Resident Sues School for Failing to Prepare Him for the College Exam

[rmorelan]

https://www.thestar.com/news/gta/2017/12/31/western-u-sued-over-substandard-medical-residency.html

This is kind of interesting - what responsibilities does the residency program have towards getting you through the final college exam? 

In this case he failed the exam 3 times(?). As I understand it that is the maximum number of times you can write the college exam which means he simply cannot proceed on that front and would have to repeat a new residency program(?) This is everyone's worst nightmare but it is extremely rare as well.

 

[la marzocco]

15 minutes ago, rmorelan said:

https://www.thestar.com/news/gta/2017/12/31/western-u-sued-over-substandard-medical-residency.html

This is kind of interesting - what responsibilities does the residency program have towards getting you through the final college exam? 

In this case he failed the exam 3 times(?). As I understand it that is the maximum number of times you can write the college exam which means he simply cannot proceed on that front and would have to repeat a new residency program(?) This is everyone's worst nightmare but it is extremely rare as well.

To a large extent, I would feel that the residency program should be structured in a way that will give you the training required to be competent in said specialty (i.e., be able to pass the exam -- shows competence).

"Stuart was insufficiently supervised and infrequently tested, and key faculty members quit during his five years as a post-graduate resident, the court document states. By the time he was in his third year as a resident, Stuart was the only one left in the medical microbiology specialist program. The program is now inactive and has accepted no students."

This fact pattern alone gives me the idea that the training program was not adequately structured to set him up for success.

Not sure how this would have worked.. but maybe he could have used that as a reason to transfer during PGY3 to let's say U of Toronto for the remainder of his residency training in med micro? 

[Edict]

14 minutes ago, rmorelan said:

https://www.thestar.com/news/gta/2017/12/31/western-u-sued-over-substandard-medical-residency.html

This is kind of interesting - what responsibilities does the residency program have towards getting you through the final college exam? 

In this case he failed the exam 3 times(?). As I understand it that is the maximum number of times you can write the college exam which means he simply cannot proceed on that front and would have to repeat a new residency program(?) This is everyone's worst nightmare but it is extremely rare as well.

 

Interesting case, initially, it sounds like it is the resident's fault that he failed the exam 3 times, however it seems as if his program essentially disappeared around him during his residency and he was the last graduate of the program. I could see that having an effect on someone's ability to learn and pass the exam. 

[liszt]

Three attempts doesn't mean a complete do-over of residency. From the Royal College, Policies and Procedures for Certification document,

Quote

A candidate whose eligibility for the examinations leading to Royal College certification has expired after three (3) years through failure on the examinations or through failure to appear at the examinations or who are in the category of severe fail may be required to satisfactorily complete a study plan and/or an additional six (6) months of residency in order to regain examination eligibility.

No denying this is a terrible situation. If his training was inadequate, whatever the reason, it makes sense to undertake more training... I wonder if this could be pursued (not necessarily at the same institution)?

[rmorelan]

12 minutes ago, liszt said:

Three attempts doesn't mean a complete do-over of residency. From the Royal College, Policies and Procedures for Certification document,

No denying this is a terrible situation. If his training was inadequate, whatever the reason, it makes sense to undertake more training... I wonder if this could be pursued (not necessarily at the same institution)?

am I reading this correctly - may have to do 6 months of residency again? If so I wonder how that would be funded etc. Does the home school have an obligation to provide that.  

if true at least there isn't some hard limit. 

On the face of it if the Western program was dissolving around him arranging for transfer would seem like a logical move. Universally schools seem to cling onto things more than they should. 

Cannot imagine the pain of having to write the test 3 times. Gah - having to do it once sounds stressful enough

I wonder how much medical microbiology preparation for the exam requires the residency program after a point. Not having anyone else in the program wouldn't help. In my field a great deal of it can and indeed has to be done outside of the program. My residency teaches me how to be a radiologist for sure but exam is a different animal. 

[rmorelan]

I guess there is still some form of a hard limit(?)

"If a candidate reaches a point where they have not passed the examination after completion of one study plan and one six (6) month period of additional training in the specialty, no further eligibility for the specialty examination will be granted."

we don't seem to spend much time going over this sort of stuff - probably as it is just so rare to consider.

[liszt]

4 hours ago, rmorelan said:

I guess there is still some form of a hard limit(?)

"If a candidate reaches a point where they have not passed the examination after completion of one study plan and one six (6) month period of additional training in the specialty, no further eligibility for the specialty examination will be granted."

we don't seem to spend much time going over this sort of stuff - probably as it is just so rare to consider.

I familiarized myself with it during that long, painful wait between my RC exam and result release 

[goleafsgochris]

I wrote last year, and to be honest didn't feel the program has THAT much to do with your ability to pass.  I don't know how medical microbiology is, but in my area the exam was so different from day to day practice that the most important part of preparing was just self study.  Seeing patients and interacting with staff had almost no benefit once you sort of know the basics.  

I do feel bad for this guy though.  Maybe the lack of other residents was the real issue (I would think this would make it very difficult to obtain advice)

[Mithril]

1 hour ago, rmorelan said:

We don't seem to spend much time going over this sort of stuff - probably as it is just so rare to consider.

Also probably because no one wants to think about it. I definitely wouldn't want to be reading about what happens when I fail a licensing exam three times just before writing it for the first time.

 

I think in this situation the school is culpable in not providing an adequate education to the resident. I know that for my college exams having built up experience throughout my residency was instrumental in allowing me to pass those exams. It made studying the minutiae easier to swallow and make more sense once you have that kind of clinical background. In this case this poor resident's program fell apart all around him.

[rmorelan]

3 hours ago, goleafsgochris said:

I wrote last year, and to be honest didn't feel the program has THAT much to do with your ability to pass.  I don't know how medical microbiology is, but in my area the exam was so different from day to day practice that the most important part of preparing was just self study.  Seeing patients and interacting with staff had almost no benefit once you sort of know the basics.  

I do feel bad for this guy though.  Maybe the lack of other residents was the real issue (I would think this would make it very difficult to obtain advice)

I do think it is program specific - I feel at this point with how the radiology exam is set up my day to day work isn't helping me prepare at all for it. They exam has pathology even in the oral that I haven't seen live in 5 years of training - and some staff have never seen in the wild. Ha - even when we look at our cases for rounds you can see why it often takes the years to get enough cases for a themed talk (say neck masses) - and why they protect those cases as they are hard to come by. We are all trying to get done our work day stuff ASAP so we can get to the "useful stuff". 

That can be a problem - in our community career days we have radiologists from places most of us would be working in all telling how annoyed they are that we aren't perfecting our skills and getting faster in our last year. Instead of preparing for the job we are preparing for an exam. Then you get out there and are suddenly stuck realizing there are key things you really aren't that good at. Cannot learn both. The US system in part rolled back the exam to 4th year which may help in that area I suppose.

Yeah there are aspects of not having other residents around would not help at all. Both in your year to motivate/help and before you to show you how it is done. The person in question was from a small program in general so even reaching out to other schools would be harder. On paper he appears quite intelligent so I don't lack of raw ability is the issue. 

[A-Stark]

On 2018-01-01 at 7:07 PM, rmorelan said:

That can be a problem - in our community career days we have radiologists from places most of us would be working in all telling how annoyed they are that we aren't perfecting our skills and getting faster in our last year. Instead of preparing for the job we are preparing for an exam. Then you get out there and are suddenly stuck realizing there are key things you really aren't that good at. Cannot learn both. The US system in part rolled back the exam to 4th year which may help in that area I suppose.

That's CBD for you. Now the last year is all about "transition to practice". Not sure quite what that means yet apart from looking for jobs (so far). 

This is an interesting situation insofar as the answer is not clear cut. Three failed exam attempts suggests that there may be problems that go well beyond the program itself. Certainly when I've met and/or worked with people that have failed on more than one occasion, I haven't had much trouble figuring out why it happened. Medical microbiology is such a small specialty that it can't be a very easy exam, but you'd think that two years as a clinical fellow would be enough time to figure it out. (Interestingly, it was my dad's original specialty back in the early 80s, but that was in an era where a rotating internship and a year or two of IM was part of it too.)

That the program is now dormant suggests more fundamental PGME issues, but I don't think that's clearcut. It's not unusual for that to happen to small programs, and surely he would have been able to do rotations outside Western. It's hard to say. 

[rmorelan]

5 minutes ago, A-Stark said:

That's CBD for you. Now the last year is all about "transition to practice". Not sure quite what that means yet apart from looking for jobs (so far). 

This is an interesting situation insofar as the answer is not clear cut. Three failed exam attempts suggests that there may be problems that go well beyond the program itself. Certainly when I've met and/or worked with people that have failed on more than one occasion, I haven't had much trouble figuring out why it happened. Medical microbiology is such a small specialty that it can't be a very easy exam, but you'd think that two years as a clinical fellow would be enough time to figure it out. (Interestingly, it was my dad's original specialty back in the early 80s, but that was in an era where a rotating internship and a year or two of IM was part of it too.)

That the program is now dormant suggests more fundamental PGME issues, but I don't think that's clearcut. It's not unusual for that to happen to small programs, and surely he would have been able to do rotations outside Western. It's hard to say. 

Yeah it is in large part the fellowship part that I don't get - if you can successfully operate at the fellowship level under that kind of supervision there much be something odd about this test to have someone fail it multiple times. 

[goleafsgochris]

On ‎2018‎-‎01‎-‎03 at 6:22 PM, rmorelan said:

Yeah it is in large part the fellowship part that I don't get - if you can successfully operate at the fellowship level under that kind of supervision there much be something odd about this test to have someone fail it multiple times. 

I don't know if its that odd, I think its a feature of many of the royal college exams.  At least for mine, the overlap between the exam and day to day competence was like 5%.  I could easily see a circumstance where someone is great clinically but cant pass the exam (I'm clearly still bitter about last year when I had to write it).  

[la marzocco]

30 minutes ago, goleafsgochris said:

I don't know if its that odd, I think its a feature of many of the royal college exams.  At least for mine, the overlap between the exam and day to day competence was like 5%.  I could easily see a circumstance where someone is great clinically but cant pass the exam (I'm clearly still bitter about last year when I had to write it).  

That's the case for many professional exams. My bar exam had practically 0% day-to-day relevance. I know many great articling students who failed twice before passing - nothing to do with competence on the job.

[Pippa756]

43 minutes ago, la marzocco said:

That's the case for many professional exams. My bar exam had practically 0% day-to-day relevance. I know many great articling students who failed twice before passing - nothing to do with competence on the job.

Yeah I noticed that with friends who went through the bar. Basically it was like training for something completely different from their professional experiences up to that point and they all found it a real challenge, despite being pretty much ahead of the curve on everything else law related.

[moonlitocean]

His fault for going to a shitty school for residency

[rmorelan]

On 1/5/2018 at 10:00 AM, goleafsgochris said:

I don't know if its that odd, I think its a feature of many of the royal college exams.  At least for mine, the overlap between the exam and day to day competence was like 5%.  I could easily see a circumstance where someone is great clinically but cant pass the exam (I'm clearly still bitter about last year when I had to write it).  

yet they are always babbling on about how the exam tests for safe competent doctors, ha.