The problem resident: learning from our mistakes

Every program has its "problem" resident(s). Residents who are academically deficient or who have aggressive styles are well-known to most programs. But, less frequent (or simply less discussed) is the true outlier resident: the resident with a drug or alcohol addiction, the severe personality disorder, the one who is physically and/or verbally aggressive, or one with a criminal history. Our program had the dubious distinction of encountering all of these problems in a single resident. Although we accepted him into the program following a standard reference check, little did we know how little we actually knew about him or his background. This paper is a description of our experience and effort in coping with this stressful situation and is a call for significant change in the whole recruiting process to help reduce or purge graduate medical education of severely dysfunctional trainees.