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Thread: Recent Accident to My Son

  1. #741
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    Thanks Cheesecase & hlh

    I feel like today was a giant positive step forward. A year ago all of the hospital departments, where Brian will be doing rotations, were suppose to submit plans. None of them did. I can only guess what happened today at Hopkins to get the ball rolling. I'm pleased that sanity prevailed and I hope the meeting tomorrow is positive. Brian is stressed but he's preparing for the meeting right now.

    I still can't believe how this happened, I couldn't make this stuff up it's to absurd. Brian came out of the meeting Friday crushed but he snapped out of it on Saturday and wrote a powerful letter that I think opened some minds. I've always felt that doctors were smarter people than most but I might be giving them more credit than they deserve. They didn't act smart on Friday.

    Roger

  2. #742
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    Below is the letter that Brian submitted to the Dean at the medical school over the weekend. I've removed all of the names for privacy.
    PETA is the acronym for physical examination teaching assistant.




    Dear Dean Wwwwwww:

    Thank you for checking with me. I am feeling a bit better now that I have had a chance to process the information. I was quite shocked, to be truthful, given that I had remediated the physical exam maneuvers with Dr. Xxxxxxx and achieved a passing grade for CFM. At that stage, I had assumed that the alternate manner in which I performed the exam skills satisfied requirements for the school. Indeed, Dr. Yyyyyyy watched the recent LC SPEX in person at the simulation center, and while clarifying that she was not sure of Dr. Zzzzzz’s requirements, commented that she assumed I had passed.

    Upon reflection, I believe the lack of consensus on suggested alternative maneuvers for satisfying physical exam requirements was the primary obstacle in achieving satisfactory performance. I should have voiced these concerns earlier. The exam maneuvers, as laid out in student templates from CFM, provide the fully functional student with instructions on how to elicit appropriate information and achieve a passing grade. Due to my limitations, I spent significant time learning from PETAs and modifying these maneuvers on my own. As a new medical student, I understand now that I did not have the expertise to teach myself this portion of the curriculum. As is now evident, determining effective alternatives to the template instructions with PETAs as guides was inappropriate. Without insisting upon a new defined standard for the physical exam given my limitations, agreed upon by faculty across the board, I set myself up for unavoidable failure.

    All medical students are afforded step by step instructions to achieve a passing grade and I would like to request this same opportunity. Going forward, I believe it paramount that I know what is acceptable and unacceptable in terms of minimum competencies from the beginning, factoring in my limitations. The only times my maneuvers were evaluated by a physician were during the final exams for CFM and the longitudinal clerkship. I believed at the time, due to my feedback from the PETAs, that my alternative methods were satisfactory. I failed to realize that standards may differ greatly between evaluators.

    I am concerned that unless we address the need for standardization, or rather, defining the steps I must take to succeed, I will be continually guessing at how to meet faculty expectations. Most importantly, I will be unable to confidently assess patients without unanimous validation from faculty. If, in fact, I am supposed to learn from my experience with PETAs, it would only be fair for at least one PETA to have prior instruction regarding approved modified exam techniques. I cannot be confident in alternative instructions from a PETA unless they are also qualified to evaluate me.

    I realize that I should have requested formal approval of alternative guidelines before the evaluation, but given previous positive feedback, I concluded that I was appropriately and safely assessing patients. I can tell you that I chose Johns Hopkins expecting to work hard and I believe I have done so. I feel that another year off would be not only counterproductive, but would also hinder my patient exam skills. If faculty would be willing to create an approved modified template for the physical exam, to remove any ambiguity, I believe that I could retake and pass the physical exam within a week.

    Ultimately, my goal is to maximize my potential given my functional abilities and to continue the long journey towards becoming an effective, compassionate physician. Thank you for the extra effort to help me confront these obstacles as they become apparent. If you have any questions, please call me at aaa-aaa-aaaa.


    Sincerely,

    Brian Bbbbbbbb

  3. #743
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    Terrific letter, and I am so glad they reversed their decision. It takes a great deal of skill to be able to write the letter above, because it addresses both the lack of help provided Brian and does so in a totally non-confrontational manner. Good job all around.

  4. #744
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    Eileen

    I agree that it's a terrific letter. I thought that it was well organized and totally honest. After reading the letter I suspect that the administrators at the medical school and hospital realized that they had a problem.

    I just hope that they're really committed to making this situation work and are not just building a file to justify some future action against Brian.

    Roger
    Last edited by Roger; 02-28-2012 at 08:00 PM.

  5. #745
    How did yesterday's meeting go?
    Every day I wake up is a good one

  6. #746
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    Cheesecake

    The meeting turned out to be between Brian and his adviser. It didn't go that well. She said some things at the meeting that made Brian feel that she wasn't really supporting him. She must have thought about what she said because later in the afternoon Brian received a few emails from her where she tried to correct that impression.

    Brian's adviser didn't like the letter he wrote. It's probably because she was mentioned in the letter and didn't like that. She felt that Brian was advocating too strongly for himself which I think is totally crazy. On Friday, Brian was told that he was out of the program. No one else was doing anything so the only one who was going to advocate for Brian was himself. Brian knew that a strong totally honest letter was his only chance to continue. The timing was critical. If he missed to many classes in the Introduction to Clinical Rotations they would have been told that he couldn't make up the classes and he would have to wait until next year to continue. I think that she was disappointed when they reversed the Friday decision to force Brian out of the program she was ready to move on.

    One of the things she said that was really nuts was that she thought that Ann and I were pressuring Brian to continue. Since Brian was 12 years old I've never been able to pressure him to do anything. What pressure can you put on someone to study 80 hours a week. I couldn't even get him to cut the grass or clean up his room. He has aways driven himself.

    Roger

  7. #747
    To make a sweeping generalization, counselors and other types of school admin are the most condescending group of a-holes I have ever met. Lacking ambition and drive themselves, they cannot understand it in others, but can only demean it. GOOD for Brian for advocating for himself; those who count will appreciate it.

    I've worked in colleges and universities my whole life and really hate those people. Ignore them--they are inadequate petty individuals. Keep fighting, Brian has as much right to his ambition as anyone else.

  8. #748
    Quote Originally Posted by catlady View Post
    To make a sweeping generalization, counselors and other types of school admin are the most condescending group of a-holes I have ever met. Lacking ambition and drive themselves, they cannot understand it in others, but can only demean it. GOOD for Brian for advocating for himself; those who count will appreciate it.

    I've worked in colleges and universities my whole life and really hate those people. Ignore them--they are inadequate petty individuals. Keep fighting, Brian has as much right to his ambition as anyone else.
    Well said, on all accounts.

    Last year I was almost railroaded out of a graduate program myself. When I turned to the one place at the university that should have supported and advocated for me--the school's office for accessibility--I was given absolutely no support. In fact, I was encouraged to withdraw myself by the head of that department. In the end, I ended up needing to advocate very aggressively for myself. And like Brian, I had to step on a few toes and put in writing things that some administrators at my university did not like. I was even threatened with an non-academic misconduct charge at one point for simply speaking the truth and forwarding emails where I was told to quit my program by disability services. It was incredibly stressful and I felt like I was going up against the university all on my own. In the end, I started to question if it was worth the personal cost to me to continue. But it was because I knew that if I gave in and went away like the school hoped, there would be another student down the road facing the same issues I faced. From what I have read about Brian in this thread over the past few years, he has an incredible will. I hope he will stick with it and advocate for himself as hard as he needs, regardless of what his adviser and others say. It will be worth it. For him and for other students after him.
    Last edited by orangejello; 02-29-2012 at 06:22 PM.

  9. #749
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    Orangejello

    Thanks for your post. Your experience sounds just like what Brian is going through. Congratulations for sticking to your guns. Yesterday Brian said just what you mentioned.
    "I started to question if it was worth the personal cost to me to continue."

    Roger

  10. #750
    Roger: I know Brian can fight his own battles but please let him know that I would be happy to assist him in outlining his accomodations. I am pretty good at it. If nothing else, he can feel free to bounce ideas off of me.
    Every day I wake up is a good one

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