Email Series II

From: Farber, Nuri
Sent: Friday, June 17, 2011 5:08 PM
To: Alade, Oladimeji
Cc: Ford, Geraldine


Subject: Re: end of year meeting with Dr. Farber

Obie,

All residents are required to have an end-of-year meeting as part of residency training. This is the same meeting that you have had as a PGY1 and 2. As you know during these meetings we go over your work and I inform you of what still needs to be accomplished before the end of the academic year. I have just looked on your required task page. You have several outstanding tasks that need to be accomplished. If you have questions about what needs to be done, please talk with Gerry Ford. We expect all of our residents to complete their task list by the end of the academic year. Not accomplishing these tasks can adversely affect your ability to successfully complete your third year of training. As we did in January for your mid-year meeting, you will be meeting with both Dr. Harbit and myself. Please schedule a time to meet for this required meeting. Failure to comply with attending your end-of-year meeting can have negative consequences on your formal summative evaluation. This evaluation remains in your file permanently and is used to fill out forms we receive from outside agencies as well as other training programs.

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From: Alade, Oladimeji
Sent: Tue, Jun 21, 2011 at 11:11 AM
To: Farber, Nuri
Cc: McAlister, Rebecca; Drake, Tia; Tegtmeyer, Barbara; Zorumski, Charles; Rubin, Eugene; xxxxxxxxxxxx.xxx


Subject: RE: end of year meeting with Dr. Farber

Dr. Farber:

I cannot sit with you or Dr. Harbit, either together or individually, without the presence of other faculty members, for any form of performance or residency evaluation.

Throughout my stay at this institution, you have exploited these review sessions to perpetuate verbal, psychological, and emotional abuse, as well as discriminative practices, against my person.

It was also during our last review session on February 14, 2011 (and not January, as you alleged) that you and Dr. Harbit overtly launched an intense and continuing emotional and psychological campaign against me, to prevent my successful completion of the residency training program.

I do not object with a meeting with the Residency Review Committee, along with my Legal Counsel, for the review session in question.

Perhaps ACGME should be contacted for full and explicit clarification of rules and procedures in cases such as this when there are ongoing allegations of unfair and discriminative practices by a resident against residency training program directors.

Alade, Oladimeji

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From: McAlister, Rebecca
Sent: Tuesday, June 21, 2011 5:02 PM
To: Alade, Oladimeji; Farber, Nuri
Cc: Drake, Tia; Zorumski, Charles; Rubin, Eugene; Harbit (Swallow), Melissa; xxxxxxxxxx.xxx; Terra Mouser; Ramatowski, Christine


Subject: RE: end of year meeting with Dr. Farber

Dr. Alade,
In review of your message below, I felt it is important that I follow up with you to confirm that you are aware of our institutional policies and processes for dealing with the concerns you have raised in your message. I would strongly encourage you to work with Dr. Farber’s office to identify appropriate faculty from the Department of Psychiatry to sit with you through the final evaluation meeting of your performance. This information will be important for you to understand as you develop your plans to further your education. However, the allegations of discrimination must be handled by BJH and WUSOM Human Resource Departments. You may recall from the phone conversation you had with Ms. Drake in my office several weeks ago that BJH Human Resources will need to be appraised of your claims of discrimination, so they can work closely with Washington University HR to begin a formal investigation. They will need to obtain detailed information from you to start this process. If you have not rendered a formal complaint with BJH Human Resources, I would strongly encourage you to immediately contact Caitlin O’Brien in their office to begin this process. I am also copying BJH legal services regarding this issue to make them aware of your concerns as well.

Sincerely

Rebecca P McAlister, MD
Associate Dean for Graduate Medical Education
Designated Institutional Official
WU/BJH/SLCH Educational Consortium

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From: Alade, Oladimeji
Sent: Thursday, June 23, 2011 10:34 AM
To: McAlister, Rebecca
Cc: Drake, Tia; Zorumski, Charles; Rubin, Eugene; Farber, Nuri; Harbit (Swallow), Melissa; xxxxxxxxxx.xxx; Terra Mouser; Ramatowski, Christine; O'Brien, Caitlin; Bettale, Jon; Ford, Geraldine


Subject: RE: end of year meeting with Dr. Farber

Dr McAlister:

Good morning.

Thank you for your reply, and I am grateful for your interest and concern in this case.

I have contacted BJH HR about Drs. Farber and Harbit's ongoing unfair and discriminative practices, as well as historical abuses, towards me several weeks ago.

While in the HR office, I was directed to speak with Dr. Jon Bettale and his HR counterpart, and I gave them detailed information about my concerns about the Psychiatry Department and its Program Directors. The day following, I met with Ms. Caitlin O’Brien, who noted that she has been briefed about my meeting, and its contents, with Dr. Jon Bettale the day prior.

My attorney, XXXXXXXXXXXX, has also been in contact with your Legal Counsel, Ms. Ramatowski, about this issue for a while now.

In addition, Mr. Benzel of the Department of Labor, has also been in contact with the Psychiatry Department and BJH HR concerning Dr. Farber's discrimination against me, in regards to my military service. The last correspondence of Mr. Benzel was to a Mr. Larry asking that BJH provide specific details about this case.

To that end, I am somewhat surprised, judging from the your email, that you didn't know of the great lengths I have gone through to have these issues addressed; needless to say, prior to seeking a legal recourse, I had canvassed the entire psych department looking for some help and intervention. Nevertheless, I am very grateful of your current involvement.

I will follow the outline you have laid out in your email. However, this email should serve as my formal application for an investigation into all the issues surrounding my disputes with Drs. Farber and Harbit and the psych department. I will follow up with Ms. Caitlin O’Brien with the necessary details as indicated in your email.

In the interim, I would appreciate some clarification from you about ACGME's policies and procedures regarding the execution of the function of the program director's office, should they be non-neutral parties in an unresolved allegation.

Thank you very much; I am humbled and grateful.

Sincerely,

Alade, Oladimeji

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From: McAlister, Rebecca
Sent: Thursday, June 23, 2011 6:25 PM
To: Alade, Oladimeji
Cc: Drake, Tia; Zorumski, Charles; Rubin, Eugene; Farber, Nuri; Harbit (Swallow), Melissa; Terra Mouser; Ramatowski, Christine; O'Brien, Caitlin; Bettale, Jon


Subject: RE: end of year meeting with Dr. Farber

Dear Dr Alde,

The institutional policy governing disciplinary policies for the WU/BJH/SLCH Educational Consortium can be found at the following link:

http://aladdin.wustl.edu/medadmin/gme/gme.nsf/d2a677860cb83e8f862565d7006b3303/617a1f8a867655d2862565d700737eeb?OpenDocument

Dr. Farber and the Department of Psychiatry advise me that, as part of the routine for all residents, you were given a copy of this among other policies on February 14, 2011. In your file is your signed statement that you received and understood this policy. On February 25, 2011, Dr. Farber notified you of the decision not to renew your contract for the next academic year and gave you the option to voluntarily withdraw from the program at the end of the year if you so wished. Dr Farber received your formal letter of resignation on March 5, 2011. According to the policy cited above, you had 30 calendar days to appeal this action to my office, but you did not. You did contact my office on May 11, 2011 and spoke to my GME manager Tia Drake about your concerns. Although this was beyond the timeframe for an appeal, Ms. Drake sent you this policy again on May 11, 2011 and, at your request, made an appointment for you to discuss your concerns with me on May 23, 2011. You later notified my office that you wished to cancel that appointment.

Our institution is accredited by the Accreditation Council on Graduate Medical Education (ACGME). Their institutional requirements can be found on their website at acgme.org. That portion of the requirements dealing with nonreappointment of trainees is quoted below:

II.D.3. The Sponsoring Institution and program directors must ensure that residents are informed of and adhere to established educational and clinical practices, policies, and procedures in all sites to which residents are assigned.

II.D.4. The resident agreement/contract must contain or provide a reference to at least the following institutional policies:

II.D.4.a) Residents’ responsibilities;

II.D.4.b) Duration of appointment;

II.D.4.c) Financial support; and,

II.D.4.d) Conditions for reappointment

II.D.4.d).(1) Non-renewal of appointment or non-promotion: In instances where a resident’s agreement will not be renewed, or when a resident will not be promoted to the next level of training, the Sponsoring Institution must ensure that its programs provide the resident(s) with a written notice of intent no later than four months prior to the end of the resident’s current agreement. If the primary reason(s) for the non-renewal or non-promotion occurs within the four months prior to the end of the agreement, the Sponsoring Institution must ensure that its programs provide the resident(s) with as much written notice of the intent not to renew or not to promote as circumstances will reasonably allow, prior to the end of the agreement.

II.D.4.d).(2) Residents must be allowed to implement the institution’s grievance procedures if they receive a written notice either of intent not to renew their agreement(s) or of intent to renew their agreement(s) but not to promote them to the next level of training.

II.D.4.e) Grievance procedures and due process: The Sponsoring Institution must provide residents with fair, reasonable, and readily available written institutional policies and procedures for grievance and due process. These policies and procedures must minimize conflict of interest by adjudicating parties in addressing:

II.D.4.e).(1) Academic or other disciplinary actions taken against residents that could result in dismissal, non-renewal of a resident’s agreement, non-promotion of a resident to the next level of training, or other actions that could significantly threaten a resident’s intended career Institutional Requirements 6
Effective: July 1, 2007
development; and,
II.D.4.e).(2) Adjudication of resident complaints and grievances related to the work environment or issues related to the program or faculty.

The appeals process for the academic decision that resulted in your nonrenewal of contract was made more than 4 months before the end of your contract year. You had been fully informed of all applicable policies by the Department of Psychiatry. You did not choose to exercise the appeals process utilized by our institution in the allowable time frame. Your allegations of discrimination by the Department are being investigated by Human Resources. Such allegations are not investigated by my office. Your discussions with Human Resources are protected and not accessible to me or my office staff. I have every confidence that the Human Resources staff will perform a thorough investigation and address any confirmed areas of concern.

Sincerely

Rebecca P McAlister, MD
Associate Dean for Graduate Medical Education
Washington University School of Medicine
Designated Institutional Official, WU/BJH/SLCH Educational Consortium

[
Comments:

There were so many distortions of facts in this email and it appeared that Dr. McAllister lost her objectivity, suddenly; I didn't see the need to reply this email.
]


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From: Farber, Nuri
Sent: Wednesday, June 22, 2011 12:26 PM
To: Alade, Oladimeji
Cc: McAlister, Rebecca; Drake, Tia; Tegtmeyer, Barbara; Zorumski, Charles; Harbit (Swallow), Melissa; Ford, Geraldine


Subject: Re: end of year meeting with Dr. Farber

Obie,

I'm sorry that you perceive the interactions with Dr. Harbit and myself as anything other than professional.  I and Dr. Harbit have never used these meetings nor any interactions with you as a forum to verbally, psychologically or emotionally abuse you, nor have we discriminated against you.  We have simply followed our procedures and policies for dealing with issues as they arise during training.

As I mentioned in my previous email, having these twice a year meetings is a requirement of the ACGME so that the Program can review the progress that a resident is making in his or her training and inform the resident about areas that need special attention.  They are even done for fourth year residents, who are graduating, or for residents, who are leaving the program.  We use the time to go over written reviews, patient logs, assigned tasks, issues, etc.  If you want to have another faculty member of your choosing present, when you meet with Dr. Harbit and me, I am fine with that.  The person can be any current MD faculty member of the Department who is engaged in residency training.   Legal counsel (either the Program's or yours) are not allowed.  Please let me know whom you would like to be present for the meeting and I will have Gerry find a time for all of us to meet.    These are the things that I have that are still outstanding that must be accomplished before you can successfully complete your third year of training:

1) You must read and certify that you have read the goals and objectives.
2) You must update your training profile.
3) You must turn in your signed psychotherapy outlines.
4) You must term in your signed psychotherapy case discussions.
5) You must turn in completed patient logs for all three clinic sites.
6) You must do your self-evaluation.
7) You must turn in your attending evaluations.
8) You must turn in your evaluations for the adult and child clinics.
9) You must turn in your 4 course evaluations.
10) You must have your attendance in the 4 main courses (Grand Rounds, Tuesday am resident lecture, Adv Resident lecture, Research Seminar) above 70%.  If attendance is less than 70%, then you must write 1-2 page reports of acceptable quality that reviews the material covered in the lectures that you missed.  Of the 4 courses, you are delinquent in Adv Resident Seminar (68.8%) and Research Seminar (56.5%).  By my count you will need to turn in one report on a topic from the Advance Resident Seminar and reports on 3 separate topics from Research Seminar.
11) You will need to turn in all keys, badges, pagers to the Department at the end of your last day of work.
12) Complete all your required chart work.

Note: #1-9 are listed in your Resident Assigned Tasks page on the intranet.  #10 is something we have discussed in previous meetings and is something that is covered in the end of year meeting.  #11 and #12 are routine things we cover in the meeting.

Sincerely,
 --
Nuri B. Farber, M.D.
Director, Residency Training Program
Department of Psychiatry
Washington University

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From: Alade, Oladimeji
Sent: Thursday, June 23, 2011 11:08 AM
To: Farber, Nuri
Cc: McAlister, Rebecca; Drake, Tia; Tegtmeyer, Barbara; Zorumski, Charles; Harbit (Swallow), Melissa; Ford, Geraldine; Ramatowski, Christine; Terra Mouser; Disabato, Brianne; Haupt, Dan; Bierut, Laura; Bishop, Monica


Subject: RE: end of year meeting with Dr. Farber

Dr. Farber:

I have no confidence in you and do not trust you or Dr. Harbit.

I had trusted you and Dr. Harbit in a similar situation such as this last March, wherein you and Dr. Harbit, illegally and forcefully demanded my resignation from the residency program. However, based on the reports I'm receiving, you and Dr. Harbit are claiming, and presenting the whole issue, as a voluntary resignation on my part. Sir, that is a lie!

In regards to the end of the year meeting and my faculty preference, I would like to have Dr. Richardson present, should he be willing.

I am also hereby formally appealing and contesting my last evaluation at the Wohl Clinic, for the months of November - March; it doesn't present a true and accurate representation of my clinical skills nor medical knowledge. Moreover, I am surprised that it alleges that I am "in remediation," whereas I have not received any notification, either formally or informally, of such measures or the rationale behind the decision.

Regarding the outstanding tasks you had enumerated, I am aware of them and in the midst of their completion.

Alade, Oladimeji

[
The evaluation in question lists 4 attendings as my evaluators, with whom I had no clinical contact with during the said period: Laura Bierut, Monica Bishop, Melissa Harbit, and Daniel Haupt.


The clinical interactions I had with Brianne Disabato, with regards to the scope covered by the evaluation was minimal at best.
]

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From: Alade, Oladimeji
Date: Fri, Jun 24, 2011 at 11:00 AM
To: Farber, Nuri
Cc: McAlister, Rebecca, Drake, Tia, Tegtmeyer, Barbara, Zorumski, Charles, Harbit (Swallow), Melissa, Ford, Geraldine, Ramatowski, Christine, Rubin, Eugene


Subject: RE: end of year meeting with Dr. Farber

Dr. Farber:

Given that:

• I am not (and have not) been fairly treated
  
  
• The spirit of due process (in light of historical and ongoing events), as stipulated by ACGME, hasn’t been followed, by you, the Psychiatry Department, Wash U, and BJH in matters relating to me
  
  
• The readily apparent conflicts of interests, on several levels, at Wash U and BJH, in regards to my current situation, brought on by:
  
  
• Your, and Dr. Harbit's, unfair and discriminative practices against me
  
  
• Your historical verbal, emotional, and psychological abuses towards me
  
  
• I will not be attending this meeting until these issues are resolved.
  

Alade, Oladimeji


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From: Alade, Oladimeji
Date: Thu, Jun 30, 2011 at 11:21 AM
To: Zorumski, Charles
Cc: McAlister, Rebecca; Drake, Tia; Farber, Nuri; Harbit (Swallow), Melissa; Disabato, Brianne; Rubin, Eugene; Haupt, Dan; Bierut, Laura; Mouser, Terra; Ford, Geraldine; Richardson, Thomas; Cloninger, Robert


Subject: Re: My Current Situation

"A nation's greatness is measured by how it treats its weakest members." ~ Mahatma Ghandi

Dr. Zuromski:

Good morning.

I remember clearly when I interviewed here in December 2007; you and Dr. Cloninger particularly stood out amongst my interviewers.

I was bedazzled by Dr. Cloninger's keen insight and intuition and use of a thermodynamic construct to explain psychiatric principles, which displayed a phenomenal ability to abstract from infinitely complex principles across seemingly disparate domains. I was mightily impressed and amazed by your simplicity, depth of knowledge, and approachability. My interactions with both of you, was the main reason why I highly ranked Wash U.

Since becoming a resident here, my initial impressions have been confirmed many times over. Furthermore, our interactions, exchange of ideas, and your gentle tutelage during your Thursday's lecture series, further solidified your image in my mind and I felt quite comfortable with you.

All these were what informed my decision to run to you at the first sign of trouble on February 18, 2011 at 3pm. That was the Friday of the Monday I met with Drs. Farber and Harbit, during which they first informed me of a possible pending dismissal from the residency program.

During our meeting on that fateful day, I informed you of my historical difficulties and perceived unfair handedness in my interactions with Dr. Farber since joining the program. I also told you that, in the entirety of my experience in the Psych Department, there seems to be a gnawing absence of empathy.

I further informed you, that at the very beginning of my third year, I had pressing family issues and some personal existential questions in regards to the depth and intensity of the psychosocial stressors and psychiatric needs of the patient population the Wohl Psychiatry Clinic. I also informed you that I had resolved these issues and have become a better clinician in light of these personal experiences.

At the same meeting, I informed you that my primary goal is to complete the psychiatry residency training program, and that I was willing to work with faculty and staff to ensure my completion of the residency training. I even informed you that I have some ideas that could potentially enhance the overall training experience in the program (and I sent you an email to that effect the following day.)

Throughout our meeting, you were kind, reassuring, and thoughtful. You informed that you were aware that a letter was to be sent out to me and of the possibility of an unfavorable action towards me. You stated that your "role" was to look for ways for me to complete the residency but that "I cannot guarantee anything." You nevertheless enjoined and encouraged me not to worry but to enjoy my weekend as things will work out fine.

Overall, my experience at Wash U and BJH has neither been fair nor pleasant. Nevertheless, the most striking observation is the relative quietness of faculty members, fellow residents, and staff about my ongoing plight. All I have been canvassing for (and I'm still requesting) is a full and fair investigation into the issues I have raised.

Sir, you are a student of history. Looking back at Nazi Germany, the atrocities Hitler perpetuated against fellow flesh and blood and uniquely human lives will not have been possible without the implicit and tactic silence of the German citizenry.

Ultimately, the decisions, actions, and inactions of the Drs. Farber and Harbit reflect the integrity of the Psychiatry Department. It logically follows that the reflection of the Psychiatry Department, reflects the integrity of its leadership.

We all have a role to play in creating a fair, equitable, and nurturing environment. Institutions do not spontaneously derive a life of their own, they represent the overall traits, characters, and fears of its comprising individuals.

Sincerely,

Alade, Oladimeji