The Problem Resident Michael J Ruckenstein MD FACS

The Problem Resident Michael J. Ruckenstein MD, FACS Jody J. Foster MD, MBA University of Pennsylvania Health System

Why are we discussing this? As a PD - 80% of your time can be spent dealing with 1 problem resident The Core Competencies demand we address all aspects of the trainee, not just surgical skills and clinical competency

Scenario 1 A 29 yo female with an MD/Ph. D from a Ivy League Institution is currently a PGY 3 Complaints have been brought by several nurses and patients pertaining to short tempered and abrupt responses Her surgical numbers lag behind her peers and when she operates a hand tremor is noted She is extremely thin and wears multiple layers of clothing (tshirt, scrubs, hoody, labcoat) and a colleague has related a concern to our GME office regarding excessive exercise habits of the residents

Scenario 2 A male PGY 3 resident has demonstrated strong surgical skills and knowledge base Multiple complaints have been lodged by the pediatric service/hospital complaining of specific incidents of unprofessional behavior of this resident detailing abusive, derogatory verbal encounters with nurses and pediatric residents Similar behaviors have NOT been noted on adult services

Scenario 3 A female PGY 3 resident is lagging well behind in surgical volume She seems to prefer to be on the floor where she is loved by patients and nurses for her collegiality and attentiveness. In the operating she is very slow and tentative When questioned about her avoidance of the Operating Room by the PD, she broke down and cried stating that every morning she cried on the way into work due to fear of going to the operating room and making a mistake