ER doctor last minute refused to work with me. And other difficulties.

[Past2023]

Hello, I am a few months from graduating and in my final rotation, which I have been looking forward to the whole time- ER.

To pretense this, I have been placed at a very rural site in a town of less than 10k people very isolated from any other towns for my entire clinical year.  So, the ER is only staffed by 1 provider in each 24 hour shift, and frequently that provider will be working 96 hours that week.

I got my hours approved a few weeks ago by the ER nurse manager, and then I showed up to my first day.

The ER doctor, after I introduced myself, looked at me incredulously, and went on a tirade in front of the entire ED staff how he is shocked a student is there, that he never agreed to take on students and he never would unless he was paid. He repeated this over and over.  He then ignored me and said "you can just work with the NP when he's here.  You will be more doing what they do, anyway (even though I was explicitly told by my program I can not work with the new NP and worked my whole schedule around that with the ER manager). He sent me home and forbade me from coming back on any shift he is working (which is 15 of the days in 1 month).

To clarify about the NP situation, I was told I was not allowed to work the days they were working, which already severely limited my schedule before this snub from the doctor.  This was because they were a new grad that was just hired and not ready to take on a student.  Fair enough, but apparently this doctor does not care.

Therefore, I will be lucky to achieve even 20 something hours working ANY possible shift (day night weekend, whatever) with these limitations, and I really would like to work 60 because I want to learn and experience the ER, and my hospital is literally barring me from being there due to this doctor's refusal to take students and also not allowing me to work whenever the NP is there.

When I talked to the head of my hubsite, I received very patronizing responses like "This is just how medicine works, not everyone will be nice, you have to be ready for anything", etc. "Won't it be nice to have all these days off?", "You just have to get used to things like this in medicine". I was like, no.... I want to work in the ER.  I am paying over 100k in tuition and it is a program requirement for you, as a hubsite, to allow me to obtain the hours I need to graduate. She said, "do you even WANT to work with this guy after this?"  And I said, "Yes, I will work with anyone.  I have no issue.  But I am not being allowed to".  The icing on the cake is she slid the evaluation form in front of me and basically said "don't worry. You need X amount of hours and I will be the one signing off on it" (implying she will falsify my hours).  Also, this doctor was hired 2 months ago and apparently nobody made him aware that students would be around once in a while, and the ball was just dropped on every front even though this rotation has been confirmed for me for 12 months at this point.  Terrible management and communication all around led to this situation.

I just can not believe this.  The rest of my program has been wonderful and it has all fallen apart at the ER rotation because of the rural nature, travel doctors and no communications that a student needs to do an ER rotation.  I know it's only 5 weeks, but it is my last rotation and I feel so embarrassed, humiliated and angry on what happened here.  I also feel so defeated that I am already 1 week in, and literally have worked 0 days this entire week due to THEM telling me I can't come essentially on any day this week so I am just sitting around when I should be in the ER.  What I came to PA school for.

Yes, I am talking to my program but I feel like it's too late to remedy my situation and I only hope this hubsite gets reprimanded or something is changed for the next 4 students about to come next month.  

Do you guys have any thoughts?

[Mayamom]

Have you reached out to the nurse manager who approved this?  Can you do something else for your last rotation to be sure you graduate on schedule.    You may have to pursue the ER position in the future.  I would try to concentrate on finishing your rotations and graduating. 

[EMEDPA]

Your program is at fault here. They owe you a rotation in EM. They should switch you to another site ASAP and not penalize you. They should also remove that site from their list. An a new grad NP working solo at a rural dept.....bad idea....

[aquafresh11]

My general surgery rotation when I was in school was at a rural CAH. My first day the surgeon who was past retirement age was pissed when he found out there was a PA student. He spent my entire first day complaining to the OR nurses in front of me that if the hospital thinks he is going to give his time to train a non doctor they have another thing coming. I sat on a stool in the corner of the OR the entire day, couldn't even see anything but the blue surgical sheet. At the end of the day he told me not to come back. I spoke to the clinic manager who said give them a day and they will figure it out. They essentially came down on him and made him take me. I spent the entire month standing in the corner of office consults, and sitting on the stool in the corner of the OR. On my second to last day he let me do the one and only thing to participate in care, hold a guys butt cheeks open as he banded some hemorrhoids in clinic. At the end of my rotation I did the polite thing and thanked him for contributing to my education, he then lectured me how healthcare should only be left to physicians, and hoped I didn't kill too many people in my career. My program apologized, said they wouldn't send any other students, but if I wanted to redo the rotation it would postpone my graduation. Sometimes you take it on the chin and move on. 

[EMEDPA]

fortunately, most physicians who feel that way have died or retired. Very few of the current generation are a$$clowns to that extent. 

[TeddyRucpin]

On 4/8/2023 at 1:41 PM, aquafresh11 said:

My general surgery rotation when I was in school was at a rural CAH. My first day the surgeon who was past retirement age was pissed when he found out there was a PA student. He spent my entire first day complaining to the OR nurses in front of me that if the hospital thinks he is going to give his time to train a non doctor they have another thing coming. I sat on a stool in the corner of the OR the entire day, couldn't even see anything but the blue surgical sheet. At the end of the day he told me not to come back. I spoke to the clinic manager who said give them a day and they will figure it out. They essentially came down on him and made him take me. I spent the entire month standing in the corner of office consults, and sitting on the stool in the corner of the OR. On my second to last day he let me do the one and only thing to participate in care, hold a guys butt cheeks open as he banded some hemorrhoids in clinic. At the end of my rotation I did the polite thing and thanked him for contributing to my education, he then lectured me how healthcare should only be left to physicians, and hoped I didn't kill too many people in my career. My program apologized, said they wouldn't send any other students, but if I wanted to redo the rotation it would postpone my graduation. Sometimes you take it on the chin and move on. 

The school should have switched you off after day 1. This isn't taking it on the chin; this is legit bodily destruction. This was painful to read.

[TeddyRucpin]

On 4/5/2023 at 12:44 AM, Past2023 said:

Hello, I am a few months from graduating and in my final rotation, which I have been looking forward to the whole time- ER.

To pretense this, I have been placed at a very rural site in a town of less than 10k people very isolated from any other towns for my entire clinical year.  So, the ER is only staffed by 1 provider in each 24 hour shift, and frequently that provider will be working 96 hours that week.

I got my hours approved a few weeks ago by the ER nurse manager, and then I showed up to my first day.

The ER doctor, after I introduced myself, looked at me incredulously, and went on a tirade in front of the entire ED staff how he is shocked a student is there, that he never agreed to take on students and he never would unless he was paid. He repeated this over and over.  He then ignored me and said "you can just work with the NP when he's here.  You will be more doing what they do, anyway (even though I was explicitly told by my program I can not work with the new NP and worked my whole schedule around that with the ER manager). He sent me home and forbade me from coming back on any shift he is working (which is 15 of the days in 1 month).

To clarify about the NP situation, I was told I was not allowed to work the days they were working, which already severely limited my schedule before this snub from the doctor.  This was because they were a new grad that was just hired and not ready to take on a student.  Fair enough, but apparently this doctor does not care.

Therefore, I will be lucky to achieve even 20 something hours working ANY possible shift (day night weekend, whatever) with these limitations, and I really would like to work 60 because I want to learn and experience the ER, and my hospital is literally barring me from being there due to this doctor's refusal to take students and also not allowing me to work whenever the NP is there.

When I talked to the head of my hubsite, I received very patronizing responses like "This is just how medicine works, not everyone will be nice, you have to be ready for anything", etc. "Won't it be nice to have all these days off?", "You just have to get used to things like this in medicine". I was like, no.... I want to work in the ER.  I am paying over 100k in tuition and it is a program requirement for you, as a hubsite, to allow me to obtain the hours I need to graduate. She said, "do you even WANT to work with this guy after this?"  And I said, "Yes, I will work with anyone.  I have no issue.  But I am not being allowed to".  The icing on the cake is she slid the evaluation form in front of me and basically said "don't worry. You need X amount of hours and I will be the one signing off on it" (implying she will falsify my hours).  Also, this doctor was hired 2 months ago and apparently nobody made him aware that students would be around once in a while, and the ball was just dropped on every front even though this rotation has been confirmed for me for 12 months at this point.  Terrible management and communication all around led to this situation.

I just can not believe this.  The rest of my program has been wonderful and it has all fallen apart at the ER rotation because of the rural nature, travel doctors and no communications that a student needs to do an ER rotation.  I know it's only 5 weeks, but it is my last rotation and I feel so embarrassed, humiliated and angry on what happened here.  I also feel so defeated that I am already 1 week in, and literally have worked 0 days this entire week due to THEM telling me I can't come essentially on any day this week so I am just sitting around when I should be in the ER.  What I came to PA school for.

Yes, I am talking to my program but I feel like it's too late to remedy my situation and I only hope this hubsite gets reprimanded or something is changed for the next 4 students about to come next month.  

Do you guys have any thoughts?

This is one of the negatives of being at non-teaching facilities. This sounds like a good environment to work in the future when one has a residency, experience, etc. However, it sounds like a poor place to train.

The big advantage of any teaching hospital, small or large, is they are used to students. It is expected that if you work there, you're going to be teaching. Some seek out this environment specifically because they want to be involved with students/residents. 

Make them get you a new ER rotation!!! Your program should have minimum clinical hours per week/rotation. If you stick with this, you are definitely not going to meet them. Also, you're spending a lot of money for an extended vacation/watered down experience.

[rev ronin]

5 hours ago, TeddyRucpin said:

The school should have switched you off after day 1. This isn't taking it on the chin; this is legit bodily destruction. This was painful to read.

And quickly moved the OP to one of the copious back-up ED rotations that every program has sitting around on their shelves, unused?

It's the last rotation, so everything else has already been done. Not a whole lot of wiggle room for the program, so I understand why they may not be able to do what we all would hope they could accomplish.

[TeddyRucpin]

On 4/9/2023 at 8:39 PM, rev ronin said:

And quickly moved the OP to one of the copious back-up ED rotations that every program has sitting around on their shelves, unused?

It's the last rotation, so everything else has already been done. Not a whole lot of wiggle room for the program, so I understand why they may not be able to do what we all would hope they could accomplish.

Some programs are better than others with having alternative options. Some are barely functioning to begin with. Yet, the excuses by the school itself seem sketchy especially when we do have mandated clinical hour requirements by ARC-PA. 

Edited April 14, 2023 by TeddyRucpin