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The Case of Dr. T. The Facts…. 25-year-old PGY-1 who arrives on July 1st, missing the week-long orientation you’ve planned, due to a family issue There had been no issues with his performance noted during medical school
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The Facts…. • 25-year-old PGY-1 who arrives on July 1st, missing the week-long orientation you’ve planned, due to a family issue • There had been no issues with his performance noted during medical school • You arrange a brief “catch-up” session for him before he starts on the wards
Beginnings on the wards... • Dr. T is late every day for the first week for every scheduled session • His notes are good, but occasional points are missed • He follows instructions well, but misses a case of hypokalemia, and is severely scolded
Response to feedback... • He responds to feedback promptly, and his performance improves with regard to timeliness and consistency • After being scolded for the electrolyte neglect, his attention to this area of patient care is without reproach
The attending complains... • A D/C summary is noted to be very sloppy and the attending complains Although Dr. T cannot recall the event, he promises he will be very careful in the future • Your review of his notes shows them to be very good
The reputation... • The next rotation arrives and the new attending has heard of previous problems. He wishes to help and you discuss the matter with him.
Crisis... • Dr. T sends someone home without an antibiotic and the resident on the service is furious. He humiliates Dr. T • It turns out that Dr. T had been instructed to do this by the attending physician • As you attempt to gather facts from Dr. T, you are informed by him that he will be resigning