A surgical resident is suing St. Louis University, its surgical residency program director, and its trauma service chief for what she claims is an unjustified decision requiring her to repeat her fourth year of training.

The St. Louis Post-Dispatch article about this has a link to a 42-page PDF describing the details of the suit. Because I suspect you won't read that PDF and maybe not even the article, I will give you some highlights. Remember, these are allegations that have not been adjudicated.

Because of poor scores on the American Board of Surgery In-Service Training Examination (ABSITE), she had been placed on academic probation at the end of her third year of training even though other residents with poor scores were not subjected to the same disciplinary action. At that time, she was not provided a faculty advisor as mandated by university policy.

During her fourth year of residency, written evaluations by faculty were generally very good, but some oral feedback she received was negative. However, she received no specific recommendations for improving her performance. In fact, she contends that attendings on some services filed no written evaluations at all which is contrary to the regulations of the Accreditation Council for Graduate Medical Education -- the national organization that oversees all residency training in the United States. She says some backdated written evaluations appeared in her file.

The surgery department's Clinical Competency Committee met and disregarded all of the written evaluations previously submitted for this resident. Instead they relied on hearsay and a "consensus letter" supposedly endorsed by all of the trauma service attending staff but later repudiated by several of them.

The resident, a nurse before attending medical school, was told she acted too much like a nurse by the residency program director, who is a woman, and the male trauma chief said she was "too nice" to be a surgeon. Too nice to be a surgeon? That's a serious accusation. We can't have that.

The resident appealed the program's decision to the hierarchy of the medical school to no avail.

Having been a residency program director for many years, I know there are two sides to every story, and so far we've heard only one.

However if the program is to prevail in this suit, the resident's dossier needs to be much more robust than what her allegations describe.

Meanwhile the Post-Dispatch reported that St. Louis University has sued the resident and her husband for "diluting SLU's brand by using the institution's trademarked name on a website the pair created." The school is demanding that all references to it be removed from the site and the domain be transferred to the school.

The website, called the SLU Compliance Project, was started by the couple to publicize the resident's allegations and to give others with complaints a platform. Apparently as a result of the university's suit, the website's look has already been altered and may be moving to another domain name.

In March 2017, the Liaison Committee on Medical Education put the school on probation because of "about 20 action items identified as noncompliant during a recent reaccreditation process." As of that time, it was the only medical school in the country on probation.

The failure to quietly resolve these issues is unfortunate for both sides. I don't know how this will turn out, but one thing is certain. Some lawyers in St. Louis will be busy.

"Skeptical Scalpel" is a surgeon who blogs at his self-titled site, Skeptical Scalpel. This post appeared on Physician's Weekly.