What are reasons for residents to be fired?

[dermplan]

If you make a mistake as a new resident - is that a reason to be fired? What are reasons for residents to be fired or be on probation?

Thank you!

[1D7]

1 hour ago, dermplan said:

If you make a mistake as a new resident - is that a reason to be fired? What are reasons for residents to be fired or be on probation?

Thank you!

The most common reason is some form of "unprofessionalism". Most of the time it comes down to not showing up for work/call shifts. Less commonly this may mean egregious HIPAA violations (e.g. looking up coworkers) or doing something that is outright criminal (e.g. sexual assault). Probably even less common than that is just making the profession look bad to a wide audience, like posting radical political opinions (though you'd be surprised what people can get away with if it's a small enough audience).

A resident will almost never be fired for a single mistake, even if it is a pretty big/terrible one. If you were to perform poorly on rotations, repeatedly and in an obvious manner, then that increases the chance that the program will try to transfer you out. But again you probably wouldn't be outright fired.

[ellorie]

I don't know anyone who has been forced out of their program entirely (though it does happen from time to time).  I do know several people who have been put on remediation for various reasons.

"Professionalism" is a wide net and a vague enough term that the program can use it to nail you for almost anything they really feel like nailing you for.  Most people I know who have been put on remediation have been for that reason.  Actual unprofessionalism is mostly things like coming late, not showing up, not doing your paperwork, lying about things, etc but sometimes it can be because your supervisor is out to nail you and it becomes something vague like "having an attitude" or "not taking feedback".

To some degree when it comes to medical errors it probably depends on the specialty and how much of the mistake was related to negligence versus inexperience.  Nobody expects you to know everything but people expect you to be able to ask for help when you don't know what to do, rather than let things spiral out of control.

[blah1234]

24 minutes ago, ellorie said:

I don't know anyone who has been forced out of their program entirely (though it does happen from time to time).  I do know several people who have been put on remediation for various reasons.

"Professionalism" is a wide net and a vague enough term that the program can use it to nail you for almost anything they really feel like nailing you for.  Most people I know who have been put on remediation have been for that reason.  Actual unprofessionalism is mostly things like coming late, not showing up, not doing your paperwork, lying about things, etc but sometimes it can be because your supervisor is out to nail you and it becomes something vague like "having an attitude" or "not taking feedback".

To some degree when it comes to medical errors it probably depends on the specialty and how much of the mistake was related to negligence versus inexperience.  Nobody expects you to know everything but people expect you to be able to ask for help when you don't know what to do, rather than let things spiral out of control.

Yea, "professionalism" is such a general term that it can be used to punish residents if there is any evidence of slip up (and no resident I know is perfect or has not cut some sort of corner). Honestly, it's a big reason I used to tell my residents to just keep their head down and fake their smiles until they finished. Too many unsympathetic academic staff out there that can really make your life hell while residents have little to no recourse.

[1D7]

I agree, if somehow you made an enemy of a staff then it's pretty easy for them to target you with "professionalism" issues. I do think this is pretty rare though and if you were otherwise performing well then that gives you a buffer. A lot of programs are big enough that a single staff disliking you is unlikely to significantly impact your ability to graduate from the program.

Overall I still think it is pretty difficult to be fired/forcibly transferred and still relatively difficult to be slapped with remediation.

No one managing the residency program, including the PD, really wants to rock the boat too much in most programs because they want you for call coverage at the very least. Programs are incentivized to keep you in the program, as long as it's safe to do so.

[Snowmen]

The only time I've heard of a resident being fired was a FM resident at my university who got blackout drunk during a call shift to the point that the nurses got him to the ER and they ran a stroke code.

Even that guy eventually managed to get his job back, which is somewhat worrying.