How Son Of Former Cabinet Minister Won A Coveted Ubc Residency

[Taengoo]

"Surgeons on selection committee manipulated hiring, documents say"

 

http://thetyee.ca/News/2015/02/06/Former-Cabinet-Minister-Wins-UBC-Residency/

 

 

 

Cardiac surgeons on a selection committee at St. Paul's Hospital manipulated the hiring process for a training position so they could hire a student who was the son of their boss and of a provincial cabinet minister, documents show.

 

Officials from the faculty of medicine at the University of British Columbia, which oversees the hiring process for the publicly funded residency positions, found the situation "disturbing" and "very challenging," and there were many pages of legal advice on the matter, according to the heavily censored documents obtained from UBC through a request under the province's Freedom of Information and Protection of Privacy Act.

The documents do not name the student, but The Tyee reported in 2013 that Kevin Lichtenstein received a residency position in cardiac surgery at St. Paul's Hospital through the University of British Columbia, where his father Sam Lichtenstein is the head of the division of cardiovascular surgery.

 

Sam Lichtenstein is also the director of cardiovascular thoracic (CVT) surgery at St. Paul's and the medical director for the regional cardiac science program at Providence Health Care and Vancouver Coastal Health. His emailed response this week to detailed questions about how his son received the residency position said, "I refer you to the Faculty of Medicine, UBC, who is responsible for the process."

 

Kevin Lichtenstein's mother is Moira Stilwell, who was the minister of social development in Premier Christy Clark's cabinet before the 2013 election --though she's since been demoted to the government's backbench -- and who as a parliamentary secretary to the health minister wrote a report in 2011 titled "Action Plan for Repatriating BC Medical Students Studying Abroad." She is also a radiologist who before being elected was head of nuclear medicine at several hospitals, including St. Paul's.

 

Kevin Lichtenstein went to medical school in Ireland, making him part of a group of Canadians who have studied medicine abroad and who have complained loudly in recent years about how difficult it is to get residency positions to complete their training.

 

[jmatt1122]

Very interesting... thanks for sharing! Good to see that this got attention and will hopefully be prevented in future. Although from what I've heard there are tons of 'unfair' confounders in the selection of residents (less obvious family/personal connections, who the team subjectively 'likes' more, names popping up in locker room / elevator conversations, etc). 

[NLengr]

Very interesting... thanks for sharing! Good to see that this got attention and will hopefully be prevented in future. Although from what I've heard there are tons of 'unfair' confounders in the selection of residents (less obvious family/personal connections, who the team subjectively 'likes' more, names popping up in locker room / elevator conversations, etc).

 

I wouldn't say "fit" or like-ability is unfair or a confounder in matching, it's an integral part. You are selecting someone to work with for 5 years. Thier ability to fit into the organization is crucial.

 

As I have said before, IMO, three factors form the majority of ranking decisions (at least in small, competitive specialties like mine):

Work ethic

Fit/like-ability

Knowledge (specific to our specialty)

 

If you miss any of those, you aren't gonna be ranked by our program.

[ophtho_gunner]

^^ sounds all fine and dandy on paper but reality is different. Likeability is extremely subjective and dependent on PD and department's individual biases. Is a happy sassy smiling female student with average knowledge more likeable than a genius and friendly although a bit quiet male ? Or vice versa.

 

Given the push for gender equalization in the broad spectrum of social movements in Western societies, residency selection has a certain component of affirmative action in trying to keep a 50-50% ratio and NOT on selecting candidates purely on the basis of excellence merit.

[Jaybird]

^^ sounds all fine and dandy on paper but reality is different. Likeability is extremely subjective and dependent on PD and department's individual biases. Is a happy sassy smiling female student with average knowledge more likeable than a genius and friendly although a bit quiet male ? Or vice versa.

 

Given the push for gender equalization in the broad spectrum of social movements in Western societies, residency selection has a certain component of affirmative action in trying to keep a 50-50% ratio and NOT on selecting candidates purely on the basis of excellence merit.

 

Er, no. Affirmative action is moronic - all it does is increase resentment towards the favoured group. 

[A-Stark]

^^ sounds all fine and dandy on paper but reality is different. Likeability is extremely subjective and dependent on PD and department's individual biases. Is a happy sassy smiling female student with average knowledge more likeable than a genius and friendly although a bit quiet male ? Or vice versa.

 

Given the push for gender equalization in the broad spectrum of social movements in Western societies, residency selection has a certain component of affirmative action in trying to keep a 50-50% ratio and NOT on selecting candidates purely on the basis of excellence merit.

 

Of course it's subjective. Welcome to real world of work where, yes, the "fit" is something considered, especially in smaller groups. 

 

It is certainly true that being "quiet" can become a disadvantage, but not for the reason you think. If someone doesn't speak up much and has a more passive personality, the result is that they often find fewer occasions to "shine" and make a strong impression. 

 

Otherwise I have no idea what you're talking about re: "affirmative action". Certainly the gender mix of different programs alone can fluctuate wildly one year to the next. For example, the CCFP-EM program at my centre has had 75% female residents the past two years, but next year 5 of 6 will be men. 

[NLengr]

^^ sounds all fine and dandy on paper but reality is different. Likeability is extremely subjective and dependent on PD and department's individual biases. Is a happy sassy smiling female student with average knowledge more likeable than a genius and friendly although a bit quiet male ? Or vice versa.

 

Given the push for gender equalization in the broad spectrum of social movements in Western societies, residency selection has a certain component of affirmative action in trying to keep a 50-50% ratio and NOT on selecting candidates purely on the basis of excellence merit.

 

What in G*d's name are you talking about?

[Lactic Folly]

^^ sounds all fine and dandy on paper but reality is different. Likeability is extremely subjective and dependent on PD and department's individual biases. Is a happy sassy smiling female student with average knowledge more likeable than a genius and friendly although a bit quiet male ? Or vice versa.

 

Remember that medical school admissions differs from residency selection in a couple of important aspects. In medical school admissions, the interviewers are tasked with selecting the best future physicians for society, and they may never see the accepted candidates again. In any smaller residency program, the focus is not societal but rather selecting who they would like to join their departmental family, because that is what it essentially is...  so, it is not a surprise that different personalities might be considered a better fit at different programs.

[Edict]

I think this article needs to be written much better. First off, Kevin Lichtenstein did not study in Ireland, he studied in the UK at Brighton and Sussex Medical School, something a quick google search would have turned up... http://www.annalscts.com/article/view/503/924 

 

Secondly, it offers no real proof, it just guesses that because his dad was a cardiac surgeon and his mom a former minister that he didn't have to try. We don't know if that is true, and its very likely that his connections got him at least access to things no one else would have gotten, however that is just the way life works. Some people are also born so rich they don't have to work a day in their lives. 

 

Take what the media writes with a grain of salt, they are willing to make things up just to get an article out there. 

[ralk]

I think this article needs to be written much better. First off, Kevin Lichtenstein did not study in Ireland, he studied in the UK at Brighton and Sussex Medical School, something a quick google search would have turned up... http://www.annalscts.com/article/view/503/924 

 

Secondly, it offers no real proof, it just guesses that because his dad was a cardiac surgeon and his mom a former minister that he didn't have to try. We don't know if that is true, and its very likely that his connections got him at least access to things no one else would have gotten, however that is just the way life works. Some people are also born so rich they don't have to work a day in their lives. 

 

Take what the media writes with a grain of salt, they are willing to make things up just to get an article out there. 

 

In fairness, previous reporting on this topic by the same author correctly identified him as having studied in the UK, and it's an error that's fairly immaterial to the story. He studied overseas, it doesn't make much difference that it was on one island in Europe instead of another.

 

Secondly, they did provide some fairly compelling evidence that the program acted unfairly, in contradiction of CaRMS rules, to ensure the position was open in the second round and did ultimately accept him into their program. Whether that has anything to do with his parents is left unanswered, that is true. Still, there is a bit of an Occam's Razor principle at work here - if a CSA gets a highly coveted position in a program after that program acts inappropriately, and that CSA's parent runs the department, it's reasonable to suspect nepotism may be at play here.

 

At a minimum, an independent investigation would seem appropriate.

[JohnGrisham]

In fairness, previous reporting on this topic by the same author correctly identified him as having studied in the UK, and it's an error that's fairly immaterial to the story. He studied overseas, it doesn't make much difference that it was on one island in Europe instead of another.

 

Secondly, they did provide some fairly compelling evidence that the program acted unfairly, in contradiction of CaRMS rules, to ensure the position was open in the second round and did ultimately accept him into their program. Whether that has anything to do with his parents is left unanswered, that is true. Still, there is a bit of an Occam's Razor principle at work here - if a CSA gets a highly coveted position in a program after that program acts inappropriately, and that CSA's parent runs the department, it's reasonable to suspect nepotism may be at play here.

 

At a minimum, an independent investigation would seem appropriate.

Late to the party, but this poster has a point. The document which was provided, although extremely late, clearly shows the intent of the CS team involved and their motives. They then work with "UBC" to keep the situation "fair". I think at that point once it was realized that the first round was not run fairly or to the guidelines of CaRMS, they should have removed that seat from consideration. As was suggested by one of the UBC FOM administrators in the emails. I suppose due to potential funding loses, lose of a resident on the team, etc they went against that thought - on the basis of practicality.  They would have been 1 person short perpetually for the duration. That wouldn't necessarily be fair to the other person who matched etc.

[GrouchoMarx]

I would not be surprised if there was nepotism at play. But this is a cardiac surgery residency, which in general is not very competitive. I wonder what the initial competition was like. 

 

The argument that nepotism is alive and well in medicine would be better served if this story had to do with a competitive residency like ophthalmology.

[A-Stark]

Cardiac surgery residency isn't that competitive but it is very selective. It's a prime example of "self-selection", but they won't just accept anyone either. 

 

This story most certainly has a strong appearance of a conflict of interest. 

[JohnGrisham]

There are 9 CS spots for CMG's in the 2015 match. And then 2 spots in the Quebec Regular stream. And 1 IMG spot. 

In 2014:
-18 CMG applicants, 4 of which only applied to CS.
-36 IMG applicants, 2 of which only applied to CS.

-7 CMG's secured seats in 1st iteration, 6 of them it was their first choice discipline.
-2 IMG's secured seats in 2nd iterations.
-2 Vacancies.

In 2013:

-12CMG applicants, 3 of which only applied to CS.
-29 IMG applicants, 2 of which only applied to CS.

-6 CMG's secured seats in 1st iteration, 5 of them it was their first choice discipline.
-3 CMG's secured seats in the 2nd iteration.
-1 IMG secured seat in 2nd iterations.
-2 Vacancies

 

The 2012 data isn't formatted similarly to 2013/2014 so its harder to piece together..

[Edict]

Don't get me wrong, I also think nepotism was at play. At the very least that research paper was probably somewhat influenced by his father's position which would have given him a leg up, but as ubc2012 points out, there still were vacancies in the end, so its not 100% guaranteed that someone actually lost out.

 

Another anecdote, and in the interests of privacy I changed some details, there was a CSA who several years ago applied to optho, their parent was a top academic ophthalmologist and they did not get a position (although there is only like 1 designated IMG ophtho spot in the entire country). I think nepotism can help but it can only go so far.

[NLengr]

Don't get me wrong, I also think nepotism was at play. At the very least that research paper was probably somewhat influenced by his father's position which would have given him a leg up, but as ubc2012 points out, there still were vacancies in the end, so its not 100% guaranteed that someone actually lost out.

 

Another anecdote, and in the interests of autonomy I changed some details, there was a CSA who several years ago applied to optho, their parent was a top academic ophthalmologist and they did not get a position (although there is only like 1 designated IMG ophtho spot in the entire country). I think nepotism can help but it can only go so far.

 

I also know of an IMG person whose father was a top academic in Canada in his field. His father lobbied extremely hard to get him into one of the few IMG spots for the field in Canada. I don't believe he got a spot. I believe he's in a US program now.

[amichel]

Don't get me wrong, I also think nepotism was at play. At the very least that research paper was probably somewhat influenced by his father's position which would have given him a leg up, but as ubc2012 points out, there still were vacancies in the end, so its not 100% guaranteed that someone actually lost out.

 

Another anecdote, and in the interests of autonomy I changed some details, there was a CSA who several years ago applied to optho, their parent was a top academic ophthalmologist and they did not get a position (although there is only like 1 designated IMG ophtho spot in the entire country). I think nepotism can help but it can only go so far.

Autonomy? I feel like that's not what you meant.

[ploughboy]

I also know of an IMG person whose father was a top academic in Canada in his field. His father lobbied extremely hard to get him into one of the few IMG spots for the field in Canada. I don't believe he got a spot. I believe he's in a US program now.

 

 

I have a similar story.  Given that we're in different fields at different schools it's probably not the same person, which makes me wonder how often this sort of thing occurs.

[NLengr]

I have a similar story.  Given that we're in different fields at different schools it's probably not the same person, which makes me wonder how often this sort of thing occurs.

 Frequently. I know several other IMGs who had doctor parents who likely played a role in them matching.

 

Just like the real world, the match is influenced by who you know.

[Edict]

Autonomy? I feel like that's not what you meant.

 

Gah, interview prep is getting to me clearly 

[amichel]

Gah, interview prep is getting to me clearly

Haha fair enough!

[leviathan]

Looks super shady. Obviously family connections plays a role in getting his foot in the door, no question. You just hope he was also really that good and that the family connection was only the catalyst.

[quackster]

Don't get me wrong, I also think nepotism was at play. At the very least that research paper was probably somewhat influenced by his father's position which would have given him a leg up, but as ubc2012 points out, there still were vacancies in the end, so its not 100% guaranteed that someone actually lost out.

 

Another anecdote, and in the interests of privacy I changed some details, there was a CSA who several years ago applied to optho, their parent was a top academic ophthalmologist and they did not get a position (although there is only like 1 designated IMG ophtho spot in the entire country). I think nepotism can help but it can only go so far.

Maybe no one lost out on a spot, but someone may have wanted and lost out on that spot at UBC.