Article~Medical Resident With Asperger's Not Qualified for Job, 6th Cir. Rules

[Guest guest]

Thanks for this educative post about the process! Very interesting. I think this article doesn't not specify however how far along the process this man is... it just says he's a medical resident... or am I missing something? What does medical resident mean exactly? Jennie

Re: Article~Medical Resident With Asperger’s Not Qualified for Job, 6th Cir. Rules

Yes Aspie's can be so Aspie that they can't communicate, but those Aspies do not get into and through medical school.But I agree with Liz's last statement. As an Aspie doctor who has also trained Aspie doctors--this guy did not make it through college, the medical school interview process, classes where he had to give oral reports and get history and physicals on simulated patients, rotations where he had to practice history and physicals on real patients and interact with them, office and hospital staff and attending physicians and the residency interview process, all of which are done in competitive, high pressure communication formats, and get to residency only to suddenly develop communication problems. If he is so bad at communicating, how did he pass all that?In the interview processes, there are lengthy meetings with people firing skills and feelings questions at you. They are not just probing for what you know, they are also probing for who you are and what you are like. They know these are high stakes. They can turn you down for personality or "I just don't think he would be a good candidate" as easily as poor grades and test scores. And all of a sudden, 9 or more years into this process someone notices for the first time he doesn't communicate well????? Uh-uh.At our school, he would have been up before the Professionalism committee as well as Student Promotion Committee in his first year if there was that much of a problem. There would have been a paper trail of problems before residency, assuming he had gotten in at all. Something is fishy or we are not getting the whole story. How about a behavior coach? A communication coach?We have had ADHD, dyslexic, Bipolar, Aspie and Tourettes students. We have had blind and deaf students (how do you read lips through a surgical mask?), students who had rods and fused backs and joints, students who were four and a half feet tall. I went to school with a guy in a wheelchair. I went to school 20 years ago with a guy in a wheelchair. And this place couldn't think of something?Yes I know the burden is on him, but as the mom of an older Aspie, there just aren't that many people who know what to do with adults. The kid communication accomodations are not well known to the older crowd unless they have kids of their own.BTW one of my most obvious Aspie students is a Lieutenant Physician in the Army Medical Corps, and they featured him on a vid treating Vietnamese patients--and talking on camera., who thinks there is more going on.> Interesting story.>> I feel I need more information on this case before I can have an > opinion. First, how Aspie is the resident? Someone with mild AS, who > has learned the basics (but not necessarily the fine points) of > social communication would make a fine doctor, especially a hospital- > based specialist. [After all, how much do patients talk to their > anesthesiologist, anyway?]>> I've met lots of doctors with poor bedside manner, including my > obstetrician, who gave off the vibes of an axe murderer, but was the > best, kindest man you'd know. Surgeons are notorious for having > Aspie-like communication patterns -- cold, logical, and very, very > precise. Pathologists tend to work in near isolation. I'm sure many > doctors are Aspie.>> However, there is a point where the AS is severe enough to interfere > with *all* communication, and if the resident is at that place, he > probably isn't fit to practice medicine. But if this is the case, > how on Earth did he get through med school and his internship?>> --Liz>> On Dec 17, 201>>>>

[Guest guest]

Jennie

Yes there is a way to figure out how far along he is.

The process is college, MCAT (medical college admissions test), med

school application, interview, 2 years of medical school in the

classroom, 2 years of medical school on various rotations in clinics,

hospitals and offices, more testing, audition rotation, interview,

then acceptance to a residency of 3 to 7 years, then practice.

A medical resident is someone who has graduated medical school, and

has an MD or DO. He is no longer a student, he is a doctor with a

license, albeit limited and in an apprenticeship. 25 years ago, they

were not even necessary--you could hang your shingle and practice

without one.

The next step used to be intern, then resident, but in most programs

now the internship year has been subsumed as the first residency

year. They are called PGY (post graduate year) 1, 2 or 3

respectively. He is anywhere from one to three years out of medical

school. He could moonlight in some emergency room or nursing home and

practice without supervision. I make the assumption if he is that

dysfunctional, he is in his first year of residency or the problem

would have come up earlier. It would be difficult to explain how he

went through one or two years of residency to have a problem in his

third year. If he is not so brilliant that he had an accelerated

college career, counting college(4 years) and medical school (4 years)

he is therefore in his 9th year from the start of college (Family

practice residencies are 3 years long, other specialties have longer

residencies.)

So this guy went through the process I described. In fact, for any

competitive residency program, you have to do an audition rotation

(usually a month long) at the facility as a student, working closely

with doctors, nurses, therapists, residents, other students and

patients in order to get a residency spot.

Imagine being in college, wanting to do an apprenticeship with someone

in your field, and you have to do a month long, volunteer " show 'em

what I've got " audition, then a competitive interview process. They

want us to believe in that time period they didn't notice any problems?

Even if he did not do a rotation at that hospital, as a student he did

rotations at some hospital, as well as two years worth of rotations in

Peds, OB, surgery, internal medicine, psychiatry, emergency medicine,

etc at somebody's hospital and offices.

On these rotations, he would have been going into exam rooms, ER

cubicles, OR's, delivery rooms, ICU's and hospital rooms. He would

have been talking to lab techs, radiologists, dieticians, physical

therapists, social workers, respiratory therapists, counsellors and

nurses as well as patients. All this before he graduated and got that

residency.

The nice thing about being a medical student is they send you into the

room to get the information from the patient, because you have more

time than the rest of the medical staff. A medical student can take

2-3 hours sitting in the room taking a history, going back 3

generations of family history, getting social history, employment

history, and all those details of doing it right that get shortcut

later when they graduate. And when the attending leaves the room, the

patient and family often try to use the medical student to clarify

what the fast moving doc in charge said. This guy had PLENTY of

patient contact in school during those rotations. His preceptors

wrote evaluations for each one, a total of 23 evaluations of patient

interaction (One month of vacation). The residency program would have

had those as they made their decision. They accepted him anyway.

[Guest guest]

Wow... very interesting and you are right... something isn't making sense. Jennie

Re: Article~Medical Resident With Asperger's Not Qualified for Job, 6th Cir. Rules

JennieYes there is a way to figure out how far along he is.The process is college, MCAT (medical college admissions test), med school application, interview, 2 years of medical school in the classroom, 2 years of medical school on various rotations in clinics, hospitals and offices, more testing, audition rotation, interview, then acceptance to a residency of 3 to 7 years, then practice.A medical resident is someone who has graduated medical school, and has an MD or DO. He is no longer a student, he is a doctor with a license, albeit limited and in an apprenticeship. 25 years ago, they were not even necessary--you could hang your shingle and practice without one.The next step used to be intern, then resident, but in most programs now the internship year has been subsumed as the first residency year. They are called PGY (post graduate year) 1, 2 or 3 respectively. He is anywhere from one to three years out of medical school. He could moonlight in some emergency room or nursing home and practice without supervision. I make the assumption if he is that dysfunctional, he is in his first year of residency or the problem would have come up earlier. It would be difficult to explain how he went through one or two years of residency to have a problem in his third year. If he is not so brilliant that he had an accelerated college career, counting college(4 years) and medical school (4 years) he is therefore in his 9th year from the start of college (Family practice residencies are 3 years long, other specialties have longer residencies.)So this guy went through the process I described. In fact, for any competitive residency program, you have to do an audition rotation (usually a month long) at the facility as a student, working closely with doctors, nurses, therapists, residents, other students and patients in order to get a residency spot.Imagine being in college, wanting to do an apprenticeship with someone in your field, and you have to do a month long, volunteer "show 'em what I've got" audition, then a competitive interview process. They want us to believe in that time period they didn't notice any problems?Even if he did not do a rotation at that hospital, as a student he did rotations at some hospital, as well as two years worth of rotations in Peds, OB, surgery, internal medicine, psychiatry, emergency medicine, etc at somebody's hospital and offices.On these rotations, he would have been going into exam rooms, ER cubicles, OR's, delivery rooms, ICU's and hospital rooms. He would have been talking to lab techs, radiologists, dieticians, physical therapists, social workers, respiratory therapists, counsellors and nurses as well as patients. All this before he graduated and got that residency.The nice thing about being a medical student is they send you into the room to get the information from the patient, because you have more time than the rest of the medical staff. A medical student can take 2-3 hours sitting in the room taking a history, going back 3 generations of family history, getting social history, employment history, and all those details of doing it right that get shortcut later when they graduate. And when the attending leaves the room, the patient and family often try to use the medical student to clarify what the fast moving doc in charge said. This guy had PLENTY of patient contact in school during those rotations. His preceptors wrote evaluations for each one, a total of 23 evaluations of patient interaction (One month of vacation). The residency program would have had those as they made their decision. They accepted him anyway.

[Guest guest]

Greetings:

Just adding this to the discussion: I would agree there is more in his file that might make this decision just or not?

One case in point: Board of Curators of the University of Missouri v. Horowittz. (1978), the United States Supreme Court considered a case brought by a student who had been dismissed from medical school, in spite of the fact she had excellent grades. The decision to dismiss the student was based on the faculty's determination that she was deficient in clinical performance and interpersonal relationship skills. Prior to the dismissal, on several occasions, the faculty expressed dissatisfaction with the student’s clinical work and informed her that she faced dismissal if she did not exhibit clear improvement. The student continued to receive unsatisfactory evaluations of her clinical work. Prior to the student’s dismissal from medical school, she was evaluated by seven independent physicians in the community, all of whom agreed with the medical school professors that her clinical skills were unsatisfactory.

After being dropped from the program, the student filed a lawsuit claiming that her dismissal from medical school violated her constitutional rights. In reviewing the case, the Supreme Court considered that the student had been informed by the faculty's dissatisfaction with her clinical performance, and the student knew that unless she made significant improvement in this area, she would be dismissed from the program. The Court held that the decision to dismiss the student from medical school was based on careful and deliberate evaluation by the faculty, and thus the student's dismissal was not a violation of her constitutional rights.

In Shueffer v. Trustees of California State University and Colleges (1977), a California court addressed a complaint similar to that of a medical student described previously. The student plaintiff was enrolled in a master’s program in counseling. The faculty determined that Shuffer's work in a practicum program was unsatisfactory, and she was required to take a second practicum. The court held that a faculty may require students to complete special requirements as long as the requirements are not arbitrary.

Other students have sued with different results in their favor. The law is not always black and white.

What do U think?

Have a great week end.