Resigned from PGY-1

[resilient resident]

I want to share my residency resignation story. I am an IMG and did not match last year. But while I was doing a rotation in an hospital i came know that there is an open spot in PGY-1 and i got the job after several interviews. It was during august and I joined at the middle of august. I filled the spot the spot of a resident who did not got visa and was stuck in his country. I got my medical license at late september . As I was filling other residents spots I was in vacation while i got the license. For info, I graduated in 2013 and it was kinda a long gap since I was in clinical medicine. From the joining till i got my license i was shadowing and did not do anything basically . I did not had ANY ORIENTATION program in the meantime. After i got my license my rotation was ICU and it was challenging for me. My attending gave me very bad eval. My senior was not that supportive as well. In the mean time my senior was not coming for job and one of ICU nurse told me that they saw the resident at ED really really sick . I did the dumbest thing in life- i looked at his chart. But it was only for 15-16 sec. I basicaly did not know what happened to him. My PD was really nice person and she knew that it was by mistake and i did not share the information with anyone. She forgave me. At November i got a letter from CCE meeting stating that some of my performances was not upto the expectation and they placed me into a remediation program. All my senior kind of knew that I was in a remediation program and i had some bad senior who bullied me. But did not speak up against them cause i was scared that they will think that I am complaining. In the meantime, i did a pap smear in one of my patient where no one was there and one of the nurse said that i requested her to say that she was with me. But i think my attending backed me up , because after that incident I directly went upto her and told her " I did a mistake" . She knew everything. I took my step 3 in the meantime passed. My remediation plan was stressfull- as I had to study for my step 3, ITE, patient etc and some seniors bullying in the middle. There was days where I went back home and just crying. I had a vacation in the end of march and i was waiting for it. In the mean- a disaster in my family happened. I brother got into jail for an antigovernment blog, my dad hospitalized and my entire family collapsed. My PD called me right before my vacation starts- saying i will have to continue working. I so burned and exhausted - i burst that( not with PD). I couldn't sleep, sent my senior a text that " I am not going to hospital. I need a ****ing break, she and the hospital is making me crazy". The next day i went to the hospital late and in the meantime- my senior shared my text with PD/APD. I got in to the meeting and was told to go home. Last friday- I had a meeting where they said they will have to let me go cause I failed my remediation. For instances- during my remediation- all except one attending told me that I improved and gave me really positive feedback. I got a eval from one of ICU attending stating-" good knowledge for PGY-1. My chief gave me an eval stating" he did not need to correct my note and seemed confident. But after the dismissal when I was going through my eval- I saw this 2 eval was not there. My PD/APD said i am like an 4 months old intern. may be because i was, cause i started on october and it was march. they always compared my with my cohort and never put themselves in my shoes. They did fire and told me to resign . My PD told me to apply other program and she told me that she will forward she anyone contact with her for any open PGY1 spot. I am really devastated now. I dont know what do I do and how do I pass my time, my life. I dont see any light, any future. I love being a doctor and being an internal medicine doctor. Medicine is my love. Can anyone help me and tell me what should I do next.

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[Splenda88]

It's a tough situation to be in... Can you talk to your PD/APD about letting you finish PGY1 so you can get credit for at least a year?

 

[evilbooyaa]

OP, you can try, but your chances are mostly gone, IMO.

To recap, you were already in a tough position with your 2013 graduation date. You lucked into a spot. You were admittedly a bad intern when you started (as would be expected with zero orientation starting in October). This is all not ideal, but OK.

But then you:
1) Broke HIPAA by looking into a co-residents chart
2) Did a pap smear without a chaperone (assuming you are a male)
3) Took out your frustrations over life stressors on your PD (who had up to this point backed you in multiple scenarios that could have already torpedo'd your career) by saying that you need a break and that she (the PD?) is making you crazy.

If I was the PD I would've canned you too after #3. I'm fine going to bat for somebody who is doing dumb **** but not if they **** talk me while I'm trying to give them chances to redeem themselves.

I don't think you have insight, and regardless I don't think it really matters. You were a very marginal candidate before you got into this residency. With these issues and a residency resignation on your record, I don't see you having success. While there's a non-zero chance you may luck into something, I think it is very unlikely, and while I can't stop you from applying going forward, it might be time to 1) move back to whatever country gave you the degree or 2) call it time for a new career.

I don't have much more to add than that, except to say I wish you the best.

 

[DocWinter]

2) Did a pap smear without a chaperone (assuming you are a male)

Small point, but male or female, a chaperone is necessary to cover yourself. Mandatory at our program.

OP, I don’t want to kick you when you are already down, but man I am not surprised you are out of a job. You may not have had good support from seniors and staff, but nonetheless as the intern your job is to overcome and survive without drama.

I wish you well but this story may not have a happy ending

 

[deleted480308]

It’s time to work on plan B. I can’t imagine anyone hearing that story would take you as a resident at this point.

There can still be happiness in other fields

 

[Splenda88]

It’s time to work on plan B. I can’t imagine anyone hearing that story would take you as a resident at this point.

There can still be happiness in other fields

It's hard for some to let it go... and sometimes it's cultural for some IMG. I have seen IMG wasting +7 years studying for steps and trying to get into residency while putting their lives on hold. It's painful to watch.

 

[resilient resident]

But they did not fired me, i resigned . My PD told me if anyone contact with her she will tell that I had family issues and I had to resign. I did research work before and I have publication. My PD told me that she will forward if any program look for resident. I have a hard time thinking that I will have to think about plan B. I am looking for PGY 1 spots. I believe I will succeed.

 

[smq123]

But they did not fired me, i resigned . My PD told me if anyone contact with her she will tell that I had family issues and I had to resign. I did research work before and I have publication. My PD told me that she will forward if any program look for resident. I have a hard time thinking that I will have to think about plan B. I am looking for PGY 1 spots. I believe I will succeed.

What makes you think that you can succeed? There’s nothing in your post that indicates that you’ve learned anything from your experience.

 

[resilient resident]

What makes you think that you can succeed? There’s nothing in your post that indicates that you’ve learned anything from your experience.

This is my learning. I know how to navigate through the system and what not to do/not to do. Why are you so angry on me?

 

[smq123]

This is my learning. I know how to navigate through the system and what not to do/not to do. Why are you so angry on me?

I'm not angry. But you have to be aware that PDs who interview you will ask the same thing. And they won't be any nicer than I was in my post.

 

[Mass Effect]

I wish all resignation/termination stories were this honest. Kudos to you, OP, for not sugar-coating.

 

[Mass Effect]

Forgot to give advice. I think it's going to be extremely difficult to get another opportunity in medicine. How many months did you work? If it was anywhere close to a year, I would try to talk to your PD about letting you get credit for the year. If not, it's going to be incredibly tough, if not impossible, to get another spot.

 

[deleted480308]

This is my learning. I know how to navigate through the system and what not to do/not to do. Why are you so angry on me?

So let’s say I’m a PD who happens to mess up and pick up the phone one day if you randomly call. You ask for a spot that I actually happen to have open. You then tell me you graduated 7 yrs ago. 7. You then say you actually landed an off season spot in a residency a year ago (literal winning the lottery there) and then RESIGNED 6 months in.

You had the dream scenario given how bleak your career situation was and you RESIGNED?!?!?

Now assume I don’t say I’m sorry and hang up. How do you talk your way out of that given the fact that there are thousands of people with better applications who didn’t already get a shot at residency and then RESIGN? For real, try to type out the answer you think works

I know you think we’re being hard on you but we’re trying to help you move on and stopping sinking more time/money into this. We are helping

 

[thumbz]

So let’s say I’m a PD who happens to mess up and pick up the phone one day if you randomly call. You ask for a spot that I actually happen to have open. You then tell me you graduated 7 yrs ago. 7. You then say you actually landed an off season spot in a residency a year ago (literal winning the lottery there) and then RESIGNED 6 months in.

You had the dream scenario given how bleak your career situation was and you RESIGNED?!?!?

Now assume I don’t say I’m sorry and hang up. How do you talk your way out of that given the fact that there are thousands of people with better applications who didn’t already get a shot at residency and then RESIGN? For real, try to type out the answer you think works

I know you think we’re being hard on you but we’re trying to help you move on and stopping sinking more time/money into this. We are helping

Now let's assume I'm a newly minted, naive doe eyed PD who doesn't read between the lines and figures I've got this great resident who happened to just resign from their last spot for family reasons but otherwise was a performance superstar. What are you going to say to convince me you won't resign from my program when the going gets a little tough? Family issues don't magically disappear.

 

[resilient resident]

I will just be honest. I did for my family and it was the right thing to do. I love medicine but my family also needed me. I am happy that I was able to be with my family in their toughest moment. I will have another residency if i continue to work but I will never have another family. My mom did so much for me when I was child and it was my responsibility. She needed me. And i am applying again it means I am dedicated to medicine as well. Its not easy to get yourself together and repeat the same cycle again. I am doing it because I love medicine. Besides i am applying for my family and they will be in USA.

 

[resilient resident]

So let’s say I’m a PD who happens to mess up and pick up the phone one day if you randomly call. You ask for a spot that I actually happen to have open. You then tell me you graduated 7 yrs ago. 7. You then say you actually landed an off season spot in a residency a year ago (literal winning the lottery there) and then RESIGNED 6 months in.

You had the dream scenario given how bleak your career situation was and you RESIGNED?!?!?

Now assume I don’t say I’m sorry and hang up. How do you talk your way out of that given the fact that there are thousands of people with better applications who didn’t already get a shot at residency and then RESIGN? For real, try to type out the answer you think works

I know you think we’re being hard on you but we’re trying to help you move on and stopping sinking more time/money into this. We are helping

But I am better than other candidate. I have 6 months of intern experience.

 

[deleted480308]

But I am better than other candidate. I have 6 months of intern experience.

If you read your story and still think that sentence wraps up the comparison between you and other candidates who didn't walk from their big chance, then you lack the self awareness needed to help you.

I wish you well

 

[DocWinter]

But I am better than other candidate. I have 6 months of intern experience.

Any candidate walking in as a new intern is a safer bet than you are. You have failed intern year after a 7 year hiatus, regardless of how you and your PD are calling it. You are behind perhaps every last single candidate available as a PGY1 and are likely the most scary option a PD could think of.

 

[GoSpursGo]

But I am better than other candidate. I have 6 months of intern experience.

Most PDs will honestly see the opposite here--a random PGY-1 applicant with marginal board scores is still an unknown quantity in clinical medicine, they could be a perfectly serviceable resident. In contrast, YOU had the opportunity and couldn't keep it together for more than 6 months. Sure, maybe your program didn't do a great job of supporting you as you jumped in 3 months late and were dealing with a family crisis... but why should a program give you that benefit of the doubt when there are plenty of other options out there?

It may well be that you made the right decision for yourself and your family by resigning to be there for them. It is a pity that your program couldn't accommodate you with an LOA to help take care of them. But decisions have consequences, and it is unlikely that you are going to get another opportunity like the one you already resigned from.

My one piece of advice--try a different specialty. At least if you're applying to FM or pathology you could say that the high acuity of inpatient internal medicine residency wasn't the right environment for you and you could do better in a program that is more outpatient/less clinical/etc. I honestly don't think that's likely to be fruitful either, but at least you could make a rational case for it.

 

[samac]

But I am better than other candidate. I have 6 months of intern experience.

Honey, that's a little naive. You were given a shot and didn't survive. You didn't just resign for family issues, you were on probation before you were dealing with that. If you want to keep trying that is your prerogative, but you won't find people sugar coating it here. It is NOT likely you'll get another spot in the US. You may luck out, but as Spurs said you'd be best served to try to get FM.

 

[chocomorsel]

I wish all resignation/termination stories were this honest. Kudos to you, OP, for not sugar-coating.

That can be very cultural. I find sugar coating to be a rather American thing in my experience.

 

[Angry Birds]

You're toast, bro.
Time to move on to either (1) medicine in another country or (2) another career choice. I suggest the latter option because some of the things in your initial post suggest a lack of insight that would be problematic no matter where you practice.

Life goes on. Rip the bandaid off now and deal with the cards (self-)dealt. The sooner you make the cognitive switch, the sooner you can move on with life in a new direction. There are a million careers out there.

Good luck! It gets better.

 

[medpride]

Hey, most people here are just trolls who do not have anything good to do with their lives. They must have something terrible happened with their lives and expect the same happen to others as well. I feel for your situation, op. Don't give a damn about these trolls. Just continue working hard, the biggest thing in your favor is you have got US citizenship, you can continue to rotate/shadow in the US hospitals. Just like the way you were fortunate to find an unfilled spot the last time, you will have a shot again (this year it is likely that many visa requiring imgs won't make it to the US or the demand might go high with the whole COVID situation, we never know). Continue to fight, you have got this. It is really sad to see fellow doctors bully like this when someone is going through a tough phase in life, instead of offering support. I really doubt their capacity to be in this profession. They are a real threat to patient care.

The things that I have noticed in your post is too much self-blame and trying to be too honest. These are the 2 qualities that this advanced world hates. Try to change them. Just take it this way to move forward, things for some reason did not work in your favor in your previous program. Don't try to explain too much to others. You know you well and you are the in-charge of your life. Write down the things that did not work the last time and try not to repeat. Chances wise nobody could predict exactly. Did anyone tell you before that you will end up in that unfilled spot? It's the same way, nobody can predict your future chances. Just like how the above trolls exist in this world, there will be good people too. You will find one if you don't quit and continue the fight. Please, don't give up!! Good luck on your journey!

 

[Angry Birds]

Hey, most people here are just trolls who do not have anything good to do with their lives. They must have something terrible happened with their lives and expect the same happen to others as well. I feel for your situation, op. Don't give a damn about these trolls. Just continue working hard, the biggest thing in your favor is you have got US citizenship, you can continue to rotate/shadow in the US hospitals. Just like the way you were fortunate to find an unfilled spot the last time, you will have a shot again (this year it is likely that many visa requiring imgs won't make it to the US or the demand might go high with the whole COVID situation, we never know). Continue to fight, you have got this. It is really sad to see fellow doctors bully like this when someone is going through a tough phase in life, instead of offering support. I really doubt their capacity to be in this profession. They are a real threat to patient care.

The only fault I have noticed in your post is too much self-blame and trying to be too honest. These are the 2 qualities that this advanced world hates. Try to change them. Just take it this way to move forward, things for some reason did not work in your favor in your previous program. Don't try to explain too much to others. You know you well and you are the in-charge of your life. Write down the things that did not work the last time and try not to repeat. Chances wise nobody could predict exactly. Did anyone tell you before that you will end up in that unfilled spot? It's the same way, nobody can predict your future chances. Just like how the above trolls exist in this world, there will be good people too. You will find one if you don't quit and continue the fight. Please, don't give up!! Good luck on your journey!

I think people are simply trying to give it to him straight. As a practicing physician for about ten years, I could never see myself hiring such a candidate. This is simply due to the number of red flags.

However, you might be right that COVID may be a saving grace here... Long shot but I guess anything is possible.
Even so, a better option would be to redirect to another career. I sense that you are from the Indian subcontinent and it is true that switching out of medicine would seem like a complete failure in that culture. That is not the case, however, in the United States. People switch careers all the time and sometimes find oodles of success in another line of work. The problem is the mentality that ties one's self-worth with a medical career. This is a positively harmful attitude.

Finally, your advice about not being "too honest" is worrisome. Honesty is highly prized here. In fact, my three rules for new residents are: Don't be late, don't be lazy, and don't lie. If you follow those three rules, you should be OK. The accusation that the OP did a pelvic exam without a chaperone and then might have asked the nurse to lie for him is truly worrisome.

 

[medpride]

I think people are simply trying to give it to him straight. As a practicing physician for about ten years, I could never see myself hiring such a candidate. This is simply due to the number of red flags.

However, you might be right that COVID may be a saving grace here... Long shot but I guess anything is possible.
Even so, a better option would be to redirect to another career. I sense that you are from the Indian subcontinent and it is true that switching out of medicine would seem like a complete failure in that culture. That is not the case, however, in the United States. People switch careers all the time and sometimes find oodles of success in another line of work. The problem is the mentality that ties one's self-worth with a medical career. This is a positively harmful attitude.

Finally, your advice about not being "too honest" is worrisome. Honesty is highly prized here. In fact, my three rules for new residents are: Don't be late, don't be lazy, and don't lie. If you follow those three rules, you should be OK. The accusation that the OP did a pelvic exam without a chaperone and then might have asked the nurse to lie for him is truly worrisome.

You must think of the OP's internal motivation to perform the physical exam alone. When his intentions are not bad, why to unnecessarily bring that up multiple times. I do agree if there exists unprofessionalism, OP would not survive not only in the medical profession but in any other profession. But it entirely depends on OP whether he wants to change or not change, why to throw mud on him. Please maintain decorum, just because we can hide identity in the forum and OP is in a vulnerable situation does not give us any right to use condescending tone.

It does not matter whether I am from the Indian subcontinent or mars, humans are humans everywhere. Everybody invests a lot in their journies and want to succeed. OP came thus far in his/her journey not to hear recommendations to quit but to learn the tools to survive.

To the OP- sorry to say this, I have never seen any supportive/suggestive posts in this forum in my 7-year experience. I suggest you, do not take the negativity in this forum to heart. After reading many comments in the forum, I realized that there are many people here who do not like/satisfied with what they do in their lives and try to vent out by bullying others.

 

[samac]

Hey, most people here are just trolls who do not have anything good to do with their lives. They must have something terrible happened with their lives and expect the same happen to others as well. I feel for your situation, op. Don't give a damn about these trolls. Just continue working hard, the biggest thing in your favor is you have got US citizenship, you can continue to rotate/shadow in the US hospitals. Just like the way you were fortunate to find an unfilled spot the last time, you will have a shot again (this year it is likely that many visa requiring imgs won't make it to the US or the demand might go high with the whole COVID situation, we never know). Continue to fight, you have got this. It is really sad to see fellow doctors bully like this when someone is going through a tough phase in life, instead of offering support. I really doubt their capacity to be in this profession. They are a real threat to patient care.

The things that I have noticed in your post is too much self-blame and trying to be too honest. These are the 2 qualities that this advanced world hates. Try to change them. Just take it this way to move forward, things for some reason did not work in your favor in your previous program. Don't try to explain too much to others. You know you well and you are the in-charge of your life. Write down the things that did not work the last time and try not to repeat. Chances wise nobody could predict exactly. Did anyone tell you before that you will end up in that unfilled spot? It's the same way, nobody can predict your future chances. Just like how the above trolls exist in this world, there will be good people too. You will find one if you don't quit and continue the fight. Please, don't give up!! Good luck on your journey!

You must think of the OP's internal motivation to perform the physical exam alone. When his intentions are not bad, why to unnecessarily bring that up multiple times. I do agree if there exists unprofessionalism, OP would not survive not only in the medical profession but in any other profession. But it entirely depends on OP whether he wants to change or not change, why to throw mud on him. Please maintain decorum, just because we can hide identity in the forum and OP is in a vulnerable situation does not give us any right to use condescending tone.

It does not matter whether I am from the Indian subcontinent or mars, humans are humans everywhere. Everybody invests a lot in their journies and want to succeed. OP came thus far in his/her journey not to hear recommendations to quit but to learn the tools to survive.

To the OP- sorry to say this, I have never seen any supportive/suggestive posts in this forum in my 7-year experience. I suggest you, do not take the negativity in this forum to heart. After reading many comments in the forum, I realized that there are many people here who do not like/satisfied with what they do in their lives and try to vent out by bullying others.

I think you’re looking at this through rose colored glasses. I’m all for being supportive, but I also don’t want to tell someone to “chase their dreams” when it seems obvious they’ll chase their entire lives and never reach them. I definitely feel for his situation, but they absolutely need to be honest. Their previous program director will be.
I’m just going to lay out the hurdles here so you understand the issue.
1) 7 years out from graduation.
2) Seperated from any meaningful clinical work in those 7 years.
3) Opened a colleague’s chart unnecessarily. Major professionalism violation.
4) Pelvic without a chaperone. I’m female and I won’t even do this. Opens the residency up to litigation.
5) Resigned by force. If the PD tells another PD anything past “family issues” they won’t touch him.

maybe COVID will open spots they’ll scramble to fill, but my guess if that happened they’d fill with US MDs/DOs/Caribbean students that failed to match this past year.

 

[V5RED]

My one piece of advice--try a different specialty. At least if you're applying to FM or pathology you could say that the high acuity of inpatient internal medicine residency wasn't the right environment for you and you could do better in a program that is more outpatient/less clinical/etc. I honestly don't think that's likely to be fruitful either, but at least you could make a rational case for it.

Just FWIW, I am pretty sure that had I answered the "Why Family Medicine as opposed to Internal Medicine" in my interviews by saying "because it is lower acuity" I would have gone unmatched.

You must think of the OP's internal motivation to perform the physical exam alone. When his intentions are not bad, why to unnecessarily bring that up multiple times. I do agree if there exists unprofessionalism, OP would not survive not only in the medical profession but in any other profession. But it entirely depends on OP whether he wants to change or not change, why to throw mud on him. Please maintain decorum, just because we can hide identity in the forum and OP is in a vulnerable situation does not give us any right to use condescending tone.

It does not matter whether I am from the Indian subcontinent or mars, humans are humans everywhere. Everybody invests a lot in their journies and want to succeed. OP came thus far in his/her journey not to hear recommendations to quit but to learn the tools to survive.

To the OP- sorry to say this, I have never seen any supportive/suggestive posts in this forum in my 7-year experience. I suggest you, do not take the negativity in this forum to heart. After reading many comments in the forum, I realized that there are many people here who do not like/satisfied with what they do in their lives and try to vent out by bullying others.

I think everyone here has been extremely polite. The only rude/unkind thing was implying OP has any chance at all of getting into another program. I would put fair odds that you and OP are the same person with 2 accounts. If you aren't, then you are being extremely unkind by encouraging OP to waste the rest of their life on an impossible goal.

 

[Splenda88]

If you are unable to obtain another residency in 2-3 years, look into the 3-yr nurse practitioner program for FMG at Florida International University.

 

[GoSpursGo]

You must think of the OP's internal motivation to perform the physical exam alone. When his intentions are not bad, why to unnecessarily bring that up multiple times. I do agree if there exists unprofessionalism, OP would not survive not only in the medical profession but in any other profession. But it entirely depends on OP whether he wants to change or not change, why to throw mud on him. Please maintain decorum, just because we can hide identity in the forum and OP is in a vulnerable situation does not give us any right to use condescending tone.

Nobody is being rude, we all just are giving our honest opinion that this was likely the OP's one chance and it will be hard to get another one. Clearly there is a reason that he did not match for 6 years after graduation in the first place, and now he is in a worse place because of this resignation.

Without addressing each individual part of your posts, I will point out that intentions literally do not matter if they result in a poor clinical decision. The fact that he did something that 99% of residents recognize is unacceptable calls his judgement into question. You might think that is harsh, but that's just the reality of how a prospective PD will view the event, and when there are thousands of other equally qualified candidates out there that's enough to get the OP passed over. For the OP's sake I hope that's not the case, but it may be the reality.

Just FWIW, I am pretty sure that had I answered the "Why Family Medicine as opposed to Internal Medicine" in my interviews by saying "because it is lower acuity" I would have gone unmatched.

Lol, obviously you wouldn't use those exact terms. As I said, I'm dubious that he can craft a logical argument that would stand up to scrutiny in any other clinical specialty... but the underlying point is that he needs to draw a distinction between what went wrong in his IM residency and why he could be successful in another field.