the conversation
You are not helpful you have destructive attitude

Forgive me for saying this, @Sarah2015, but you are being self-destructive right now. The SDN community, including @ThoracicGuy, is taking their precious time away from their busy schedules to help you and you are not hearing them. No person on this thread is out to get you. Please, stop being defensive and start listening.

I am an intern in a very competitive surgical specialty and I have had my share of friction (not within my specialty) with certain PAs/residents/fellows but I tend to never take it personally (although, I have to admit, sometimes, it is hard). Medicine is a high stress profession as it is and it involves our patients' lives and well-being.

We the residents are in our current placements because of our passion for medicine and our high academic achievements; and, if we want to continue grow and advance as medical doctors, now is the time to learn the ways to connect with our colleges on a professional level which means to concur our emotions even when it may not seem fair.

In all truth, I have observed some people being out of line but, again, this is the time to learn to navigate our little boats between the ocean liners, figure out the best ways to connect with them and learn, learn and learn from EVERYONE on the floor and in the operating room.

Some time ago, someone asked me what my secret was to getting high scores and I said, "I just go and have fun."

Please, find ways to connect with your colleagues and faculty; don't take things personally - think twice before you dwell or act upon someone's words or actions for it may as well be that you might have misconstrued someone's words or actions; and always think positively. Tell yourself, "I am good. I work hard." After all, we are the lucky ones to get what we wanted. So, whether you'll manage to stay in your current placement or to find a new one, go on and have fun.

Gotta love what you do!

 

[Jamie561]

I agree with your advice but I have Ben taking this attitude already but all what I see they increase in their hostile attitude. Accusing me with never happened scenarios and a lot that I can't detail it here. I am very humble and sucking every harm and they still taking this attitude and I I am undairly treated. I frankly asked PD If he want me to find other program and he said I have no intentions to kick you !!

unfortunately as my PD says- if i can Pick then i can Kick


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[Innocent resident]

The program director put me on probation and I am following his instructions and Human resources is not helping me most of the time they take the side of the program director ..they are cooking together to kick me out...

What I can do?what is the role of GME office and RRC office?
Is there any website to read about our rights as residents on how to deal with these probation?

My pd also put me on probation.
In our program img and amg treated differently..

 

[Innocent resident]

He wasn't trying to be disrespectful, but you are proving his point.

It is hard to understand you because your proficiency with the language is not great. It is possible that you may have misunderstood some things that were said to you, because of that language barrier. That was not to take the "dialogue out of the respect frame." He was pointing out that your dialogue makes it so that there are misunderstandings. That may be why your program seems to be treating you "out of the respect frame."

No one sets out to ruin someone else's career for fun. But if it is frustrating to communicate with you, that might be why they have lost patience and are ready to push you out.

I don't understand why every one here so much focused on English proficiency..I mean we are bringing up things on the forum to get some help and solutions from seniors and all we get is comments on our English..with due respect, plz we already have good scores in USMLE which includes English proficiency test, we made it to interviews and finally got residency, how come we have that bad English that we can't understand or communicate our concerns..plz members try to come out with suggestions and help rather than putting more pressure on the person who is already in lot of trouble..thank you

 

[Promethean]

I don't understand why every one here so much focused on English proficiency..I mean we are bringing up things on the forum to get some help and solutions from seniors and all we get is comments on our English..with due respect, plz we already have good scores in USMLE which includes English proficiency test, we made it to interviews and finally got residency, how come we have that bad English that we can't understand or communicate our concerns..plz members try to come out with suggestions and help rather than putting more pressure on the person who is already in lot of trouble..thank you

We mention it because you are NOT proficient. You are not able to communicate your points clearly enough that the reader can understand them without considerable difficulty. You may have been able to pass tests, but that does not mean that your command of the language is truly fluent when you use it yourself. Similar to how being able to pass didactic exams doesn't translate into evidence of clinical proficiency.

I'm not putting you down as a bad person or saying that you can't succeed. I'm pointing out a deficiency which is impairing your capacity for success. You can consider that honest criticism to be "putting more pressure" on you, or you can accept it for what it is... a sincere effort to make you aware of a problem that is holding you back. It doesn't hurt me in any way if you choose to reject my advice, other than that it means that offering it was a waste of my time. You only hurt yourself, and that is entirely your right.

 

[Innocent resident]

Thank you for your advice..
I am trying to communicate with nurses and colleagues, what else should I do to improve my English..No time for tv/movies / lives close to hospital so radio listening would be out of the choices.

 

[Helpful Troll]

Thank you for your advice..
I am trying to communicate with nurses and colleagues, what else should I do to improve my English..No time for tv/movies / lives close to hospital so radio listening would be out of the choices.

Write and communicate formally with every email, text, post, phone call, and written note. Communicate only in English even at home. Ask a colleague that is not involved in your evaluations to provide honest feedback (though it may feel hurtful to you - it's not) when they hear or observe poor language use or ineffective communication.

What did your PD say was required to remediate? I haven't seen you answer that question. What plan did you make with your PD, or whomever is the approval authority, to get off probation?

 

[rokshana]

I don't understand why every one here so much focused on English proficiency..I mean we are bringing up things on the forum to get some help and solutions from seniors and all we get is comments on our English..with due respect, plz we already have good scores in USMLE which includes English proficiency test, we made it to interviews and finally got residency, how come we have that bad English that we can't understand or communicate our concerns..plz members try to come out with suggestions and help rather than putting more pressure on the person who is already in lot of trouble..thank you

This post demonstrates your poor proficiency in English and, in the US, the majority of your attendings, co-residents, and your patients will communicate in English... you can't do that, well then you start out behind the right ball and problems will arise if you don't work t fix the issue...and if you somehow think this is a minor issue, well then you will most likely not be renewed...

 

[Promethean]

Thank you for your advice..
I am trying to communicate with nurses and colleagues, what else should I do to improve my English..No time for tv/movies / lives close to hospital so radio listening would be out of the choices.

I don't think that you lack knowledge of English vocabulary. You don't lack words. You just need to work on how you use them. There are a lot of native speakers whose usage is sloppy. They can be harshly judged for that, but it is worse for you. As an IMG, you do have something to prove. That may not be fair, but it is a fact. I do have a few specific suggestions.

1) Don't use slang or informal language, even in informal communications. Sure, text messages and forum posts aren't like professional emails. But the habits you develop in one area spill over into others. Shortcuts like plz give an impression that the writer is either uneducated or doesn't care enough to use 3 more letters to make the full word. That is a bad look on anyone. Medical documentation is full of abbreviations because of time and space constraints. It is a bad example to follow when writing pretty much anything else.

2) Use proper grammar. If you aren't skilled with English grammar, that may mean keeping sentences short and to the point. My personal sentence structure tends to be very complicated. I'm deliberately doing the opposite here. Making every sentence convey one clear idea will make your writing easier for the reader to understand. Every sentence needs to have a subject, a verb, and an object. Every sentence should have appropriate punctuation. Statements should end with periods. Questions should end with question marks. Don't use the little dot dot dots... unless you really truly know what you are doing with them. This may make your writing seem too formal. That isn't nearly as bad as having it seem too informal.

3) The advice you were given about only using English can be helpful. I don't know if TV or movies or radio is really going to be incredibly helpful to you. I haven't heard you speaking. Your writing is what I noticed. So, I would recommend reading and writing, especially reading something that isn't a medical textbook. It doesn't have to take up a lot of your time. If you choose the books well, you could get double benefit as your language skills improve along with your understanding of US medical culture. I recommend "Nursing Against the Odds," "Overtreated," "Survival of the Sickest," and basically anything by Atul Gawande. Find even 10 or 20 minutes a day to read well-composed nonfiction.

4) Finally, I will tell you the secret to clear writing in any language. As you write, you should imagine what each sentence would sound like if you said it out loud. Evaluate how it sounds in your head. If you said it to someone, would they understand what you meant? Is there anything you could change that would make it easier to understand?

Small changes can quickly make your writing seem much more professional. This isn't something that has to take a lot of time, but it will require some attention while you build new habits.

I just want to end by saying that I'm not talking down to you at all. I have enormous respect for you. You've not only learned a complicated second language that has many odd grammar and spelling rules, but you've also learned medicine in that language. That is pretty impressive. It suggests to me that you can accomplish anything you decide to attempt.

Good luck!

 

[bannie22]

There is significant discrimination against people who might not speak American english. In fact, many Americans will endorse that there is discimination against almost anything in this nation. The country is getting progressively more divisive as witnessed in the most recent election.

This is just what it is, and something you will have to accept if you want to continue in the US.

 

[Innocent resident]

Thank you, my pd wants me to have 12 hand written cases with complete history, physical exam, assessment and plan and differentials diagnosis in 12 week period.
I am done with 7 cases in 2 months.
My plan is to improve my clinical knowledge because I know I m very deficient in that.
I m doing mksap these days along with Washington manual..
This past week my pd Called me and have me evaluation for my clinic week with him.
He clearly said that I like you and you have good presentation skills but I want every one likes you..
In the clinical competency meeting there is this one attending ( who I never worked with, but he has good say in the hospital because he is in management of the hospital)said to my pd just get her off the program and my pd said no I have given hey 3 months of probation time I want you to evaluate hey, so I have my floor rotation with that particular attending..
Of note I have good elective evaluations

 

[Innocent resident]

Thank you every one for the advices.
I have huge respect for all of you.
I am really trying hard to prove my self.
Is really difficult for me .
Elective attendings I worked with gave me written evaluation that you have very present personality to work with.
My pd seems not concern with written evaluation.
He trust more on the things which attending discuss in clinical competency meeting.
My other problem is my race and nationality which I can't change and I don't want to change.
But belive me it is a huge problem.
People like me because I am good looking may be but at the same time they just don't like my hijab and my identity.

 

[Promethean]

Thank you every one for the advices.
I have huge respect for all of you.
I am really trying hard to prove my self.
Is really difficult for me .
Elective attendings I worked with gave me written evaluation that you have very present personality to work with.
My pd seems not concern with written evaluation.
He trust more on the things which attending discuss in clinical competency meeting.
My other problem is my race and nationality which I can't change and I don't want to change.
But belive me it is a huge problem.
People like me because I am good looking may be but at the same time they just don't like my hijab and my identity.

The hijab does cause a lot more problems than it should. I am saddened to note how much racism and bigotry does exist among physicians. I was once under the illusion that educated people were less likely to think about others that way, but I've learned that isn't true. That is one of the reasons that I'm in medical school. I saw a doctor be biased against her patients because they were different from her and it bothered me so much that I needed to do something about it. Trying to get her in trouble wouldn't change anything. Instead, I decided that stepping up and becoming a doctor who wouldn't discriminate was the best thing that I could do.

I don't really pray, but I will keep you in mind and hope good things for you. Keep trying. Be better and kinder than anyone who tries to tear you down.

 

[Gastrapathy]

"A pleasure to work with" is a meaningless statement. Your PD knows that. It is a commonly used compliment that doesn't reflect your fund of knowledge, clinical decision-making, or anything else that matters.

You need to have someone read your H&Ps because if they read like your posts, they could hang you. I know you feel this is insulting and unfair but there are grammatical, punctuation or spelling errors in all but one of the sentences in your last post.

 

[Domperidone]

@Innocent resident, so, I've worked with IMGs from the middle east. One has a hijab. (It feels really weird saying that in the sense that I've enjoyed working with them so much that's kinda the last thing I ever think about.) What stands out first about them is that they're amazing clinicians, supportive co-workers and compassionate with patients. I don't see them as IMGs, as they're my co-workers. For one of them, the nurses routinely tell their supervisor and the head of dept how wonderful they are. That said, they're now PGY5-6, and have fully adapted.

Whether they struggled at first, I've never actually asked. It was only much later in working with them that it came out that they were formerly refugees with foreign medical degrees. I'm sure I had assumed as much, but it wasn't really the first thing that ever came up in conversation while we were swamped with jobs. If there's been discrimination against them in some way, it hasn't affected their standing in the teams or discipline as they're both well regarded and everyone enjoys working with them. Their contributions far outweigh any discrimination that could arise from their 'identities.' (Hope that gives you a bit of hope).

I have no idea if their English is grand enough to write textbooks with, but what's key is that they are able to communicate clearly and appropriately. Their notes read like how you would expect for any doctor or resident in a Western, English speaking country.

(I work in Australia by the way, to give some context. On the side, when that Muslim ban initially happened, I remember the department head where I was rotating went "fudge, I guess we'll have to re-think going on any international conferences in the US." one of the attendings is from Sudan, not to mention 1-2 of their senior residents and fellows being originally from affected countries in the middle east. Sorry, random side story. Moving on...).

On the other hand, I've just heard of a native English speaker in another program/hospital being put on probation, for a myriad of reasons, but a few on the list include poor communication, poor English language skills and being unable to accept or understand criticism enough to improve. Native speakers too can struggle with English proficiency. It's rare that it does occur, particularly as they would have had to survive medical school. Regardless, poor English language skills is one of the reasons for the program to see this particular intern as unsafe.

Unfortunately, the medical profession is one that requires a command of the English language that is higher than average. Because you have to be a safe practitioner. You're dealing with the lives and well being of your patients. So, it matters. For instance, any text you write while at work after seeing a patient etc. is considered legal documentation. Any ward round notes are forms of communication to other staff, co-residents and other treating teams that will need them to check the progress of your patient or to action any jobs. If it's not clear to them what is going on or if there's any misunderstanding it can lead to errors. When you go to write a referral letter to another discipline - they need to understand clearly what's going on, and why their assessment is required, as they won't know your patient. When you go through informed consent with your patients you have to effectively communicate the risks and benefits to them. The list could go on. No one is saying that you have to sound like David Attenborough, but they have to feel comfortable enough to allow you to be responsible for their patients.

Try not to wallow in what you're working against with discrimination or being on probation. It's tough, I can't even imagine how hard that is to cope with, but it's something you cannot change. Or try to reserve only 5 minutes a day to allow yourself to reflect and feel bad about it, but then return to focussing on changing the things that you can control - your ability to communicate and your clinical skills.

 

[hello1234!]

I don't think the language is the big issue. In residency, you have to take criticism regarding your clinical management. Board scores won't make up for lack of clinical application of medical knowledge. The residents I know who didn't do well relied on their board scores, did not accept criticism well, or did not truly re-evaluate their clinical skills when attendings noted need for improvement.

 

[Domperidone]

Oh there is a lot of major things important in surviving residency.
I'm not personally saying English is a 'big' issue. But, there's been a specific questions about English and just trying to help them see why it is sometimes brought up.

Communication is important. it doesn't have to be a barrier, but it's an issue if people can't understand you. Among criticisms that can come up, I've seen it come up about specific residents. Things like, 'you can't be sloppy about your notes and discharge summaries.' Or please use 'appropriate clinical or professional language for things taht will go into medical record.' Patients complain if you cannot communicate effectively to them some thing complex into layman terms they can understand. It may not be a big issue per se, but it's not trivial either.

If the affected residents don't understand why, how horrible a feeling is it to live under believing it to be discrimination against them? There's a hopelessness to that. Most normal people aren't asking for phenomenal skills (granted you have to have a higher level than say engineers). It still needs to be enough so that it is not getting in the way of day to day to practice and it's not noticeable. May be there could discrimination in their depts, but I can't know that for sure from an internet forum. It would be a shame if in fact there was no discrimination intended and the criticism about language was meant well. apart from the dept being misunderstood, that resident will have lost a sense of support that is being extended to them. Feeling supported, I can't over state how important that is to get through. Even when you're not struggling, none of us are immune to mistakes. You have to feel like you have a chance to improve or redeem yourself the next day, not some lost cause for which everyone is just trying to build a case against you.

That said, generally...
If either language or communication is brought up as an issue, usually it's part of a bigger picture. it's not the biggest issue. Often it's just the tip of the iceberg. (I'm not directing this at anyone posting here, but that's from what I've seen)

 

[hello1234!]

Oh there is a lot of major things important in surviving residency.
I'm not personally saying English is a 'big' issue. But, there's been a specific questions about English and just trying to help them see why it is sometimes brought up.

Communication is important. it doesn't have to be a barrier, but it's an issue if people can't understand you. Among criticisms that can come up, I've seen it come up about specific residents. Things like, 'you can't be sloppy about your notes and discharge summaries.' Or please use 'appropriate clinical or professional language for things taht will go into medical record.' Patients complain if you cannot communicate effectively to them some thing complex into layman terms they can understand. It may not be a big issue per se, but it's not trivial either.

Interesting. I have never witnessed anyone experience problems with language during residency. It could be though that my program was in an underserved area where a lot of the attendings were foreigners with heavy accents themselves.

 

[Domperidone]

My point is communication is another facet to doing well in residency, among many, many other things.
A heavy accent is fine if the clinician is still well understood and safe.
(Arguably we all have accents anyway)

Great if you haven't had to watch someone suffer or struggle for a particular reason, in this case due to communication or language. However, to state the obvious, no two departments are alike, no two hospitals, no two programs etc. (just agreeing with your last comment).

I'm not personally saying these situations run rampant. However, occasionally it does crop up. Or the question wouldn't even have been posted. And I wouldn't have been in a position to even try to respond.

Also the poster sounded like they've gained insight. they're genuinely wanting to improve. they even have what sounds to me like an incredibly supportive PD that is trying hard to help them navigate through their program (which may or may not have discrimination within it).
To quote:

This past week my pd Called me and have me evaluation for my clinic week with him.
He clearly said that I like you and you have good presentation skills but I want every one likes you..

So, what I'd hoped to do, was to make them feel less alone and have incentive to keep improving in all aspects of what they're faced with. they're already aware that clinical skills are important and it's something they need to work on. I don't really feel a particular need to keep hammering on that. their other road block was language, and I was trying to "unblock" that so they can keep going and survive.

I don't see it as a particularly terrible type of 'criticism" ~ improving language. if it comes from a place of well meaning and has context. And I don't think it particularly detrimental if the intent behind it is to make you a better doctor for the patients in the community being served, and a better fit in the dept/program/etc. The point is integration and unity, not about giving something up like culture or a particular heritage.

 

[Innocent resident]

Thank you all for the great advices.
I am trying to be a better intern.
As you know I am on probation and trying hard to get out of this phase smoothly.
As I mentioned earlier I had poor ITE score.I am doing mksap these days.
Of note we were supposed to provide 2 written evaluations from 2 of our pts we working on and fortunately I got excellent evaluations from my patients.
I have a question here, will I be able to get pay for my 3 months probation period?
It was written on the letter that your salary for the intern year would be 55,000. Does this mean that I won't get paid for the 3 months of probation?
Thank you

 

[Light at end of tunnel]

Thank you all for the great advices.
I am trying to be a better intern.
As you know I am on probation and trying hard to get out of this phase smoothly.
As I mentioned earlier I had poor ITE score.I am doing mksap these days.
Of note we were supposed to provide 2 written evaluations from 2 of our pts we working on and fortunately I got excellent evaluations from my patients.
I have a question here, will I be able to get pay for my 3 months probation period?
It was written on the letter that your salary for the intern year would be 55,000. Does this mean that I won't get paid for the 3 months of probation?
Thank you

yes, you will get paid - its the law

also, you get evaluated by your patients? seems bizarre. id ask around and make sure you arent being rodeo clowned around by your pd. honestly, this to me sounds like
they are building a 360 case against you which includes 'patient complaints'

pds 'like' all their residents - get your head outta the sand

'trust' your PD; but always have a plan B

 

[hamstergang]

also, you get evaluated by your patients? seems bizarre. id ask around and make sure you arent being rodeo clowned around by your pd.

I got patient evals on myself in my fellowship, and it had nothing to do with me or probation.

 

[Innocent resident]

I checked it with all other residents, they all have to get it from their patients.
I still trust and respect my pd although the things which happened with me were clearly discriminating.
But I am working really really hard to get out of probation..that's all I can do I belive

 

[Innocent resident]

What could be the plan B?
I didn't think about that.
All am I doing is religiously following their instructions and trying to do as much better as I can.

 

[Light at end of tunnel]

Whats become abundantly clear after skimming the SDN threads is that probation seems to be a predicate for termination in that it documents the necessary due process rights/procedures hospitals "have" to provid residents prior to letting them go.

You feel that they have discriminated against you, which although something youd have to prove, already speaks to the way they have been treating you up to this point.

Ask yourself this: what will you do if at the end of probation your PD decides to terminate you? This is a very real possible outsome given the circumstances. If so, it would have been the second time your PD fooled you.

 

[rokshana]

Whats become abundantly clear after skimming the SDN threads is that probation seems to be a predicate for termination in that it documents the necessary due process rights/procedures hospitals "have" to provid residents prior to letting them go.

You feel that they have discriminated against you, which although something youd have to prove, already speaks to the way they have been treating you up to this point.

Ask yourself this: what will you do if at the end of probation your PD decides to terminate you? This is a very real possible outsome given the circumstances. If so, it would have been the second time your PD fooled you.

That's because, per ACGME guidelines, you can't be terminated from a residency without first being on probation.

 

[Innocent resident]

I am really scared about termination.
Does the probation mean that they gonna kick me out, no matter how much improvement I show?
Honestly I have no idea what is their in there brains but I am working hard to make my position strong.
They said they will decide about my future in September, till September I will be clue less no matter if I am getting good verbal evaluations because the only thing my pd consider is the clinical competency meeting.
I don't know what else I do to prove myself.
Honestly I never thought that after getting residency you have to face so much trouble.

 

[Innocent resident]

I feel so depressed and hopeless.
Why my program is so cruel.
I went to see my pd and asked him how I am doing and if there is any thing you want me to Improve, he said I am very busy with upcoming ACGME visit and I didn't get a chance to speak to your attending.
My attending on other hand giving me positive feedback and saying I am conveying your feedback to pd.
I am so clueless here

 

[mcl]

I feel so depressed and hopeless.
Why my program is so cruel.
I went to see my pd and asked him how I am doing and if there is any thing you want me to Improve, he said I am very busy with upcoming ACGME visit and I didn't get a chance to speak to your attending.
My attending on other hand giving me positive feedback and saying I am conveying your feedback to pd.
I am so clueless here

It sounds positive that your attending is giving positive feedback on your rotation. The Clinical Competency Committee will take that attending's comments, along with other faculty evals, nursing evals, patient evals, peer evals, test scores, conference attendance, and any other relevant factors in order to place you on a continuum from "novice" to "competent" in specific areas predetermined by the ACGME. The closer you are to graduation, the closer you need to be to "competent" (level 4) in all of the areas being assessed.

My suggestion would be to download and review the Milestones for your specialty so that you can better understand what the Clinical Competency Committee will be doing in September. Look at any previous scores (programs have to do this for each resident every six months so you should have had at least one report) and give yourself an honest self assessment--especially in the areas where you had identified weaknesses. If your PD isn't available due to the site visit (and those ARE really stressful and time/energy consuming), make an appointment to meet with the Chair of the Clinical Competency Committee (your PC will be able to identify this person if you don't know who it is). Hopefully that will provide some reassurance that you are on the right track and improving to meet their expectations for your level of training.

 

[Light at end of tunnel]

Your probation letter should have laid out everything you need to accomplish in order to successful complete probation. If it doesnt, and youre still wondering what you have to do during this period, I would consider that a red flag.

Your probation period isnt the time to be wondering what and why you are under probation, that should have been addressed by a previous remdiation plan/warnings type of stuff.

Also: what your attendings "tells you" is hearsay; the only thing that holds water is documented evaluations, which you should be getting for every rotation per ACGME standards. Dont be the fool that gets great verbal evaluations but somehow always manages to get negative written evaluations (you will look foolish in the end).

Technically, peograms can terminate you without probation, but this would have to be bc of egregious behavior: like using drugs at work, assaulting a patient, etc. These types of instantly fireable actions fall more in the court of things HR would have to deal with rather than an issue related to the core competencies.

 

[Domperidone]

I feel so depressed and hopeless.
Why my program is so cruel.
I went to see my pd and asked him how I am doing and if there is any thing you want me to Improve, he said I am very busy with upcoming ACGME visit and I didn't get a chance to speak to your attending.
My attending on other hand giving me positive feedback and saying I am conveying your feedback to pd.
I am so clueless here

Keep up the 'fight' that's left in you, bounce back.
You have until September. that's 5 months more. Keep going. There's no other direction to go except up.
it's okay to be scared or anxious, but don't let it take over. (If you let it, you'll go down again). Don't let yourself get overwhelmed. Focus on your goal and keep going. One step at a time, choose to be positive at least when you show up to work. Again, when you're home, reserve a small segment of time a day to think about plan b's or to straight up wallow and feel sorry for yourself.

Generally, if you know you're doing well, you'll be able to sense it at least a bit.
It's probably harder because you've been hard hit (whether deserved or not).
you can try asking other residents for their honest opinion and see what they say (if you trust them).
If they care, they will tell you gently.

If in the end, they were not actually being a supportive program and were lying to your face the whole time.
Would you really have wanted to stay with them for years of your life and felt hopeless for who knows how long?
I wouldn't lol. I'd get the hell out of there come September (personally. my mental health is worth more than this career. I wouldn't see it as a loss if you're leaving a place you could never thrive or be happy in. Let's face it, we're at the wards more than we're home and we see the people we work with, more than we see our own families. it better be worth it. it's gotta be worth fighting for).

 

[tennischamp822]

Keep up the 'fight' that's left in you, bounce back.
You have until September. that's 5 months more. Keep going. There's no other direction to go except up.
it's okay to be scared or anxious, but don't let it take over. (If you let it, you'll go down again). Don't let yourself get overwhelmed. Focus on your goal and keep going. One step at a time, choose to be positive at least when you show up to work. Again, when you're home, reserve a small segment of time a day to think about plan b's or to straight up wallow and feel sorry for yourself.

Generally, if you know you're doing well, you'll be able to sense it at least a bit.
It's probably harder because you've been hard hit (whether deserved or not).
you can try asking other residents for their honest opinion and see what they say (if you trust them).
If they care, they will tell you gently.

If in the end, they were not actually being a supportive program and were lying to your face the whole time.
Would you really have wanted to stay with them for years of your life and felt hopeless for who knows how long?
I wouldn't lol. I'd get the hell out of there come September (personally. my mental health is worth more than this career. I wouldn't see it as a loss if you're leaving a place you could never thrive or be happy in. Let's face it, we're at the wards more than we're home and we see the people we work with, more than we see our own families. it better be worth it. it's gotta be worth fighting for).

I would do this + network like crazy with other programs so that you have a way out in case you need it.

 

[ThoracicGuy]

I am really scared about termination.
Does the probation mean that they gonna kick me out, no matter how much improvement I show?
Honestly I have no idea what is their in there brains but I am working hard to make my position strong.
They said they will decide about my future in September, till September I will be clue less no matter if I am getting good verbal evaluations because the only thing my pd consider is the clinical competency meeting.
I don't know what else I do to prove myself.
Honestly I never thought that after getting residency you have to face so much trouble.

Not everyone that goes on probation ends up being fired.

 

[Innocent resident]

Thank you so much all.
I do have the feeling that I am doing good.
I go early, make notes of every new and relevant thing happen with patient.
I am trying and working hard, hoping for good.

 

[gutonc]

I go early, make notes of every new and relevant thing happen with patient.

Just for the record (and to help those who come after you)...you should have been doing this from July 1 onward. This is "how to be an intern 101".

At this point, you should be the first person on your service (not your team, but your entire residency program) in the hospital each day, and your notes should be done before your attending gets out of his/her car in the garage.

 

[Lostin_space]

Your probation letter should have laid out everything you need to accomplish in order to successful complete probation. If it doesnt, and youre still wondering what you have to do during this period, I would consider that a red flag.

Your probation period isnt the time to be wondering what and why you are under probation, that should have been addressed by a previous remdiation plan/warnings type of stuff.

Also: what your attendings "tells you" is hearsay; the only thing that holds water is documented evaluations, which you should be getting for every rotation per ACGME standards. Dont be the fool that gets great verbal evaluations but somehow always manages to get negative written evaluations (you will look foolish in the end).

Technically, peograms can terminate you without probation, but this would have to be bc of egregious behavior: like using drugs at work, assaulting a patient, etc. These types of instantly fireable actions fall more in the court of things HR would have to deal with rather than an issue related to the core competencies.

So a program actually CANNOT terminate you for academic reasons without 1- remediation, and 2-probation if remediation does not go well. The only way a program can fire you is if you do something really bad that goes out of the realm of academic stuff including like you said, assaulting a patient/staff member, being under the influence during work, etc. If a program fires or attempts to fire you without due process, there are serious legal ramifications. Also note that a program has to give you 4months of notice prior to firing you unless something really egregious as mentioned happens.

 

[Light at end of tunnel]

So a program actually CANNOT terminate you for academic reasons without 1- remediation, and 2-probation if remediation does not go well. The only way a program can fire you is if you do something really bad that goes out of the realm of academic stuff including like you said, assaulting a patient/staff member, being under the influence during work, etc. If a program fires or attempts to fire you without due process, there are serious legal ramifications. Also note that a program has to give you 4months of notice prior to firing you unless something really egregious as mentioned happens.

Exactly. They may have absolute decision making power over residents, but they have to follow written established institutional/GME compliant policies pertaining to remediation, probation, and termination in achieving their decisions. If they dont, they open themselves to serious legal ramifications.

Everyone plays by the rules when they finally have to, especially when a knowledgeable lawyer is involved. Sounds like you may have found one yourself innocent. Keep up the good fight.