I quit today

[Doowai]

1) 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.



2) 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.

3) 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.
.

One of the residents forwarded an email the PD circulated about how I resigned. Its mostly true. I contacted one of my preceptors who said they would draft a LOR stating I was a pretty good resident.

Do you think it is still a good idea to get the letter from the PD and what should it say. You and I had many private message exchanges about this program and how they would not send contracts to sign until we had completed the training.

There are many good programs out there, but I doubt many of them are friendly to FMG's. The repayment for my expenses is not mentioned in the contract. The training is required, but they are clear they will not pay for it. The $5000 bonus is mentioned in their program brochure but not in the contract.

And in actuality I think this is a good program in which a person can learn alot.

Now that I am not getting paid for the actual time I spent, I am feeling pretty angry. I had to borrow money from my teenagers to to cover this period of time.

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[michaelrack]

Doowai, do you think your age had a role in how you were treated by the residency program? It probably won't get you your job back, but an age discrimination suit might bring you some much needed $$.

 

[Doowai]

Doowai, do you think your age had a role in how you were treated by the residency program? It probably won't get you your job back, but an age discrimination suit might bring you some much needed $$.

I don't know. It was brought up alot and used as jokes by other residents alot. I think everyone noticed and I played it off a bit as a joke, but it bothered me. One pediatric intensivist walked up, looked me up and down and said "so you are the new resident. You certainly look more senior than most". Everyone noticed and brought it up. I doubt there is much I could do about it, and don't think I have any proof of such

 

[Doowai]

ddd

 

[Doowai]

A first month intern w/no resident should not be doing procedures unsupervised. .

Just to reiterate, the pediatrician in the PICU supervised me

 

[exPCM]

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.



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.

I think aProgDirector has made some very good points. However I must say that I have no respect at all for the ACGME. Programs are violating rules and yet we rarely hear of accreditations being stripped. Does anyone seriously believe there is not one program in the whole country that is not committing violations at this moment worthy of having their accreditation pulled? Why are ACGME reviews of residency programs not made public so that residents can see them and use the information when deciding where to interview and how to formulate their rank lists? The ACGME IMHO functions as a paper tiger that tries to give the appearance of regulating residency programs while their actions generally serve the interests of residency program directors and administrators rather than protecting the residents in the programs. I will repeat what I posted on another thread:
The ACGME is a big f***ing joke IMHO. They act like the Red Cross representatives going into German POW camps in WWII and asking the prisoners how they are being treated. What resident is going to speak the truth to the ACGME when they are interviewed without anonymity in a group setting? I have seen a chief resident go straight to the program director after the group resident meeting with an ACGME representative to report on which residents made any negative comments or criticisms to the ACGME representative. This is a situation that is ripe for retaliation against the resident, In addition, if the ACGME pulls your program's accreditation it may totally mess up your residency plans as you may not be able to sit for the boards if your program is not accredited and transferring to another program in some specialties may be very difficult.
If the Red Cross wanted to really know the true conditions at the POW camps they should have concentrated more on interviewing prisoners who had escaped.
Similarly, if the ACGME was really serious about finding out about the true nature of a residency program they would speak confidentially on an individual basis with residents who had already graduated from the program.
If I were in charge of the ACGME I would push through tighter enforcement of rules resulting in loss of accreditation for violators. I would also work to mandate that if a program loses accreditation they would be responsible for monetary damages to pay for moving expenses for displaced residents and be responsible for finding them positions in other programs (including paying their salaries while they attend the other program if needed). This would give programs greater incentive to follow the rules. The RRCs and ABMS boards should not be allowed to make any resident have to extend their duration of training simply because they attended a program that lost accreditation (in other words all the contiguous year rules should not apply to residents who are caught up in a situation where the resident has been performing their duties appropriately and their program loses accreditation due to rules violations by the program)..

 

[8744]

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....

"Earl."

Nothing more need be said.

 

[radslooking]

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.

whoa, you had a residency interview, and you excused yourself because you didn't want to go there? Doowai, you're killing me here. Can't pull that stuff, man!

 

[Doowai]

whoa, you had a residency interview, and you excused yourself because you didn't want to go there? Doowai, you're killing me here. This is some serious lack of judgment. I hate to pile on here. But you got to stick these things through. You're dealing with highly motivated, highly performing individuals. You cannot pull stuff like this. If you're going to be in medicine you have to be able to stick things like this through.

I don't know. I was very niave about how it all worked, and did not want to do residency there. So I saw no point in staying. I have known lots of med students to not show up to residency interviews at all - I do not see it as much different than that. I really did not expect the guy to get on the horn to start calling around (note to people interviewing soon : when you are at future interviews and they ask you where else you are interviewing - don't tell them).

In my judgement, people who don't show for interviews and people who leave interviews are the same. When interviewing in Wisconsin , one of the other people interviewing got a phone call and left saying her mom was sick. That would have been a better exit strategy, in retrospect than telling the truth. I just have a hard time of getting out of the habit of telling the truth - I was prepared to do it for when the program discussed work hours with us, but usually I try to just tell the truth. Mistake in medicine it seems.

I was niaeve as to how small the medical world is and how vindictive it can be. How highly motivated or performing they are is not as much an issue as vindictive they could be.

as someone who has employed many people I would prefer honest people, but honesty often backfires in medicine.

 

[radslooking]

I don't know. I was very niave about how it all worked, and did not want to do residency there. So I saw no point in staying. I have known lots of med students to not show up to residency interviews at all - I do not see it as much different than that. I really did not expect the guy to get on the horn to start calling around (note to people interviewing soon : when you are at future interviews and they ask you where else you are interviewing - don't tell them).

In my judgement, people who don't show for interviews and people who leave interviews are the same. When interviewing in Wisconsin , one of the other people interviewing got a phone call and left saying her mom was sick. That would have been a better exit strategy, in retrospect than telling the truth. I just have a hard time of getting out of the habit of telling the truth - I was prepared to do it for when the program discussed work hours with us, but usually I try to just tell the truth. Mistake in medicine it seems.

I was niaeve as to how small the medical world is and how vindictive it can be. How highly motivated or performing they are is not as much an issue as vindictive they could be.

as someone who has employed many people I would prefer honest people, but honesty often backfires in medicine.

well, i apologize if that sounded harsh. But I would disagree with you that not showing up and leaving are the same thing. At least in the former with the program there is some doubt...maybe he forgot the time, maybe he missed the plane, maybe he was sick, maybe this or that. If you show up, and you leave, it's like meeting a girl out for a date, and leaving in the first 5 minutes because she's ugly. You will catch hell for that. Honesty does not matter in such situations--you have damaged their pride regardless of how you leave. Anyhow.

 

[Doowai]

well, i apologize if that sounded harsh. But I would disagree with you that not showing up and leaving are the same thing. At least in the former with the program there is some doubt...maybe he forgot the time, maybe he missed the plane, maybe he was sick, maybe this or that. If you show up, and you leave, it's like meeting a girl out for a date, and leaving in the first 5 minutes because she's ugly. You will catch hell for that. Honesty does not matter in such situations--you have damaged their pride regardless of how you leave. Anyhow.

Okay once when I was 25 I went on a blind date with a woman who had a child. I was not into her - half way through dinner I said "soooo... it must be hard for you to be away from your kid so long.... should I take you home?" - she got the hint and I took her home. So yeah - I may be a bit ruthless that way.

I am sorry a program cannot stand having its pride hurt by a med student telling them he is not interested and thank but no thanks. I do and probably will continue to get in trouble because of speaking what I feel is the truth - what I really think and feel. it happened to me alot here when I joined SDN.

Your analogy is good because a program director calling around like that is very much like girl who got her feelings her hurt. Its ironic that a program so full of highly motivated and educated professionals resort to such childish tactics

 

[tncekm]

While some people may appreciate your "honesty", most probably won't because to them its not a matter of being honest, its being rude. Honest and polite would have been, for example, sitting through the interview and then sending a letter afterward stating that you appreciate the opportunity to interview, but the program isn't for you.

If you don't mind me asking, were you born/raised in the US?

 

[futuredo32]

whoa, you had a residency interview, and you excused yourself because you didn't want to go there? Doowai, you're killing me here. Can't pull that stuff, man!

I'm just a student (so my opinion could be way off), but I think that if I were a PD and an applicant realized somewhere during the interview that this was absolutely not the program for him/her, I 'd appreciate the honesty as well as the time-saving factor. I would imagine that a PD could put his/her time to much better use than interviewing someone who absolutely would not rank their program.

 

[8744]

I'm just a student (so my opinion could be way off), but I think that if I were a PD and an applicant realized somewhere during the interview that this was absolutely not the program for him/her, I 'd appreciate the honesty as well as the time-saving factor. I would imagine that a PD could put his/her time to much better use than interviewing someone who absolutely would not rank their program.

No no no no. You are already there, they are prepared to interview you, and have cleared their schedule. There is no time-saving and you need to learn, in this and in life in general, that occasionally you just have to go through the motions. Screw being honest. When the day is done the program will forget all about you except what they need to rank you. To walk out however is to mark yourself as a diva and to offend them like nothing else can.

Now, in a residency interview you probably flew or drove in so what's an extra couple of hours? Just enjoy the lunch and the presentation and, please trust me on this, if you are angling for a competitive specialty if you dislike the program just rank them last. You may not like them but you wil like sitting out a year or doing a transitional year waiting for another chance to match even less.

 

[Arch Guillotti]

No no no no. You are already there, they are prepared to interview you, and have cleared their schedule. There is no time-saving and you need to learn, in this and in life in general, that occasionally you just have to go through the motions. Screw being honest. When the day is done the program will forget all about you except what they need to rank you. To walk out however is to mark yourself as a diva and to offend them like nothing else can.

Now, in a residency interview you probably flew or drove in so what's an extra couple of hours? Just enjoy the lunch and the presentation and, please trust me on this, if you are angling for a competitive specialty if you dislike the program just rank them last. You may not like them but you wil like sitting out a year or doing a transitional year waiting for another chance to match even less.

What he said. Don't hate the player, hate the game.

 

[Winged Scapula]

I'm just a student (so my opinion could be way off), but I think that if I were a PD and an applicant realized somewhere during the interview that this was absolutely not the program for him/her, I 'd appreciate the honesty as well as the time-saving factor. I would imagine that a PD could put his/her time to much better use than interviewing someone who absolutely would not rank their program.

We've given Doowai heck for this decision before and it probably doesn't deserve beating the horse again, but residency interviews are not casual get togethers where if someone doesn't show up or leaves in the middle, you can call another candidate to drop by. They are planned months in advance and require a not inconsequential amount of scheduling and expense. Programs generally interview multiple people for each position (we tended to interview about 30 per position) so one person who wasn't going to rank my program is not going to make a significant difference in who we match.

There is also the issue that since most of us admit that we didn't really know about our residency programs until we were actually *there* working, how can you fully evaluate a program in a few minutes? So, it would not have been unseemly to stay for an entire interview and if you didn't change your mind about the program, let them know if you feel that strongly or even better, don't rank them. Medicine is a small field and people "talk". Walking out, whether its on a date or a residency interview is widely considered rude and *very* different than simply not showing up.

 

[coprolalia]

Copro's ten quintessential rules about employment:

1) Work is work. Never take anything said at work personally. If someone is making it personal, either quickly learn to tune them out or file a complaint at HR.

2) Never leave a job until you have another job lined up.

3) Avoid the seductive lure of the "grass is greener" thinking. Make the best with what you've got. Usually, the grass is not greener elsewhere... it's browner.

4) Never make employment decisions based on emotions.

5) Document, document, document. If you have a complaint, keep a record about time, place, and specifics of the conversation/incident. Do not interject emotions into your complaint. Just the facts.

6) If you've worked, you deserve the money for that work. But, employers have far more resources than you do in screwing you over; remember this. Your paper-trail needs to be watertight if you are going to lodge a legal complaint. (However, in this case, there are many employment attorneys who are willing to take-on an "agism" case, especially if they can sue a hospital. Hospitals have deep pockets, and are willing to pay a "nuisance" settlement. Hospitals are especially chickensh*t when an agism suit may arise, and the possibility of public scrutiny may befall them.)

7) Never underestimate the power of a firm handshake and a warm smile - even if done completely disingenuously and inside you're thinking inside that this is the biggest c**ksucker you've ever met in your life.

8) Discretion is the better part of valor. Always watch out for Numero Uno (which is you). Misplaced comments, however innocently concocted and expressed, can be completely misconstrued by someone else. Better to keep your mouth shut.

9) People at work, first and foremost, are not your friends, despite the fact that many of them can be friendly. Remember that. You may over time develop friendships at work with colleagues who are on equal footing, but never consider a supervisor or a subordinate a friend - and don't try to develop friendships with them.

10) In the end, you still have yourself. Nothing anyone else can say or do to you can change you... unless you let them. (This is especially difficult in residency when you're constantly exhausted, your guard is down, and so much is expected of you by so many people - most of whom are intelligent, controlling micromanagers who will try to squeeze every ounce of blood and tears from your very soul, and push you to the breaking point on a daily basis. Keep solace in the fact that it is a finite amount of time, and that at the end, and before you know it, you will be able to say, "Adios, m***** f*****s! Thanks for nothing!")

-copro

 

[futuredo32]

We've given Doowai heck for this decision before and it probably doesn't deserve beating the horse again, but residency interviews are not casual get togethers where if someone doesn't show up or leaves in the middle, you can call another candidate to drop by. They are planned months in advance and require a not inconsequential amount of scheduling and expense. Programs generally interview multiple people for each position (we tended to interview about 30 per position) so one person who wasn't going to rank my program is not going to make a significant difference in who we match.

There is also the issue that since most of us admit that we didn't really know about our residency programs until we were actually *there* working, how can you fully evaluate a program in a few minutes? So, it would not have been unseemly to stay for an entire interview and if you didn't change your mind about the program, let them know if you feel that strongly or even better, don't rank them. Medicine is a small field and people "talk". Walking out, whether its on a date or a residency interview is widely considered rude and *very* different than simply not showing up.

Ok, like I said, my opinion was just a student opinion and it was obviously very incorrect.

 

[mjl1717]

God damnit this is the 3rd time I am writing this. This damn thing times out as i type long posts. It pisses me off. Please don't reply too this until I finish the story.

I formally quit my residency today with a signed resignation, returning pagers, ID badges etc.

After selling 16 year old chiropractic business, doing a Caribbean medical school, failing to match for 2 years, teaching in a violent inner city heavily gang-infiltrated and subsisting on a below poverty level income for those 2 years, .... finally matching, moving 1400 miles away from my family, especially painfully from my 4 children. I quit.

It really has been tough. Senior residents say I am cursed with a dark cloud and I believe it.

TODAY : I get up off the bare floor where I sleep, in the smoke filled apartment (my neighbors chain smoke and it seeps through the walls and floor into my non-smoking apartment - which I h-a-t-e ), way before the sun came up. I have no furniture other than my pillow. Largely because I have yet to get paid a penny. Nothing for 2 weeks of orientation lasting 12 hours a day. Nothing for 3 weeks of rotation so far. Some attendings really feel they are doing you a favor to make things as hard as possible, - if you could do something with one step they feel it is a privilege to make you do it in three steps.

I am supposedly doing one of the easier rotations for the year. I was told it would have a census of 2 to 6. No senior resident as its slower. The attending comes around mid day. I have been very busy, more than double what I was told would be my max. Often having more admits in a day than the total census usually is. Skull fractures, partial small bowel obstruction, sickle cell, intrauterine fetal demise,cholecystitis, pancreatitis, urinary tract infections, pyelo, meningitis, gastroenteritis, sepsis, and more.

So first thing this morning I see 2 newborns, and then go visit with their parents. Then as I go down the hall, an angry husband comes up and starts yelling at me....... end part one

Good luck in your endeavors Doowai, you'll be ok..
Also one IS allowed to change ships in midstream!

 

[Winged Scapula]

Ok, like I said, my opinion was just a student opinion and it was obviously very incorrect.

My comment wasn't meant as a personal affront but rather as a recognition that, as a student, you weren't on the "other side" and wouldn't see it from a faculty POV.

 

[Blade28]

Thread closed at the request of the OP.