The culture of impunity for senior staff at hospitals affiliated with McGill is putting patients at risk, according to Dr. Alexander Nataros, a first-year family medicine resident at Saint Mary’s hospital.
In November 2012, Nataros, who is currently on a forced paid leave of absence, received a patient after senior doctors made what he said were “significant life-threatening medical errors.” Nataros, who says he rectified these errors, and thereby saved the patient’s life, is now under fire for questioning his supervisors’ actions.
“As the junior doctor receiving the crashing patient, I acted as needed […] The tertiary hospital which received this patient on transfer recognized the corrective actions I took, as well as the senior doctors’ significant errors that threatened this patient’s life,” Nataros wrote to The Daily by email.
As a medical resident, Nataros, who received his medical degree from McGill in 2012, must work under the supervision of a fully licensed doctor at the hospital he works at. However, Nataros and other residents have experienced humiliation when asking questions of their supervisors, enough that this discourages open communication. This is detrimental pedagogically and negatively affects patient care.
“It’s a shame because there is definitely a culture that discourages medical students and residents from questioning or disagreeing with the decisions of their supervisors. Someone in a position of power can so easily shame and embarrass you if they feel their authority challenged due to the breadth of information in the medical field. It’s the exception to the rule, but it doesn’t take long to become socialized into the fear, and unfortunately there are no really valid avenues to go about removing these individuals from teaching,” another family medicine resident at McGill, who wished to remain anonymous, told The Daily by email.
McGill is not alone in having allegations against them that they treat their medical residents, who are the first point of contact for most patients that come through the hospital, as subordinates.
“Medical education,” wrote Dr. Pauline Chen in the New York Times in February, “[is] a process often likened to military and religious training, with elder patriarchs imposing the hair shirt of shame on acolytes unable to incorporate a profession’s accepted values and behaviours.”
Nataros, who says that his life is devoted to treating his patients, was put on academic probation in January by Dean of Postgraduate Medical Education Dr. Sarkis Meterissian after receiving two negative evaluations from his supervisors. These negative evaluations were based on perceptions that Nataros was argumentative.
However, many doctors who have worked with Nataros wrote to Meterissian saying that they believed that his standing up to authority was for patient safety. The authors of these letters, however, wished to remain anonymous, fearing the effect that publishing them would have on their careers.
The authors of the character references portray Nataros as a doctor who cares deeply for his patients. They cite Nataros’ commitment to social advocacy, including previous work he carried out with institutions such as the Red Cross and his position as Oxfam Canada’s national youth director. One of the references mentions that Nataros is only willing to challenge authority when his patients are threatened.
Nataros believes that senior staff at McGill affiliated hospitals who feel threatened by residents are trying to distract people from their medical errors by launching personal attacks on them.
McGill’s residency program is currently undergoing a periodic accreditation by the Collège des Médecins du Québec (CMQ), which ensures that the hospitals are properly educating residents. Failing accreditation would mean that McGill would be put on probation and need to undergo further reviews.
Nataros, who is vocal about the problems with McGill’s residency program, was told he was not allowed to be at the meeting with the accreditors due to his academic probation, even though other residents were required to be there.
Nataros’ case has been put in front of the CMQ, which grants residents their license. The outcome of this case will determine whether Nataros will be allowed back into his residency program, however, Nataros says he has not yet been given the chance to tell the CMQ his side of the story.
Nataros hopes he can return to Saint Mary’s soon. “I love Saint Mary’s. It’s what the future of medicine looks like – putting primary care first. I just want to be allowed to return to serve my patients,” he told The Daily by phone.
Citing confidentiality concerns, Meterissian declined requests for an interview.