When Conversations Become Heated

Program Directors are not perfect. They have bad days, too.

As we all know, sometimes people have bad days. They say things without thinking about how what they say may be interpreted by the other person. And we all know how emails and text messages can be misinterpreted.  

As the Executive Director of your union, I’ve had a surprising number of residents contact me regarding conversations where a Program Director has threatened everything from probation of a graduating House Officer to threats about “yanking” a fellowship offer, even telling a resident they aren’t ready for independent practice after a recommendation has already been given and a new job offer accepted.  The list goes on...

Deep breathing and extreme caution are needed when confronted with inappropriate, and hurtful conversations with any authority figure, especially your program director.  It’s unfortunate, but the power dynamic of residency, even with a union, puts you at a disadvantage.

While the HOA doesn’t condone these unprofessional conversations and outbursts from Program Directors or other faculty, they are human and imperfect beings and have their share of bad days. What should you do when confronted with this type of conversation?  

Calmly acknowledge that you heard what has been said, either verbally or with a nod, and do not engage in a back-and-forth.  This tends to deescalate the exchange. If the situation warrants, you might say something like, “You’ve given me a lot to think about, excuse me, but I have a lot of work to do.”  Extricate yourself from the physical location of the conversation as soon as possible.  Of course, if the conversation turns into an investigation where you have every reason to believe that unwarranted discipline will be the result, ask for union representation. You have Weingarten Rights for your protection.

Always, always, send yourself an email (time stamped) with details of the conversation in case you end up needing to defend yourself against unfounded accusations.  Writing down an unfortunate conversation forces one to critically replay the conversation and this can be helpful on many levels.  

At this point, you have a few options. After you’ve slept on the exchange and given it plenty of thought, you can follow up with a very professional email briefly describing the exchange and stating your case. Remember to say how much you appreciate the residency program and every experience you’ve had as a trainee, before the big "BUT." Another option is to simply acknowledge the transgression, express your gratitude for being made aware of the issue, and commit to improving the deficiency if you can.  The third choice would be to ignore the exchange and wait and see whether any repercussions would impact your career goals. 

Navigating a relationship with someone who has power over your future career goals and aspirations is challenging. The HOA staff is available to discuss these types of issues. Your conversations are held in confidence.