Terminated during PGY7 - AMA

[Guest]

This thread brings up an important point I always tell interns / junior residents: don't rock the boat. Residency is not the time to take a stand and change the system. Multiply this by 100x if you have been formally warned of some behavior or your performance before.

You have a chief that's an asshole? Grit your teeth, take it for the year that you have to, make note of what not to do when you're in charge.

You feel like an attending is doing questionably indicated cases? Not your business, take care of the patient to the best of your ability and move on.

A nurse is rude to you? Of course they were. Tell them "thank you so much for your help," smile and move on.

A resident dumps call on you? Just take the call, it's 24 hours out of 7 years, you won't even remember it happened as an attending. Making a big commotion about it, complaining to the chair, and mentioning your work hours restriction is the exact way to get on everyone's secret shit list.

Just know that every time you fight with anyone, get reported, get called to the PD or chair's office, you're putting your career in jeopardy. It's a decision that can cost you millions of dollars. Even if OP gets back into a nsg residency and graduates, the cost of missed year of salary as an attending plus interest over a career is astronomical (not to pile on OP, very sorry about what happened to you). Don't lose sight of the real goal here.

[Guest]

An excellent point. Do a good job, keep a low profile, don’t rock the boat

[artichoke2me]

Part of the diffiuclty of appealing insitutional action is that they are expecting you to admit some fault or responsibility. I went through something similar in the past, they do not want to hear it from you (how your being treated unfairly). Try to speak with your PD and see if he would support a swap to a different program, I think you would need to repeat 2 years at the minimum but it better than getting dismissed. Take care of your mental health as much as possible and whatever way this goes practice self kindness.

[six_and_done]

I can see how rocking the boat may be perceived as a nuisance. Putting things in perspective is helpful.

I agree that a lower PGY is expected if transferring to another neurosurgery program.

Thank you for the advice.

[Guest]

How do you tell a new program you are interviewing at when they ask "why did you leave or what happened"?

[six_and_done]

As of now, much of the organization/content for this response is the result of preparation for multiple hearings.

In general, the response would need to be succinct and compatible with the department’s official stance:

-Describe timeframes and events. Provide commentary on personal reflection and growth.
-Minimize discrepancies by referencing official documentation (evals, case logs, summative statement, etc) when clarifying or providing details.

[Guest]

How do people get back in who left or got fired? I see it occur many times. What happens or what is said?

[six_and_done]

There are 6 examples of which I know of the outcomes:

3 transferred to another neurosurgery program and assigned equivalent PGY years (2 of them were junior residents, one was a PGY7)
reasons cited: family proximity, educational opportunities

1 transferred programs (personal reasons), ultimately discontinued residency (unclear why), and then eventually returned to neurosurgery years later.

2 were terminated during junior years. One began another residency in a different specialty; the other has not returned to training.

From this, it appears that leaving a program as an arranged transfer is feasible.
But in the case of termination, it is highly unlikely. keep in mind that these termination examples occurred in junior residency (PGY1-4).

In my particular case, at such an advanced stage in training (PGY7), it will be interesting to see what opportunities are identified moving forward.

[Guest]

I don’t understand this — if your issues in PGY1-4 were due to relationships with seniors, shouldn’t they have already graduated? At the very least, they should have had issues with other trainees that you could have pointed to in discussions with your program leadership. No one gets “surprised” by probation either, particularly when starting their chief year.

You sound lost. I hope you find something good, perhaps not directly patient-facing. Best of luck.

[Guest]

So mean!