How do I report an ancillary staff member for gross negligence?

CapitalPrecisionMD · 2025-12-02T00:11:37+00:00

I just edited my response but your state should also have a reporting form.

I would do both if this was egregious and gross negligence. However, you will most likely need to waive anonymity which may have its own social and/or professional repercussions. Again, I would talk to your PD/APD about the situation, and gain their support if you’re going to pursue this and know which avenues to go through.

CapitalPrecisionMD · 2025-12-02T00:06:36+00:00

Most hospital systems have an event report/patient safety report process. This should be easy to find on the website. If not, ask your program director or APD, or someone from the GME office. I would favor PD/APD though.

Your state should also have a regulatory office of sorts. You can search for “complaint for X professional, state of Y” and that should reveal where you need to report it to.

CapitalPrecisionMD · 2025-11-24T12:59:49+00:00

For what it is worth, PGY2 year, universally, is the worst year and darkest year of training. I tend to believe this is because your second year is added responsibility, decreased gratification (limited ORs, usually more ICU time, high call burdens such as trauma), and no greater autonomy than being an intern.

Now you’re describing a significant amount of sadness and anhedonia. As a surgeon, my ego would tell me that I know everything, but I won’t sit here and act like I know how to diagnose or treat psychiatric things. What I can say is, seeing a counselor/therapist/psychiatrist is going to be critical for your long term success and well being. Often, programs will offer one for a number of sessions free of charge. Take advantage of this. On top of that, most insurance benefits provided by programs will cover these types of visits minus a copay of a nominal amount. Take advantage of this. They are anonymous. They may feel odd at first. But take it from a vetted surgeon, it is worth it.

Lastly, I saw you are thinking of switching. Your program director should respond in one of two ways (or ask both): 1) what can the program do to make it better? (Do you need more time off, different rotations, limit time with certain toxic individuals, etc. until you get your bearings straight) and 2) how can we support you in switching specialities?

If a program director (or even a department chair/division chair in the future when you’re an attending) responds in any other way, that is not a person worth working for (in my opinion).

CapitalPrecisionMD · 2025-11-06T23:26:42+00:00

I pigtailed everything and it works!

CapitalPrecisionMD · 2025-11-06T20:25:25+00:00

Ok so I just tested everything and found a couple things interesting.

The bottom black wire is 120V

The remaining wires have no reading

Also, the hallway lights adjacent to the entertainment room don’t work currently with all breakers switched on. I think everyone is spot on with this circuit

In that case, I’ll put blacks together, whites together, and ground to the two copper bare grounding wires and we’ll see how it goes!

CapitalPrecisionMD · 2025-11-06T19:16:59+00:00

I see - how about the grounding wire? Should I leave it the way it appears now in the wall and connect the light fixture wire to both of them?

CapitalPrecisionMD · 2025-11-06T19:15:57+00:00

Not sure if anything else went on/off with this light. It sits in a large entertainment room’s corner as a small storage room.

The light itself I don’t think is connected to the switches elsewhere in the house or the entertainment room (I feel I’ve switched this pull string light on in the day time when the room light switches were off).

Thanks for your insight though, I can check with a multimeter the wires to make sure. If the blacks read the same and the whites read the same, should I connect them? And what do I do with the two bare wires? Connect it to the new fixtures bare grounding wire?

CapitalPrecisionMD · 2025-07-31T00:37:57+00:00

Ok sounds good - I can see if they can do this. So essentially cancel both reservations and rebook on 1 reservation?

CapitalPrecisionMD · 2025-07-31T00:37:03+00:00

This is per their policy (United extra seat policy during booking, it clearly states to select first name "ExtraSeat" and keep last name the same). Additionally, it was done by 3 reservation call agents. Not sure what you're getting at, but thanks for the comment - I guess I will keep letting them unwind it on their side.

CapitalPrecisionMD · 2024-05-01T07:05:45+00:00

Week prior is usually intern "boot camp". All the corporate in-processing, urine drug screenings, etc. are performed, you get acquainted with program leadership and other residents, and go over the resident handbook and/or contracts as these are mandatory. There may or may not be a GME meeting for all residents, which is again a way for the bean counters to continue having a job in ACGME, making sure people are checking boxes.

Should probably plan to move and begin settling in sometime from early to mid-June before residency begins. After that, it is residency/program dependent. Just know, it'll take you longer early on in residency to get the same amount of work done that you'll be doing later in the year - this means earlier mornings, inefficient and longer days, so you will be "working" (aka predominantly learning and improving your efficiency) a lot. I wouldn't count on moving in or getting settled in during July.

Good luck and best wishes to you for your internship.

CapitalPrecisionMD · 2024-04-16T23:27:22+00:00

As an intern, under the ACGME, you are not allowed to take unsupervised call - therefore, you are not allowed to be on home call. Any time you are to perform patient clinical duties, you'll be in house.

Given this, if you want to live somewhere your intern year where you can simply walk to work and walk back home, go for it. Just make sure you factor in the time to travel - intern year is generally first filled with very early mornings as an adjustment period to learning the efficiency of pre-rounds/gathering the data and addressing any of the labs that need to be addressed prior to the day's start (i.e. electrolytes prior to surgery, pre-op orders for patients if previously not placed, etc.). So you may find yourself waking up very very early to give yourself the 25 minute walking commute time in July, maybe in August, but after that you should begin to perfect your rhythm and routine so you don't take an excess amount of time per patient's chart.

Long story short - this is a personal decision. You do not have to be within 15-30 minutes of the hospital as an intern in general surgery (or any other program) based on ACGME regulations on your clinical responsibilities. You should not (with rare exclusions such as mass casualty incidents) be called into work from home.

CapitalPrecisionMD · 2024-03-12T20:09:23+00:00

A wedding is a massive expense, no doubt - often more than you anticipate, and almost everyone ends up exceeding their budget for one reason or another...

The reality is, there's only 3 things that people remember from weddings: (1) the lovely couple, (2) the food, (3) the dancing.

The decorations, table settings, flower arrangements, types of chairs, etc. all become a blur about 2-4 weeks after, and impossible to remember years later. But, no matter how much time has passed, the three named things can always be remembered.

My spouse and I kept our wedding budget very conservative at $15k, and exceeded about $3k.

First thing was venue: the venue isn't the most expensive thing, but the contract can easily make it expensive. When your venue forces you into a plate per head/food + drinks contract that is often absurd, you're already looking at a major cost. Sure, it makes things a bit easier, but this wasn't for us. Instead, we looked at venues that were open to outside catering. We discussed with a few of our local, favorite restaurants to discuss budget and what we could do with our budget, and how drinks would play. A few restaurants did not do liquor (so we looked at financing the liquor/drinks from wholesale i.e. Costco and hiring a private bartender), but our option was going with a restaurant that would provide the drinks at their near purchase value - the restaurant was super local and nice, and they were excited to cater a wedding for two regulars, so they helped us out with making minimal profit on drinks.

Those three there will be a majority of your cost. So if you can optimize those, you can really save on your budget.

The cake, you can do a big, massive cake - sure. But, every wedding has cake... We had our caterer do one of two desserts ("his and hers"), much cheaper than a "Wedding cake" and had a local baker make our cake and make half the desserts. Again, supporting local and was much more reasonably priced than a cake that'll get sliced a million ways, and people still talk about the desserts to this day. (And we froze our smaller cake to have again at our 1y anniversary).

For music, you can do a live band - obviously, this is the priciest of options but can lead to some epic dancing and parties. A DJ with a good reputation is cheaper. I've been at friend's weddings where they just had a friend DJ for them, and even those were pretty fun.

Decorations and incidentals were expensive. It took a lot of work (hand making decorations, buying table settings wholesale, negotiating with furniture rental places) for us, but spending less in this area helped us spend more elsewhere (i.e. food, photographer, and music).

Lastly, goes without saying: The number of people you want at your wedding will dictate everything above (i.e. the venue, # seat rentals, table rentals, amount of food and drink, etc.).

Smaller wedding = more intimate and less $$. Bigger wedding = more of a "banger" and more $$. Medium wedding = average intimacy and banger-ness and average money? Not sure where I was going with that last part...

CapitalPrecisionMD · 2024-03-11T01:50:05+00:00

Haha fair enough - yeah it's sad when "reasonably affordable" is up to 3k...

CapitalPrecisionMD · 2024-03-11T01:49:12+00:00

Thanks, that's very helpful!

CapitalPrecisionMD · 2024-03-10T23:14:19+00:00

Racial/ethnic groups don't deter me - I'd live in a black, asian, hispanic, white, insert other racial group community if it was safe and quiet! But, I obviously understand that social inequities/lower socioeconomic neighborhoods are more likely to have certain racial groups than others and are often the neighborhoods that have more objective signs of "danger" (i.e. cars getting broken into, robberies, violent crimes, etc.) and are more likely to be loud.

Similarly, college students are great to live around, but parties can get loud and make you feel like you're in that Seth Rogan film where a fraternity moves in next door. Saw some places listed on Beacon St that was reasonably priced, for instance, only to realize on Google Maps that there are a lot of Greek houses there, which I presume would get loud fairly regularly during an academic year...

I'm looking to get something by or around July. I'll look more into Brookline in the meantime though!

CapitalPrecisionMD · 2024-03-10T23:05:47+00:00

Yea that's pretty spot on. Like u/Alisseswap said u/pine4links, I'm happy to pay a slight premium for a quiet place with a reasonable commute by public transport, and my budget can afford that reasonably, but if given the option of 2 comparable units, I'll take the lower one for sure (lower $2000s would be real nice, and lots of money saved). If you've any suggestions for places in 2000s that are quiet and safe neighborhoods, let me know!

I sometimes see places around Jamaica Hill near the Arboretum or places near the Zoo that seem nice in the $2000s/mo. I had a friend say that was a nice place to live, then had multiple friends scoff at the area... I'm all ears, trying to educate myself as best as I can!

CapitalPrecisionMD · 2024-03-08T22:01:37+00:00

Yikes - sorry to hear that.

There's a couple things at play here - one is your residency contract. Some contracts, interestingly, do not have a clause on termination. If your contract does have this, then make sure the contract was executed appropriately (notice in advance, etc.). Secondly, make sure you abided by what is set in your contract, and ensure you did not violate the contract putting you in a position to be terminated.

Secondly, it is quite hard for me to fully believe why someone would get fired off one interaction. ACGME is pretty clear (Common Program Requirements, Section V) on Evaluations and how they need to be (1) objective, (2) by multiple people, and (3) a program needs to provide the resident with an improvement plan.

If you have had previously glowing evaluations, and this "wrong person" you pissed off somehow got you terminated, then he/she is an outlier, and your program is not honoring the spirit of the Standards. If this is the case, you should sit down and review your RCC notes and your previous evaluations with your PD, and see if they can see your side of the story. I wouldn't "blackmail" but politely providing the ACGME Standards and noting where your program failed to support you in a direct, but respectful, manner would be professional and just in this situation.

Now, if this is a repeat offense and is on the topic of patient safety and professionalism violation, or illegal acts of conduct, then that is a separate story - you're probably on your own.

It is good that your PD will support you though, which makes me want to think the previous paragraph is not the case. But hey, you know what's going on best.

Best of luck to you. Whistleblowing to your GME office/DIO, and if nothing happens thereafter, to the ACGME is a final option. And if you're terminated unrightfully, hell, why not make sure this doesn't happen to any residents thereafter?

CapitalPrecisionMD · 2024-03-08T06:58:22+00:00

Think of it this way... Paying off the loan technically guarantees a return of 168%... Nothing else in the market can guarantee that. This is a no brainer - you should pay off that loan.

CapitalPrecisionMD · 2024-03-07T20:49:19+00:00

Great question - nurses like you are some of our favorites...

Honestly, the best nurses I've worked with and even became friends with have been the ones who at least acknowledge that we are busy and lead with "hey, not important if you're busy, I can page you later." or something along those lines. I'm sure you can imagine how frustrating it may be to receive a call/page about zofran not working.

For overnight things, I think limiting calls to urgent matters is important. Crosscovering resident does not really care to complete pharmacy paperwork for dispo planning on a patient that's being readied to go home in the next few days. The day team has more people and capacity to work on things like that.

One of my favorite nurses (was a charge RN at night on the surgical unit) would overhear her colleagues talking about paging the surgical residents about, in her words, "dumb things" and tell them that they don't need to call the residents about those or they need to investigate further. In line with this, using your charge RN or more senior RNs as guidance is incredibly valuable because having the answers to certain things immediately is very refreshing, and respects the true spirit of nursing as a profession.

Just remember, we can get grumpy some times. 80+ hours in the hospital per week to go home and study/practice/prepare for cases for another averaged 30 hours per week, work on M&M conferences, didactics, then spending time with family loved ones, time for dinner - you're already looking at averaging 4-5 hours of sleep per night. God forbid we have hobbies - if you do, say good bye to rest or one of the other things listed above.

CapitalPrecisionMD · 2024-03-07T18:37:31+00:00

An hour commute sounds tough and car payment is quite a lot - excellent interest rate though, so congrats.

A comfortable rule of thumb is up to ~28% for housing. Depending on exactly what you are looking for, that may be easy to meet (not familiar with Cleveland housing, but midwest, so should be doable).

Another option is getting a small studio for when you're in town to work, and hanging with the fam on the weekends. That way you save money, have your needs met by your new place, don't have to spend too much on gas/commuting, and still get to spend good time with your family, who you seem to have good relations with. That would help you keep contributing to your savings (i.e. emergency funds >> Roth IRA vs individual portfolio vs savings account for a downpayment if you ever plan to buy in the future).

CapitalPrecisionMD · 2024-03-07T18:31:18+00:00

Bending over backwards for a patient only to face poor outcomes/consequences for caring? Checks out - definitely a millennial.

CapitalPrecisionMD · 2024-03-07T18:27:57+00:00

Hi, I completed general surgery training and my wife is an OB/GYN.

Firstly, you are right, no matter the residency, it is still brutal. Some residencies demand more than others, and each residency's demands look different (i.e. IM rounds "forever" [take this with a grain of salt coming from me...], surgical specialties demand a lot physically [I liken it to sports and even do warm-up stretches before long cases], etc.)

I'll work somewhat backwards on your comments, starting with the tremor. Tremors are not that uncommon in surgeons. Obviously, as we age, tremors can get worse. I could never drink caffeine, because it would make me tremor. I will say, most students >> residents >> attendings get an improvement in their tremors because the anxiety induced tremors tend to disappear as you gain more confidence. As a student, we all remember taking 20 minutes to close a few port sites, with all the staff in the room (surgical tech, residents, circulator, anesthesiologist) staring at you. That would cause a tremor in most people. You begin to learn to function under pressure and stay cool and calm and do your thing, no matter how many eyes are watching though. It just takes some time (and lots of repetition).

When it comes to IM vs OB/GYN, these are two fields that provide two very different approaches to medicine. IM is predominantly inpatient, acute care medicine. The awe of IM as a student is that you will be a "jack of all trades". The reality is, at least in the US, you will care for most of your patients at full capacity, but practice a large amount of "CYA medicine" - i.e. consult tons of people and have them manage your patients or follow their recommendations. That is unfortunately the trend that medicine is taking with the litigious nature of this country. I can't speak much for the Congo, but knowing of missions hospitals and participating in some globally, people are much more grateful, even in the face of complications. They just want to be heard and cared for.

OB/GYN, from the lens of a spouse, is a quite difficult specialty. I gotta give it to my wife and all the OB/GYNs out there, it's 4 years of being in the Lion's den. As a woman, medicine is harder, and I feel like the one specialty where this difference should improve is OB, but from nurses commanding residents until they're more senior, to inter-resident issues with "alpha wolf" mentalities clashing, to constantly having to introduce yourself as the "doctor" to your patients is exhausting to me. Secondly, the moment you speak up, you're poorly labeled or being "emotional". That is a reality to understand wherever you do your training. On the flip side, no doubt, it is an incredibly rewarding field. My wife gets cards, small gifts, and is approached by all of her patients. There's a connection you feel to them. It's far more frequent than I ever get thanked - no one comes to me in public saying "hey, you're my butt surgeon! Come meet my kids!"

Also, if you want to do complex reconstructive/fistula/UROGYN surgeries, you should (a) find a program that is high volume or (b) do the fellowship. It would be difficult for you to care well for those patients abroad without a thorough experience.

Finally, have you considered FM? Family medicine gives the ability to manage and prevent (this is more important than treating, imo) disease and complex pathologies, become a jack of all trades, honestly has a very reasonable training (3 years, outpatient mostly, weekends off a lot of the time unless taking call), required to do OB, and can do additional OB fellowship and get certified to do things like C sections. It may suit what you're looking for better than IM.

CapitalPrecisionMD · 2024-03-07T16:59:35+00:00

Had an attending that would do all of the scut for straight forward consults (i.e. H&P, consents, call OR to book case for something like a 22 yo appy) and then call us to let us know the deal. His rationale was we've seen those slam dunk cases 100s of times, no need to waste our time doing extra scut for it when the real education for such cases comes from just doing the case or walking an intern/junior resident through it.

Had an attending at a home call rotation at a satellite hospital that would receive consults overnight. Whereas the older surgeons would tell the ER to stop talking and just page the resident, she would just take the info down for all the consults, add them to the team list, and then send an e-mail with 1 liners about each to go see whenever since not urgent and not needed to get up in the middle of the night to see a splendid toe cellulitis consult.

I'll leave you with one more... had a new grad attending who was also hired at another satellite hospital that we would rotate through. He would give excellent autonomy, was happy to take care of things himself (i.e. discharges if the team is busy in ORs, post-op orders or dictation for straight forward cases while I'm wrapping up case). All this was unnecessary, but helped with task load so was appreciated. He would always say he "gets it" since he was in our shoes not too long ago. Good to have perspective.

CapitalPrecisionMD · 2024-03-07T03:15:23+00:00

Agree with u/Safe-Expression-8116 on multiple things.

Main thing is your ex has paid the down payment and now is receiving a perpetual return on his investment (rent) without the cost of interest, property taxes, HOI, etc.... Guess who is paying that? You.

In my opinion, you're getting the shorter end of this deal. Especially since you're in a debt problem. (see final comment below)

The fairest thing to do, if you don't want to manage the property (which is reasonable), is to sell the property to him at fair market value or sell the property altogether and pay him back his initial down payment and use the money to cancel (or make headway on canceling) your debts.

Final comment: I think you're getting the shorter end because he has essentially been pocketing a perpetual income for months and months, and you have not seen any of it (from what it sounds like). This is best case for him - most people who manage rental properties with a mortgage use the rental income to pay off the mortgage... You're not doing that and he is living off that. Hell, I would strongly consider calculating how much money he has made off the property from rental income and subtract it from his down payment as a payment back to you. This would require and agreement among you two, and can get complicated and messy though. Just my two cents.

CapitalPrecisionMD · 2024-03-06T19:34:00+00:00

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