'Whistleblowers' Say Medical Residency Discriminates When Illness Strikes

John Watson

Disclosures

October 26, 2016

In This Article

Cracks in the Foundation

In the popular imagination, medical residency is less a training program than a rite of passage. Those who successfully navigate this process are crowned physicians, with the ability to make life-and-death decisions. Those who don't succumb to the necessary culling process that ensures optimal patient care. The system, the theory goes, is a merciless but impartial judge.

Recently, stories have come to light that challenge this egalitarian notion. Some residents claim that they have been forced out of programs, not because of any deficiencies in their abilities or knowledge base, but rather because they experienced serious physical illnesses that required accommodation. Collectively, their stories paint a picture of an educational system that at best has serious flaws, and at worst is punitive and discriminatory.

Claims of Discrimination

At the heart of this emerging story are three residents from different programs with separate areas of clinical training. Because their cases are currently in various stages of litigation, the programs from which they say they were dismissed are notably constrained in their ability to respond. These allegations, although all different and all disputed by the universities, come at a time when the rights and working conditions of residents—established more than 125 years ago—are being vigorously debated in the medical community.

The first case to appear in the press—as an article in the May 14 issue of the New York Post —was that of Svetlana Kleyman, MD. Dr Kleyman was a fourth-year surgical resident at the State University of New York (SUNY) Downstate Medical Center in Brooklyn when, during a trip home to Indiana, she began to experience symptoms eventually diagnosed as a spinal infection. After extensive rehabilitation, Dr Kleyman received medical clearance to return to work and attempted to restart her residency. However, in her lawsuit, she alleges that the university was nonresponsive, and eventually informed her they did not have the capacity to take her back. (Citing ongoing legal action, neither Dr Kleyman nor SUNY Downstate chose to participate in this report.)

For Stephanie Waggel, MD, the trouble began when a medical workup in the spring of 2015 uncovered a malignant kidney mass. A year later, Dr Waggel was dismissed from the psychiatric residency program at George Washington (GW) Hospital in Washington, DC.

Figure 1. Stephanie Waggel, MD

According to a lawsuit filed in July, the full details of which were previously reported by Medscape, Dr Waggel alleges "a pattern of discriminatory conduct." The suit states that GW falsely claimed that Dr Waggel missed time and did not respond to calls when it was aware she was attending appointments relevant to her cancer treatment. The lawsuit also claims that Dr Waggel was subject to discriminatory or harassing behavior from her supervisors. Dr Waggel was eventually placed on administrative leave and was subsequently fired.

In response to our communication, Anne Banner, a spokesperson for the GW School of Medicine and Health Sciences, wrote, "We are dedicated to supporting our medical residents suffering from health conditions and have programs in place to assist them. It is important to understand that Dr Waggel's account of her dismissal from the psychiatry residency program reflects only her allegations. The university categorically denies Dr Waggel's allegations, including that her dismissal was improper, but it will not litigate this matter in the media. The university will defend the integrity of our medical education program in the appropriate forum."

Figure 2. Erin Kalan, DO

The most recent case is that of Erin Kalan, DO, who posted the details of her account on a physician and patient advocacy website in September. Dr Kalan, a former resident at the University of Virginia (UVA) Health System, suffers from ataxia, hearing loss, balance issues, and nausea as a result of previous surgeries.

In her lawsuit, Dr Kalan alleges that she sought and was denied the accommodation afforded by the Americans with Disabilities Act (ADA), which would have allowed her to train on an adjusted and elongated schedule. She describes years of what she categorizes as institutional harassment that led to her decision to leave the program.

UVA does not comment on individual cases such as Dr Kalan's. However, a written statement provided to Medscape from Eric Swensen, from the UVA Health System, read in part, "The UVA Health System's Graduate Medical Education Office works closely with any resident who asks for an accommodation because of a disability to enable the resident to continue his or her training. In some instances, we have granted multiple accommodations for an individual resident. UVA has a nondiscrimination policy, and the UVA Health System is in compliance with that policy."

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