Leaving residency and re-applying to the CaRMS.

[lilytiger72]

I’m a CMG resident in a somewhat competitive speciality and unfortunately I had some trouble during my academic year. I had some personal issues and I ended up failing 1 rotation.

 

After this, I went to my program director, told him about my problems and he agreed to give me a sick leave for a couple of months. During these months, I sought help and I was able to get back on my feet. Upon my return, I was (understandably) put on probation and I had to retake a particular rotation. There was a problem on my first call, the staff with who I was on call got mad and spoke to the other attendings.

 

One problem for which I completely accept the blame, is that I didn't clearly document my management for a particular patient on that first call. After that incident, the remaining of the rotation went well. My following calls went well and for the 2 following months, there were no problems. The attendings with whom I’ve worked after the incident were satisfied with my work and each of them told me I met their expectations. I was glad to hear that, but unfortunately when my eval came, it only focused on the sole incident of the rotation and I was given a bad grade, although not a failure.

 

I called the staff who filled the eval (with whom I’ve never worked btw) and I called some of the attendings I’ve worked with and told them to reconsider the eval. They agreed that some points needed to be re-discussed and also told me that they couldn’t guarantee anything, which I understand perfectly.

 

The eval committee will meet up at some point, they will judge my 2 months rotation and they're going to decide if it's a pass or fail. However, I just don’t know how forgiving or strict they are. Now the problem is that if they deem the rotation a failure, I will most likely get kicked out. So right now I’m thinking about the worst case scenarios. During my sick leave, I realized that I would be happier in family medicine and it was my plan to ask for a switch. Unfortunately, before doing so, I need to pass that goddamned rotation.

 

 

If the verdict is that I should be expelled, they will give me a couple of days to appeal. However I can resign before the final decision is made. Now I wonder, would it be less damaging for my files (Resigning rather than being expelled) or does it make absolutely no difference? I’m already preparing my CaRMS application for the 2nd iteration just in case. I will be aiming for family medicine everywhere in Canada to maximize my chances. But, realistically speaking, is there any hope? I don’t expect it to be an easy road but I refuse to give up.

 

 

Now here's the thing:

 

1- I made a mistake during my first call, and I recognize I was at fault. Unfortunately what is done is done. I've learned a good lesson and the following months/calls/rotations went well. What should have been done on that call, I now know and it's not the issue I want to discuss.

 

2- Have you ever heard of a resident who left his residency (for any reason: illness/resigned/expelled) and was able to lend a 2nd residency spot somewhere? While being rare, I doubt there's absolutely 0 case like this in the history of medicine in Canada in the last 10 years, right? Right? If you leave a residency, again for whatever reason, are you forever doomed? My canadian MD diploma is now toilet paper!? If I apply to unfilled spots, my application will go straight to the recycle bin? Is the medical community really that unforgiving? =/

 

3- Any advice for trying to get a 2nd residency spot (be it through the CaRMS, by carving stone statues of PDs in their frontyards or whatever other method that offers a gleam of hope)

[lilytiger72]

I’m a CMG resident in a somewhat competitive speciality and unfortunately I had some trouble during my academic year. I had some personal issues and I ended up failing 1 rotation.

 

After this, I went to my program director, told him about my problems and he agreed to give me a sick leave for a couple of months. During these months, I sought help and I was able to get back on my feet. Upon my return, I was (understandably) put on probation and I had to retake a particular rotation. There was a problem on my first call, the staff with who I was on call got mad and spoke to the other attendings.

 

One problem for which I completely accept the blame, is that I didn't clearly document my management for a particular patient on that first call. After that incident, the remaining of the rotation went well. My following calls went well and for the 2 following months, there were no problems. The attendings with whom I’ve worked after the incident were satisfied with my work and each of them told me I met their expectations. I was glad to hear that, but unfortunately when my eval came, it only focused on the sole incident of the rotation and I was given a bad grade, although not a failure.

 

I called the staff who filled the eval (with whom I’ve never worked btw) and I called some of the attendings I’ve worked with and told them to reconsider the eval. They agreed that some points needed to be re-discussed and also told me that they couldn’t guarantee anything, which I understand perfectly.

 

The eval committee will meet up at some point, they will judge my 2 months rotation and they're going to decide if it's a pass or fail. However, I just don’t know how forgiving or strict they are. Now the problem is that if they deem the rotation a failure, I will be most likely get kicked out. So right now I’m thinking about the worst case scenarios. During my sick leave, I realized that I would be happier in family medicine and it was my plan to ask for a switch. Unfortunately, before doing so, I need to pass that goddamned rotation.

 

 

If the verdict is that I should be expelled, they will give me a couple of days to appeal. However I can resign before the final decision is made. Now I wonder, would it be less damaging for my files (Resigning rather than being expelled) or does it make absolutely no difference? I’m already preparing my CaRMS application for the 2nd iteration just in case. I will be aiming for family medicine everywhere in Canada to maximize my chances. But, realistically speaking, is there any hope? I don’t expect it to be an easy road but I refuse to give up.

 

 

Now here's the thing:

 

1- I made a mistake during my first call, and I recognize I was at fault. Unfortunately what is done is done. I've learned a good lesson and the following months/calls/rotations went well. What should have been done on that call, I now know and it's not the issue I want to discuss.

 

2- Have you ever heard of a resident who left his residency (for any reason: illness/resigned/expelled) and was able to lend a 2nd residency spot somewhere? While being rare, I doubt there's absolutely 0 case like this in the history of medicine in Canada in the last 10 years, right? Right? If you leave a residency, again for whatever reason, are you forever doomed? My canadian MD diploma is now toilet paper!? If I apply to unfilled spots, my application will go straight to the recycle bin? Is the medical community really that unforgiving? =/

 

3- Any advice for trying to get a 2nd residency spot (be it through the CaRMS, by carving stone statues of PDs in their frontyards or whatever other method that offers a gleam of hope)

[lilytiger72]

I’m a CMG resident in a somewhat competitive speciality and unfortunately I had some trouble during my academic year. I had some personal issues and I ended up failing 1 rotation.

 

After this, I went to my program director, told him about my problems and he agreed to give me a sick leave for a couple of months. During these months, I sought help and I was able to get back on my feet. Upon my return, I was (understandably) put on probation and I had to retake a particular rotation. There was a problem on my first call, the staff with who I was on call got mad and spoke to the other attendings.

 

One problem for which I completely accept the blame, is that I didn't clearly document my management for a particular patient on that first call. After that incident, the remaining of the rotation went well. My following calls went well and for the 2 following months, there were no problems. The attendings with whom I’ve worked after the incident were satisfied with my work and each of them told me I met their expectations. I was glad to hear that, but unfortunately when my eval came, it only focused on the sole incident of the rotation and I was given a bad grade, although not a failure.

 

I called the staff who filled the eval (with whom I’ve never worked btw) and I called some of the attendings I’ve worked with and told them to reconsider the eval. They agreed that some points needed to be re-discussed and also told me that they couldn’t guarantee anything, which I understand perfectly.

 

The eval committee will meet up at some point, they will judge my 2 months rotation and they're going to decide if it's a pass or fail. However, I just don’t know how forgiving or strict they are. Now the problem is that if they deem the rotation a failure, I will be most likely get kicked out. So right now I’m thinking about the worst case scenarios. During my sick leave, I realized that I would be happier in family medicine and it was my plan to ask for a switch. Unfortunately, before doing so, I need to pass that goddamned rotation.

 

 

If the verdict is that I should be expelled, they will give me a couple of days to appeal. However I can resign before the final decision is made. Now I wonder, would it be less damaging for my files (Resigning rather than being expelled) or does it make absolutely no difference? I’m already preparing my CaRMS application for the 2nd iteration just in case. I will be aiming for family medicine everywhere in Canada to maximize my chances. But, realistically speaking, is there any hope? I don’t expect it to be an easy road but I refuse to give up.

 

 

Now here's the thing:

 

1- I made a mistake during my first call, and I recognize I was at fault. Unfortunately what is done is done. I've learned a good lesson and the following months/calls/rotations went well. What should have been done on that call, I now know and it's not the issue I want to discuss.

 

2- Have you ever heard of a resident who left his residency (for any reason: illness/resigned/expelled) and was able to lend a 2nd residency spot somewhere? While being rare, I doubt there's absolutely 0 case like this in the history of medicine in Canada in the last 10 years, right? Right? If you leave a residency, again for whatever reason, are you forever doomed? My canadian MD diploma is now toilet paper!? If I apply to unfilled spots, my application will go straight to the recycle bin? Is the medical community really that unforgiving? =/

 

3- Any advice for trying to get a 2nd residency spot (be it through the CaRMS, by carving stone statues of PDs in their frontyard or whatever other method that offers a gleam of hope)

[1fuzzy2dino3]

I’m a CMG resident in a somewhat competitive speciality and unfortunately I had some trouble during my academic year. I had some personal issues and I ended up failing 1 rotation.

 

After this, I went to my program director, told him about my problems and he agreed to give me a sick leave for a couple of months. During these months, I sought help and I was able to get back on my feet. Upon my return, I was (understandably) put on probation and I had to retake a particular rotation. There was a problem on my first call, the staff with who I was on call got mad and spoke to the other attendings.

 

One problem for which I completely accept the blame, is that I didn't clearly document my management for a particular patient on that first call. After that incident, the remaining of the rotation went well. My following calls went well and for the 2 following months, there were no problems. The attendings with whom I’ve worked after the incident were satisfied with my work and each of them told me I met their expectations. I was glad to hear that, but unfortunately when my eval came, it only focused on the sole incident of the rotation and I was given a bad grade, although not a failure.

 

I called the staff who filled the eval (with whom I’ve never worked btw) and I called some of the attendings I’ve worked with and told them to reconsider the eval. They agreed that some points needed to be re-discussed and also told me that they couldn’t guarantee anything, which I understand perfectly.

 

The eval committee will meet up at some point, they will judge my 2 months rotation and they're going to decide if it's a pass or fail. However, I just don’t know how forgiving or strict they are. Now the problem is that if they deem the rotation a failure, I will be most likely get kicked out. So right now I’m thinking about the worst case scenarios. During my sick leave, I realized that I would be happier in family medicine and it was my plan to ask for a switch. Unfortunately, before doing so, I need to pass that goddamned rotation.

 

 

If the verdict is that I should be expelled, they will give me a couple of days to appeal. However I can resign before the final decision is made. Now I wonder, would it be less damaging for my files (Resigning rather than being expelled) or does it make absolutely no difference? I’m already preparing my CaRMS application for the 2nd iteration just in case. I will be aiming for family medicine everywhere in Canada to maximize my chances. But, realistically speaking, is there any hope? I don’t expect it to be an easy road but I refuse to give up.

 

 

Now here's the thing:

 

1- I made a mistake during my first call, and I recognize I was at fault. Unfortunately what is done is done. I've learned a good lesson and the following months/calls/rotations went well. What should have been done on that call, I now know and it's not the issue I want to discuss.

 

2- Have you ever heard of a resident who left his residency (for any reason: illness/resigned/expelled) and was able to lend a 2nd residency spot somewhere? While being rare, I doubt there's absolutely 0 case like this in the history of medicine in Canada in the last 10 years, right? Right? If you leave a residency, again for whatever reason, are you forever doomed? My canadian MD diploma is now toilet paper!? If I apply to unfilled spots, my application will go straight to the recycle bin? Is the medical community really that unforgiving? =/

 

3- Any advice for trying to get a 2nd residency spot (be it through the CaRMS, by carving stone statues of PDs in their frontyard or whatever other method that offers a gleam of hope)

 

Oh man, I wish you lots of courage and good luck! Everyone makes mistakes and everyone deserves at least a second chance. I hope ppl on this forum can help you. Have you been able to chat about this with your school's career counselling office? Or your dean of student affairs?

 

Wishing you well in this uncertain time. I hope it all works out for the best (for everyone involved)

[NLengr]

If you resign, they'll probably ask you what the circumstances surrounding your resignation were. They may even ask around at your old program about you. Unless you plan on concealing past events, it probably won't make a difference. At least that would be my take on it. But I'm by no means an expert.

 

Apply to unpopular programs (location or specialty). They probably would be more forgiving since they can't afford to be picky.

[justletmein]

I know you are stressed out, but did you really need to triple-post this in 3 different sub-forums?

[ploughboy]

1) Where does your program director stand on the issue? Have you met with him/her? You need to have your PD on-side.

 

2) Who are your allies and who is advocating on your behalf? You need to have a face-to-face meeting with a senior staff in your department who a) likes you will go to bat for you and c) has enough credibility and seniority to be taken seriously. This person can't be your PD.

 

3) I know of a resident from a competitive residency in a desirable location who left that program under a cloud and is now rumoured to be in an undesirable program in another province and different discipline. I don't know the path that individual took to get there, whether through CaRMS or some sort of backroom dealing, but it has happened.

 

4) The medical community in Canada is small, and people do talk. Any ability/inclination to go through NRMP and then come back to Canada?

 

 

 

 

I’m a CMG resident in a somewhat competitive speciality and unfortunately I had some trouble during my academic year. I had some personal issues and I ended up failing 1 rotation.

 

After this, I went to my program director, told him about my problems and he agreed to give me a sick leave for a couple of months. During these months, I sought help and I was able to get back on my feet. Upon my return, I was (understandably) put on probation and I had to retake a particular rotation. There was a problem on my first call, the staff with who I was on call got mad and spoke to the other attendings.

 

One problem for which I completely accept the blame, is that I didn't clearly document my management for a particular patient on that first call. After that incident, the remaining of the rotation went well. My following calls went well and for the 2 following months, there were no problems. The attendings with whom I’ve worked after the incident were satisfied with my work and each of them told me I met their expectations. I was glad to hear that, but unfortunately when my eval came, it only focused on the sole incident of the rotation and I was given a bad grade, although not a failure.

 

I called the staff who filled the eval (with whom I’ve never worked btw) and I called some of the attendings I’ve worked with and told them to reconsider the eval. They agreed that some points needed to be re-discussed and also told me that they couldn’t guarantee anything, which I understand perfectly.

 

The eval committee will meet up at some point, they will judge my 2 months rotation and they're going to decide if it's a pass or fail. However, I just don’t know how forgiving or strict they are. Now the problem is that if they deem the rotation a failure, I will be most likely get kicked out. So right now I’m thinking about the worst case scenarios. During my sick leave, I realized that I would be happier in family medicine and it was my plan to ask for a switch. Unfortunately, before doing so, I need to pass that goddamned rotation.

 

 

If the verdict is that I should be expelled, they will give me a couple of days to appeal. However I can resign before the final decision is made. Now I wonder, would it be less damaging for my files (Resigning rather than being expelled) or does it make absolutely no difference? I’m already preparing my CaRMS application for the 2nd iteration just in case. I will be aiming for family medicine everywhere in Canada to maximize my chances. But, realistically speaking, is there any hope? I don’t expect it to be an easy road but I refuse to give up.

 

 

Now here's the thing:

 

1- I made a mistake during my first call, and I recognize I was at fault. Unfortunately what is done is done. I've learned a good lesson and the following months/calls/rotations went well. What should have been done on that call, I now know and it's not the issue I want to discuss.

 

2- Have you ever heard of a resident who left his residency (for any reason: illness/resigned/expelled) and was able to lend a 2nd residency spot somewhere? While being rare, I doubt there's absolutely 0 case like this in the history of medicine in Canada in the last 10 years, right? Right? If you leave a residency, again for whatever reason, are you forever doomed? My canadian MD diploma is now toilet paper!? If I apply to unfilled spots, my application will go straight to the recycle bin? Is the medical community really that unforgiving? =/

 

3- Any advice for trying to get a 2nd residency spot (be it through the CaRMS, by carving stone statues of PDs in their frontyard or whatever other method that offers a gleam of hope)

[rmorelan]

side note - it is a bit horrifying to think a mistake on the first call shift can result is such dramatic punishment. This is a lot of pain and suffering for what is a mistake.

[uwodesperate]

I know you are stressed out, but did you really need to triple-post this in 3 different sub-forums?

 

Just let him/her be... He/she is obviously going through a very difficult time. Did you really need to reply to the post?

[rogerroger]

side note - it is a bit horrifying to think a mistake on the first call shift can result is such dramatic punishment. This is a lot of pain and suffering for what is a mistake.

 

Agreed. It would have to be one heck of a mistake to pretty much void the rest of the rotation. There must be more to this.

 

It is hard to give advice because as the situation is described it seems pretty exceptional. Regardless, it's obvious you will need the support of your home PD. If you reapply then any prospective program will want a reference letter from your PD. They will want to know what happened and what risk you may poise to their program. Not an unreasonable concern given the circumstances. If your relationship with your PD is less than ideal I really have no idea how to advise you. Maybe others have thoughts?

[NLengr]

I would try to stay in at all costs. Withdrawing will be questioned by whatever program you reapply to. They will talk to your old program. They may request documents of the incidents that happened. In short, I don't think withdrawing gains you anything.

 

If you get expelled, appeal it. Keep appealing till you run out of options. I would also talk to a lawyer to get a legal opinion at that point, prior to starting your appeal. You may have access to legal advice through your university, residency association or the CMPA. After all, getting expelled carries a real risk of not being able to practice medicine again (because you can't get another residency given your history). That's gonna cost you over a million bucks of lost pay and student loans in your lifetime. It's worth spending whatever you can to avoid it.

[NLengr]

side note - it is a bit horrifying to think a mistake on the first call shift can result is such dramatic punishment. This is a lot of pain and suffering for what is a mistake.

 

I think he/she explains there had been prior issues with performance requiring a period of leave to overcome whatever the root cause was felt to be.

[lilytiger72]

Not yet but I'm on it.

[lilytiger72]

It's a risky gamble since I can only appeal once. I fear that being expelled carries a bit more weight then withdrawing. I may be be completely wrong, but it seems like it's easier to explain a decision to withdraw (which could be not just academic related) than to defend against termination during an interview (If I get any). Also, I'm well aware that prospective programs will want to know what happened and I don't intend to hide it from them as I'm an honest woman. Every single valuable piece of information will be sent with my application, great, good, bad evals alike. I hope this will obviate the need to speak with my PD (As I don't have a particularly great relationship with him), but if It's a usual procedure that can't be avoided then whatever. I also wonder if I should write a little something about my situation (and measures taken to fix it) in personal statements. Would it be a good idea?

 

I'll try to arrange a meeting with a career counselor to see if there is any non-clinical job I could do with an MD in the meantime (pharm or whatever)

[Real Beef]

Wishing you the best as well.

 

Not that it makes any difference but was it an off-service rotation you failed and had the on-cal mishap on? Take care.

 

Beef

[Icebox]

I would personally withdraw and then do whatever is possible afterwards to get into the program you want. I agree with some of the other posters saying that any program you would apply to, would contact your former program about you. And in my mind, it'd be much better to hear from them that you had personal issues that forced you to withdraw, than to hear that you had personal issues, wanted to stay in their program but they expelled you, you appealed, pursued legal action, got the CMPA involved, etc. Other programs would perceive this as a huge headache and someone they would not want in their program. A lot of the latter would result in a PD that is no longer going to vouch for you, whereas if it's simply about personal issues, he/she may.

 

It sounds like it's fairly clear that you don't want to be in this program, so your best bet would be to leave them on good terms, rather than create an overall negative impression for them when you do eventually switch/leave/transfer out. It will only serve you better in the long run to get into another program, and I also suspect you'd be much, much happier than fighting to stay in a program you don't want to be in. Sounds like a difficult situation - I hope it works out for the best.

 

Edit: And I would definitely talk to the PD and be on good terms with them. This is key to ensuring you have a solid chance at being accepted to another program.

[rogerroger]

I hope this will obviate the need to speak with my PD (As I don't have a particularly great relationship with him), but if It's a usual procedure that can't be avoided then whatever.

 

 

I would think twice about not talking this over with your PD. If you can get your PD on your side then your reapplication chances are way higher IMO. Any program you apply to will seek out your former PD to try to figure out what you are about. If your PD does not think highly of you I can't see any program being motivated to take you.Realistically the main thing programs want to avoid during CaRMS is a high maintenance resident. I think most if not all programs would rather have empty spots rather than a problematic resident.

 

A key component in selling yourself to future programs could be getting your former PD to smooth things over for you.

[rmorelan]

I would think twice about not talking this over with your PD. If you can get your PD on your side then your reapplication chances are way higher IMO. Any program you apply to will seek out your former PD to try to figure out what you are about. If your PD does not think highly of you I can't see any program being motivated to take you.Realistically the main thing programs want to avoid during CaRMS is a high maintenance resident. I think most if not all programs would rather have empty spots rather than a problematic resident.

 

A key component in selling yourself to future programs could be getting your former PD to smooth things over for you.

 

yeah exactly - that PD is really hugely important in all of this. Imagine what happens when people call him - and they will - during this process and he doesn't really have any idea as why all this is going on.

 

Are we even sure at this point you can leave without the current programs permission anyway? The entire carms contract and all that.

[lilytiger72]

Won't need permission, most of the attendings within the program want me to get the boot for a couple of reasons (wasn't high on their rank list, academic problems didn't help). I'd say that overall the program would be happy if I left. The same goes for me but I want to grab the next branch before I fall.

[rmorelan]

Won't need permission, most of the attendings within the program want me to get the boot for a couple of reasons (wasn't high on their rank list, academic problems didn't help). I'd say that overall the program would be happy if I left. The same goes for me but I want to grab the next branch before I fall.

 

yeah but formally doesn't the program have to release you? Honestly not all that sure how that works!

[ploughboy]

Another piece of advice - have you talked this over with your provincial residents' association? They can probably advise you strategically and legally, and might even be able to help mediate the situation.

[Jochi1543]

Another piece of advice - have you talked this over with your provincial residents' association? They can probably advise you strategically and legally, and might even be able to help mediate the situation.

 

Excellent suggestion.

[rogerroger]

Another piece of advice - have you talked this over with your provincial residents' association? They can probably advise you strategically and legally, and might even be able to help mediate the situation.

 

This is absolutely essential. If you have not done this stop reading and pick up a phone. Seriously, you gotta do this, this might be one of the most important calls you will make in your career.

 

Your provincial residents union has the legal resources to give you very significant backup. Dealing with these issues is one of the primary reasons these associations exist. They are experienced at dealing with your problem.

[cdnmaple]

 

2- Have you ever heard of a resident who left his residency (for any reason: illness/resigned/expelled) and was able to lend a 2nd residency spot somewhere? While being rare, I doubt there's absolutely 0 case like this in the history of medicine in Canada in the last 10 years, right? Right? If you leave a residency, again for whatever reason, are you forever doomed? My canadian MD diploma is now toilet paper!? If I apply to unfilled spots, my application will go straight to the recycle bin? Is the medical community really that unforgiving? =/

 

Sorry to say, but the prospects are NOT good. Once you have started training, and until you have successfully finished training, if you apply through CaRMS then you will find that most programs will request your ITERs. They will want to know if you have ever failed/resigned/etc and you will be obliged to tell them. Second iteration is competitive -- for every specialty.

 

Frankly, I was successful at my first residency, and I still wouldn't have wanted to share my ITERs. Most were fine. Some had comments that could be interpreted badly. So I was happy to not have to share them as part of my application and I feel for those who do.

 

I have never met someone who actually LEFT a residency and then went on to get back into a different one. But I have met those who have switched, sometimes for stories not much different than yours. Having not gone through that, personally, I can't tell you much about that, but it does seem that you should be able to find someone within your university or provincial residents' association that can help guide you. Perhaps someone in the postgrad office?

 

One bad call like that should not be impacting on you so severely. I don't disbelieve that things could snowball out of control like that, though. If you really think that most of the attendings in your program want you out, can you spin it to them that you've realized that your heart isn't really in it as much as you thought it would be and you've found your true passion in this other specialty? Is there one attending that can be on your side?

 

 

3- Any advice for trying to get a 2nd residency spot (be it through the CaRMS, by carving stone statues of PDs in their frontyard or whatever other method that offers a gleam of hope)

 

Talk to your postgrad office. There may be room for a transfer within the university (I've heard of those) but otherwise you may be looking at round 2 of CaRMS.

 

Another thing about staying in residency: you can sometimes ask to do some soul-searching/career-testing electives. These will help you find another residency, and you stay employed too.

[Knovecc]

it's funny that someone's dirt is really other's treasure...

Lilytiger I'm sure there are tons of FM residents who would love to trade their family medicine residency with you, whatever your specialty is

 

I know this doesn't help, sorry for my useless comment here...