SIU School of Medicine has created a hostile work environment for doctors from foreign countries who training to become pediatricians, according to complaints.

Southern Illinois University School of Medicine has created a hostile work environment for young doctors from foreign countries who are going through training to become pediatricians, according to complaints filed by two recent trainees in the school's pediatrics residency program.

The alleged discriminatory practices, outlined in complaints submitted to the Chicago-based Accreditation Council for Graduate Medical Education, put the quality of patient care at risk at St. John's Hospital, where the program is based, according to the complaints by physicians Fereshteh Hajsadeghi and Jyoti Assudani.

“They set me up to fail,” said Hajsadeghi, a native of Iran who resigned from the program in April and had to abandon her dream of becoming a pediatric cardiologist.

She said Tuesday that she moved from Springfield to the Chicago area and will begin a training program in radiology in July at the University of California at Los Angeles.

Assudani, a native of India who will be terminated by the program effective June 26 and still lives in Springfield with her husband, also a physician, said SIU faculty members supervising her publicly belittled her and gave her unfair, subjective and sometimes contradictory evaluations.

“Foreign-born doctors are being treated differently,” she said.

The alleged bad treatment of trainees, known as “residents,” included statements and actions by residency director Dr. Michelle Miner, SIU pediatrics department chairman Dr. Mark Puczynski and by Dr. Karen Broquet, SIU's associate dean for graduate medical education, according to Hajsadeghi and Assudani.

Standards defended

The not-for-profit council has the power to put the residency program on probation or remove its accreditation, effectively shutting the program down, though such sanctions are rare.

ACGME spokeswoman Emily Vasiliou said the council doesn't confirm the existence of complaints. It can take weeks or months for the council to evaluate complaints and make any decisions, she said, adding that those decisions become public only if a program is sanctioned.

Officials from SIU, which sponsors 19 different residency programs, declined to be interviewed for this story. They issued a written statement that said the medical school “maintains a highly ethical educational environment for all its residents. We cannot comment on an individual resident's educational standing. SIU School of Medicine received the maximum allowable accreditation by the ACGME in March 2012, and we will of course comply with any investigation that the ACGME deems appropriate.”

St. John's officials wouldn't answer questions, either, and issued the following statement: “St. John's Hospital sets high standards for the delivery of care to our patients. Our high standards for patient safety and quality are recognized by such organizations as The Joint Commission, Leapfrog and Healthgrades. St. John's is consistently fair in holding our colleagues and physicians to those high standards.”

Residency programs provide specialty training to graduates of medical schools. Though the trainees have medical degrees and are doctors, they can't be licensed or practice independently until they have completed an accredited residency program, Vasiliou said.

The hospitals that employ residents can't qualify for Medicare payments to offset training costs if a residency loses its accreditation, she said.

Cheap labor?

Assudani, 31, who received an annual salary of about $45,000 as a resident, said SIU faculty members ramped up the harassment against her and other trainees after meeting with them in February to discuss a survey in which several residents anonymously expressed dissatisfaction with the program.

“I didn't expect that after this meeting they would retaliate,” she said.

The harassment, Assudani and Hajsadeghi said, is difficult for residents to combat through traditional administrative channels because of bias against foreign-born trainees and because faculty members have the power to sabotage or short-circuit careers of young doctors.

The situation, the women said, leads to overworked and insufficiently educated residents at St. John's, where most training during the three-year residency program takes place.

Both women said pediatrics residents are encouraged to under-report their work hours so SIU won't violate ACGME rules and so St. John's can use the residents as cheap labor, caring for hospitalized babies and children.

Hajsadeghi and Assudani said residents compensate for insufficient staffing levels by St. John's and SIU when it comes to the number of nurses and experienced SIU doctors who are scheduled to work.

“They are using the residents as slaves there,” Hajsadeghi said.

U.S. vs. foreign born

Laurie Leader, an attorney from ITT Chicago-Kent College of Law, is representing the former pediatric residents.

Leader said the residency program “has created an atmosphere of terror that discriminates against residents on the basis of nationality, ethnicity, visa requirements and gender in decisions related to remediation, extension of training, verification of credentials, work schedules and contract renewals.”

Assudani's complaint says residents are “treated poorly, often humiliated publicly in (the) presence of other residents, medical students and frequently in (the) presence of patients and families. Residents' questions are often unwelcome, priority is given to service over education, and attending physicians are unapproachable, unprofessional and difficult to work with. This not only endangers patient safety but also resident well-being.”

Several foreign-born residents still in the program — which serves about 20 trainees at any one time — are fearful of speaking out, the doctors said.

Foreign medical graduates are common in U.S. residency programs, especially in the primary care specialties of internal medicine, where foreign students fill 43 percent of the slots, family medicine (36 percent) and pediatrics (24 percent), according to ACGME data.

U.S.-born doctors often are preferred by residency programs over foreign-born medical graduates. But U.S.-born doctors often gravitate toward residencies that lead to higher-paid specialties such as orthopedic surgery, dermatology, ophthalmology and anesthesiology.

Assudani said she would like to complete a pediatrics residency elsewhere and hopes the complaint results in SIU agreeing not to continue to question her competency in statements to other residency programs.

Hajsadeghi said she filed her complaint to influence SIU officials from this point forward and benefit the foreign-born residents who remain in the pediatrics program.

“I want them to shut down this hell,” she said.

Contact Dean Olsen: dean.olsen@sj-r.com, 788-1543, twitter.com/DeanOlsenSJR.