Resident Physician - harassment/hostile work environment - will appreciate inputs

I am a resident physician in a prominent university program. Over the past year, I have been facing an increasingly hostile work environment and will appreciate any suggestions or advice anyone can provide. Attempting to provide a summary of my situation below:

Q4, 2007: Had a verbal disagreement with a senior attending over work related practices and their individual preferences that could compromise patient safety - attending misrepresented these as issues on my part and exaggerated them as part of my day's performance evaluation

My other performance evaluations had been mostly positive (91-92% positive; 8-9% - neutral or suggesting some areas for improvement but not negative)

Less than a month after the above incident, based on the attending's evaluation (incl. things that were misrepresented and exaggerated), I was placed on probation. The mandated process of providing feedback, warnings and other opportunities for improvement was not followed - I was directly placed on probation.

Anytime I tried to document the wrong-doing on part of the program and/or talk to others, I was indirectly threatened with consequences - I still need to complete the residency, finish my boards, get positive recommendations from them in order to get a job, get a license, etc.

I worked extra hard at overcoming even the slightest of areas that needed attention - and my evals over the next 4-6 months improved even further. However, while appreciating the improvement in my performance, my director informed me that it would be necessary for me to spend an extra 6 months on the program. This was informal - not written. Upon questioning it and bringing it to the attention of a higher-up who promised to look into the matter, the 6 month extension of residency was taken off (nothing written again, since the extension itself had been communicated verbally).

As part of my rotations, I was assigned to work for 4 weeks with a team that was led by the same attending I had an issue in Q4 2007. While this attending did not confront or do anything directly, they made sure that the team intimidated me at every turn and made my job very difficult. In addition, one of them communicated feedback to me on my performance in a manner that was extremely unprofessional and bordered on abusive. Most of the issues they raised were extremely non-specific and subjective without referring to any particular actions or performance from my side. Based on this, I was taken off this posting at the end of 3 weeks - this has now (very recently, after more than 3 months) been documented as being expelled from the rotation.

I raised concerns over this experience with my director and his higher-up who promised to look into the situation but did not do anything or provide feedback on any actions they had instituted. Now, they have indicated that it is customary and expected of physicians to work in a hostile environment and that they 'believe' there was no malice intended in anything that happened.

Throughout this time, I have had experiences of other attendings being wrongly communicated about problems with my performance. Some of them have been supportive, while others have attempted to intimidate me by bringing these up at work in the presence of my fellow residents, patients, as well as other staff.

Now, I have been handed a letter that refers me to another department in the university to help address my issues - without specifically stating what the issues are in the first place. I have come to realize from research and interactions with others that this department does not do anything constructive. They work with the program to identify/ document subjective areas (things such as anxiety, depression, psychological issues that cannot be conclusively proven or ruled out) and build a case that is favorable for the program.

My apprehension is that they will misrepresent or inaccurately document things to build a case. However, they have made working with this department as a condition of my employment - I am not sure if there is a way to overcome this condition or limit its impact. Can I have someone else join me for the discussions or audio/video record the discussions? I have also noticed that if I bring up anything by way of issues in how I am being treated (even verbal), the typical response is a combination of:

a. Inaction on part of the department

b. A couple of false/fabricated subjective performance evaluations being added to my record. While the evaluations entered are confidential (I cannot see the source), it is anybody's guess as to how these mysteriously show up each time I bring up something.

My goal is to successfully complete the residency in a dignified manner. And I am happy to disregard these issues but am finding it increasingly difficult given the program's actions. I will appreciate any advice or suggestions anyone can provide.

PS: I did not indicate this earlier but I am not a native American, am colored, and to make it a trio – I am considered to be the 'wrong sex' for my physician specialty!

You could ask that it be recorded or that legal counsel be involved given the high stakes at this point. You could threaten legal action if they will not compromise on that point.

Document, document, document. Keep a journal and record any and all activities or verbal confrontations or remarks. A dated journal is admissable in court and always document and write letters to your superiors of any untoward conversations and events. Once a paer trail is created, the superiors will realize that your are not to to tolerate bad behavior, abuse or retaliation. They are trying to treat you so that you will resign and they look good. I am a CRNA who has one attending that is very verbally abusive. I have documented these things in the past and three years agohe had to eat crow and apologize. He remained quiet until now and I am starting again. Make sure you have witnesses to the situations and document their names. You can also buy a small tape recorder that will fit in your pocket and record the conversations. You have to defend yourself or nobody else will. Believe me, trying to pacify these bullies do not work, you have to expose their behavior in a proper fashion. They will fear what you will do with the information. Never issue a threat, your behavior will speak for itself. Good luck!