Is Director right to take me out of surgeries?

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Reverdin green

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I am in a program that I won’t disclose.
recently told my director I will be transferring to another program and right there banned me from the OR. Haven’t seen OR since then. Is it fair treatment? Haven’t made it a big deal because it is his program but is that justified? What would you do in my position?

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May not be fair but they could definitely make your life worse in the future.
Would shy on not rocking the boat until you are clean and clear of the program. .
 
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I know what I wouldn't do if I was in your position

Post about it on social media. Podiatry is a small world and you'll be easily identifiable. There are only so many programs in that state. Even less programs that have transfers out of that state.

Just be the bigger person in the situation, go out with your head high and don't burn too many bridges. It's a small world and things can easily come back to bite you in the butt. Even if you are justified for leaving your program
 
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Is it fair? no

However, by transferring, your director no longer has any stake in training you, so it's understandable that they would want to allocate case volume to future graduates.

In the future, play your cards closer to your vest. You're not in elementary school, your teachers aren't as altruistic now as they were then, everyone has an axe to grind, and always trust but verify.
 
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Your PD sounds vindictive. To transfer you need your PD’s OK not only that but to also sign off on credit for your PGY time completed. I’d be more concerned about that.
 
It is to your PD's discretion to have you in a case or not for any reason. It's much more important if it's their surgical case. By telling him/her that you're transferring, it automatically shuts the door for you as you're no longer beneficial to their program. I'd leave peacefully as much as possible and don't burn any bridges, but make sure everything is in order (paperwork, cases transfers, etc.) before you leave.
 
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In Reverdin Green's defense, this is a very podiatry way for things to play out. When I was in residency, one of the general surgery residents had an opportunity to transfer to the next big hospital across town where they were a major organ transplant center and was going to set him up for career success. Everyone was really excited for him to have this chance and wished him well.

Such a shame we're like a bucket of crabs (or lobsters) pulling each other down
 
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Sounds like you made a good decision to transfer. PD sounds immature.

But we are also only hearing your part of the story, either way not really our business. Ultimately the patient is under the care of the attending/s and they can do what they want because they take full responsibility for any poor outcomes.

Were I in your position, particularly during the stress of residency, I would welcome the break.
 
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Let it go.

Chances are it's a crap program, and they just don't have enough cases. Most podiatry residencies are like that... and you're leaving it for a reason. On the flip side, they want/need to have residents who want to be there scrubbed in and logging as much as possible with their limited caseload. Honestly, can't blame them.

I would enjoy the additional free time personally
^Yep... learn the lesson and move on.

The PD can hurt you much more than you can hurt them.
Just read and do hobbies and hit the ground running at your new xfer residency.

Delete your entire post.

Experience is what you get when you don't get what you wanted.
100% ^^

If you think this experience is a frustration, just wait until you are looking for a podiatry job in a year or two. :(
 
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I am highly disappointed in a lot of the responses. Especially those telling me to delete my post. When did it become a norm for directors to become dictators? I signed a contract to learn medicine and surgery and as long as I am that contract it is my right to be taught medicine and surgery. I am highly disgusted by people here thinking it is okay for directors to treat residents anyhow because they hold power. How about I exercise my power by taking director to HR for unfair treatment? Or how about I also stop ****ing showing up because I am leaving the program? Y’all talking about not burning bridges but how about the ****ing director burning bridges already.
 
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I am highly disappointed in a lot of the responses. Especially those telling me to delete my post. When did it become a norm for directors to become dictators? I signed a contract to learn medicine and surgery and as long as I am that contract it is my right to be taught medicine and surgery. I am highly disgusted by people here thinking it is okay for directors to treat residents anyhow because they hold power. How about I exercise my power by taking director to HR for unfair treatment? Or how about I also stop ****ing showing up because I am leaving the program? Y’all talking about not burning bridges but how about the ****ing director burning bridges already.

I can feel your anger. It's ok to be upset.

But what you do NOT want to do is make a big deal of it. Why? Because unfortunately you can't ignore this year of training. You can't leave it off your resume. You will always need to list it as a place where you trained unless you want to commit fraud.

So why is this important? Because when you graduate from your new program and you need to get licensing paperwork and hospital privileging paperwork done, when you become an attending, unfortunately you are going to need this director to sign off on these documents. You are also going to need to make sure they sign off on them in a positive light too and not say you are incompetent or a bad doctor because that could ruin you.

They will begrudgingly do it or else you can sue them at that time if you prefer. If you switch jobs and have to do it all over again in a new state and hospital guess what you will need to rely on this person again. And again. And again. If you keep switching jobs.

Another thing to understand. Is your program director letting you transfer or are they going to fire you then allow you to leave? They could very well fire you. In that case I would lawyer up. If they fired you that would be bad as it would be something you would have to also declare on licensing paperwork and hospital privileging paperwork for the rest of your life. It would be impossible to explain or for others to believe in a positive light either. What a mess it could be.
 
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Unfortunately I didn’t even have enough cases (less than 20 first assist from July to March) to transfer so I would have to start over as PGY-1. I literally don’t need anything from my current program as I am starting over.
 
You should at the very least get credit for your off-service months, IM, rads, etc, right? Why can't you be mature adults about this and acknowledge it's not a fit and have a mutual parting of ways?

Also, it doesn't make sense to transfer if you're starting over as PGY1, because it's like you're re-entering match/scramble
 
Unfortunately I didn’t even have enough cases (less than 20 first assist from July to March) to transfer so I would have to start over as PGY-1. I literally don’t need anything from my current program as I am starting over.

Problem solved. Don’t worry about it and move on. Enjoy your free time. Gear up to start over somewhere better. Don’t make a big deal about it
 
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When did it become a norm for directors to become dictators?
When they become the reference checks for when you apply for hospital privileges at your first job as an attending or when they ask about the employment gap when you choose not to mention what happened in the gap between graduation and your new PGY-1 program.

Clearly your frustration may indicate some need for self-reflection as usually incompatibilities between a program and a resident are a two-way street, especially if they have historical success graduating successful podiatrists.
 
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I am highly disappointed in a lot of the responses. Especially those telling me to delete my post. When did it become a norm for directors to become dictators? I signed a contract to learn medicine and surgery and as long as I am that contract it is my right to be taught medicine and surgery. I am highly disgusted by people here thinking it is okay for directors to treat residents anyhow because they hold power. How about I exercise my power by taking director to HR for unfair treatment? Or how about I also stop ****ing showing up because I am leaving the program? Y’all talking about not burning bridges but how about the ****ing director burning bridges already.
We are doing that to try to protect you. You could go full scorched Earth but your PD will have a higher position of power and be able to do more to damage your career and prospects than you can as a resident who has already asked to transfer out and lost favor.

Put your ego aside and do what's best for YOU right now.

Just because you can, doesn't mean you should.
 
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I am highly disappointed in a lot of the responses. Especially those telling me to delete my post. When did it become a norm for directors to become dictators? I signed a contract to learn medicine and surgery and as long as I am that contract it is my right to be taught medicine and surgery. I am highly disgusted by people here thinking it is okay for directors to treat residents anyhow because they hold power. How about I exercise my power by taking director to HR for unfair treatment? Or how about I also stop ****ing showing up because I am leaving the program? Y’all talking about not burning bridges but how about the ****ing director burning bridges already.

Are you expecting the director to give you equal attention as your co-residents until June 30th?

If you only got 20 cases, then I would say the director has even more reason to shut you out of the OR. You are transferring and restarting your training as PGY-1, why continue to "waste" valuable case numbers towards you when they have other mouths to feed. Correct me if I'm wrong, but if you are restarting your PGY-1, I don't think any numbers you have accomplished transfer. If true, you have another 3 years to collect cases while the remaining ones have 2. This is what I would expect any director in this situation to do, whether it is fair or not. Also, yes a contract was signed but you and the director have essentially nullified it so........................

Welcome to the real world my friend. Just like any job in this world, you have to recognize who has real leverage regardless of who is right/wrong. Like many have said prior, this director will be involved in your career whether you like it or not. It's not worth your energy to pursue any action and go out with a smile.
 
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Future grads must be aware of malignant programs/PDs and do their best to avoid them. I am happy to post any anonymous complaints about such programs in the residency review thread.

Good luck OP, hope the new program treats you well; work hard!
 
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Are you expecting the director to give you equal attention as your co-residents until June 30th?

If you only got 20 cases, then I would say the director has even more reason to shut you out of the OR. You are transferring and restarting your training as PGY-1, why continue to "waste" valuable case numbers towards you when they have other mouths to feed. Correct me if I'm wrong, but if you are restarting your PGY-1, I don't think any numbers you have accomplished transfer. If true, you have another 3 years to collect cases while the remaining ones have 2. This is what I would expect any director in this situation to do, whether it is fair or not. Also, yes a contract was signed but you and the director have essentially nullified it so........................

Welcome to the real world my friend. Just like any job in this world, you have to recognize who has real leverage regardless of who is right/wrong. Like many have said prior, this director will be involved in your career whether you like it or not. It's not worth your energy to pursue any action and go out with a smile.
Okay I understand that others need the numbers but I can’t even scrub as 2nd and 3rd? I am not even allowed to go to the OR. How is that fair? Even students are allowed to scrub cases.
 
Also my program doesn’t even have off-service rotations so I don’t have any under my belt
 
Also my program doesn’t even have off-service rotations so I don’t have any under my belt
What have you been doing for the past year?

Look-up CPME 320 online (that's what the document used to be called) and you can see the mandatory off service rotations you have to complete to graduate ie. IM, ID, gas, general/vascular surgery, "behavioral", etc.
 
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Well it could be the dynamic in the OR. We don't really know what your particular program does for 2nd/3rd scrubs. Some programs you are just a fly on the wall and glorified retractor. Some the 2nd scrub does the whole case while the 1st scrub teaches. If there's any educational value to being 2nd/3rd scrub, I think your director still has justification, however miniscule. Not ideal or fair, but it is a crappy world out there.
 
Also my program doesn’t even have off-service rotations so I don’t have any under my belt

Whut? I feel like my whole first year was mostly off-service stuff. I trained many moons ago.

Thank you
 
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Also my program doesn’t even have off-service rotations so I don’t have any under my belt
If that’s true you should probably report the program to CPME. Every program has to reach rotation requirements. Most of your first year should be off service. If you weren’t scrubbing or off service what were you doing everyday?
 
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What have you been doing for the past year?

Look-up CPME 320 online (that's what the document used to be called) and you can see the mandatory off service rotations you have to complete to graduate ie. IM, ID, gas, general/vascular surgery, "behavioral", etc.
Clinic everyday, wound care and rounding on inpatients. None of my co-residents in first year have had any off-service rotation. Haven’t seen any second or third year as well. It’s optional as far as I know to go off-service and you have to fight hard to be allowed to go.
 
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Clinic everyday, wound care and rounding on inpatients. None of my co-residents in first year have had any off-service rotation. Haven’t seen any second or third year as well. It’s optional as far as I know to go off-service and you have to fight hard to be allowed to go.

Sounds weird. You can’t complete a residency unless you’ve done off service rotations. It’s mandatory for a residency to be approved.
 
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Clinic everyday, wound care and rounding on inpatients. None of my co-residents in first year have had any off-service rotation. Haven’t seen any second or third year as well. It’s optional as far as I know to go off-service and you have to fight hard to be allowed to go.
I think we're opening up a can of worms here. This doesn't sound right. Off rotations are a definite requirement for all residencies and I'm not sure how your program is able to pass this approval process without them. If this is the case, the program needs to be audited and shut down immediately.
 
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"They're called surgical privileges, not surgical rights."--Charles Lombardi (I think)

Probably him, he was my director. Absolutely sounds like something he would say. He was tough, but I learned so much from him and I am very thankful.
 
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I think we're opening up a can of worms here. This doesn't sound right. Off rotations are a definite requirement for all residencies and I'm not sure how your program is able to pass this approval process without them. If this is the case, the program needs to be audited and shut down immediately.
I am sure a lot of Podiatry programs in NY and other states are being run like that. They basically tick the boxes, make up fake evals and graduate residents
 
I am sure a lot of Podiatry programs in NY and other states are being run like that. They basically tick the boxes, make up fake evals and graduate residents

I have several friends in different NY programs and they all complete off service. Report your program. These are the ones that shouldn’t exist.

Your attendings just want a program for a resident mill
 
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I am sure a lot of Podiatry programs in NY and other states are being run like that. They basically tick the boxes, make up fake evals and graduate residents
Again- opening a brand new problem that's entirely different to your current situation.

You are encouraged to take any action you think is morally correct. Do not be surprised if it comes back to bite you- even if you are doing the right thing.

I am asking you to look out for yourself right now so you are able to transfer peacefully. The program and staff can do much more damage to your future prospects.

If it is frustrating to be left out of educational opportunities right now-but slow down and think for a second.

You are on the tail end of graduating from a well trained program. You have job prospects lined up or have already signed a contract. You have begun your onboarding process. All of a sudden you get a phone call- your program from 3 years ago mentioned something your new job is not comfortable with. Are you willing to put your future at risk for this program by calling them out?
 
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I am sure a lot of Podiatry programs in NY and other states are being run like that. They basically tick the boxes, make up fake evals and graduate residents
I don’t think so bro….there are bad programs for sure but this should be reported and program shut down immediately as it’s likely been operating like this for a while. Have you spoken to prior grads from this program to confirm this?
 
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I am sure a lot of Podiatry programs in NY and other states are being run like that. They basically tick the boxes, make up fake evals and graduate residents
As mentioned, it is worth reporting to CPME (after you start at new program)... it's a violation for not having med rotations and not enough surgery.
It won't do anything, though... CPME owned and in bed with APMA/AACPM (surely planning more new schools as we speak), so nothing gets done. That's podiatry: hundreds of thousands in tuition, and most grads get inadequate residency training. They've outright stated they won't close/probation programs right now due to new pod schools and concern of possible upcoming residency shortage.

There are many programs like that with residents running nail/wound clinic and very little surgery (nearly every VA, nearly every NYC program, many Chi ones). It's good you're getting out to a new spot. Don't drive looking at the rear view mirror, you know?
 
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As mentioned, it is worth reporting to CPME (after you start at new program)... it's a violation for not having med rotations and not enough surgery.
It won't do anything, though... CPME owned and in bed with APMA/AACPM (surely planning more new schools as we speak), so nothing gets done. That's podiatry: hundreds of thousands in tuition, and most grads get inadequate residency training. They've outright stated they won't close/probation programs right now due to new pod schools and concern of possible upcoming residency shortage.

There are many programs like that with residents running nail/wound clinic and very little surgery (nearly every VA, nearly every NYC program, many Chi ones). It's good you're getting out to a new spot. Don't drive looking at the rear view mirror, you know?
This shows how little oversight CPME really provides
 
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Maybe a fellow SDN residency director can weigh in
 
I have very low expectations that CPME would do anything. I offer this sad but true anecdote. One of my classmates scrambled into a New York program where his senior residents were literally making up cases for their logs. He said all they did was wounds or nails for the most part. That program made it through the audit unscathed. In fact, the program director was recently elected president of one of our most prestigious podiatry organizations.
 
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When they become the reference checks for when you apply for hospital privileges at your first job as an attending or when they ask about the employment gap when you choose not to mention what happened in the gap between graduation and your new PGY-1 program.

Not true. You put the name of the program and call it “intern year” on your CV. Since plenty of real doctors actually do intern years at separate facilities and programs than where they completed their specialty training, the folks hiring you or credentialing you won’t even think twice about it. The first year director will never have to fill out any paperwork or provide any references. Only the PD from the program you graduated from. And even then, the extent of their involvement is generally having their secretary send in a letter on hospital letterhead confirming you graduated from the program.
 
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Not true. You put the name of the program and call it “intern year” on your CV. Since plenty of real doctors actually do intern years at separate facilities and programs than where they completed their specialty training, the folks hiring you or credentialing you won’t even think twice about it. The first year director will never have to fill out any paperwork or provide any references. Only the PD from the program you graduated from. And even then, the extent of their involvement is generally having their secretary send in a letter on hospital letterhead confirming you graduated from the program.
Thanks for your information. I was transferred after 4 months, smooth, got a cpme's letter which confirms successful transfer and I will graduate on time. My PD was nice and he quit that job 1 year after my transfer. Not sure if I will need his signature or paperworks in the future ?
 
Not true. You put the name of the program and call it “intern year” on your CV. Since plenty of real doctors actually do intern years at separate facilities and programs than where they completed their specialty training, the folks hiring you or credentialing you won’t even think twice about it. The first year director will never have to fill out any paperwork or provide any references. Only the PD from the program you graduated from. And even then, the extent of their involvement is generally having their secretary send in a letter on hospital letterhead confirming you graduated from the program.

If you are saying a podiatrist reviewing an application/CV would not think twice about a stated intern year, I have severely severely overestimated our colleagues.
 
If you are saying a podiatrist reviewing an application/CV would not think twice about a stated intern year, I have severely severely overestimated our colleagues.

If you are applying for jobs where the first person reviewing your application is another podiatrist (or his wife)…then it is us who have overestimated you. A job in which a podiatrist is in charge of hiring you, is rarely a good job

Kidding aside. It’s easy to explain the situation to those who are savvy enough to ask or care. “I was getting crap training, so I transferred to a better program where I completed all 3 years.” The reality is, nobody is going to care about the transfer and the OPs first PD can’t do anything to Sabatoge his/her career at this point. I personally wouldn’t go scorched earth on the place before I left, but the OP could, and I would support it, and I would hope it was documented in some way for our entertainment…
 
If you are applying for jobs where the first person reviewing your application is another podiatrist (or his wife)…then it is us who have overestimated you. A job in which a podiatrist is in charge of hiring you, is rarely a good job

Kidding aside. It’s easy to explain the situation to those who are savvy enough to ask or care. “I was getting crap training, so I transferred to a better program where I completed all 3 years.” The reality is, nobody is going to care about the transfer and the OPs first PD can’t do anything to Sabatoge his/her career at this point. I personally wouldn’t go scorched earth on the place before I left, but the OP could, and I would support it, and I would hope it was documented in some way for our entertainment…
I agree here. HR is not oblivious to the idea that not everyone gets along with everyone.
If the year is not counting anyways, it's not a big deal.

The real problem with changing is the cobble residency (1 year here, 2 there, ...or 1+1+1, etc). That was common in podiatry 30 years ago, and it still happens a bit. Facilities will absolutely verify that with each place if they require 3yr training for pod surgical privi, staff, etc.

...It was definitely contributory negligence in 100% of these type of cases, not devil program director and angel resident, not hero surgeon and witch nurse, not good guy associate and bad guy PP owner, etc. Get realistic. Do better.

At the end of the day, don't go out of your way to hurt other people or settle scores. It's not worth it. You know from high school that life's not fair (I know bcuz I'm not kickin it with Paige Spiranac).
Win by not playing blame or revenge games... success after leaving is the best thing, in many ways.
Just learn the lesson and move on.
 
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The OP highlights the overwhelming control that residency directors have over their residents lives and future. There needs to be more resources available to residents for reference when going through this process. There are too many malignant programs out there with poor leadership and residency directors who abuse their power. This is a consequence of poor Med Ed oversight in non-academic, community-based programs. I’m sorry that you’re going through this. And, you are not alone.

Still, the advice given is sound. Move on. Get them back with your future successes.
 
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The OP highlights the overwhelming control that residency directors have over their residents lives and future. There needs to be more resources available to residents for reference when going through this process. There are too many malignant programs out there with poor leadership and residency directors who abuse their power. This is a consequence of poor Med Ed oversight in non-academic, community-based programs. I’m sorry that you’re going through this. And, you are not alone.

Still, the advice given is sound. Move on. Get them back with your future successes.
When you think about it, it is really just a learning exp for the next stages (attending).

Out in the real world, you will deal with hospital admins, chief of X, tough nurses, owner doc of your office, managers, CMO, CEO, HR, whatever. It is a fact that most of them can hurt you if they sour on you, and it's good to get along... and simply avoid the malignant ones.

This is reason #98 why pod students need to AVOID THESE CRAP RESIDENCIES, pick clerkships wisely, and have options going into match. Sadly, that 'crap residencies' is still a third or even half of our "accredited" podiatry programs that lack enough cases, lack good enough attendings, severely lack good attendings, lack true teaching hospital or trauma center sponsor to get good cases and good off-service teaching. We all know that the worst ones even farm residents to see their consults or clinic, triple scrub, fudge logs, etc while APMA and CPME open new podiatry schools.

Further, this is reason #286 why being owner/solo can be nice: it is pretty easy to just cut or minimize ties with the majority of tough or unreasonable relationships (facilities, employees, admin, ancillary services, vendors and products, etc). That is a lot harder in employed jobs as those relationships are largely dictated to you by bosses in various forms, but it's critical to have those soft skills for overall success of any DPM.
 
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Claim that your extra year was a fellowship so that you can get a leg up on those sweet PP associate gigs I keep hearing about. Be sure to be willing to follow protocols and take 4 weeks of call per month.
 
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