Hello. I've been following this thread since January. I never posted anything before because I was hoping I wouldn't get terminated, but last week I got the awful news. Here's my story.
I am Caribbean grad recently terminated two weeks ago before completing my PGY-1 year in IM. In January I was called into the program director's office where he mentioned that he was concerned that I was staying late and my clinical judgement poor. He felt that I was not ready to progress to my PGY-2 year and wanted me to repeat my PGY-1 year. I guess he saw my anxiety and reassured me that I would have a job next year. After discussing this with him, I agreed that I had these deficiencies and thought repeating the year would be beneficial. He also mentioned that I would be continued to be monitored by the faculty and depending on their recommendation I would be promoted or not. Again he mentioned that I would have a job for next year. The program director then decided to leave the program after he was offered to be the program director of a new IM program. So our chief of medicine became the interm program director.
After that meeting, I worked as hard as I could. Asking attendings if they saw any deficiencies and making any necessary changes. I tried working faster and read more. I spoke to my residents to see if I could make any changes.
In February, I met with the chief of medicine/interm program director and he handed me a letter listing my deficiencies. The letter ended with a statement stating that if I failed to correct these deficiencies, I would be terminated from the program. I was very confused because I thought that my job secured and the question was there I would be promoted with my class or not.
I was very confused and frustrated. I was making the appropriate corrections. I was not staying as late and working more efficiently. I knew that I still had alot to improve, but I guess it wasn't enough. I spoke to a resident that I knew and worked with and he mentioned that other residents felt I was a hard worker and professional and that if asked by the program, the residents would support me. The attending who I worked with for 1 week, felt that during that time, he did not get a sense that my medical knowledge was severely lacking.
So I continued to work harder, coming in early and trying to get feedback from residents and attendings. I attempted to make as many corrections to deficiencies that I could.
Finaly two weeks ago, I was to meet with the interm program director for my annual review. I got a sense something was wrong when the GME director was also present at the meeting. That was when he handed me the letter of termination. I told him that the prior program director told me that my position was secured and likely I would be repeating my PGY-1 year. Then I asked him what changed, he mentioned that the faculty felt my clinical judgement was poor and that I was not working efficiently. I guess I should also mention that during this time, none of my patients were ever harmed by my actions. I got along well with private attendings and specialized attendings.
I was not angry or shocked when this happened. I guess I had a sense this was coming. When I first met the interm program director in Febrary and got the probation letter, the letter mentioned so many deficiencies that I felt that the program was looking to terminate me and now they were looking for evidence to support termination. What did upset me was that after I got the termination letter, the program wanted me to leave the hospital as quickly as possible. The GME director immediately took my pager and ID, went with me to the resident's lounge to help with cleaning my locker. When I asked her if I could speak to the chief residents to discuss this and what I should do next, she just mentioned that being terminated was a lot to take in and I should go home and think. If I wish to call the chiefs I could do it later. I told her I would really like to speak to the chiefs, she stated "with all due respect, you've just been terminated" and then gave me a look, which I interpreted as "you've just been terminated and now need to leave the hospital grounds". She then walked me off the hospital grounds. I felt so insulted. I worked faithfully and treated my patients, colleagues, and staff with the highest professionalism since I started my residency last year. And on the day I was terminated they felt the need to escort me out the hospital.
I do not deny that I have the deficiencies mentioned and I do agree that repeating my PGY-1 year would be good for me. I just don't understand what my attendings saw in me that made them feel I should be terminated. During my time, I did not harm any of my patients. I treat everyone with great professionalism. I was liked by the private attendings and specialists. I know I need to work more efficiently. And I am reading when I am at home. I felt that my deficiencies are correctable.
Now I am unlikely to continue with medicine. I spent the last two weeks thinking of what I should do next and preparing my resume. I am planning to look for jobs in consulting (I read that they are looking for people with analytical skills and are open to people to advanced professional degrees) or pharmaceutical research (I worked as a research technician for several years prior to entering med school) or possibly teaching biology at a community college. I was also thinking of reapplying to another program, but was concerned that if I get terminated I would have wasted another year.
I just wanted to share my story. Thank you for reading.
I am in a similar situation. I, too, am a caribbean graduate from one of the "big four" with phenomenal board scores (upper 90's), first time passes, good grades, good clinical evaluations, good letters of rec, and managed to match into a university program for a "non traditional residency".
About a month before my residency began, I encountered a devastating personal event, which I believe may have been a factor that marred my performance. My first rotation, which was three months in length was completed satisfactorily with few issues. The next rotation, however, I encountered issues in the first week which ultimately culminated in my being called into the division chair's office and I was sent home for the day. I later was called by my chief resident mentioning that I could come back to work on monday. I did come back work on monday, however, my confidence in my abilities was shattered. I attempted to avoid the situation that led to the previous encounter with the division chair and it consequently led to my inefficiency at performing my duties. I got to the point where I dreaded going to the hospital every morning because I was afraid that I would get some case that would be hard for me to complete and would reflect poorly on me. I was highly inefficient and I had a great deal of anxiety at this time too.
After about three weeks on this rotation, I was called into my PD's office and was asked about what was going on? They were curious about why someone with my stats would be having a lot of trouble in residency. I did mention a few of the personal events that were transpiring in my life at the time and how I felt they were impacting me. My PD did mention that I would be relieved of my duties on my current service and placed onto another service; I was also issued a letter that stated my deficiencies and how they were to be remedied and the consequences of not remedying them.
I did start on my new service and I completed it. I was to repeat the rotation I had trouble with at the end of this new rotation.
I started my repeat rotation and I got through about a month of it until early february, when I, too, received a page stating to come to my PDs office. I did go, and I somehow knew immediately what was going on and what was going to occur. I was handed a letter stating that my contract would not be re-newed since some of the issues voiced during my previous attempt at that service were still present and that that day would be my last day. I was effectively defrocked of my ID, keys, and pager. I was encouraged to go to the GME office where I could be apprised of my options. Thankfully, I left the program in good standing.
I did attempt, unsuccessfully, to scramble into another position in another specialty.
I did meet with my PD a few times after the incident to discuss my situation and what could be done. The PD mentioned that a strong letter would not be able to written; the best that could be done is telling a future program that I "deserve a second chance".
Understandably, I am at a complete loss as what to do. In a few short months, I went from stellar medical student and promising physician to someone who's future in medicine and even life is jeopardized. I now have a scarlet letter that will follow me for the rest of my natural life. People keep telling me that this is a blessing in disguise and that I will eventually find my way. My meetings with my PD after the incident seemed to revolve around the fact that I would somehow need to redeem myself by garnering more data points to make this seem like a mere anomaly and not a pattern. How to go about this, I have no idea. With the specter of a "termination" hanging over me, it could be difficult to procure a research position or even a lab job at a hospital with a residency program. I guess I go through days where I feel somewhat optimistic about my prospects, and there are days when I feel it is utterly hopeless. The fact that differentiates me from the previous poster is the fact that I have no work experience in any lab or research capacity- so that in itself is another obstacle to ovecome.Anyhow, I guess if one door closes, another opens right?
