RED FLAGS To Watch Out For When Selecting Residency Programs. #454 Part 2 - podcast episode cover

RED FLAGS To Watch Out For When Selecting Residency Programs. #454 Part 2

Apr 01, 202520 minEp. 454
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Episode description

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When facing a bully in medicine, your strongest defense is competence. Identifying problematic programs before committing to them is very important. If you've ever faced professional intimidation or worry about encountering it in your medical career, this discussion offers practical wisdom on how to navigate these challenges while preserving both your professional standing and personal identity.


We discuss:

00:00 How to play the game correctly when dealing with bullies.

04:35 Can you make the bullying stop when you're already deep into a bullying situation?

10:50 Watching out for red flags during pre-interview dinners.

17:18 The consequences of bullying during medical training.




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Transcript

Strategies for Dealing with Medical Bullies

Speaker 1

Especially if you're being bullied for something that you know most likely this may follow me in my career . You do need to pause because you have to strategize . This is just as essential a skill set as learning how to suture . You know whether it's you having a certain name , a certain build , a certain gender , a certain sexual identity .

You have to build that skill set of how do I deal with these bullies . That could be when you take that time to go home and talk to your village , talk to your parents , talk to your friends , talk to your family , gather the opinions on how to address it , coalesce them together and then come up with a plan .

Speaker 2

So I have a list here of who are the perpetrators , right , and the perpetrators could be anybody from your co-resident , which is not that likely , but that could happen to your residents who are more than likely higher than you , Right ?

So if your first year , your second year can push you around , they can do things with your schedule to make it more difficult for you . Or if your chief does a schedule you know .

Speaker 1

I have .

Speaker 2

I have nurses can sometimes bully , obviously attendings . I even have patients .

Speaker 1

They can bully you .

Speaker 2

Let's focus on the interrelationships between residents and how that plays right , because it's almost like is someone going to take your cornbread , are you going to stand up and if everybody sees that they take your cornbread ?

So I like the part about the name part right , which is like you established you , you established what , how important your name was , and then you just kind of joked on them and said , hey , like you have like the multiple syllables and all these different things , like I got you also . But like how do you like is there a way to come in ?

Like yo , like I'm not playing around , like how do you separate the emotion from the ? You know , dr Bilbroy ain't nobody to mess with . Like just keep it moving , do you ?

Speaker 1

see what I'm saying . How do you do that ? Yeah , you know what I think that the greatest hey , I'm not messing around is just to be an on-point intern or an on-point resident . You come in , you're early , you're the last to leave , you're inquisitive , you're prepared , inquisitive , you're prepared .

Honestly , I think there isn't a residency in this nation that if you have those basic things and you're on top of your game and you're studying , you're asking the right questions , you're following up with your articles , they're going to be like okay , right Now , of course you're going to have people that will still , you know , do those set things , and then you

have to go back to your strategizing . But I really think that 95% of the time , if you are that prepared resident or medical student it is going to be very hard to find you at fault .

That's the strongest card that you have , the second strongest and this is so subjective and I really I hate when I say this but like playing the game like they got to like you right .

Speaker 2

So I- no , but that game is dangerous though .

Speaker 1

It's dangerous . It's dangerous and you have to play it correctly , like I wish that we Because you don't want to be a cap .

Speaker 2

You don't want to be a cap because you could become just like them .

Speaker 1

Right , right .

Speaker 2

That's my personal story .

Speaker 1

Oof , yeah , yeah , yeah . You don't want to , you don't want to become like them . And then you go home and you don't feel like you're you anymore , right .

Speaker 2

Yeah .

Speaker 1

But I think that it's worth it . Also , like I said , I trained in Texas . I was the second black female and when they were like hey , you want to go out with beer , so I don't drink beer , I'm going to take a Chardonnay , and so I'm going to sit here and listen to y'all tell me about what it

Preventing and Responding to Resident Bullying

was like to grow up on a farm and hunt deer and quail and honestly opening myself up with boring . but opening myself up to someone else's experience actually made it easier for them to understand mine and to ask me to finally get comfortable to be like okay , so tell me about Atlanta .

Y'all have shootouts like that and I'm like , no , but the medical students be taking care of the gunshot wounds in the ER , like that's our thing . And so it broke barriers by putting myself and you really are like a martyr I need to find a better word than that .

But you know , when you're in that position where you're being bullied or whatever , you're putting yourself in the point where you do have to interject yourself and say , all right , well , tell me about you , which I think is just emotional intelligence . They're doing it because they're uncomfortable and they're threatened . That's why people bully .

They don't bully because they're confident in themselves . They're bullied because they don't understand what you are and they don't have the emotional intelligence to just ask can you tell me about your hair ? Can you tell me about your background ? So they poke fun of you , right ? Or maybe there's just some serious . They just don't like your background .

Speaker 2

What about ? Okay , cause I in my I can feel like my . I can hear the audience like , what if I'm two years into being bullied ? I ain't like I got what you saying about how to step in and make sure that nobody steals your cornbread , how to step in and make sure that nobody messes with you from the get go . I missed that . I missed that episode .

Dr Bill Brew , I'm two years in . They bothering me Three years . How ? do I get out , how do I turn a page ? And I'm not leaving my residency , right ? I got a spouse here , they got a job and they told me they're going to kill me if I'm going to another .

You know , if I change to another residency , how do I turn the page and make sure I got like two more years to go ? I can't take this . How do I change the ? How do I change the ? How do I make a 180 degree change ? Boom .

Speaker 1

Fix that one , dr Bill . So here's the thing like and I'm a realist , you can't If you're three years in because you missed lessons one through five and now you're being bullied . I think there's two ways You're being bullied . But you're a strong resident , there's no risk of you being held back , of you being fired or anything like that . Okay , let's terrible .

You know it's mentally , it's emotionally , it's all of that . And you still have another two years left . You know , if this is like a five-year program , this again , I always go back to a village because I think it's important you have to make it through . At this point we're almost over the hill .

Speaker 2

So now this is a- , so you just accept it .

Speaker 1

I'm not saying to accept it . You have to accept that it is a part of your process and that process doesn't last forever , right ? So you know , I think it's like giving birth when you're in like that . You know you're like seven hours into labor and you're like dang , I got another like 10 hours to go .

There's nothing you can do to speed it up , embrace the suck . You embrace the suck and say I'm here , I'm going to focus on my education , I'm going to focus on maybe using these experiences for the person that's coming behind me .

I'm going to focus on how , at the next stage of where I'm going fellowship or attending or whatever that this is not going to happen to me again and at the same time , I'm going to seek the support that I need , whether that is the mental health therapy , your family , your friends . I'm going to enjoy those moments outside of my training .

I'm going to make the best of them . So I had to listen to gospel music every day walking into that hospital , like every day .

Speaker 2

That's it Before I go into this hospital .

Speaker 1

Like people think it's a game . Like I the the mental games I had to play at , you know , like year two

When You're Already Being Bullied

, when you're like , ah , there's still three more years of this . Like three and a half , it plays games with you .

Speaker 2

So does escalating this help at all ? I'm going to go to my PD about this . I'm going to go to my chair about this .

Speaker 1

Yes , I think you should always let the individuals who have the power and authority to make a change know what's happening at a not like a weekly basis . But they need to be notified enough , because that's your receipt . You can't keep it to yourself , Even if it's your program , under your chairman doing it .

You need to have a meeting and say I'm just taking notes , or send an email Per the conversation we have . I just want to recap .

Speaker 2

Oh Lord , here we go Per the conversation . That's when they know , this is when you get your Claire Hu huxtable on per the conversation you gotta record it okay , wait . So so quick question . I forgot to to . I forgot to close the loop on the , the question I asked about , or the , the point you were making about you being an awkward surgeon in residency .

Yes , right , so when you kept it to the objectives , right , and you're attending with stuttering afterwards and so forth when you go back and look at , is that was that ? What do you look at that as ? Is that like bullying or is that mistreat ? Is that criticism ? Talk to me like what . Knowing how to operate , he operated in a very specific way .

Speaker 1

I do think it would have became a form of bullying and a form of harassment , because it was the beginning of the stages where you're starting to operate independently and that it would have definitely been used against me .

It would have turned into an academic criticism , right , because I can now look back and say wow , actually it is bullying because you're in a senior position . I now look back and say wow , that's , that is actually it is bullying because you're in a senior position . I now look at myself . I would never say to somebody man , you operate awkwardly .

What I would do is hey , afterwards let's spend a little brew , stop playing you said what .

Speaker 2

Dr Bilbrow , stop playing . You know you've seen some awkward ass surgeons residents . Why are you suturing like that ? For why are you using a vertical mattress ? Why are you using this If it's getting ?

Speaker 1

done , though . If it's getting done like was the outcome the same , but if it's something dangerous you know , I've had residents I'm like that's a little dangerous . Hey , why don't you ? Let's go over how to hold this drill . You know , let's practice that we're not firing like this , like we need to . That's how I would address it versus .

Speaker 2

That's the superficial femoral . Be careful y'all , there's an artery .

Speaker 1

behind that bone there are arteries and nerves that you can cut . You know that's how I would address it , so it was bullying . That's not . That's not how you talk to someone . You're trying to how to educate

Addressing Bullying Through Official Channels

the next generation of servants .

Speaker 2

Yeah , he was a bully , yeah , I got it . I got it Because , you know , renee , she experienced bullying and she talks about that , and she had it from two angles one from an attending and one from senior residents . And it just came to a point where this is her first year .

She was like yo , I'm out , and she , like , submitted her resignation and then , like at the last minute , you know , the chairperson was like yo , I need you here , I want you here , like we're going to handle this and so forth , and she decided to stay , like at the very last minute and so forth , and then everybody changed .

But it's , you know , it happens way more than you think .

Once again , with the stats , like I said , like one of the things that I'm interested in so that we can talk about is like those consequences that we were talking about earlier , which is the effects of residents or , excuse me , the effects of bullying on burnout , performance , depression , you know , like , is there anything that residents , or even med students who

are going through the interview process , is there anything that they can see that are like red flags so that when they're going on that dinner , when they go on ?

Speaker 1

you know , I don't know , whatever you do nowadays , I forget how they even check out programs and they rank them .

Speaker 2

Yo , this is a toxic environment . You got to be careful . I should be careful when I go in here . Yo , talk to me about that .

Speaker 1

Right , I think that and I think they still do the pre-interview dinner . Pay attention to how the residents interact with each other and then how

Red Flags in Residency Interview Process

they interact with the interviewees , because , if you're noticing , everyone is kind of on edge . Nobody is comfortable with each other . There's some dynamic that's off . At the end of the day , if you're doing surgery , or even if it's peds , it's three to seven years that you're spending probably more time with them than you do with your family .

Speaker 2

If they're not interacting comfortably .

Speaker 1

it's kind of like going to a family reunion and no one's talking Red flag . What mess do y'all have behind the scenes ? And I think then , just talking to residents individually , what's your experience like ? And if they're not saying the truth , which is there , should be good and bad If they're just putting raisins in a potato salad .

Speaker 2

should be good and bad if they're just saying Putting raisins in a potato salad . Like who this ? Who's this ?

Speaker 1

Like who would they come from ? You know it's not matching up . Things aren't matching up , and let me tell you programs . I didn't rank based on the pre-interview dinner . I was like I can't end up here .

Speaker 2

Give me some examples . What'd you see ? You see , what'd you see ?

Speaker 1

come on you don't have to name the people , but talk to us . Come on , let's get the juicy details . I was at one and you know again , it's orthopedics for those that don't know very male , dominated , very macho , especially back . You know when I did it and um , and it's not like that as much . Now .

Everyone's like how much can you lift , deadlift and all of that ? I wasn't even into that at the time . I was like listen , hair and nails , but I was clueless . I went into this field not even understanding what it was going to be like , but I went to a the bro mentality yeah . I had no clue . I had Dr Simpson , mason . Who's this fly ?

You know black female orthopedic surgeon who wears skirts and dresses and heels . I'm like , oh , we're all like that . And I was shocked , nope . When I showed up to , I'm like , oh , we're all like that . And I was shocked , um , when I showed up to residency , like , ooh , y'all are men's . Um , like manly man .

Listen , I can tell you stories for days of sometimes they forget that you're a woman and the things they say . Um , but I went to a pre-interview dinner at a place that will not be named and it was at a bar right , and so they got everybody what are ?

Speaker 2

they called jagermeisters oh , jagermeister , yeah , yeah , yeah yeah , I don't even know , you see all my jagger bombs , yeah , like a jet and yeah , yeah , the j is silent . I don't don't ask me how I know , it's just the j is silent because that you I'm clueless on this , bro mentality right . Right right .

Speaker 1

So there's 20 of us . They're lining up on the bar and they chugging it At a pre-interview dinner . Listen , ortho is no joke . There's some that happened at strip clubs . That's another story .

Speaker 2

Stop lying , you lying , you potting Dr Bilbr it though .

Speaker 1

That's great . Are you serious ? Listen the ones people who interviewed between 2000 and 2010, . There was a certain program that would take you to the strip club afterwards . I will not name the program and I did not get an interview there , but there was a program , I think it's what Would you go ? Would you have gone ? No , no , what .

Speaker 2

Would you go ? Would you have gone ?

Speaker 1

No , no , Listen , the reason I got my spot is because there was another girl that they liked that got drunk at the pre-interview dinner and I didn't make my program's pre-interview dinner . She missed the interview the next day because she was hungover and they told me when I matched like you took her spot .

Speaker 2

Word . They ranked me above her . Big no-no , big no-no .

Speaker 1

Exactly Talk about wanting to get bullied . She's been known for that , like I'm not going to call her out . So they had these Jaeger Meisters and they're chugging them back and I didn't know what it was , and like the chairperson , is there Programs ?

Speaker 2

The program directors are there .

Speaker 1

I don't recall but I know the residents and the chief was there and then they had a shot right next to it and I tasted the Jaeger and I was like at that point I didn't even drink beer and so I left mine to the side and I ordered a Chardonnay from the bar and the chief and some of the other residents came over and said who's Jaegermeister is this on

the bar ? I'm like I know he's not calling me out and I was like it's mine . It was like boo from the residents , she can't drink the Yago . And it became a whole thing that I could not chug a beer down in like 15 to 20 seconds .

That told me already I'm not ranking y'all If this is the environment that if somebody is different than you , that you jump on them to make fun of them . This is like a frat boy type situation

Bullying Impact on Performance and Care

. Instead of being like oh cool , you ordered Chardonnay , what kind ? Tell me about what you know about Chardonnay . Like what's your favorite wine ? No , it was straight clowning on me aggressively and not in a way that I could participate . It was like well , let me just head back to the hotel .

Speaker 2

Those are the , and it's kind of like , if you're going to treat someone like this now , before they sign on the dotted line , imagine what's going to happen when you really are . You know you there for five years and it's going to be hard to change programs . So yeah , I get what you're saying .

Speaker 1

Yeah .

Speaker 2

I get what you say . So you didn't even practice at all , trying to chug beers at all , doing residency and all that .

Speaker 1

For what ? For what reason ? I don't even like . I think I'm a little light , go on .

Speaker 2

You're an ortho . You got to keep it light sometimes , though , go on . Yeah , I'm a boy .

Speaker 1

I'm a boy , I'm , you know my program would respect that . Once I was like I'll take a Chardonnay , they were like OK , order her Chardonnay , everyone else get Jagermeister . You know . So it was . It was respectful , it was . You're different , but OK , tell us about your difference . They weren't perfect , but it was a better situation than the other program .

Speaker 2

Well , I want to say and I appreciate you sharing that , because that puts like a picture or video in our mind that you know you just don't anticipate , and I think you know med students and even residents don't anticipate .

So I want to say that you know there are stats that show that this is going to affect learning this is going to affect your performance in residency . you know your board examinations . There's a possibility it could . It could also affect patient care as well as increase the amount of medical errors .

Like there are statistics that show this yo , yes , get ganged up on by you know another surgeon . I've seen it with young attendings who come into maybe you know a practice or come into a hospital and you know now they're taking a pie out of , or a slice of the pie that maybe one surgeon was used to enjoying for themselves .

Right , like you are literally taking money out of their you know out of their retirement fund .

Speaker 1

Can I pause just to say that slice of the pie . Oh Lord and God , I'm going to incriminate myself . This partner knows that I love him . Today , my favorite partner that I work with currently pulled me aside and said I didn't vote for you to be here because you've pretty much taken a slice of the pie and there's not enough pie to go around .

Speaker 2

There it is . Y'all heard that right , y'all heard that right . So my attending prep me for that . He prepped me for that conversation . I didn't believe that .

I thought that there was enough for everybody to eat , but I didn't know that when you go to these smaller hospitals , once you leave residency , you know they are using whatever all the cases and all these different things , the relationships that they have with you know trauma , or the relationships that they have with family medicine and the hospitalists , all these

hip fractures and all those different things . Like that's how they're paying for their kids Private school , that's how they're paying for you know their boat . So when you come in as a young attending , like sometimes you will catch that ire and they will come after you and there's bullying there , right .

Like sometimes you will catch that IRA , they will come after you and there's bullying there , right , yeah , that could affect the confidence of how you operate If they find maybe one small little thing or maybe a couple of cases . You have some infections that everybody else has . But if they're going to , you know , completely focus on what you have .

Oh you , you got some drink , you know something coming from the knee and stuff like that and whatever . You know what I'm talking about , but exactly you know what I'm talking about Exactly . We got folks switching specialties , possibly because it is yeah . Leaving medicine , so this has a strong impact on people .

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