1) Accusing the confrontation of outlandish generalizations as being abusive and bitter by calling it a diatribe illustrates a lack of humility and willingness to learn from considering a perspective that contradicts your own.
2) The duration of your membership on SDN has no relevance to your understanding of residents who have terminated.
3) Though your academic positions may have exposed you to a small sample of physicians in this constituency, you fail to acknowledge that making generalized statements about a population based on the cohort you have encountered is objectively biased and invalidates the significance of claims that you make because you fail to address that bias.
4) The vast majority of these cases are resolved with a non-disparaging agreement, precluding anyone that wasn't personally involved from ever knowing the facts. To reference one case in the last 50 years that was not concluded this way and make conjectures about 100% of cases is yet again biased and invalid.
5) My confrontation about your lack of insight into the consequences of being unable to obtain board certification in no way suggests that I have an "
everyone-gets-a-trophy approach," nor that I am "
implying that even someone terminated for incompetence (by the OP's own words, can't recognize emergencies) deserves an unrestricted medical license as if it's a birth right or something."
6) I apologize if confronting careless and/or inaccurate comments/perspectives makes you feel that I am "insulting" you.
7) As you said "
most things aren't significant enough to terminate a resident over." It would be unreasonable to suggest that his completion of 3 years was because the "
PD's are too nice" and they "
allow things to slide." Since you failed to list being a PD in your recitation of your academic positions, it would be difficult to support your opinion that PDs are too nice beyond speculations.
8) A PD has an immense influence on a former resident's ability to obtain a position in another residency program, regardless of specialty. That is why a neutral PD letter approved by the resident in question is often negotiated for in settlements.
9) My own biased opinion is that most, if not all, physicians that match into a residency program would not have gotten there if they were objectively incompetent. It would seem to me that if a resident was struggling due to any number of issues aside from/in addition to incompetence, it would not be unreasonable to determine that a transfer to another program was more appropriate than trying to remediate, place on probation, etc... until a PD is forced to terminate because he no longer has any other direction to go. This would benefit not only the resident but the PD, as the sequence of arduous disciplinary actions might have been avoided by exploring the option of transfer earlier.
9) Yet again, it is inappropriate to make the conjecture that all physicians who fail to finish their residency program and/or go before the medical board are incompetent and/or detrimental to public safety. The point that I was trying to make was that the adverse implications of the onerous process involved when going before the medical board has for a former resident physician that cannot find employment unless issued a medical license are substantially greater than for a physician that is actively working. Understandably, a medical board would be unlikely to give preferential treatment to an applicant for a medical license in this position. Yet, it is difficult to understand the damage that refusing to explore the possibility of transfer early on can have if you are unaware of these unforeseen consequences. I am not suggesting that PDs have any responsibility to explore this, but I believe that many PDs are genuinely trying to help residents that are struggling and going through the sequential disciplinary processes until termination may not be the optimal way of proceeding.
10) I made no indication that I am the only person who can "
comprehend this stuff." I suggested that it is impossible to comprehend the impact that not being eligible for/having board-certification has unless you have personally been through it, which many people (myself included) have had to face. I'm not sure who "
people on the other side of the table" refers to in this case. Feel free to clarify.
11) I live in Missouri. I don't expect everyone who fails to complete their residency to move to MO to provide "
only primary care services and only in medically underserved rural or urban areas of this state or in any pilot project areas established in which assistant physicians may practice." (
Missouri Revisor of Statutes - Revised Statutes of Missouri, RSMo, Missouri Law, MO Law, Joint Committee on Legislative Research)
12) Please identify how I insulted you with a "
barrage of names while misquoting" you when I confronted you for ending your suggestion that a physician could get hospital privileges without being board eligible with the rhetorical and flippant comment "
if your mom went to urgent care for any reason, would you want her doctor there to be someone who was not allowed to complete residency because he was clinically incompetent." This is objectively a conjecture that physicians ineligible for board certification were not allowed to complete residency because of clinical incompetency. Your statements are directed at all physicians in this scenario, not just the OP.
13) If you know of someone else who has reviewed 164 of these cases over the last 50 years, please have them to contact me. Until you know the facts of every situation, please refrain from attacking people that you know nothing about. It undermines your credibility and reflects poorly on the medical community.
