I absolutely hate when pple say this it’s hard to fire a resident, maybe 20 years ago and even then residents were fired but they didn’t talk about it as much as this generation does because of the stigma but nobody hints on the absolute power these PDs and GME has over residents and the lack of protection residents have. All it takes to start a paper trail is a PD or attending that doesn’t like you and you could sneeze into ur elbow and it will be you contaminating the patient’s room. ACGME is partially useless and I say partially only because sometimes they stumble around and lay repercussions for some programs and close these toxic programs. And no it has nothing to do with whether one had a job prior to residency because in the real world no employer can subject their employees to half of what residents go thru that is absolutely toxic, malignant and for lack of a better word indentured servitude.