I quit today

[tncekm]

Thanks , man.

I was settled in my heart about it until he called. I ended up asking if I could come back and he said No.

Sorry to hear that.

So, I know I'm no physician or student physician, but I don't think I need to be to add my .02, so here it is.

IMHO, the "no" isn't really a no until they say no to you while you're really begging If you are interested in going back, I'd figure out how to get face to face with your PD so he can see the sincerity and distress in your face when you apologize.

Best of luck.

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[Tired]

haha

"you're awesome"

"can I come back?"

"no"

wah, wah, waaaaaaaaaaahhhhhhhh

Ouch, even I felt that one.

 

[Doowai]

Sorry to hear that.

So, I know I'm no physician or student physician, but I don't think I need to be to add my .02, so here it is.

IMHO, the "no" isn't really a no until they say no to you while you're really begging If you are interested in going back, I'd figure out how to get face to face with your PD so he can see the sincerity and distress in your face when you apologize.

Best of luck.

Thanks, but I basically begged. he said "I have accepted your resignation, and as much compassion as I have, my answer is a firm no"

he is a very nice guy, a very sincere man, and I think he is really a good man. No malice at all. But from this I have decided one way to devide people is into 3 categories. The largest part are very devoted to things. A smaller part are very devoted to institutions. An even smaller part are very devoted to people. I believe I am the latter and the PD the former.

He is an individual devoted to 2 institutions : his church (very devoout Christian) and the residency program. As such his treatment of people stems from that - he is kind and good but does what is best for the program, and as he said "The fact yuo so firmly severed your relationship with us initially does not bode well. If you had come and spoken with me, a maybe - probably-maybe-probably could have worked this out. But the fact you didn't, really does not bode well". If he was a PD devoted to people he might have bent the rules to benefit the people, but as someone devoted to institutions his actions are based on his ethics and duty to the program. This is not to say he screws any people, because of his devotion to his church, he treats people fairly and with consistency. I, would have probably felt more devoted to the person than the intitution.

 

[Doowai]

~~~~~~~~~~~~~~

 

[tncekm]

Ahh... well, sorry to hear it Best of luck in the future.

 

[Doowai]

For those that are interested its the XXXX fam med program in XXX

 

[Doowai]

Dude, better to get out early if you really don't like it.

Actually I liked it - the hospital and facilities are all brand new, very top notch. I loved seeing the little skyline of XXXXX as I drove in every day - its like a minature city. I am enjoying the humidity after living in the desert all those years. The facilities have won several awards for its improvements and how high-tech it is. Its cancer treatment center is top notch. I wish I could have handled it better, but I just could not. I did my best, and it was not good enough, for anyone

The 2 chief residents had been very kind to me - one of them who knew I got yelled at and had a bad morning tried to talk to me at lunch about it, but I was just not in the mood.And I was also embarrassed because I was telling 2 of my classmates about the incident and loudly called the angry patients husband a fat son of a bitch [note: I did not call the guy a fat sob during the incident, I refered to him as that when i was telling 2 of my classmates the heated story in the doctors lounge], and this one chief resident is very overweight - I was embarrased too talk to him, after saying "fat son of a bitch'. I felt ashamed of myself.


I just could not handle the constant barrage of communications that I am doing everything wrong - I mean seriously, I got chewed out for not being physically close enough to my attending when they left the room, but for being a few steps behind when they left the room that the angry patient was screaming in. I mean seriously, I was getting chewed out for that. I felt like I did nothing right.

I really wish that if someone had felt I had done well with the worst patient encounter THEY had experienced they had told me so, or at least not spun around and then chewed me out for being a little slow in following them out of the room. I realize Dr.Phillips had just been yelled at herself, but yelling at me for being slow to exit the room is too damn much. What in her life sucks - she has a real doctors salary, her son is being drafted to the New York Giants as a linebacker, her entire body is not aching from sleeping on the damn floor, and she is not getting chewed out for every damn thing including how they do not walk close enough to the attending or being constantly given crap from the nurses - I swear that damn pede nurse was moving the one month old baby back and forth so I could not get a good stick. That probably sounds funny but I think Dr.XXXXXX would back me up (he superevised me on the CSF, or rather the failure to tap the babies spine) - near the nursing station I asked himm how I did and he said "on a one month infant, half the succcess in getting a spinal tap is the person holdiing'.

I am just a bit soft and just needed someone to say "Damn, that guy was difficult you handled it well" - and not "See... that... that is what I am talking about - Dr.XXXXX will chew you up and spit you out on Alpha rotation if you walk that far away. Never...NEVER leave your attendings side. DO YOU UNDERSTAND! When I walked out of that room you should have been right there with me. You got to get it together. You can't even walk out of the room right, how are you going to handle the other rotations? C'mon, get your ass in gear! Dr. XXXXX sounds like Dracula and he will come to me and say : that new resident, he is terrible" Whew, I am just had all I could take. I overwhelmingly feel I have not done one thing right yet.

Also I got sick of the nurses enjoying seeing me torn down in front 0f them, and of just standing there like a ***** when a patient is yelling in my face about crap I had little control over or else that really did no harm

 

[tncekm]

IMHO, I think you should toughen up and not make the past 6+ years of medical school / waiting to match, etc, just a waste of time, especially considering you said you like what you do.

Try again if you like it, don't quit if you think you'll regret it forever. Just don't act rashly again.

 

[Doowai]

Just don't act rashly again.

I hear ya bro

 

[Doowai]

haha

"you're awesome"

"can I come back?"

"no"

wah, wah, waaaaaaaaaaahhhhhhhh

I do like how easily exaggeration makes things funny. But it truly is an exaggeration - there is a big difference between awesome and "satisfactory evaluation" and "the nursing manager said you handled it well"

 

[AlternateSome1]

Thanks, but I basically begged. he said "I have accepted your resignation, and as much compassion as I have, my answer is a firm no"

he is a very nice guy, a very sincere man, and I think he is really a good man. No malice at all. But from this I have decided one way to devide people is into 3 categories. The largest part are very devoted to things. A smaller part are very devoted to institutions. An even smaller part are very devoted to people. I believe I am the latter and the PD the former.

He is an individual devoted to 2 institutions : his church (very devoout Christian) and the residency program. As such his treatment of people stems from that - he is kind and good but does what is best for the program, and as he said "The fact yuo so firmly severed your relationship with us initially does not bode well. If you had come and spoken with me, a maybe - probably-maybe-probably could have worked this out. But the fact you didn't, really does not bode well". If he was a PD devoted to people he might have bent the rules to benefit the people, but as someone devoted to institutions his actions are based on his ethics and duty to the program. This is not to say he screws any people, because of his devotion to his church, he treats people fairly and with consistency. I, would have probably felt more devoted to the person than the intitution.

It sounds like he is devoted to people, the patients. If he were to accept you back, he would have no way of knowing if you would walk out when a patient needed you. It sucks, but it is a pretty tough thing to recover from.

 

[dragonfly99]

wow. Sorry about your troubles. It seems you were in a situation where you didn't have enough supervision. I have been on a team w/18 patients as an intern, and taken multiple admits/day, BUT I had a resident with me. A first month intern w/no resident should not be doing procedures unsupervised. HOW did they think you should be able to do an LP on a neonate (that other residents and attendings had had trouble getting) with NO supervision. That is a bad plan, and it doesn't have to do with your competence vs. noncompetence.

Having said that, I think that quitting hastily was maybe not a great plan after all you have gone through. However, there are lots of docs in your boat. There are IMG's who work in other medical jobs (like you have mentioned) or who get business-type jobs. Obviously, you were doing something all these years to support your family - I mean before you went to med school.

You could consider reapplying next year. If you are willing to go to a small town/rural residency, you might find there to be less craziness (I mean less patients/day to admit) and people might be more supportive. However, in my opinion you are going to have to take crap from nurses for the first 1-2 years of residency and the best way to approach that is to NOT say anything ever to them that could be offensive, and to let their offensive comments roll off your back (make like a duck). Even the "good" hospitals have some nurses like that. I agree with you about the ratio of negative/positive feedback in residency. It needs to change but don't expect it to in 1 year. People are going to more frequently mention what you do wrong vs. what you do right. They are trying to be constructive but sometimes it feels like an attack. Again, that gets better/less with each year of residency, especially if you work hard. I believe you had a "hell day". However, a lot of us have had similar (maybe not as bad, but similar) ones.

You don't have a guarantee you'll not be in this position again if you choose to stay in medicine. Medicine is a lot of pressure. The thing is, the working conditions, the money, and your level of knowledge goes up with each year of training, so that makes things better. Still, medicine is not easy.

If you reapply you will have to address the problem of why you left residency suddenly. They will probably call your old program director to try and find out what happened. I would just be up front about it, and tell them you had a really bad day (yelling parents, no senior resident with many, many admission and a difficult LP on a neonate with no supervision). Also, tell them what your plan is to make things different in your next residency (i.e. have some stellar time management strategies in mind to knock out those admissions quickly, move to be closer to your family, get a strategy so that you never 'forget' to round on a patient which we have ALL probably fallen prey to, or almost have, as interns...)
It sounds like you would be happier closer to your family - can you try for a residency closer to them? How about a different specialty, like physical medicine/rehab or pathology? Wouldn't your chiropractor background help you out in PM and R?

Best of luck to you and your family. We here on SDN sympathize.

 

[dragonfly99]

OK
Now that we have more info.
doowai,
it sounds like people were trying to help you (such as supervising the spinal tap, the chief resident trying to talk to you at lunch, etc.). Actually, sometimes I didn't even GET lunch (or dinner) at times on call. And referring to a patient's family member with expletives is definitely NOT cool...we've all wanted to at times, but we can't. Patients and families can cuss us out, but we can't and can't yell at them. It's just what we do. We grit our teeth and move on. I suspect the PD and others weren't reacting to you not being good at some things yet (LP's, etc.) but more to how you reacted to being stressed out (refusing to talk to the chief resident at lunch, quitting the residency program, etc.). They think if you are in the same situation in a couple of weeks, what is to stop you from blowing your top and just quitting again? If you want back in your residency program, the only option I see left is to
a) have an old preceptor who LOVED you call up your program director,
and
b) find some attending at your current program who likes you and tell that person you really, really want to come back, and can he intercede for you with the program director.
This would all be a long shot, but if you want to practice medicine then it might be worth it. Remember, EVERY intern is incompetent in some way(s) at this point in the year. You are NOT a fully trained doctor right now. Don't beat yourself up about that, but you have to think about how you were reacting to situations. Nurses and patients are going to be unreasonable from time to time, and so are attendings. How will you deal with that if you come back.

Medicine fellow

 

[Faebinder]

Errr... so where are all those senior residents? No one is checking on you all 3 weeks? Sheesh.

I agree to the statment that an FM or IM intern handling 10+ patients 3 weeks into internship is malpractice world.

 

[Doowai]

A first month intern w/no resident should not be doing procedures unsupervised. HOW did they think you should be able to do an LP on a neonate (that other residents and attendings had had trouble getting) with NO supervision. That is a bad plan, and it doesn't have to do with your competence vs. noncompetence.

.

I was supervised. My attending was not there, but I went to the PICU and got the doctor in charge there (XXXXX). I was handling 3 wards : pedes, womens and the nursery. He supervised me, even though he is not my preceptor/attending. I have had alot of good hand holding or I would have done much worse. Dr. P is very good and I like her sense of humor, but she had alot to critique about me.

It sounds like he is devoted to people, the patients. If he were to accept you back, he would have no way of knowing if you would walk out when a patient needed you. It sucks, but it is a pretty tough thing to recover from.

I see that point, but I waited until the end of the shift to quit. It was very rash though. My temper was thin and I felt I might embarrass myself if I went back today (the next day) and got a repeat of more of the same.

 

[debuub]

Did you happen to interview with any of the attendings that are now treating you like s hit?

I think you should try to put a personal spin on your behavior. Explain that your own child is seriously ill and hospitalized, that you are scared and that it has affected your demeanor and performance.
Tell them you feel like a failure because you are not there for your own seriously ill child so how can you be expected to care for other parent's children at this time. Ask for their understanding.

Do not make it about how they treated / mistreated you, but about your turmoil over your own child.

Don't accuse, just be apologetic.

 

[Doowai]

Errr... so where are all those senior residents? No one is checking on you all 3 weeks? Sheesh.

I agree to the statment that an FM or IM intern handling 10+ patients 3 weeks into internship is malpractice world.

The seniors supervise other services. As I think I mentioned, an attending came around mid day to look over all my notes and orders, and round on the patients.

 

[Doowai]

OK
And referring to a patient's family member with expletives is definitely NOT cool...we've all wanted to at times, but we can't. Patients and families can cuss us out, but we can't and can't yell at them.

Yeah my cussing happened in doctor's dining. it was very innapropriate and I was embarrassed for several reasons.

 

[Faebinder]

The seniors supervise other services. As I think I mentioned, an attending came around mid day to look over all my notes and orders, and round on the patients.

That's like punishment rather than what I was trying to ask... where are all the seniors checking on the new interns to make sure they are not sinking day after day..... not checking to see if they did the work correctly. Sounds like a crappy program. Sorry to hear that.

 

[Doowai]

Did you happen to interview with any of the attendings that are now treating you like s hit?

I think you should try to put a personal spin on your behavior. Explain that your own child is seriously ill and hospitalized, that you are scared and that it has affected your demeanor and performance.
Tell them you feel like a failure because you are not there for your own seriously ill child so how can you be expected to care for other parent's children at this time. Ask for their understanding.

Do not make it about how they treated / mistreated you, but about your turmoil over your own child.

Don't accuse, just be apologetic.

I like that, but its not true. My son was out of the hospital after one week. I have been here 5 weeks

 

[elwademd]

wow. i was waiting for you to say that you were kidding, but you never did.

i suppose this will be a wake up call for that program, and perhaps they'll change their practices (though i doubt it).

for you, i'm not sure what to say. so, i'll just wish you the best of luck at this point and chime back in if something pops in my head.

 

[KeratinPearls]

Dude primary care sucks.

I don't know your whole story, but I say transfer into a PMNR program (you were a chiropractor?). It seems as if ppl in PMNR are laid back.

 

[Doowai]

That's like punishment rather than what I was trying to ask... where are all the seniors checking on the new interns to make sure they are not sinking day after day..... not checking to see if they did the work correctly. Sounds like a crappy program. Sorry to hear that.

Well the attendings are really knowledgeable, and they are there about 3 hours of the day, and I can usually reach them by phone whenever I want.

but for a first rotation, its kind of difficult to be a bother for every little thing. I mean everyone else has work to do, and the first few days I am like : um... where are progress notes kept? Um... where is the prescription pad? um.... do we have to put a billing sheet here? Um... my password for the hospital EMR does not work, can you log in so I can check some recent lab reslts? Um.... where do you keep ophthalmoscopes? etc etc etc. I mean, nurses are working too - and its a pain for me to ask them to help me with every little thing.

and I hate calling the attending for everything: can I discontinue the IV rocephin and put them on oral omnicef? Can i discontinue the D10W or should I just reduce the IV rate by half? After they have the IVP do they still have to be NPO or can I let them have something to eat?

 

[Old_Mil]

Patients and families can cuss us out, but we can't and can't yell at them. It's just what we do. We grit our teeth and move on.

Is this part of that newfangled patient-centered medicine everyone seems to be talking about? Seriously, if a guy gets in your face, why not just call hospital security or the police and have his behind removed until he can act like a human being?

 

[me454555]

Why set yourself up for failure like that? You're undergoing a stressful time and you compounded that by living 1400 miles away from your family w/no bed or furniture. I don't know if it would have changed anything but I'm sure you would have been a lot happier if you had a good night sleep and came home to your family every night. Good luck w/the rest of your life, sorry medicine didn't work out for you

 

[dragonfly99]

Agree that it is VERY difficult to be a new intern in a new hospital that you are not familiar with, and having everything computerized/electronic now makes it a little worse. The computer in 6 months will be your friend b/c it does some things for you, but now it's a pain in the a-- because you are still learning how to use it. I feel your pain. I was in a similar situation the 1st month of residency because learning how to use the computer and navigate a new hospital takes time. Those who did med school at that hospital have an advantage t he first couple of months.

Be aware that anything you post on this forum can be read by others...others at your residency program might be on here right now. Be careful what you say.

At this point, you can give up and go home, or you can try one last ditch effort to stay in your residency. The PD already said no so it will be hard. Like I said, someone who knew you well in the past (past preceptor, etc.) who is an attending may be able to try and pull some strings for you, but difficult if there is nobody willing to go out on a limb for you. Also, I would write a letter to your PD apologizing for what happened, and asking to come back, and telling him specifically what you would do differently if you were to come back (such as promise to not lose your temper or make any disparaging comments about patients, even those who drive you nuts...and promising to have better time management skills).

A lot of us got criticized for "time management" during the first few months of internship. Some of the critiques might be justified, but some of them are just a factor of being the low person on the totem pole. You will get blamed for things you did do, as well as things you didn't (or which shouldn't have been your responsibility). If you go back to ANY residency, I suspect that will be the case. It's tough from your perspective b/c you are not a 26 year old and have other life experiences. It's tough to be in the "low man on the totem pole" position for a couple of years as you will be.

I think that being on a busy ward service with no senior resident helping you is a tough row to hoe for a new intern - any new intern. Having an attending around a couple hours a day really doesn't compensate for having a resident around. Also, having not done med school there (or even anywhere in the US) I am sure there was a lot to get used to. The question is, are you willing to potentially give up a medical career without more effort? You have done a lot to get where you are...

 

[radoncadonc]

Doo,

You are a DOCTOR. There are plenty of jobs that you can do that don't involve practicing medicine. You can consult for companies, you can be a pharm rep, you can open a med spa. There are lots of people looking to hire people that have MDs. You can do research if you want. Why settle on truck driver?

If seeing patients wasn't for you, then use your education to do something else.

 

[AlternateSome1]

Is this part of that newfangled patient-centered medicine everyone seems to be talking about? Seriously, if a guy gets in your face, why not just call hospital security or the police and have his behind removed until he can act like a human being?

Very nice thought, but that won't quite fly unless he starts threatening you or disturbing other patients. You really do just have to grin and bear it. Most of the people who act like that are just worthless scumbag drugseekers who feel entitled to anything they want, but occasionally you get some distraught family member that turns around with a little TLC. This story just reeks of the former, however.

 

[Doowai]

OK
Patients and families can cuss us out, but we can't and can't yell at them. It's just what we do. We grit our teeth and move on. I suspect the PD and others weren't reacting to you not being good at some things yet (LP's, etc.) but more to how you reacted to being stressed out (refusing to talk to the chief resident at lunch, quitting the residency program, etc.).

I never cussed or yelled at them. I was telling 2 of my classmates the story in the doctors dining room, and the story got heated and i refered to the guy as a fat sob. I did not want to talk to the chief, mostly because of using the epithet "fat sob". I was embarrassed since he is overweight.

 

[Tired]

Is this part of that newfangled patient-centered medicine everyone seems to be talking about? Seriously, if a guy gets in your face, why not just call hospital security or the police and have his behind removed until he can act like a human being?

That's what I do.

You just gotta man up and do it, consequences be damned. If staff or allied health wants to get in your face over it later, lets those chips fall.

 

[radslooking]

The seniors supervise other services. As I think I mentioned, an attending came around mid day to look over all my notes and orders, and round on the patients.

I don't know how you are used to medical systems working, but your attending shouldn't come strolling in around midday with an new intern slogging away on 10+ patients. that's just asking for trouble.

 

[dragonfly99]

agree w/you radslooking
Rounds usually happens reasonably early in the a.m. (like 7, 8 or 9 am at latest) with the intern prerounding from 6-7 or 8 in the a.m. and then presenting to the attending. At least that's how it was at my medicine program.

 

[ozzie20]

I think we should all learn from this case and make sure that nothing like this ever happens in our respective residencies. What A lot of attendings and residents fail to realize that all those times they bash the juniors for being incompetent, they are bashing their future colleges, future doctors who could refer patients to them, and make them more money.
True, this is how the medical profession is, but I for one would change things DRASTICALLY given the opportunity (and eventually I will have that shot, we all will)
Don't worry about what you post here doowai, what are they gonna do? fire you again? As for what to do in the future, you are a doctor, you won't lose that.

 

[Doowai]

agree w/you radslooking
Rounds usually happens reasonably early in the a.m. (like 7, 8 or 9 am at latest) with the intern prerounding from 6-7 or 8 in the a.m. and then presenting to the attending. At least that's how it was at my medicine program.

well this is really pretty similar, interns preround a little earlier (4 or 4:30 on alpha rotation). I may just not be cut out for a profession like this. I wish I was - my classmates are great, people are very smart here. It just may not be a great fit - my age and life situation, etc. I enjoy alot of things about medicine,and about family medicine. I am not a big fan of the yelling by patients nor a big fan of the criticism stacked higher and deeper on top of the yelling.

I owned business' for 16 years and never would have thought of saying such critical things to employees. And its not that I could not find people to replace them.The program director told me this morning that he was already interviewing other people, but because a person can be easily replaced does not mean you can beso critical. All my staff in my offices could be trained much more quickly than a resident that is for sure but I appreciated the fact they worked for me - helped me - were willing to be there on time etc.

Residencies really do not seem to appreciate their residents much. Being hypercritical of every thing someone does has never increased performance in my estimation. A little praise goes a long way. I still have a couple of employees that stay in touch with me , one over 10 years after she moved away. Partly because I tried to always treat them well.

 

[Doowai]

agree w/you radslooking
Rounds usually happens reasonably early in the a.m. (like 7, 8 or 9 am at latest) with the intern prerounding from 6-7 or 8 in the a.m. and then presenting to the attending. At least that's how it was at my medicine program.

My choice of words was not quite fair. This is basically how it was supposed to be in the program, except we were supposed to meet at 8:30. I had a different attending each week, but one of them was very punctual and there at 8:30. So my choice of words made this seem worse than it was

 

[billydoc]

Why set yourself up for failure like that? You're undergoing a stressful time and you compounded that by living 1400 miles away from your family w/no bed or furniture. I don't know if it would have changed anything but I'm sure you would have been a lot happier if you had a good night sleep and came home to your family every night. Good luck w/the rest of your life, sorry medicine didn't work out for you

Yup, and that's exactly what I've said before.

Doowai, things won't be that bad for you, or at least you won't feel them so edgee if you stayed with your family. Yeah, I know you'won't see them as much, but the fact of them being near you physically will make things a lot more easier for you.

Good Luck buddy. Really, try to (whatever you've got to do) to make it back.

 

[Doowai]

Yup, and that's exactly what I've said before.

Doowai, things won't be that bad for you, or at least you won't feel them so edgee if you stayed with your family. Yeah, I know you'won't see them as much, but the fact of them being near you physically will make things a lot more easier for you.

Good Luck buddy. Really, try to (whatever you've got to do) to make it back.

Missing my children was killer. In the 5 weeks I was here, not a night went by that I did not cry. I wanted to just go in and see my 6 year old sleeping so bad. When I got a partial text from my oldest son that my 6 year old was in the hospital with what they thought was miningitis it was extremely stressful - I could not reach my wife, when she would text me the messages were not very clear except he had a 106 temp despite combinations of tylenol and motrin. Over the first weekend I drove 24 hours non-stop to see them for just a few hours, and then drove 24 hours non-stop back for more training. I pulled into XXXXXX at 3 AM Monday morning for the 7 AM ACLS training - we finished late and it was a loooonnnggggg day. I missed seeing my son win 2 regional swim events.

 

[jdh71]

Missing my children was killer. In the 5 weeks I was here, not a night went by that I did not cry. I wanted to just go in and see my 6 year old sleeping so bad. When I got a partial text from my oldest son that my 6 year old was in the hospital with what they thought was miningitis it was extremely stressful - I could not reach my wife, when she would text me the messages were not very clear except he had a 106 temp despite combinations of tylenol and motrin. Over the first weekend I drove 24 hours non-stop to see them for just a few hours, and then drove 24 hours non-stop back for more training. I pulled into Shreveport at 3 AM Monday morning for the 7 AM ACLS training - we finished late and it was a loooonnnggggg day. I missed seeing my son win 2 regional swim events.

Damn. That is hardcore. Did your PD know about all of this? He might be more understanding if you give him context.

 

[Doowai]

Yes he knew about it

 

[ozzie20]

Yes he knew about it

Then him and his program aren't worth the time of day in my book. I'll probably make recommendations to all future med students not to even apply to this program.

 

[Doowai]

And at the end of the day, when I am releived of patient duties, the attending wants me to go to clinic to check messages from outpatient clinic nurses and I tell her word for word:

"Dr. P, I have made a decision and its final. Its nothing personal against you or the program. But this is just not working out."

You know this is not quit true, I told them it was not personal and simply a matter of feeling stretched too thin intellectually and emotionally - but a huge part of it was the ass chewings from this one attending. In 16 years of employing people I never disciplined someone in front of others, especially patients. I knew it would bite me in the but t, if for no other reason than if patients lost respect for my staff it would lead to poor compliance. I can walk away from patients, but due to the differential of power I cannot walk away from attendings. Being told to "heel" for my attending is just wrong - I mean this person ordered me to "heel" when I went to the sink to wash my hands in the nursery and when she stormed out of the angry patients room. It really was partly personal.

I wonder if I should make that clear to the PD?

Tactically speaking, might not have been a bad idea to get that first paycheck before pulling the trigger.

.

Yeah more than I realized. I signed up for direct deposit. I was supposed to get paid today - nothing. My first paycheck, plus a $5000 sign on "loan repayment" check, plus the money we had to shell out for orientation. Not only were we not paid for 2 weeks orientation, but we had to pay for our hotel rooms in Shreveport. We were supposed to be reimbursed for this. I mean need the money - my kids need the money. Now I am really ticked. THAT really sucks.

 

[billydoc]

Yes he knew about it

I agree w/ ozzie20 on it. FP should be one of the most family-friendly recidencies. After all it's got "family" in it's name. Try to explain it somehow one more time. Just give it a shot (albeit in the dark). Who knows? May be the stars will be aligned in your favor this time around . Sure you've got some bad blood already w/ them. And even if they let you stay you'll always have to watch your back, and feel like you're on parol. I only suggested trying to stay is b/c of the age thing. Pushing big 50 you don't want to take too many yrs off if you don't have to. And you kind of need to be sure that these ppl are not vendictive. One worst case scenario I envision is they'd let you stay.....and still screw you at the end of the year . May be you'd be luckier finding PGYII spot next year, but if they fail you just to get back at you you're back to square one. That is likely to really push you over the edge. Who needs this ****!!!. May be, just may be you'd be better off now staying w/ your family for this year, or be lucky enough to scramble next month in the area where your family leaves. I think these personal stuff demons could attack you again, if nothing is changed in this regard. But only you know what's best and realistic for you.

Best of luck friend

 

[jdh71]

I agree w/ ozzie20 on it. FP should be one of the most family-friendly recidencies. After all it's got "family" in it's name. Try to explain it somehow one more time. Just give it a shot (albeit in the dark). Who knows? May be the stars will be aligned in your favor this time around . Sure you've got some bad blood already w/ them. And even if they let you stay you'll always have to watch your back, and feel like you're on parol. I only suggested trying to stay is b/c of the age thing. Pushing big 50 you don't want to take too many yrs off if you don't have to. And you kind of need to be sure that these ppl are not vendictive. One worst case scenario I envision is they'd let you stay.....and still screw you at the end of the year . May be you'd be luckier finding PGYII spot next year, but if they fail you just to get back at you you're back to square one. That is likely to really push you over the edge. Who needs this ****!!!. May be, just may be you'd be better off now staying w/ your family for this year, or be lucky enough to scramble next month in the area where your family leaves. I think these personal stuff demons could attack you again, if nothing is changed in this regard. But only you know what's best and realistic for you.

Best of luck friend

Yes. I you have to try again to get back in. I mean they will need someone in that spot. Tell them it was a really, really, really bad day with your own sick child on your mind, and that it will NEVER happen again. Eat the pride - they can only hurt you for so long, time's on your side.

 

[Arch Guillotti]

You know this is not quit true, I told them it was not personal and simply a matter of feeling stretched too thin intellectually and emotionally - but a huge part of it was the ass chewings from this one attending. In 16 years of employing people I never disciplined someone in front of others, especially patients. I knew it would bite me in the but t, if for no other reason than if patients lost respect for my staff it would lead to poor compliance. I can walk away from patients, but due to the differential of power I cannot walk away from attendings. Being told to "heel" for my attending is just wrong - I mean this person ordered me to "heel" when I went to the sink to wash my hands in the nursery and when she stormed out of the angry patients room. It really was partly personal.

I wonder if I should make that clear to the PD?



Yeah more than I realized. I signed up for direct deposit. I was supposed to get paid today - nothing. My first paycheck, plus a $5000 sign on "loan repayment" check, plus the money we had to shell out for orientation. Not only were we not paid for 2 weeks orientation, but we had to pay for our hotel rooms in Shreveport. We were supposed to be reimbursed for this. I mean need the money - my kids need the money. Now I am really ticked. THAT really sucks.

I too have been reprimanded by an attending in front of a pt. (for something dumb and minor) which burned me up. You just have to swallow your pride in the form of a **** sandwich. Residency is full of these moments and yes there is a beautiful light at the end of the tunnel.

 

[maceo]

Thanks.

After the second patients husband yelled at me, I was texting friends and family like crazy. I got texts back that said things like "Oh that is awful, but you will make th right decision". Usually when I complain about things I don't want advice. This time I wanted advice. What i got was votes of confidence, but my confidence in myself was shot at this point.

A few minutes after I gave my resignation in the evening I started getting texts and calls saying "You can't quit, hang in there". But it was too late, it was done. There is a 2 hour time difference between here and back home where my family and friends are. About an hour after I quit the guy I did my anesthesiology rotation with called and said "You can't quit" - to which all I could reply was "too late, its done, thank you for calling, I really don't want to talk now". A half hour sooner and I would probably still be in residency.

If you are not in residency do not expect anyone to do anything other than make you feel inadequate - and many of the people (like nurses) to completely enjoy making you and seeing you feel inadequate.

About 40 minutes ago the program director called me. While seeing how I was doing, he told me that he had received a satisfactory evaluation from my first preceptor. I was told, after asking, that the nursery manager had said I handled the angry dad well and professionally. The program director told me that my preceptor had told him that it was the angriest and rudest patient they had ever seen, and the worst patient encounter they ever had. It really really really really would have meant alot and changed my feelings about quitting if anyone had told me those things at the time. Instead my preceptor chewed me out for not being right by her side when she marched angrily out of the buthole patients room. I followed her soon after she marched out, but I guess she expected me to be shoulder to shoulder with her. When it was done, I was sure I could not even walk by someone correctly.

Its a shame there really does not seem to be room for a bit of kindess in the methodology of residency training. People have been about as friendly as you can be to strangers, which is what I am to a program.People have been helpful and willing to teach. But everyone is very quick to tell you where you are inadequate, but if you do something well they might mention it to others but they never will tell you.

Seriously, I have put up with alot to do this - one person saying I did a good job at something would have relieved alot of pressure. Give some feeling of hope. That constant barrage communication of "you are no good" just reminds me too much of my childhood upbringing - and at my age, I just am not willing to put up with it. Those of you who can put up with it, and still retain heartfelt kindness to patients - my hat's off to you. Its more than I can do.

I expected it to be hard. But I guess I expected either a bit more encouraging atmosphere (or at least a blend of positive comments with the negative comments), or at least them to be funny when giving you the negative comments - like Dr.Cox on scrubs. This place is not too "malignant", nobody has cussed at me or called me names. But the general atmosphere of residency here is such that it seems nobody will tell you that you are doing okay, - and if you are a confident person you can handle that, and if you are not it sort of eats at your self confidence and your sef esteem. I am not - at least not anymore.

i think you have just become my personal hero.

I should have quit long ago. there is no holy grail. Its just heartache and more heartache with decreasing reimbursements and longer hours. Good for you. Move on with your life. You will be very very happy

 

[ozzie20]

My vote is to NOT call him back and ask for your job back. Forget that, you don't need the stress, you'd be going back to an even worse environment than before. You can wait it out a LONG time with your family doing other jobs, and then you can reapply to whatever specialty you want to in the area your family is in. There is LOTS of money out there, outside of medicine and inside of medicine, just do what makes you happy, and in your case, I think what makes you happy is to be with your family and friends (I wholeheartedly agree, there isn't a numerical value of paycheck big enough to compensate for time away from my family).

 

[Doowai]

And you kind of need to be sure that these ppl are not vendictive. One worst case scenario I envision is they'd let you stay.....and still screw you at the end of the year .

Well I hear you on that. 3 years ago I interviewed at a place I knew I did not want to be , and thanked them for inviting me and excused myself. I thought I was polite, but did not realize how important residencies feel they are . Anyway this program called all the other programs I applied to and told them I was a dick - which I am, but they don't have to announce it.

 

[Doowai]

or be lucky enough to scramble next month

??????? I thought the scramble was in March after the match??? Has that changed??

I think what makes you happy is to be with your family and friends (I wholeheartedly agree, there isn't a numerical value of paycheck big enough to compensate for time away from my family).

Last week I woke up - still half asleep - and could see my oldest son laying next to me when he was 3 (that would have been 14 years ago). back then I was still growing my first business. I was so busy and so consumed with finances. My wife would sometimes bring my then 3 year old son to me, just to make sure we spent time together.I sometimes spent too much time with work. I wanted the business to go so well - not supporting my family is the worst thing. I felt put upon to be interrupted back then. That morning last week I would have done anything to get to go back to that moment. To pick him up one last time when I could , when his arms only reached from shoulder to shoulder when he hugged me.

Now a decade or two later I cannot remember anything real significant ever from work, but I can still remember his hair cut when he was 3, the blue button up sweater he used to wear, the way he would crawl up inside my shirt so his head stuck out the same neck hole as mine, and the way he would call me "my daddy".

Medicine when it is all said and done is just a job. I get emails almost daily from the kids I taught at school the last couple of years. I want to enjoy my work - but I want to work to live, not live to work

 

[NotAProgDirector]

I was supposed to get paid today - nothing. My first paycheck, plus a $5000 sign on "loan repayment" check, plus the money we had to shell out for orientation. Not only were we not paid for 2 weeks orientation, but we had to pay for our hotel rooms in Shreveport.

You theoretically should get paid for the days you worked. Your sign on bonus might be void -- most contracts require that you pay it back if you leave in a certain time period. They have to pay you for required orientation -- but it sounds like they won't. They don't have to repay you for your expenses, unless it says so in the contract.

Residencies really do not seem to appreciate their residents much.

Let's not toss all residency training in the wastebasket. There are many good programs out there. You may not have found one of them.

Your experience sucked. Obviously I only have your word here, and I bet the PD might have a different view of the world, but this clearly seems very dysfunctional. Virtually every order that every intern writes in my program for the next few months is watched carefully. There is always someone right there to help -- either a more senior resident, a fellow, faculty -- immediately available, no begging. There is no yelling at interns (well, I do have this one trauma surgeon in the ICU who does yells at everybody, but I'm trying to fix that).

It's hard, and the hours are long. It's physically and emotionally draining. Whether there's a holy grail or not is unclear -- I love my job, I love going to work, I love seeing my patients. I hate the fact that I have limited control over my workday -- one really sick patient and I'm calling my wife and telling her I won't be home for dinner. When I'm on for the weekend, it's 7A - 6P at a minimum both days. And the administrators who run the hospital make twice as much and seem to work half as hard (although I bet they'd state otherwise).

Advice:

1. I'm thinking that it might be a bad idea to go back. Sounds like that door is closed anyway, but if you go back begging now you'll "owe" your PD, and that's probably not a good place to be. Are you really going to be able to stay there for 3 years?

2. Get a letter from your PD. Now. Make sure that he/she puts in writing what you've stated above. Do not "waive" your right to the letter. Get a copy for your records. You'll need it should you decide to try again.

3. You;ll have to decide how hard you're willing to fight for your paycheck, if it never comes. It's clearly illegal for them not to pay you. As mentioned above, your salary alone (without the bonus and expenses) may simply not be worth the fight. Needless to say, address #2 first!

4. If there is a GME director, you could try to get them involved. They could help settle issues #2 and #3. Might not work, if the place is truly malignant.

5. FYI, your ex-program is getting site visited on 10/23. Play nice first. If you don't succeed, make sure you mention you'd be happy to contact the site visitor. Needless to say, this should be your last resort -- they'll be no love if you threaten them, and they'll try to destroy your credibility. if the other residents don't back you up, you'll be ignored as a failed out resident with an axe to grind.

 

[Leukocyte]

Doowai, I feel your pain. The problem is Family Medicine as a specialty. Family Medicine sucks. It sucks becuase it is tough. I do not care what others say, Family Medicine is a TOUGH specialty. It is in FM were we need the top med students with 99 on the USMLEs, not in Radiology or Dermatology. Knowing a little (by little I mean 50-60%) about EVERYTHING is tough and confusing. It takes a special person to be a good Family Medicine doc. It sucks also because it involves constant, high volume patient contact. Infact clinical medicine, in general, sucks.

Unfortunately, I can never be a good FM doc. My AADHD brain just cannot keep shifting from IM to peds to ob to gyn to ortho to er back to peds then to cardiology to endo to neuro to....... I just want to FOCUS on one thing and know it well.....with minimal pt contact.

I said it, and I will say it again...clinical medicine and constant pt contact SUCKS.

Good Luck Doowai.