There's a woman in my program who's been the subject of rumors all year-- she messed up this, she messed up that, three of her patients died, she missed two days of work without calling in, she tried to write herself a prescription under her resident's name, etc. Every bad thing you can do as a resident, people have said she's done. I've assumed it's all just rumors, and I haven't worked with her directly so I barely even know her.
Today they sent out the e-mail with next year's schedules, and she is on a "research sabbatical" for the fall. So now the rumors are that "research sabbatical" = forced time off, to punish her for any one of a million things she might have done.
And then this afternoon my attending mentioned this intern in passing-- he worked with her a few months ago, and recommended she be removed from the program. So maybe it's not all rumor, maybe some of it is actually true.
But here's the thing-- if there's an intern who really is a danger to patients-- who's harming people, because of incompetence or laziness or whatever-- what good is a "research sabbatical" and then she just comes back in the spring and does it all over again? No hospital wants to fire its interns-- it would be crazy if we went around all day worried we would be fired if we accidentally screwed up. We're supposed to be learning, we're not supposed to know everything, mistakes inevitably happen. But on the other hand, these are real patients we're learning on, and surely there should be consequences for being worse at this than any well-meaning intern ought to be.
And yet I'm not sure there are. I've never heard of an intern getting fired, anywhere-- and I've heard some crazy stories about mistakes people have made over the years. These interns are your doctors, my doctors, everyone's doctors. There are interns in my program I wouldn't want as my own doctor, and there are some who I'd be thrilled to have. I don't know what the line should be for learning vs. incompetent, and when someone should get fired-- but surely there should be some line, right? Not everyone who can get through medical school and pass a bunch of multiple choice tests is cut out to treat actual human beings, are they? Maybe they are. Maybe med school is the hurdle and if you can make it through med school, you're good enough-- but I don't think that's quite right.
I don't know that I have a conclusion-- or a point, at all-- after all, I'm sleepy, and I have three patients screaming that they want to go home even though they're still sick. So what do I know.