Taking an idea from the NFL, residency and medical directors across the country are newly empowered by a recent rule change that will allow them to keep their best talent in-house after they graduate from residency. Starting this July 1, residencies will now be allowed to apply a “franchise tag” to one resident per year upon their graduation which will compel them to remain at their teaching hospital for one more year as an upper level resident.
The idea will be similar to the NFL‘s version of the tag where they may target one key player of theirs about to enter the unrestricted free agent market and “tag them” so they are forced to stay with their team instead of seeking employment elsewhere. Their salary will in turn be guaranteed to equal the average of the top 5 salary earners at that institution who have a similar level of experience as the target resident.
“This new system will ensure that residency training programs get a fair shake in keeping their own talent,” commented ACGME president Dr. Rudyard Alexander, “Too many times we have put incredible effort into training our residents only to see them leave when they are done. This new system will reward residencies for developing high quality physicians and serve to maintain that talent pool for the future.”
Residents, predictably, are up in arms about the proposal. They have expressed their concerns that if they have plans to go to fellowship, move elsewhere for family or professional reasons, or genuinely don’t want to stay, then they are essentially forced into staying where they trained without recourse.
“I have always had a dream of going into toxicology,” stated one despondent graduating Emergency Medicine (EM) chief resident, “I was accepted at my dream fellowship last month in San Francisco, California, where my wife’s family resides. Yesterday, I learned that my residency director here in Chicago ‘franchised me’ thus forcing me to remain here for at least one more year. I could not be more upset.”
To this, Dr. Alexander changed tone and responded in a surprisingly evil and cackling fashion: “Residents are trainees, not employees of our organization. We can do whatever we want! If they have a problem, they should direct their concerns to that brick wall over there. HA HA HA!”
Residents looking to get around the new rules have started trying to perform a “tank job” in residency to avoid being the most likely to be tagged. One EM resident, who requested anonymity, stated, “The key is not to be the best. You want to hit that sweet spot where you are well-liked but not highly sought after. I always make sure I leave a few minutes early from my shifts and do just a little less patient care than is required. That means less pain meds, a few misplaced stitches here and there, and a little bit of abrasiveness with my consultants I found can really go a long way. Good thing too….my attendings think I’m smart and capable, but just ‘not their type.’”