Affichage des articles dont le libellé est Losing co-residents. Afficher tous les articles
Affichage des articles dont le libellé est Losing co-residents. Afficher tous les articles

vendredi 1 janvier 2016

Losing co-residents, options

Be so careful as they are saying above.

Proving hours violations is really the only way to hold the program accountable to whoever (the ACGME I believe), but as pointed out, getting your program into trouble is like spiting your nose by biting your face. (yes that's how I meant that).

However, if the hour violations are so bad as to lead to some serious patient danger badness, that never did a program any favors either. Or if someone quits over this making things worse.

ACGME pretty much always expects you to try to resolve these things at the local level first (if I remember what I read right, doublecheck their website on grievance procedures) and proof of that before they intervene, although hour violations whistle-blowing may be in a different category as far as what they expect you to have done before bringing it to them.

I suggest the following:
1) Read the ACGME website closely about these topics, grievances, hour violations
2) Your specialty board has residency rules that are much more specific than ACGME, like about supervision, vacation, breakdown of hour rules, grievance procedures (I think), read this
3) Read your contract carefully, especially sections about hours and how to bring grievances to GME, HR
4) Let all of that reading sink in
5) The more anonymous you can make noise to address this, the better, if you have to come out of the shadows to make these waves, DON'T
6) Always get set up at least with a lawyer to call if not actually on retainer that can help you with the following: employment law, and medical licensing board. They exist you just have to find them. An anonymous call to the local bar association or even a google search can yield help. If a lawyer says it's outside their expertise, you can always ask if they know someone who can for referral. I say this if after reading the above you're about to start taking those sort of steps
7) Document document document
8) You might consider going to your Chief or PD with your concerns, but if you take any stronger action along the lines of the above, you will have outed yourself, which might lead to actually outing yourself, although with the schedule this tight you may not be fired, but they can always make you wish you were, and there are so many ways they can hurt your career you have no idea the world of hurt they can unleash upon you

Aside from the above official pathways, there is jack you can really do to twist the program's arm on this, and any attempt to twist a program's arm usually not only fails but can pile drive your head straight into the mat leaving you a quadriplegic.

Oh, and like Law2Doc suggested, while poaching from programs is frowned on, troll these threads for the people desperately seeking a residency slot. PM them and try to recruit for your program. You never know it might work.

TLDR
do your homework reading the ACGME, specialty, and hospital paperwork
always have a lawyer secretly in your back pocket
tread carefully, if you can't safely stay in the shadows or address this without making enemies, your safest bet is to suck it up
sorry
you can try recruiting from SDN, residentswap website (hopefully your program has that one covered, I'm willing to be they're already on Frieda)

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Losing co-residents, options

vendredi 25 décembre 2015

Losing co-residents, options

Looking for advice from those who may have experienced something similar or know about legal rights of residents:

I belong to a very small residency program in a surgical field. We have lost one resident this year, have one resident who is unexpectedly unable to work for an undefined amount of time, and a third resident who will be going on maternity leave shortly. A larger program might be able to absorb this loss, but for us, it results in a dramatic change in work load. So far, our program has tried some stop gap measures, but none have resulted in an increase in the number of people taking primary call. The end result is, the remaining few residents are having to take the extra primary call of those who are gone. Seniors are taking the amount of call a typical PGY2 or 3 would be taking, our PGY2 has likely been breaking work hour restrictions for the past few months, and all of use are losing out on education/research because we are taking so much primary call. We are several months into this "temporary" situation, which is only getting worse.

My hope is that we can find a solution through hiring additional residents, but our program has been slow to find replacements. It's also the holidays, so all the pending paperwork is only prolonging things. With the upcoming (and also unpredictable) maternity leave, we are all losing a lot of sleep over our situation and some of the existing residents are actively looking for other residency spots.

Who can help us in this situation?

If our program really cannot find a solution, like ASAP, I'm not even sure which organization to go to for help (ACGME, my hospital's GME, the governing body for my specialty?). I'm not interested in leaving my program out to dry, and turning it into a malignant relationship, because I do think they've been trying. They've also been reaching out to us for possible solutions, but... we are still being asked to take more and more primary call as residents are dropping by the wayside, with no backup plan or room for anyone to even get the flu at this point. Suggestions?

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Losing co-residents, options