A radiology residency program is like a family. When one person is afflicted academically or professionally, all of its members suffer down the road. Just as important as it is to be aware of and help the struggling radiology resident, it is also important to remember that one struggling resident can have severe repercussions for the remainder of the radiology residency program. It is not just the program director and chairman that reap the consequences of the struggling resident. Often unfairly, the class members take up much of the additional burden. The result be extra call shifts, less time spent on educational rotations, uncomfortable personality conflicts, or spare time spent educating the failing resident. So, I am dedicating this post to the other radiology residents affected by the struggling radiology resident. First, we will explore how other residents can appropriately identify and help the struggling resident and possibly get this person to the program director’s attention. Then we will go through what a resident should and should not do when a resident is academically or professionally struggling. And finally, we will examine how the residency program should commit its resources toward the struggling resident vs. the other radiology residents.
Identification of Struggling Residents by Colleagues
Often, the first residency program members to notice that a resident is struggling are not the program director, chairman, or attendings. Instead, it may be the struggling resident’s colleagues. Fellow residents are more likely to interact with struggling residents socially in a more comfortable setting. Here, the struggling resident is more likely to discuss his/her issues. This interaction is an opportunity to learn more about your classmates’ feelings about residency. They may even ask for your help. My advice is to give your classmate whatever assistance is reasonable so they can perform well. Residency is not a competition; it is a team environment. In addition, the help you give your fellow struggling resident will return to you many times. Whether you decide to teach your colleague or help them out with other residency issues, you will find that you will learn more about your material and yourself. Even better, you may be able to stem a progressive downward spiral to probation. Or, even better, prevent your classmates from suffering more dire consequences.
How To Identify The Resident
Sometimes the identification of the struggling resident is a bit more subtle than a simple comment about their struggles. Unlike an attending that sees a resident on a noon conference or a single day, you, as a fellow resident, may notice a pattern of taking cases and missing all the findings each time or multiple absences not recorded by the program. Or you may see bad habits such as drinking too much, something a little bit off, or a strange affect. These signs can be essential sentinel events. And you may want to address the issue with your program faculty to ensure the struggling resident gets the help they need.
In the end, it pays to identify the struggling resident. Remember, it often affects not just that resident but the entire program.
How Can The Residents Help With The Academically Struggling Resident?
The program directors, attendings, and chairman are primarily responsible for handling the academically struggling radiology residents. But, for the struggling resident’s rehabilitation to succeed, the program often needs to have the participation of all. The role of the other residents can be the key to the stability of the program through this trying time as well as increasing the likelihood that the struggling resident will eventually succeed.
Before any remediation, it is critical to determine if the struggling resident is willing to accept the help of the other program members. So, the role of the other residents can only begin when the struggling resident asks for help from their colleagues. You certainly cannot force a struggling resident to participate in remediation efforts if the struggling resident is unwilling or able.
Interventions To Help Academically
If you remember the previous article- The Struggling Radiology Resident, we discussed how the academically struggling radiology resident might have difficulty coping with the quantity or quality of their work. So, I will briefly review how the other residents should attend to these issues.
What should their colleagues do for a struggling resident who cannot schedule an appropriate time for studying? This dilemma becomes a time management issue. It would be fair to help the struggling resident to create a schedule for themselves. Sometimes it helps to sit down with the struggling resident and show them how you schedule your study time and what you have been reading on each rotation.
For a struggling resident with difficulty with the quality of study time, it would make sense to have group study time and present cases to one another to improve their presentation when reviewing studies. Or, it may be a good idea to go over questions with all the residents to practice testing skills. These processes help the struggling resident and may be good practice for the team.
How Can The Residents Help With The Professionally Struggling Resident?
Regarding a professionally struggling resident, fellow residents must be more careful with assisting in interventions. The intervention will depend on the primary cause of professionalism problems.
The Absent Resident
For the resident that is often absent, it may be possible to address this issue by asking the resident where they have been or why they have not been around in a non-confrontational manner. Sometimes the struggling resident may not be aware of the burden they are placing on the other residents. This interaction may make this resident aware of the issues he is causing and take responsibility for his actions. Again, if this does not work, bringing the matter to the program’s attention may just be as essential.
The Personality Dilemma
You must be more careful with the resident with personality issues, whether an abusive or unengaged resident. If you are friendly with this resident, it may pay to find out the cause of the behavior. But be careful not to be overly intrusive, as getting involved much further may be inappropriate. Indeed, if the struggling resident is amenable to helpful suggestions for conflict resolution within the residency, talk to this person about some of these issues in an appropriate setting. Or, it may be relevant to suggest this resident seek professional help if the resident is amenable.
In many programs, some struggling residents will experience psychiatric issues just like the general population. Or, they may get involved with alcohol or illicit drug use. These situations can be extremely touchy. Many of these residents may not have insight into their problems. And, they are likelier to refuse help from colleagues or attendings. Of course, a few may have an understanding. But, if you notice a struggling resident with one of these issues, it is usually best to bring the issue to the attention of the program director or chairperson of the department so that they can get the resident into the appropriate channels for treatment. Of course, there are exceptions to every rule. And occasionally, the struggling resident’s colleagues may have intimate knowledge of the resident. Therefore, they may be more likely to be able to get the resident appropriate help. But, be careful in this situation because there can occasionally be unforeseen legal and professional ramifications to the caring colleague. A resident without insight into their problems may see this helpful resident as antagonistic and can theoretically pursue these channels.
How to Commit the Program’s Resources
Over my tenure as associate residency director, I have learned that dealing with struggling radiology residents’ issues can drain a program’s administration and resources. The time you usually spend toward improving the residency program instead needs to be placed on the problems of the one resident. Especially in smaller programs with less faculty and monetary resources, the extra time can overwhelm the program directors, chairperson, and heads of Graduate Medical Education. While the struggling resident must get the necessary help and remediation, we have to remember that other residents also need to have a functional residency program. It is easy to forget about the other residents in this process. So, it is the residency director and chairman’s role to place additional efforts to concentrate on not just the struggling resident but the other residents at these times and to ensure the residency program continues running smoothly.
Back To The Other Residents
Every program, at one time or another, will have struggling radiology residents. And fellow resident colleagues need to help out, if possible, with identifying and remedying the struggling resident. But, the other residents often suffer the most from the consequences of a struggling resident’s actions. And the residents can be hurt by the administration’s choices to help the struggling resident. So, everyone involved needs to make a concerted effort not to forget about the struggling resident’s colleagues. Or else, these residents can truly become the “other struggling residents.”
