Changing residency: Please HELP!

I just finished 3 months in a DO family residency. The last day of the 3rd month they told me I needed to repeat my medicine rotation but would not give me any reason. They wanted me to sign something making me retake the rotation again and take a test only given to 3rd year internal med residents. I said no and quit. Now they want me to sign a paper releasing them. I want to make sure I can get another residency. Who should I talk to? Should I get a lawyer? What kind? What do I need from them to get into a new residency? Is there anyone out there who can help me? I am an older nurse and I think that is what has triggered this.

You reacted hastily and now it is going to be very hard to get more/better feedback. I don’t really have any idea what to suggest in terms of your next step; my instinct is to recommend that you eat a whole bunch of crow and crawl back on your knees to that program, at least long enough to ask them for constructive feedback and advice about what to do next.


Being asked to repeat a month or a section is not that unusual, but you should’ve been informed as to what your deficiencies were that required you to do this.


I seriously doubt this is because you are an “old nurse.” Try to get rid of that thought, as it doesn’t help you figure out what to do next. Good luck.


Mar

I agree with Mary, you were very hasty in quitting and now you may have to pay the price. Taking the exam which I think may be the ABIM practice exam? which btw we as IM residents take each year starting intern year, is no biggie. Repeating one rotation is also no biggie in the big scheme of things. Now, you may be SOL and have a difficult time getting another spot. Eat crow and beg your program to reconsider…and let you do what they suggested. Good luck.

I am afraid I have nothing positive to tell you. Essentially, you screwed the pooch. Unless your program is willing to sign off in a positive manner to allow you to transfer, I seriously seriously doubt any program would risk picking you up. The path that you chose can only make other programs - and your own program - have serious & legitimate doubts about your maturity and ability to cope with adverse circumstances.


Your your choices are to return to your previous program and do so fancy talking. Or, research and move into a non-clinical career for physicians. The latter choice is far from a bad one as there are innumerable non-clinical options. The preponderance of them do not require any post-grad training nor board certification; however, having those is a positive.


I am sorry to tell you, but a large dose of “humble pie” appears to be in your immediate future. And, in my mind, the longer you take to address this issue, the worse it will be.

Nicely said. I’m crabby, maybe this post should be deleted…by the admins…


Wolf, your attitude sucks.


I had an employee one time like you. Blamed the sun being too bright in his eyes to show up to work for his $85,000 job then blamed his lack of motor skills to walk to work when his car quit (he lived 3 blocks away) and yet when I asked him what he wanted to do for my team’s goals that would motivate him and make him satisfied with work, he growled that he’d wait for the real VP to show up. (I was not yet board confirmed.)


By the way, he was perfectly fine bowling, perfectly fine driving to the golf range, and perfectly fine… with anyone who tolerated his crap attitude and insolence.


I didn’t want him for an auditor, I wouldn’t want you for a doc… that attitude translates into poor patient bed side.


Good luck. I hope you can change both for your sake - your “poor me someone is out to get me I better hire a lawyer and sue somebody” attitude and your current predicament.


My guess is without changing the former, you’re stuck with the latter.

When I was considering changing programs, I found a website that listed all of the open neurology positions by year. Back when neurology was in the SF Match, they also had a list of positions that were open. I would think that the DO match service (I forget the acronym) would have something similar.


Changing residencies isn’t that uncommon. I left on vacation my PGY-2 year and told them that I wasn’t sure if I would be back. Now that I am a PGY-4, I wish I had left to another program (the fact that I owned a house here and would have taken a major loss was one of the major reasons I didn’t leave). I discovered this summer that one of the docs I worked with on an away rotation my senior year of med school is now a program director at a respected program and tells me that he “would have taken [me] in a heartbeat” (he had written me a glowing LOR when I was applying for residency so I don’t think he was blowing smoke). I have med school classmates in competitive specialties (i.e. ENT) who changed residency programs. I also have another non-trad med school classmate who left after completing her IM intern year to work at a non-profit. She loves her job and is much happier than me. Medicine isn’t all it’s cracked up to be, so choosing a non-practicing role is a viable option.


It’s not impossible to change. Good luck!!

Tara, I think what her post made me so incredulous was the tone… and attitude.


I would imagine the people you knew thoughtfully went through a residency change without being insolent and approached it with thought and consideration. I don’t get that from Wolf’s post. I get that she was asked to do something she didn’t want to do, blamed her past nursing life on the request from the residency coordinator and is pouting.


Glad you can offer insight and encouragement!

Also, they offered her a way to “remediate” and she just flat out refused, poor judgement.

I guess I am not put off by the tone so much because I have felt that same tone inside myself many times in residency (though for different reasons) so I am more forgiving of it.

“I said no and quit”, yeah I have had my share of ate up days during PGY1 and PGY2 but regardless, would never just “quit”. Hell no, not after the nightmare of matching and the possibility of leaving a residency in bad standing and having to find another…although yes, I am sure it has been done before.

Believe me, we have all had days, probably many days, where we felt like telling the program to go “f### itself, I quit!” However, as older professionals, we are allegedl in possession of greater maturity and coping skills. That does not mean I advocate knuckling under, becoming a doormat & conceding at every juncture (believe me, I did not do that at Dartmouth and that is a place where that sort of personal resolution is fairly novel).


The long & short of it is - it absolutely must be done in an adult, mature & professional manner. Furthermore, while I adamantly agree that the program owed you an explanation - in writing - that your approach was completely dysfunctional.

Hi Wolf,


I’m a newbie here and only a pre-med, so I can’t give advice about residency like the knowledgeable docs on here.


You came here sincerely requesting advice and feedback about the situation and your choices, and the doctors gave you ample advice and constructive criticism…some probably hard to swallow, yet we all have to be in receive mode on occasion about a life choice we made.


You have great value to offer others; otherwise, you would not have proven yourself as a nurse/pre-med/med student. Whatever doors you may have closed, pick yourself up and start moving quickly with a positive attitude, get back on the path before you, and doors will again be opened for you soon. DON’T GIVE UP on yourself! Learn from your decision, and then get back in the fight!


Layne

Forgive me for chiming in as well; since I am not a physician–though I am nurse working to become one.


Wolf,


Listen, I know certain places can be punitive–and some people just have to make other people’s lives more difficult than necessary. Now I don’t know that is the case with you, I am just saying. . .I’m trying to understand.


I must say, however, that I don’t understand why you seemed (by way of your explanation–nothing else to go on really) to have acted so hastily. So are you saying they out and out refused to give you any rationale for their position?


It’s like you put the cart in front of the horse; b/c you said “no” and “quit” w/o everyone working together to help you to see their POV. Again, sometimes I’ve seen where, say, ‘performance improvement plans’ we just another way to find fault and further pad a reason for weeding or eliminating someone. But this is something I’ve seen more in nursing than in medicine–so, I’m somewhat surprised if what you share or maybe what I may be suggesting is true.


If you quit, what will a lawyer do for you? I mean, unless you claim you quit under duress, I don’t see how this helps.


I guess I’m a bit confused, since, in trying to give you the benefit of the doubt, there seems to be some bigger pieces missing here. And since you are past medical school and thus a physician, why would being a nurse in a past life be an issue now?


One thing is certain though from my POV. . .I want to hold on to hope that medicine is more supportive and mentoring than nursing. No offense to nursing–and in so many ways it has been great to me. It’s just that for some reason it doesn’t seem to have the overall support I see with physicians. Of course there are always exceptions.


I agree with the others. Try to go back and find out what exactly the issue/s was/were. It’s hard to go forward when you don’t know what may be keeping you back. If it’s something bogus, it’s bound to show up under further investigation. You worked so hard; I’d hate to see you mess things up for yourself.


I will add that my friend’s husband changed residencies 3 times. He was a Harvard undergrad and went to a nice allopathic med school on the EC. His father was a very wealth physician, and well, my friend’s husband was used to having most things his way. Most of us didn’t think he would take the guff one has to in order to go through a surgical residency. He didn’t. So, he changed again, and that didn’t work out for him, and then finally he went into this third residency–where he has stayed–though he has moved around a bit. People do change residencies.


Guess there’s no such thing as a “perfect match.” But I will say that that person did have people in high places pulling strings for him. . .so. . .


At any rate, I don’t think you can bring a lawyer in until you know what’s going on. . .and since you simply quit w/o investigating further, well, you are in a very hard place. Try to call a meeting and work things out in the most positive light.

Wow! Except for Tara, you are all so hash. I guess my post was not very clear. My fault: I did not give you enough information. I had a very hard time during the 2nd month. The attending did not like nurses (it was known to many other people there). There was also a change during the 1st month where the hospital was sold and the new administration decided to fire all the old (as in age) docs. This is also a known fact and told to me by many doctors in the new administration and the docs that lost their jobs. They wanted a “new” look and pumped up the census to double what it was giving the interns double the patent load.


They would never give me a reason for their request that I repeat the 2nd month which I did my 3rd month. Again the 3rd month when they requested I repeat IM again they would not give me any reason to continue repeating IM rotations. I would have continued to repeat IM rotations if they had been straight and said they were short of interns (as they were). I had very good evals from my patients (forms were requested by all patents). The attending that did not like me requested I take the MKSAP but I refused to sign a paper saying I would (they were going to give me 3 weeks to take it). This test is for 3rd year IM residents not brand new family med interns. None of the other new interns were required to take this test. Also, because the attendings were all over worked, the interns were not getting the education that they needed. I had done a month there as a med student (the year before) and the environment had completely changed from an intensely educational one to no time for teaching nor explaining. I think it is very important to learn as an intern, that is what an internship is for.


I was asking how to get out of my contract when I asked “should I get a lawyer” - I was looking for someone who had also been through a change of residency and hoping they could share their insight.


I have since obtained a “mutually agreed upon” end to my contract and presently applying to other open “off tract” spots. This (“mutually agreed upon”) is what is needed to obtain a new DO spot (per AOA advice) in case anyone reading this ever needs to know.

WolfMom,


Thank you for the additional explanation. This added information changes the coloration immensely. Furthermore, it is reassuring to see that you actually did conduct yourself as one would expect a professional, with years under her belt, to do so.


In retrospect, we undoubtably came across as harsh. However, if you reread your post, the conclusions and reactions were congruent with the information initially provided.


In light of the additional info, I feel compelled to offer my apologies for my/out forwardness. I think serves to highlight the pitfall of text-only communication as all of the non-verbal elements are necessarily omitted. However, even though the situation turned out to be a misrepresentation, the following discussion and advice is germane to the topic and will, hopefully, provide food for thought for anyone contemplating doing what we erroneously thought you had done.


I wish you the best of luck & success in finding a new home. I think it goes without saying, the conditions that you have described DEFINITELY justify searching for a new place to land. Again, my apologies, but I/we were only going on the data we had been supplied.

I am not sure about MKSAP about for IM interns and up we take yearly exams to assess where we lay before we take the big kahooona the IM boards. It can be used as a tool for YOU to assess your weakness and strengths. Now, if they were doing this because you fell “short” of academic standards I can see why, OTOH if it was just to “punish” you for something then I do not get it. Also, a comment, getting good reviews from patients pretty much means nothing to the PD, they want good reviews from attendings. Regardless, good luck on your new program finding.