Comments on: Residency Training is Dysfunctional

By: CobraCommander

CobraCommander — Sun, 25 Mar 2007 12:32:38 +0000

Heh heh heh.
“The most important thing in medicine is INTEGRITY! Physicians have to be HONEST! You need to make SACRIFICES!
But be sure to lie about your hours worked so we don’t get in trouble. Oh, and Sue broke her leg, so you all have to do her work with no extra pay. Don’t look at US, it’s HER fault for slipping and falling. After renovating the office, and the staff trip to Cancun, we just don’t have the money for a moonlighter. Besides, admitting gomers for dehydration at 3am is how you learn. PatientcarePatientcarePatientcarePatientcarePatientcare
PatientcarePatientcarePatientcarePatientcarePatientcare!

Four legs good, two legs better!”

By: Panda Bear

Panda Bear — Sun, 25 Mar 2007 01:57:26 +0000

Residency is not the military. With the exception of the military, you cannot sign away your civil rights and any contract that requires terms that have been made unfair or illegal by legislation (”Unfair Terms”)is void ab initio (”from the start,” as the lawywers say).

Also, as residency programs sometimes demonstratably misrepresent the conditions of employment, there may be no consensus ad idem and the contract is also probably void.

Restrictive covenants, when they are challenged in court, rarely stand as most courts view them as unfair restrictions on trade.

You sign a contract for a year but either party can dissolve the contractual relationship for various reasons that are spelled out clearly. I just signed my contract for next year and there was no penalty for my quitting at any time.

You may indeed quit a residency contract without consequences, just like your program can terminate you for any number of reasons including downsizing and disbandment (like what happened at King Drew in LA.

By: Puryear

Puryear — Sat, 24 Mar 2007 21:58:52 +0000

i would like to point out it “may be” a breech of contract, not sure what the prelim or residency contracts say. i know my contracts make specific statements in terms of non renewal for both parties, like amount of notice needed before leaving without cause, reason you may shorten this period with cause, reasons they may not renew my contract, etc.. there is usually some type of no compete clause as well. there is a lot of legal terms that i needed a contract attorney to explain to me.

if i sign a year contract, i am obligated to follow the requirements of my contract. like my military contract, i can just up an quite without consequences.

this is just a side note. A problem we see for many students of go into my specialty and do not match is the prelim year. it cuts into the resident funding, so if the go into a specialty that is 5 years, they do a prelim and then match into a program the second time around (not into a R-2 position), they are only funded for 4 of those years. the department has to pick up the extra year and some programs are not willing to incur that cost. just a note, random.

By: Panda Bear

Panda Bear — Sat, 24 Mar 2007 19:32:18 +0000

Tiny Surgeon is exactly right. I have never, at any other job, been intimidated to not ask about the pay, the benefits, or the hours for fear of looking weak and selfish. “How many hours will I work in a week?” is a perfectly reasonable question and deserves an honest and immediate answer.

The fact that some programs lie about this, coerce their residents to lie about their hours, and don’t think twice about it shows you the value of integrity in much of the medical training establishment.

I.e, I ‘m only going to obey laws and rules with which I agree.

By: Panda Bear

Panda Bear — Sat, 24 Mar 2007 19:25:36 +0000

Puryear is mistaken. Quiting a residency program is not a breach of contract. No contract may be written which subjects one of the parties to indentured servitude which is what such a clause in a contract would amount to.

In other words, you cannot be forced to work at a job if you don’t want to. You can’t even be forced to give a two-weeks notice except that your contract may specify some damages if you don’t give two weeks (loss of accumulated vacation, etc.) but I’m very sure this would be easily nullified in any lawsut and I have never, in my 25-year working life (I’m 43) heard of such a thing.

This is the problem of people going straight through from high school to residency. They internalize the completely atypical and abusive customs of medical training and think this kind of behavior is normal. I agree that residency training is a special case and requires continuity. But in the case we are discussing, the resident quit to start a completely new program and specialty that did not require the intern year she was currently struggling through.

Puryear has read my blog but has not understood it. It is the program which screws over the remaining residents. Period. End of story. The prisoners are not responible for the capriciousness of their captors. that some residents believe their absent colleague is to blame is probably some kind of Residency Stockholm Syndrome.