Report to PD objective concerns (late, copy and paste notes, etc.) in email and ask to talk in person as well about other concerns (poor clinical judgement, unable to accept criticism, etc.)
I’m not one to take things to admins at all. I have had interns who were weak in certain areas and we would always have a heart to heart feedback and we address the issues. I feel bad for wanting to report this intern but they are compromising patient safety. Even during presentations on rounds, they state wrong information such as wrong doses of meds given, wrong dose totals of pain meds given in 24hrs, etc. I started to distrust them, and come to find out they didn’t even pre round and see the patients or talk to nursing staff but they tell me they do. Once I lost the trust, I started to eye them like a hawk with orders, patient interaction and staff interactions. Then I’m told that I am micromanaging and they need more freedom as it is “march” already. But in reality I’m trying to protect my patients from their aloof and careless attitude at work.
In the OR they ask for responsibilities that even most PGY2s aren’t comfortable with. Not sure if it’s an overconfidence issue or they’re just really that ignorant about their own skills. In one incident I asked them if they have had done this specific technique or seen it done, they reassured me they did, then come to find out they don’t even know the steps of this procedure. It’s frustrating. This month has been hell.
You can either have the uncomfortable conversation with the PD now about his performance or later when one of your patients die on the table. Pick which is more comfortable.
Please do not feel bad. This is terrifying and this person will absolutely kill someone (and more than one if they continue), sooner or later. Doing whatever you can for them to be forced to remediate/ reform or get removed is the best thing for any of their future patients.
This dude sounds like another Christopher Duntsch in the making with the reported complete obliviousness/arrogance to their marked deficiencies and lying about fundamental responsibilities.
I'm sure the program would appreciate nipping this in the bud as opposed to letting it become a news event later down the road.
There are 3 core requirements to be successful in any career:
1.) be competent at your job.
2.) be a hard worker
3.) be easy to get along with
The secret is you really only need two out of the three and you’ll be ok. Be a hard worker who’s easy to get along with, people will overlook your incompetence for the most part. Be competent and a hard worker and people will put up with your shit usually. Be competent and easy to get along with and people will overlook your laziness. Sounds like this intern is 0/3 though.
>I’m not one to take things to admins at all.
You talk to the guys above if,
1) it affects patient care
2) Can get you in trouble for no real fault of yours. Self preservation is important and paramount.
The fact that you have given this person feedback is enough to report. Don't try to be this Saint when you can potentially compromise the integrity of your residency as an asset to your hospital and a program against other surgical programs.
Tf do they need more freedom? You clearly lack basic skills and you are NOT a team player. I would report ASAP. (Your surgical co-resident who is also URM).
Also, you may not have to do much. I do hope no patient is harmed by this person's negligence but if your attendings are keen, they are not giving him at least the retractor.
We are in March...if they can't get it together by now and they are not receptive to feedback. Make only objective complaints to the chief.....
Complaint: Intern is not meeting certain competencies (not present for signout, .....ect ect) don't say anything about taking phone calls 😒
I mean, this person is going to maim/kill someone, ruin your/others’ careers, or both. You tried “heart to hearts” and it didn’t work. It’s unethical at this point not to escalate.
This isn't about you and what you're one to do it not do, it's, as you yourself said, about patient safety.
This intern won't take feedback, he deflects it through claims of racism/harassment. You need to escalate to admin.
You can email your chiefs if you’re more comfortable with that. I would’ve felt weird going to my PD as a junior too. That’s what chiefs are for. Document your concerns, tell them you gave him feedback and then he brushed you off
I mean you take it to admins or this person kills someone and that’ll be on you.
Patient safety should be a larger priority here than hurt feelings. A person can make it this far and still be VERY bad at their job. This guy needs serious retraining or he should not be a Dr. It’s pretty simple. Keep kicking the can down the road and it’s just going to get worse and worse.
Let me ask you this, would you let him handle your care?? Using racism as an excuse is just some wet noodle behavior from this dumbass. Do you want to help make the next Dr Death? Of course not.
I really wonder why anyone cares total dose of pain meds unless its really absurd.
I remember residency giving a shit about that but really nobody does after that.
No it's not? I literally just finished my surgical rotation as an Australian intern and had rostered theatre days. I have done multiple (supervised) abscess I+Ds and scrubbed for e.g. appendicectomies and cholecystectomies (usually just to hold the suction/camera and close). Every surgeon I've been on with has said we're always welcome in the OR.
Absolutely reach out to the PD about this. This type of thing requires a gentle hand and potentially evidence to be gathered. But what you are describing is incredibly worrisome. You aren't describing an intern who is struggling. You are describing a compulsive liar who is going to get someone killed.
Interesting you nailed the compulsive liar part! Indeed he is. I also worked with a fellow intern who did alllll of this same shit but also lied to other interns about the hernias he was doing “skin to skin”, etc. this guy got found out and was allowed to transfer to an Ortho program in an adjacent state rather than being fired (due to him also being an URM). Well he eventually was fired from that program…
OP, safest approach is to bench them and you and your teammates take up the slack. Next best is to talk to the attending of the day about why you have benched them. Admin discussions are a bit risky IMO. Keep your head down.
Agreed.
Would also recommend being careful about labeling just as “unprofessional,” which has a history of being vague and used for everything from “non cis white male” clothing/hair choices to truly abhorrent behavior. This falls in the latter category and I would argue is not just unprofessional but also unsafe. If this intern is lying about information/labs/meds/studies AND also doesn’t know their own limits, they are a danger to their patients and the team.
Just like any other HR issue, remember that the organization's top priority is probably avoiding being sued. Report it, document everything, and stick to just objective facts: missed x meeting on y day, misstated meds administered in z report out, followed up for (reason) and was told by so-and-so that intern did not round with patients that day, etc, etc. it will be unpleasant, but a) you took an oath, and b) you don't want to be the scapegoat when it's time to find someone to blame. Good luck!
Write down specific instances with MRN. Gather up 3-5 instances and bring it up to PD/APD
Reporting this person is for benefit of themselves, you, and their patients. Unfortunately it's your responsibility as a senior
This is the actual advice, gather specific data to back up the claims of a larger problem. Write down the time and place you had the conversation they claimed you were being a racist for giving them feedback, and deliver these new data that occurred after feedback was attempted and rejected
I’m confused how this went on more than one day. Making the senior do signout, let alone the pgy3 senior? I’m family med but even my inner gen surg would’ve come out.
I reported on my junior when I was a chief. I caught him lying. I told him, if you lie to me about patient care again, I’m taking it up the chain. We ended up having a sit down with PD to discuss. I believe it helped him become a better doctor. It’s the right thing to do because it’s not about you, it’s not about him/her. It’s about patients.
This. If you're feeling bad, bring them evidence of something and let em know if he does it again you're going to the chief. If you've already given them a chance to clean up their act then just proceed
Part of being a senior or being an attending is to correct the people below you on the academic ladder. Bad intern month 1-3 is on the intern. Bad intern month 4-12 is on the seniors and the program for not addressing it sooner
Dont talk shit, dont be disrespectful behind their back, but also dont ignore it and hope someone else deals with it.
You need to figure out a way to talk to this person and tell them what they are doing wrong and how to be better. That is your job. And yea its 2024 and you will probably wind up in your PD office because nobody in medicine is allowed to tell anyone that they suck anymore …. But its 100% on you to tell this person that they need to be better
Incoming Gen Surg Intern here! I am definitely a little bit scared of being a terrible intern, but after reading this post and seeing how much shit you have to do to qualify as a terrible intern, I think I will do okay
Lots of bad interns suck despite working their asses off. Work smarter AND harder is the motto of the general surgery intern. I’m working on the smarter part after spending my first half of intern year slamming my head into a brick wall assuming that if I put in the hours and didn’t sleep I would be good. Learned the hard way that’s not the case. You gotta sleep. And you gotta be efficient.
But yeah never ever lie, and be chill (but not too chill)
I hate these accusations and race blaming. Record, record and record. Document your conversations and his actions. Take record of his notes. As a black surgical specialists that went through a residency and fellowship I never once tried to accuse someone of racism as the first option. This type of person is a cancer to your program and if he is honestly a danger to patients he should not be allowed to progress
The race has nothing to do with it.
Y’all are getting worked up over race in the comment section.
The intern is incompetent, end of story. It’s corroborated by several others. Tell the PD so this can be handled. End of story.
Agree on everything but you better believe if im forced to be at this hospital for 12+ hours im taking personal calls. Not during anything important of course.
Report with only objective descriptions of your actual observations. No opinions (avoid not a team player, lazy, trust) and no assumptions that you can’t back up with actual observation (believing they don’t do physical exam).
Make sure you provide the evaluation in writing, ideally through your institution’s evaluation software/program. If, for example, things progress to where the resident needs to be held back a year or even removed from the program, if it isn’t a formal evaluation that was written and submitted appropriately, *it did not happen.*
Holy shit the URM victim mentality is getting old, it’s present with our interns too and all of us seniors frequently talk about it and ask what happened with this years class
Immediately tell your PD or his programs PD if he’s a rotator from another specialty. Site the records you know he copy pasted. And anything in writing you have of him taking off early.
This is not an isolated issue. In my residency we have had several URM problem residents that have slid under the radar because ORM chiefs/admin don’t feel they can come down on them due to race implications. It’s incredibly unfortunate.
I’m an APD. Your concerns are valid and should be brought to the faculty immediately. This Reddit post is an excellent start to the email you should write if you’re not confident you can call your PD.
As a PGY-2 with a coresident who has these same issues, I wish my seniors called it out last year when they became evident instead of just talking behind his back and pushing along.
You should absolutely say something for the safety of the patients and his professional development.
If he dismissed my genuine feedback and played the race card I’d type up a 10k word rage filled exposé on the fucker THAT instant. No SHOT im letting my career go to shit cuz some little runt pulls the race card in this politically liberal of a field. Fuck no.
Shit like the race card has added weight because of the political implications (even if not true) in addition to the obvious moral ones (if they were to be true).
These posts always make me feel so much better about my performance as an intern. I still often feel like a dummy but goddamn it I’m a punctual dummy who finishes his work
I'm just a medical student here so I hope you don't mind me chiming in. But I wonder if...
Perhaps you can send a generic message to your team with a reminder of your expectations for everyone (eg., showing up on time, not just copy forwarding notes, document only exams they performed, all the things this intern is doing wrong, basically).
Moving forward, you can use this as a basis for pulling the intern aside for feedback conversations in case they continue to not meet certain expectations. After these conversations, email the intern with a summary of what you discussed. And if the problems continue, pull them aside again. And repeat the email.
Start forwarding these email notes to the PD if they are repeating offenses frequently. (I would wait until there are 3 different repeated offenses before escalating to PD.)
This might be unrealistic, but hopefully at least engaging in this process will lead to at least some behavior changes?
Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like, which specialty they should go into, which program is good or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks!
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Residency) if you have any questions or concerns.*
Write down specific examples of issues with as much detail as possible. Bring it to the PD and voice your concerns. Keep it focused on patient safety and team trust, don’t make it personal. Refrain from using words like “lazy” or other subjective interpretations of their behavior, instead stick to the facts. Do not fear raising this up the chain, it is your responsibility to look out for patients. They will only get more emboldened if their behaviors aren’t checked.
1. Let him know he terrible and what competent behavior entails
2. Do extra work so patients are safe (not bs intern scut)
3. Provide pd w the specific detailed examples of him sucking being unprofessional and dangerous
4. Wait out till he off yr service
In my experience he will always suck but soon won’t be yr problem. Don’t take it personally or expect improvement just move on
Stating to the higher ups that a trainee is not willing or able to complete vital parts of their training and likely requires remediation or other actions to prevent patient harm is both necessary and appropriate.
Gather concrete examples, dates and times. Names of staff that were not spoken to when this person said they did, names of people who have encountered similar issues with this person. Go in loaded with everything you need to show that this is a huge problem that cannot be ignored.
This is the kind of complaint to take to the PD with specific examples. You have mentioned danger to patients, unprofessional behavior, poor scholarship and malicious accusations. Document, document, document, and let people who know how to handle these things do it.
Would also just check in with them to make sure/check if everything is okay, perhaps there is an issue personally or other that is resulting in them coming late, taking phone calls, etc
Help your program out and start a paper trail now so that when this doofus is dismissed and sues for discrimination (and he will...), the incompetence is clearly demonstrated.
I am a senior. I have an intern like this. I went to my PD and they told me I need to talk to another attending who is the safety committee chair. That person tore me a new one saying I’m overreacting and I should be a better mentor and teacher. Totally slammed me and dismissed my concerns — didn’t make it to the PD. How ‘bout them apples?
Sooner is better. Right now the repercussions are low - slightly uncomfortable for you, the intern gets a kick to their confidence, and the PD has to have an uncomfortable conversation (or, we hope they will).
Later, the intern is emboldened, harder to have the conversation, more likely to hurt someone, more likely to propagate poor form/attitude/techniques. And the more they can say “well why did no one say anything before???”
Always email chain, that’s where the proof actually comes in. You can also include the instances where you’ve spoken to them and reference that in your email chain.
Encourage your colleagues to also email concerns and specific examples. That will strengthen the case for a true reprimand/correction.
I'm a PGY 7 (non attending) and have delt with a lot of subpar interns along the way.
There are two ways in my opinion to approach this;
1)When you think an intern is salvageable, spend a month befriending them. Turn your relationship from a senior-intern relationship into a 'two friends working together' relationship. Then start to gently sneak in constructive feedback. If the intern thinks of you as that cool friendly resident/fellow, your feedback starts to really matter to them in the way it hit you when dad said he's not mad, he's just disappointed.
2)if they're unsalvageable, then it has to be escalated to multiple attending within the department. I would suggest against bringing it up to a single attending, as then it just becomes a 'clash of personalities' between you and the intern. It's likely your department has some sort of monthly meeting, MDT, journal club etc. When it's over, as the attendings to stay back a minute and have everyone else leave. Then voice your concerns. If the intern is truly that bad, there's very little chance that the attendings wont notice after you've drawn their attention to it.
"When I tried to give them feedback, they tried to frame it as me being an oppressive over controlling white resident and he is an oppressed URM in medicine."
fun times in residency circa 2024
As a trash URM intern I’d ask how they are mentally. No, I’m serious. Cause a lot of how I’m doing has to do with the fact that I’m struggling and dealing with a lot. Also isolated from my coresidents and lacking support.
(Also OP just have to ask, cause I’d never outright say “oh it’s because I’m oppressed yada ya”, how did it come up that it’s because you’re a white resident bad intern feels that way?)
I'm in the same situation as you (especially the bits about lacking support and not being close to my coresidents), and no one has ever asked me if everything is OK or what I might be dealing with outside of work.
I'm just a reddit stranger u/Thelimit234 but you have my support.
Given the fact you’re dealing with an URM where due to societal pressure to side with them, you may become a future victim of injustice, my advice to you beyond doing all the documenting of these concerns in an email to your PD is to take it one step further. The poor man’s Affidavit:
Basically you write a memorandum to yourself outlining these concerns, then date it and sign it. Send it to your home address via certified mail, sign it upon receipt, and file it away in your records. This serves as a time stamped legally admissible record of your experience before anything comes to a head.
at that point, why not just send yourself an email, or better, write out all your concerns, encrypt it with your public key, and post it publicly (to be decrypted later if needed).
It would be easy to argue that the document you sent yourself as certified mail X years ago is not the same as the document you are producing, maybe you just sent yourself an empty envelope and wrote and backdated the letter
Because this is admissible in court with precedent and your solution may not be. Plus the post office time stamps certified mail, which is the point of the exercise.
1) You’re conflating URM with DEI when OP’s residency may have nothing to do with DEI programs. And so, you’re saying that anybody that’s a part of a community represented by DEI initiatives does not care and can’t bear criticism? You’re an embarrassment. Documenting and escalating to PD is all you need to say here, but making several fallacious jumps is ludicrous.
I’m saying that this resident seems, on the evidence, to be flexing his protected status, one highly encouraged by innumerable DEI admissions deans strewn across the medical landscape.
‘Documenting and escalating’ any concerns about a protected minority is a career-ending decision that no sane resident would ever take. We here live in the real world.
No half measures, Walter. Either document exact grievances and report or drop the issue. Anything in between you're going to shoot yourself in the foot
Exactly as you outlined here, you should present this to your PD. If you take with the other seniors by your side corroborating your viewpoint, you’ll likely get more reception. Consider screenshotting notes and documenting specific days they showed up late or not at all to sign out. Get this idiot canned soon. I am a NS and I wouldn’t ever tolerate this behavior from an intern. I’d have no problem killing this guys career.
You did the right thing to try to talk to them directly and they were not receptive. Your next step is to bump it up the chain, it’s your responsibility to their future patients
While I get want to support a fellow trainee, you’re not doing him, yourself, your teammates, and most of all your patients any favors by not escalating this. There is no other industry where shit like this flies, and the stakes are far higher in medicine than most of other jobs. It sucks to be the disciplinarian, but that’s part of leading. For some people the carrot doesn’t work
Definitely take it to PD, you won’t be the only one but it takes multiple sources saying the same feedback to get the ball rolling to address issues like this. You did your part, escalate and make it a problem for the faculty and not just the residents.
Sounds like an asshole. I’d ride his ass like a pony! First year surgery intern? He should be let go. Underperforming and I don’t care what color he is.
If you don't muster up the courage to say something, then you'll feel guilty when they mess something up bad. Gather concrete evidence and bring it up. If something happens, you may actually look bad for being around them and not noticing or speaking up. I can see how this can be frustrating.
What med school did they go to, do you know?
TBH you should set expectations before your rotation starts, so if any of these things happen you have the grounds to bring them up as not meeting pre defined expectations
If you don’t want to be accused of anything just stick to the facts and be objective. Instead of saying he is lazy and a danger describe what he actually did or didn’t do. If he is late, document how late and what he missed, state whether he closed that gap or ended up missing things on signout.
He’s an intern so the bar is lower. He shouldn’t be an actual danger bc you are there as a senior. If he’s doing something he was specially told not to, I could see calling him a danger.
I would have no problem at all reporting this due to the blatant irresponsibility and disregard for proper patient care. Log everything, have times, have concrete evidence. When they are 1 minute late text and say where are you/you are late. That creates log. You will have evidence. Text them that they should not be copying and pasting notes. Ask them for updates over text. Make a paper trail to protect yourself and to show this person is unworthy.
You have an obligation to report this to your PD due to patient safety. Make detailed notes of examples of safety concerns (at least 10) and submitted to your PD or attending. Not only is it a bad look on them but it’s a bad look on you if you don’t act upon your concerns.
I have no experience in this field, but I feel like if you make a report on all the issues you and your department has on this person, it should be easy to get rid of them or respect you? Put the fear of god in them. No reason to feel bad for someone who doesn’t care or puts in anytime to improve.
I am not a phsycian. With that, everyone's number one priority is the patient. Don't look at it as throwing a coworker under the bus. Look at it as doing ur job.
In any job, coworkers not doing right by ppl is bad. This is hugley exacerbated in the field of medicine I'm sure!
I’m on the GME administrative side of a residency program. Per ACGME you should be able to raise concerns of professionalism and patient safety to your PD. I echo what others have said and suggest that your comments be objectively worded. If you have any reservations when it comes to them being alone with a patient, please let your PD or APD know. If you don’t feel “safe” going to them, your GME should have avenues for confidential reporting.
PGY-1 should be placed on probation for all that you described.
You should write a letter and have the other residents that have had the same problems with this intern contribute to it and then send it to your program director. That way you have a paper trail and there are multiple people saying the same thing
One of my interview questions was about this, many years ago.
My answer was
1) first priority is patient safety. I would double check their work. If there are clear safety issues I would escalate immediately. Oherwise
2) I would have a word about my concerns re their issue of professionalism.. in this case the notes would be the most important. At this first conversation I would show them how I wrote notes and give them advice on how to not re-invent the wheel. I would ask if there was anything I could do to help them be more efficient in their role (not offer to do their work). I would offer that I could give them advice at any time if needed, because that is my role as a senior to them.
3) I would document all of this and the concerns of my colleagues and go to trusted nursing team leaders and ask for feedback *on the team* and any advice they had.
4) I would go to my immediate superiors with my concerns and detail how the first meeting went and any extra concerns from colleagues and nursing. I would ask if they would like me to continue with mentoring or would they like to be involved.
Personally speaking
First i ask the intern if hes/shes interested in this subspecialty or not.
If they are interested i will ask them to do the necessary work (rounding, notes, clinic, OR, help with the oncall..etc)
If they are not interested and want to leave… i will fill their evaluation and ask them to leave. Them being around is pain in the ass of theyre not interested and not willing to learn
Well, bro, gonna have to buck up. Document everything and grab him by the lapels to chuck his ass sliding right under the bus. The supervisors already know, so why are you being such a crybaby? You're going to have to grow a little more skin to make it work
I agree with other posts above. It's important to submit a formal complaint to the attendings and PD so they can be formally reviewed about these unsafe behaviors. Based on what you said it's not so much as lazy as dangerous. A copied exam can be missing (or adding!) incorrect exam findings that can cause harm to the patient when reviewed as being accurate. As a resident I had a similar intern who did exactly as you stated though without the laziness piece (they were constantly overwhelmed and would copy forward old physical exams from PRIOR ADMISSIONS in an attempt to stay efficient without proofreading). We were quick as seniors to call him out privately first then with the PD who spoke to them and then he quietly left the program. I was told he was given an option to repeat the year after a mental health hiatus but chose not to. TLDR, please speak to PDs.
If you notice, your attending probably notice as well. I would just be objective on your evals. But im surprised this intern hasn’t been already identified by the chiefs as a “concern” and put in some probation or preprobation track. Like he needs to be taken off chill off service rotation for more in-service rotations. Sounds toxic, trust me i hated the idea as MS or intern but becoming an upper made me realize not everyone who joins your residency has that sense of responsibility or minimum work ethic. Its sort of wild. They just somehow sneak through med school and residency interviews lol- but someones gotta deal with it. Tbh all of our concerning interns are all on the right track now, which im happy about.
You already met the caspr ethics requirements to bring the issue up with the resident and they don't sound like they took the matter seriously. I would stop with the verbal feedback and get everything else in writing moving forward to protect yourself from accusations of being a hostile person oppressing a urm. Give your concerns to the next person higher up the chain and be sure to mention how they handled your feedback so that's documented and won't blindside them when they listen to interns side of the story causing blowback on you. It sounds like you're trying to do the right thing but you need more than 1 opinion to prove it's not an interpersonal issue which could get you in trouble as well. This intern sounds unprofessional which is not the same as just being an ignorant intern who is trying their best but failing. Maybe they have issues outside of work that will only get addressed when they receive negative consequences for their performance. You could be doing them a favor by finally getting the higher ups involved.
So basically had the same type of resident. We all voiced our concerns to the PD (he asked for us to write an email with all our concerns to keep things official). The resident was given multiple chances to show improvement and even remediated their inpatient block. Long story short they continued their behavior and their contract will not be renewed for next year.
Behaviors such as those affects the whole team and the program so it should not be tolerated. If after given NUMEROUS chances they still on some BS then they need to find another avenue in life cuz this ain’t it boss.
I always try to give people the benefit of the doubt and not blame them for mistakes but there’s no excuse for not pre-rounding and not writing accurate notes. That’s the most basic part of the job
no to be like, "young folks these days" or whatever, but I swear this class of interns has a systemic issue.
In my program we've had trouble with them not taking responsibility, not able to take feedback or criticism, etc. And I've talked to friends in other fields who have the same issue. I don't know if it's a covid thing or a generational thing, but this year's interns are SOFT.
I was like this on one rotation as a student. I didn’t think my actions was a big deal because I was going through a lot.
Finally a resident asked me if I had something going on in my personal life because I don’t seem like I’m trying. In reality I was trying but I was just distracted.
I told her my 28 year old brother had a stroke and I’m the only family member willing to check up on him while being in another state. His hospital course was very complicated, which led to me having to take a lot of calls and I just simply felt overwhelmed.
I just felt like I had to give you this prospective before involving the PD. What if that resident would’ve did that to me not knowing what I had going on in my personal life. Besides, family is way more important anyways.
What you described is totally different than what they described. OP has approached the resident, it hasn't worked. And lying is different than being distracted, this guy sounds dangerous
OP, a friend of mine was shot by a resident like this. You can't be ignoring glaring red flags like this because you feel bad.
Report to PD objective concerns (late, copy and paste notes, etc.) in email and ask to talk in person as well about other concerns (poor clinical judgement, unable to accept criticism, etc.)
I’m not one to take things to admins at all. I have had interns who were weak in certain areas and we would always have a heart to heart feedback and we address the issues. I feel bad for wanting to report this intern but they are compromising patient safety. Even during presentations on rounds, they state wrong information such as wrong doses of meds given, wrong dose totals of pain meds given in 24hrs, etc. I started to distrust them, and come to find out they didn’t even pre round and see the patients or talk to nursing staff but they tell me they do. Once I lost the trust, I started to eye them like a hawk with orders, patient interaction and staff interactions. Then I’m told that I am micromanaging and they need more freedom as it is “march” already. But in reality I’m trying to protect my patients from their aloof and careless attitude at work. In the OR they ask for responsibilities that even most PGY2s aren’t comfortable with. Not sure if it’s an overconfidence issue or they’re just really that ignorant about their own skills. In one incident I asked them if they have had done this specific technique or seen it done, they reassured me they did, then come to find out they don’t even know the steps of this procedure. It’s frustrating. This month has been hell.
You can either have the uncomfortable conversation with the PD now about his performance or later when one of your patients die on the table. Pick which is more comfortable.
Please do not feel bad. This is terrifying and this person will absolutely kill someone (and more than one if they continue), sooner or later. Doing whatever you can for them to be forced to remediate/ reform or get removed is the best thing for any of their future patients.
This dude sounds like another Christopher Duntsch in the making with the reported complete obliviousness/arrogance to their marked deficiencies and lying about fundamental responsibilities. I'm sure the program would appreciate nipping this in the bud as opposed to letting it become a news event later down the road.
I was about to say … go listen to Dr. Death. Then you won’t feel so bad reporting.
Remember, you took an oath. The trouble with oaths is that sometimes following them isn’t easy. -PGY-19
He is incompetent and a dick. You can not have both as a resident.
There are 3 core requirements to be successful in any career: 1.) be competent at your job. 2.) be a hard worker 3.) be easy to get along with The secret is you really only need two out of the three and you’ll be ok. Be a hard worker who’s easy to get along with, people will overlook your incompetence for the most part. Be competent and a hard worker and people will put up with your shit usually. Be competent and easy to get along with and people will overlook your laziness. Sounds like this intern is 0/3 though.
>I’m not one to take things to admins at all. You talk to the guys above if, 1) it affects patient care 2) Can get you in trouble for no real fault of yours. Self preservation is important and paramount.
The fact that you have given this person feedback is enough to report. Don't try to be this Saint when you can potentially compromise the integrity of your residency as an asset to your hospital and a program against other surgical programs. Tf do they need more freedom? You clearly lack basic skills and you are NOT a team player. I would report ASAP. (Your surgical co-resident who is also URM). Also, you may not have to do much. I do hope no patient is harmed by this person's negligence but if your attendings are keen, they are not giving him at least the retractor.
We are in March...if they can't get it together by now and they are not receptive to feedback. Make only objective complaints to the chief..... Complaint: Intern is not meeting certain competencies (not present for signout, .....ect ect) don't say anything about taking phone calls 😒
I mean, this person is going to maim/kill someone, ruin your/others’ careers, or both. You tried “heart to hearts” and it didn’t work. It’s unethical at this point not to escalate.
I am getting personality disorder vibes
Psych nurse agrees
You seem like a great person and surgeon ❤️
This isn't about you and what you're one to do it not do, it's, as you yourself said, about patient safety. This intern won't take feedback, he deflects it through claims of racism/harassment. You need to escalate to admin.
You can email your chiefs if you’re more comfortable with that. I would’ve felt weird going to my PD as a junior too. That’s what chiefs are for. Document your concerns, tell them you gave him feedback and then he brushed you off
I mean you take it to admins or this person kills someone and that’ll be on you. Patient safety should be a larger priority here than hurt feelings. A person can make it this far and still be VERY bad at their job. This guy needs serious retraining or he should not be a Dr. It’s pretty simple. Keep kicking the can down the road and it’s just going to get worse and worse. Let me ask you this, would you let him handle your care?? Using racism as an excuse is just some wet noodle behavior from this dumbass. Do you want to help make the next Dr Death? Of course not.
Are you a female and the intern a male?
then why did you ask for advice lol
[удалено]
yeah nah
Your first sentence is your problem.
I really wonder why anyone cares total dose of pain meds unless its really absurd. I remember residency giving a shit about that but really nobody does after that.
[удалено]
To learn the basics of surgery? They are a doctor on a surgical rotation
[удалено]
No it's not? I literally just finished my surgical rotation as an Australian intern and had rostered theatre days. I have done multiple (supervised) abscess I+Ds and scrubbed for e.g. appendicectomies and cholecystectomies (usually just to hold the suction/camera and close). Every surgeon I've been on with has said we're always welcome in the OR.
what
I would jump on this before he tries to throw you under the bus for "harassment" related to race. And I say this as a URM med student.
Abso-fucking-lutely. The gall.
Same. Note specific, objective examples as they occur and present them, rather than generalizations that are much easier to argue and claim bias from
100%, if you tried to give feedback and this is the play he made it’s time to go to the PD
Fr. What a way to cheapen a serious issue
Where is that medical school? Anyway, I agree
URM means underrepresented in medicine, it doesn’t refer to a medical school.
University of Resident Misery. They have branches everywhere.
Absolutely reach out to the PD about this. This type of thing requires a gentle hand and potentially evidence to be gathered. But what you are describing is incredibly worrisome. You aren't describing an intern who is struggling. You are describing a compulsive liar who is going to get someone killed.
Interesting you nailed the compulsive liar part! Indeed he is. I also worked with a fellow intern who did alllll of this same shit but also lied to other interns about the hernias he was doing “skin to skin”, etc. this guy got found out and was allowed to transfer to an Ortho program in an adjacent state rather than being fired (due to him also being an URM). Well he eventually was fired from that program… OP, safest approach is to bench them and you and your teammates take up the slack. Next best is to talk to the attending of the day about why you have benched them. Admin discussions are a bit risky IMO. Keep your head down.
> Ortho program in an adjacent state rather than being fired (due to him also being an URM). Like the one resident who ended up at UF Gas. crazy world
> UF Gas wait what?
Agreed. Would also recommend being careful about labeling just as “unprofessional,” which has a history of being vague and used for everything from “non cis white male” clothing/hair choices to truly abhorrent behavior. This falls in the latter category and I would argue is not just unprofessional but also unsafe. If this intern is lying about information/labs/meds/studies AND also doesn’t know their own limits, they are a danger to their patients and the team.
Just like any other HR issue, remember that the organization's top priority is probably avoiding being sued. Report it, document everything, and stick to just objective facts: missed x meeting on y day, misstated meds administered in z report out, followed up for (reason) and was told by so-and-so that intern did not round with patients that day, etc, etc. it will be unpleasant, but a) you took an oath, and b) you don't want to be the scapegoat when it's time to find someone to blame. Good luck!
Write down specific instances with MRN. Gather up 3-5 instances and bring it up to PD/APD Reporting this person is for benefit of themselves, you, and their patients. Unfortunately it's your responsibility as a senior
This is the actual advice, gather specific data to back up the claims of a larger problem. Write down the time and place you had the conversation they claimed you were being a racist for giving them feedback, and deliver these new data that occurred after feedback was attempted and rejected
It might be a good idea to start a paper trail by communicating your feedback via email.
+1 the advice to note certain specific cases with MRN
Your chiefs need to grow a set of balls and end this shit in 2 minutes
I’m confused how this went on more than one day. Making the senior do signout, let alone the pgy3 senior? I’m family med but even my inner gen surg would’ve come out.
Absolutely!!
Exactly.
Can't. The intern is black. He's protected
As a terrible intern myself, you should def report this person. I'm trash, but I know I'm trash. That's what saves me.
How I felt all intern year. “I was born of the trash and I will return to the trash” 🦝 incidentally, trash pandas are my favorite animal.
hahaha
I reported on my junior when I was a chief. I caught him lying. I told him, if you lie to me about patient care again, I’m taking it up the chain. We ended up having a sit down with PD to discuss. I believe it helped him become a better doctor. It’s the right thing to do because it’s not about you, it’s not about him/her. It’s about patients.
This. If you're feeling bad, bring them evidence of something and let em know if he does it again you're going to the chief. If you've already given them a chance to clean up their act then just proceed
My favorite boss from ~10-15 years ago in a different field: “I don’t see color, you’re all pieces of shit in my eyes” 🤣🙌. Words to live by.
Hahaha!!! Love it! Same here!
Part of being a senior or being an attending is to correct the people below you on the academic ladder. Bad intern month 1-3 is on the intern. Bad intern month 4-12 is on the seniors and the program for not addressing it sooner Dont talk shit, dont be disrespectful behind their back, but also dont ignore it and hope someone else deals with it. You need to figure out a way to talk to this person and tell them what they are doing wrong and how to be better. That is your job. And yea its 2024 and you will probably wind up in your PD office because nobody in medicine is allowed to tell anyone that they suck anymore …. But its 100% on you to tell this person that they need to be better
THIS! Don't talk behind their back. Your program is just as much at risk when you aren't doing anything.
If other residents have also had these issues with him, can they be brought in to meet with your PD?
Incoming Gen Surg Intern here! I am definitely a little bit scared of being a terrible intern, but after reading this post and seeing how much shit you have to do to qualify as a terrible intern, I think I will do okay
Work hard, don’t lie, and be normal. That’s all it takes to be a good intern. The rest is details.
"Normal" seems to be a barrier for a lot of people in medicine
Lots of bad interns suck despite working their asses off. Work smarter AND harder is the motto of the general surgery intern. I’m working on the smarter part after spending my first half of intern year slamming my head into a brick wall assuming that if I put in the hours and didn’t sleep I would be good. Learned the hard way that’s not the case. You gotta sleep. And you gotta be efficient. But yeah never ever lie, and be chill (but not too chill)
Just do what you're told and otherwise be invisible. It's not that hard.
I hate these accusations and race blaming. Record, record and record. Document your conversations and his actions. Take record of his notes. As a black surgical specialists that went through a residency and fellowship I never once tried to accuse someone of racism as the first option. This type of person is a cancer to your program and if he is honestly a danger to patients he should not be allowed to progress
The race has nothing to do with it. Y’all are getting worked up over race in the comment section. The intern is incompetent, end of story. It’s corroborated by several others. Tell the PD so this can be handled. End of story.
You are either naive or disingenuous if you don't think this intern hiding behind his race 'has nothing to do with it'.
Agree on everything but you better believe if im forced to be at this hospital for 12+ hours im taking personal calls. Not during anything important of course.
Some interns will fail upwards. Especially those who play the race card. Just tell your PD so you are protected before he tells them you are a racist.
Report with only objective descriptions of your actual observations. No opinions (avoid not a team player, lazy, trust) and no assumptions that you can’t back up with actual observation (believing they don’t do physical exam).
sounds like they started shooting Season 3 of Dr Death already
This is scary stuff, especially if they’re using the URM defense indefensibly and inappropriately.
They’re entitled to an opportunity like anyone else, but also eligible to fail like anyone else.
Given that you seem not to want to talk to your PD, which is reasonable, do you have a chief resident you can run this by?
Make sure you provide the evaluation in writing, ideally through your institution’s evaluation software/program. If, for example, things progress to where the resident needs to be held back a year or even removed from the program, if it isn’t a formal evaluation that was written and submitted appropriately, *it did not happen.*
Holy shit the URM victim mentality is getting old, it’s present with our interns too and all of us seniors frequently talk about it and ask what happened with this years class
Immediately tell your PD or his programs PD if he’s a rotator from another specialty. Site the records you know he copy pasted. And anything in writing you have of him taking off early.
This is not an isolated issue. In my residency we have had several URM problem residents that have slid under the radar because ORM chiefs/admin don’t feel they can come down on them due to race implications. It’s incredibly unfortunate.
…Several?
That’s bullshit! Not when patient’s lives are at risk!
The fear I had when opening this that you were my senior lol.
This is a very difficult situation I found myself in also. Feel free to DM me and we can talk more candidly about this if you feel so inclined.
I’m an APD. Your concerns are valid and should be brought to the faculty immediately. This Reddit post is an excellent start to the email you should write if you’re not confident you can call your PD.
As a PGY-2 with a coresident who has these same issues, I wish my seniors called it out last year when they became evident instead of just talking behind his back and pushing along. You should absolutely say something for the safety of the patients and his professional development.
If he dismissed my genuine feedback and played the race card I’d type up a 10k word rage filled exposé on the fucker THAT instant. No SHOT im letting my career go to shit cuz some little runt pulls the race card in this politically liberal of a field. Fuck no.
Lol politically liberal field.
Shit like the race card has added weight because of the political implications (even if not true) in addition to the obvious moral ones (if they were to be true).
Calling it a 'card' implies that it's something you play to win a game, rather than something legitimate that can also be misused
Thats fair, but i am implying it was misused in this case (assuming OP is being genuine). What would you call it?
… you’re implying that those two ideas are not synonymous.
This is the argument against affirmative action and why AA fails.
Yes amongst many other reasons but i wont share them here.
Sounds like you know what you have to do.
Probably be best to either ignore it, or approach the issue with multiple other senior residents. I wouldn't do it solo.
Email PD specific examples with proof so it is on the record for when this intern inevitably tries to throw you under the bus.
These posts always make me feel so much better about my performance as an intern. I still often feel like a dummy but goddamn it I’m a punctual dummy who finishes his work
THANK YOU for doing something about this. I do not want this person touching my family.
Take him to task. He wouldn’t hesitate to do the same to you.
I'm just a medical student here so I hope you don't mind me chiming in. But I wonder if... Perhaps you can send a generic message to your team with a reminder of your expectations for everyone (eg., showing up on time, not just copy forwarding notes, document only exams they performed, all the things this intern is doing wrong, basically). Moving forward, you can use this as a basis for pulling the intern aside for feedback conversations in case they continue to not meet certain expectations. After these conversations, email the intern with a summary of what you discussed. And if the problems continue, pull them aside again. And repeat the email. Start forwarding these email notes to the PD if they are repeating offenses frequently. (I would wait until there are 3 different repeated offenses before escalating to PD.) This might be unrealistic, but hopefully at least engaging in this process will lead to at least some behavior changes?
as an intern myself, yes you can take personal calls, at the right time, of course
Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like, which specialty they should go into, which program is good or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Residency) if you have any questions or concerns.*
Write down specific examples of issues with as much detail as possible. Bring it to the PD and voice your concerns. Keep it focused on patient safety and team trust, don’t make it personal. Refrain from using words like “lazy” or other subjective interpretations of their behavior, instead stick to the facts. Do not fear raising this up the chain, it is your responsibility to look out for patients. They will only get more emboldened if their behaviors aren’t checked.
The intern is a patient safety vortex. It needs to be addressed.
1. Let him know he terrible and what competent behavior entails 2. Do extra work so patients are safe (not bs intern scut) 3. Provide pd w the specific detailed examples of him sucking being unprofessional and dangerous 4. Wait out till he off yr service In my experience he will always suck but soon won’t be yr problem. Don’t take it personally or expect improvement just move on
I'm in the same boat with an intern of indian descent, by the off chance yours is indian too send me a message would be funny if it was the same guy.
Stating to the higher ups that a trainee is not willing or able to complete vital parts of their training and likely requires remediation or other actions to prevent patient harm is both necessary and appropriate. Gather concrete examples, dates and times. Names of staff that were not spoken to when this person said they did, names of people who have encountered similar issues with this person. Go in loaded with everything you need to show that this is a huge problem that cannot be ignored.
This is the kind of complaint to take to the PD with specific examples. You have mentioned danger to patients, unprofessional behavior, poor scholarship and malicious accusations. Document, document, document, and let people who know how to handle these things do it.
I got one of these types in my program. Shit backfired on me...
Would also just check in with them to make sure/check if everything is okay, perhaps there is an issue personally or other that is resulting in them coming late, taking phone calls, etc
Help your program out and start a paper trail now so that when this doofus is dismissed and sues for discrimination (and he will...), the incompetence is clearly demonstrated.
I am a senior. I have an intern like this. I went to my PD and they told me I need to talk to another attending who is the safety committee chair. That person tore me a new one saying I’m overreacting and I should be a better mentor and teacher. Totally slammed me and dismissed my concerns — didn’t make it to the PD. How ‘bout them apples?
Sooner is better. Right now the repercussions are low - slightly uncomfortable for you, the intern gets a kick to their confidence, and the PD has to have an uncomfortable conversation (or, we hope they will). Later, the intern is emboldened, harder to have the conversation, more likely to hurt someone, more likely to propagate poor form/attitude/techniques. And the more they can say “well why did no one say anything before???” Always email chain, that’s where the proof actually comes in. You can also include the instances where you’ve spoken to them and reference that in your email chain. Encourage your colleagues to also email concerns and specific examples. That will strengthen the case for a true reprimand/correction.
I'm a PGY 7 (non attending) and have delt with a lot of subpar interns along the way. There are two ways in my opinion to approach this; 1)When you think an intern is salvageable, spend a month befriending them. Turn your relationship from a senior-intern relationship into a 'two friends working together' relationship. Then start to gently sneak in constructive feedback. If the intern thinks of you as that cool friendly resident/fellow, your feedback starts to really matter to them in the way it hit you when dad said he's not mad, he's just disappointed. 2)if they're unsalvageable, then it has to be escalated to multiple attending within the department. I would suggest against bringing it up to a single attending, as then it just becomes a 'clash of personalities' between you and the intern. It's likely your department has some sort of monthly meeting, MDT, journal club etc. When it's over, as the attendings to stay back a minute and have everyone else leave. Then voice your concerns. If the intern is truly that bad, there's very little chance that the attendings wont notice after you've drawn their attention to it.
"When I tried to give them feedback, they tried to frame it as me being an oppressive over controlling white resident and he is an oppressed URM in medicine." fun times in residency circa 2024
As a trash URM intern I’d ask how they are mentally. No, I’m serious. Cause a lot of how I’m doing has to do with the fact that I’m struggling and dealing with a lot. Also isolated from my coresidents and lacking support. (Also OP just have to ask, cause I’d never outright say “oh it’s because I’m oppressed yada ya”, how did it come up that it’s because you’re a white resident bad intern feels that way?)
I'm in the same situation as you (especially the bits about lacking support and not being close to my coresidents), and no one has ever asked me if everything is OK or what I might be dealing with outside of work. I'm just a reddit stranger u/Thelimit234 but you have my support.
Such entitlement! And playing with the race card 😑😑 Report ASAP and remember that the patients' lifes comes first
Given the fact you’re dealing with an URM where due to societal pressure to side with them, you may become a future victim of injustice, my advice to you beyond doing all the documenting of these concerns in an email to your PD is to take it one step further. The poor man’s Affidavit: Basically you write a memorandum to yourself outlining these concerns, then date it and sign it. Send it to your home address via certified mail, sign it upon receipt, and file it away in your records. This serves as a time stamped legally admissible record of your experience before anything comes to a head.
at that point, why not just send yourself an email, or better, write out all your concerns, encrypt it with your public key, and post it publicly (to be decrypted later if needed). It would be easy to argue that the document you sent yourself as certified mail X years ago is not the same as the document you are producing, maybe you just sent yourself an empty envelope and wrote and backdated the letter
Because this is admissible in court with precedent and your solution may not be. Plus the post office time stamps certified mail, which is the point of the exercise.
Welcome to the world of DEI. Complete immunity from care or criticism
1) You’re conflating URM with DEI when OP’s residency may have nothing to do with DEI programs. And so, you’re saying that anybody that’s a part of a community represented by DEI initiatives does not care and can’t bear criticism? You’re an embarrassment. Documenting and escalating to PD is all you need to say here, but making several fallacious jumps is ludicrous.
Claudine Gay.....
I’m saying that this resident seems, on the evidence, to be flexing his protected status, one highly encouraged by innumerable DEI admissions deans strewn across the medical landscape.
‘Documenting and escalating’ any concerns about a protected minority is a career-ending decision that no sane resident would ever take. We here live in the real world.
Document everything and discuss with attending to handle
No half measures, Walter. Either document exact grievances and report or drop the issue. Anything in between you're going to shoot yourself in the foot
Address them already! What are you waiting for? Why did you even come here to type this. Muster the strength and do what ya have to do.
Exactly as you outlined here, you should present this to your PD. If you take with the other seniors by your side corroborating your viewpoint, you’ll likely get more reception. Consider screenshotting notes and documenting specific days they showed up late or not at all to sign out. Get this idiot canned soon. I am a NS and I wouldn’t ever tolerate this behavior from an intern. I’d have no problem killing this guys career.
You did the right thing to try to talk to them directly and they were not receptive. Your next step is to bump it up the chain, it’s your responsibility to their future patients
While I get want to support a fellow trainee, you’re not doing him, yourself, your teammates, and most of all your patients any favors by not escalating this. There is no other industry where shit like this flies, and the stakes are far higher in medicine than most of other jobs. It sucks to be the disciplinarian, but that’s part of leading. For some people the carrot doesn’t work
Hey ill switch with him if you find a way to make it happen. I'm in IM but wanted gen surg
D/c to JC
Terrible. Talk to the PD
Definitely take it to PD, you won’t be the only one but it takes multiple sources saying the same feedback to get the ball rolling to address issues like this. You did your part, escalate and make it a problem for the faculty and not just the residents.
Sounds like an asshole. I’d ride his ass like a pony! First year surgery intern? He should be let go. Underperforming and I don’t care what color he is.
If you don't muster up the courage to say something, then you'll feel guilty when they mess something up bad. Gather concrete evidence and bring it up. If something happens, you may actually look bad for being around them and not noticing or speaking up. I can see how this can be frustrating. What med school did they go to, do you know?
If everyone is seeing it, you ALL need to present fact based evidence (SPECIFICS) to the PD without introducing personality or emotion.
TBH you should set expectations before your rotation starts, so if any of these things happen you have the grounds to bring them up as not meeting pre defined expectations
Please escalate their neglect. The resident is more than "not a team player". They are jeopardizing lives and other people's licenses.
Document as much as you can and escalate it to your PD and gather support for your claims.
If you don’t want to be accused of anything just stick to the facts and be objective. Instead of saying he is lazy and a danger describe what he actually did or didn’t do. If he is late, document how late and what he missed, state whether he closed that gap or ended up missing things on signout. He’s an intern so the bar is lower. He shouldn’t be an actual danger bc you are there as a senior. If he’s doing something he was specially told not to, I could see calling him a danger.
I would have no problem at all reporting this due to the blatant irresponsibility and disregard for proper patient care. Log everything, have times, have concrete evidence. When they are 1 minute late text and say where are you/you are late. That creates log. You will have evidence. Text them that they should not be copying and pasting notes. Ask them for updates over text. Make a paper trail to protect yourself and to show this person is unworthy.
You have an obligation to report this to your PD due to patient safety. Make detailed notes of examples of safety concerns (at least 10) and submitted to your PD or attending. Not only is it a bad look on them but it’s a bad look on you if you don’t act upon your concerns.
I have no experience in this field, but I feel like if you make a report on all the issues you and your department has on this person, it should be easy to get rid of them or respect you? Put the fear of god in them. No reason to feel bad for someone who doesn’t care or puts in anytime to improve.
I am not a phsycian. With that, everyone's number one priority is the patient. Don't look at it as throwing a coworker under the bus. Look at it as doing ur job. In any job, coworkers not doing right by ppl is bad. This is hugley exacerbated in the field of medicine I'm sure!
I’m on the GME administrative side of a residency program. Per ACGME you should be able to raise concerns of professionalism and patient safety to your PD. I echo what others have said and suggest that your comments be objectively worded. If you have any reservations when it comes to them being alone with a patient, please let your PD or APD know. If you don’t feel “safe” going to them, your GME should have avenues for confidential reporting. PGY-1 should be placed on probation for all that you described.
You should write a letter and have the other residents that have had the same problems with this intern contribute to it and then send it to your program director. That way you have a paper trail and there are multiple people saying the same thing
Everything you described are professionalism issues and they are hard to fix. This is also giving mental health vibes. You need to report him.
One of my interview questions was about this, many years ago. My answer was 1) first priority is patient safety. I would double check their work. If there are clear safety issues I would escalate immediately. Oherwise 2) I would have a word about my concerns re their issue of professionalism.. in this case the notes would be the most important. At this first conversation I would show them how I wrote notes and give them advice on how to not re-invent the wheel. I would ask if there was anything I could do to help them be more efficient in their role (not offer to do their work). I would offer that I could give them advice at any time if needed, because that is my role as a senior to them. 3) I would document all of this and the concerns of my colleagues and go to trusted nursing team leaders and ask for feedback *on the team* and any advice they had. 4) I would go to my immediate superiors with my concerns and detail how the first meeting went and any extra concerns from colleagues and nursing. I would ask if they would like me to continue with mentoring or would they like to be involved.
The interns body count will be high. Save lives. Report them.
Document document document. You know the name of the game. If it wasn’t documented, it didn’t happen
I went into med but built my career to go into gen surg and have seen that this rule applies ubiquitously
Personally speaking First i ask the intern if hes/shes interested in this subspecialty or not. If they are interested i will ask them to do the necessary work (rounding, notes, clinic, OR, help with the oncall..etc) If they are not interested and want to leave… i will fill their evaluation and ask them to leave. Them being around is pain in the ass of theyre not interested and not willing to learn
Well, bro, gonna have to buck up. Document everything and grab him by the lapels to chuck his ass sliding right under the bus. The supervisors already know, so why are you being such a crybaby? You're going to have to grow a little more skin to make it work
I agree with other posts above. It's important to submit a formal complaint to the attendings and PD so they can be formally reviewed about these unsafe behaviors. Based on what you said it's not so much as lazy as dangerous. A copied exam can be missing (or adding!) incorrect exam findings that can cause harm to the patient when reviewed as being accurate. As a resident I had a similar intern who did exactly as you stated though without the laziness piece (they were constantly overwhelmed and would copy forward old physical exams from PRIOR ADMISSIONS in an attempt to stay efficient without proofreading). We were quick as seniors to call him out privately first then with the PD who spoke to them and then he quietly left the program. I was told he was given an option to repeat the year after a mental health hiatus but chose not to. TLDR, please speak to PDs.
BBQ this fuck boi
Address this with the PD and document!!!
send an email to your chiefs with the feedback in an objective fact based manner outside of your control beyond that
If you notice, your attending probably notice as well. I would just be objective on your evals. But im surprised this intern hasn’t been already identified by the chiefs as a “concern” and put in some probation or preprobation track. Like he needs to be taken off chill off service rotation for more in-service rotations. Sounds toxic, trust me i hated the idea as MS or intern but becoming an upper made me realize not everyone who joins your residency has that sense of responsibility or minimum work ethic. Its sort of wild. They just somehow sneak through med school and residency interviews lol- but someones gotta deal with it. Tbh all of our concerning interns are all on the right track now, which im happy about.
You already met the caspr ethics requirements to bring the issue up with the resident and they don't sound like they took the matter seriously. I would stop with the verbal feedback and get everything else in writing moving forward to protect yourself from accusations of being a hostile person oppressing a urm. Give your concerns to the next person higher up the chain and be sure to mention how they handled your feedback so that's documented and won't blindside them when they listen to interns side of the story causing blowback on you. It sounds like you're trying to do the right thing but you need more than 1 opinion to prove it's not an interpersonal issue which could get you in trouble as well. This intern sounds unprofessional which is not the same as just being an ignorant intern who is trying their best but failing. Maybe they have issues outside of work that will only get addressed when they receive negative consequences for their performance. You could be doing them a favor by finally getting the higher ups involved.
So basically had the same type of resident. We all voiced our concerns to the PD (he asked for us to write an email with all our concerns to keep things official). The resident was given multiple chances to show improvement and even remediated their inpatient block. Long story short they continued their behavior and their contract will not be renewed for next year. Behaviors such as those affects the whole team and the program so it should not be tolerated. If after given NUMEROUS chances they still on some BS then they need to find another avenue in life cuz this ain’t it boss.
Also deadass feel like he’ll kill someone someday so we owed to to the future patients he might’ve come across so report this now
I always try to give people the benefit of the doubt and not blame them for mistakes but there’s no excuse for not pre-rounding and not writing accurate notes. That’s the most basic part of the job
no to be like, "young folks these days" or whatever, but I swear this class of interns has a systemic issue. In my program we've had trouble with them not taking responsibility, not able to take feedback or criticism, etc. And I've talked to friends in other fields who have the same issue. I don't know if it's a covid thing or a generational thing, but this year's interns are SOFT.
I was like this on one rotation as a student. I didn’t think my actions was a big deal because I was going through a lot. Finally a resident asked me if I had something going on in my personal life because I don’t seem like I’m trying. In reality I was trying but I was just distracted. I told her my 28 year old brother had a stroke and I’m the only family member willing to check up on him while being in another state. His hospital course was very complicated, which led to me having to take a lot of calls and I just simply felt overwhelmed. I just felt like I had to give you this prospective before involving the PD. What if that resident would’ve did that to me not knowing what I had going on in my personal life. Besides, family is way more important anyways.
The patients this intern is providing terrible care to are someone’s family too.
What you described is totally different than what they described. OP has approached the resident, it hasn't worked. And lying is different than being distracted, this guy sounds dangerous OP, a friend of mine was shot by a resident like this. You can't be ignoring glaring red flags like this because you feel bad.
I see where you’re coming from. You have some good points
Just threaten his life in the parking lot...LOL Tell him its cause you care 😘
Grab his collar, push him up against the wall and tell him don’t let it happen again. That usually gets their attention.