This is a quick update.
I hope you are doing well. I should start out by saying that I am currently a life-fellow of the Indian Psychiatric Society (IPS) and also a life member of the Indian Psychiatric Society – Karnataka Branch (IPS-KC).
I am writing, so that you become enlightened, educated and literate about what goes on with foreigners who seek higher education, in Utah(UT), a Mormon Christian predominant State in the USA. As of this date more than 4 years have passed since having filed my case with the court system in the States. The case was transferred from Texas where it was filed due to unavoidable circumstances to Utah. My case was dismissed by the District Judge Robert J. Shelby, with prejudice at the “Mormon” District Court of the District of Utah.
Utah, for beginners, is full of Mormons and discriminating people, who are white supremacists (similar to the Ku Klux Klan) and have scant respect for the human rights of individuals – any other individuals or groups – they just have to be non-Mormon. Or, they have to fall in line with Mormon ideology as they staunchly believe that Mormonism was founded in America and Americans are all one race – i.e. Mormon. This is evidenced by their trying to actively proselytize and convert any successful non-Mormon.
I will brief you about my case in this blog and I have plenty of documentation to substantiate the statements I make. However I was not able to appear in the court due to financial reasons at that time, discrimination in visa issues and the active role the University of Utah in association with the ECFMG (Educational Commission for Foreign Medical Graduates) played in actively eliminating my presence from the states – i.e. extermination or modern GENOCIDE. They also knew that as a resident and a trainee I had a shortage of resources to hire an attorney at that time. Their awareness of my visa situation just made it more easy for them to destroy my life and career at that time, which was expressly written in one of the emails from the Director of Graduate Medical Education – Alan Smith, Ph.D. – at the University of Utah. I had also requested the Northern District court in Texas to hire an attorney on my behalf citing financial reasons which was accepted there. However, I do not understand why there was such a delay in continuing with my case at Utah. I later found out that after the case was transferred to UT, the attorney of the state of UT had denied accepting my case, obviously for discriminatory reasons, not having enough boldness to even ask for evidence. Again a case of prejudice.
The following are the details of the case in brief:
- I went to the USA on a B1/B2 (visitor) visa in October 2005 and was given a time period of 3 months at the port of entry (Chicago) for the clinical skills (CS) component of United States Medical Licensing Examination (USMLE).
- I subsequently extended my visa status for another 3 months based on the fact that I had interviews lined up for medical residency spots.
- I went through the residency match – the National Resident Matching Program (NRMP) for 2006. However, I was automatically withdrawn from the residency match for 2006 due to not having my USMLE step 2 CS scores on time (though this was different with US graduates, a.k.a seniors, during the time since they could still go through the match without their step 2 CS scores in on time for the NRMP match). Therefore, I could not match that year.
- Since I was about to complete my time on the extended B1/B2 status and because I also needed some study time for step 3 of the USMLE, I applied at Kaplan University for a course and applied with immigration to switch my status to F1 (student). I was granted the student status and was given about a year for the course on that status, during which time I also applied for residency training positions, again, in different states, mostly in the mid-west since I lived in Chicago at the time.
- After matching in a program in Psychiatry at the Department of Clinical Neuroscience, University of North Dakota, Fargo ND in March, 2007. Unfortunately the program sponsored only J1 (exchange visitor) visa for psychiatry trainees, though I had all the credentials required for an H1 visa (Steps 1, 2 CK, 2 CS and 3 of the USMLE). The same university, University of North Dakota was sponsoring H1 visas for internal medicine residents/trainees, which I was made aware of only after I signed the contract to start the psychiatry residency at the University of North Dakota’s southeast Campus in Fargo ND.
- I was on the J1 visa/visa status for the entire period of residency at the University of North Dakota. I asked for and was fast-tracked to a child psychiatry fellowship. This means that I completed all the requirements stipulated by the American Board of Psychiatry and Neurology (ABPN) of a general adult psychiatry residency in three years instead of four. This was excepting the child psychiatry component which I completed during my fourth post-graduate year in the child psychiatry training program that I was going to be transferred to.
- This means I worked very hard to complete all requirements in 3 years instead of 4 and had excellent to outstanding reviews from my supervisors on most rotations during the psychiatry training at the University of North Dakota.
- It is also notable that I was elected and had served on the Residency Training Committee (RTC) of the general adult psychiatry residency in the Department of Clinical Neuroscience at the University of North Dakota.
- I was also working simultaneously since the PGY-2 i.e. post graduate year 2, on a Master of HealthCare Administration (MHA) degree simultaneously and was able to complete the courses and graduate with an M.H.A. in December, 2010.
I interviewed in eight programs for a child and adolescent psychiatry training fellowship, including Stanford University in California, for the Post Graduate Year-4 (PGY-4) position in psychiatry and chose to rank the University of Utah on top for the position. I went through the NRMP’s specialty match – Child and Adolescent Psychiatry fellowship match. I chose to rank the University of Utah for the position on top because the program director, Douglas Gray, MD, of the child psychiatry program basically lured me into the program.
Gray promised that I would be greatly helped with my J1 status and that the program would be a great fit for me. Gray also had my full waiver to get all the information needed from my previous program at the University of North Dakota. This waiver was requested from me and granted to the University of Utah’s child psychiatry training program.
I later on realized that those promises about helping me with my visa status were hollow. My visa status did not change to a work visa after I matched into the program. I continued on a J1 visa status. Gray feigned ignorance of the visa status issues and was not asking any questions about my visa status and problems involved with the same, although it was very well known that it would be hard to work on a J1 visa status at the University since there was not scarcity of physicians nor was the area a mental Health Professional Shortage Area (HPSA). Basically the J1, (similar to many of the non-immigrant visas of the USA like F1, H1, L1) is a very exploitative and restrictive visa.
Gray gave me a great review for the first half of my training year. This would basically mean that whatever happened thenceforth, I would have to be given a chance with the extension of my training year at the very least. However, ultimately I was put on probation, under duress, for a month and a half for the end of that academic year (June 30, 2011) from May 8, 2011 to June 21, 2011. I had vacation time left for about a week for that academic year which I chose to take at the end of the academic year and combine it with the leave for the next academic year. The program director approved this leave application. I did so because leave from one academic year was not transferable, if unused, to the next academic year according to my PGY-4 contract and that I had not visited my family in India for more than two and a half years. Despite my request for giving me a verdict on my residency training status earlier to my departure on vacation to India, the program director gave excuses and wanted me to hear about the decision of the residency training committee after I left for India – again a clear attempt at extermination after exploitation from the USA.
The decision of the residency training committee (RTC) was to not give me credit for the training year in general psychiatry or child psychiatry, not extend my training year to compensate for any potential deficiencies, and to make me ineligible for taking my board exams for certification in general adult psychiatry (This is illegal – as the determination of eligibility for board examination can only be made by the American Board of Psychiatry and Neurology – ABPN – upon getting appropriate documentation from the program director. The program director cannot make the determination of my board eligibility). I appealed these decisions by email, although I was on vacation. I replied to e-mail from the program director – Gray – (contact: http://medicine.utah.edu/psychiatry/child/contact.htm) and the dean for Graduate Medical Education (GME) at the University of Utah where I was “Employed” (sic since a J1 visa is an exchange visitor visa not an employment visa) (contact: http://medicine.utah.edu/GME/contact.htm), that the determination by the RTC was unfair. My appeals were brushed aside. The access to my University of Utah email account was denied and although I had requested that my emails be forwarded to my personal e-mail account, they were not forwarded to the email address that I provided the program as well as the GME of the University of Utah.
The program director wrongly determined that since I had not made appeals within the stipulated period of 7 days (again this was when I was not vacation and also this did not come with the specifier of whether these 7 days would be business/working days or otherwise), I was not in a position to appeal anymore. This was ridiculous, since I had appealed by e-mail and my appeals were not given heed to, and also because I was on vacation during that same period. I filed for discrimination based on 6 items among the list of items that I could file for discrimination given to me by the OEO/AA (Office of Equal Opportunity/Affirmative Action), a wing of the University of Utah. The personnel at the OEO took up the matter for investigation, although I had asked for Mediation/Negotiation. The investigation was based on 2 of those items that were chosen by the OEO/AA – discrimination against me based on race and national origin and concluded that there was no cause for the same. I had appealed that decision giving them plenty of evidence to suggest that I was worthy of getting at least a year’s worth of credit for training in psychiatry let alone child psychiatry. I was however left with a negative outcome, which seemed to be obvious and redundant, because the OEO/AA was employed by the University of Utah.
Breakdown of events in the child psychiatry training year at the University of Utah (July 1, 2010 – June 30, 2011):
I started my child psychiatry training fellowship year on July 1, 2010 at the University of Utah with much enthusiasm. I had looked forward to starting my fellowship in child and adolescent psychiatry, very much. Below is a breakdown of events in the rotations, all of which were 4 and all including child or adolescent psychiatry rotations. I have to start out by saying that I was not given the opportunity to see evaluations from any of the rotations in my training file. In fact, thus far, I have been denied access to my training file and the GME at the University of Utah gave me a letter stating that I was “employed” at the University of Utah in the Department of Child Psychiatry on a “J1 [exchange visitor] visa status”. This was given by the director for GME at the University of Utah – Alan Smith, Ph.D. This is however illegal to due so on many levels.
My first rotation was at the Wasatch Canyons campus of Intermountain Healthcare’s Primary Children’s Medical Center (PCMC). It was in a residential and day treatment setting for adolescents with psychiatric and substance dependence disorders. The program was run by Scott Whittle, who was also the rotation supervisor. Dr. Whittle was trained as a psychiatrist and had done his child and adolescent psychiatry fellowship. The rotation was for 3 months and it was smooth sailing. I liked the rotation, had great supervisory sessions and enjoyed working with the patient population. My rotation supervisors and team members also appreciated my work. My duties included evaluating and formulating treatment plans, discussing with team members and attend weekly staffing meetings and grand rounds and attend some case conferences.
My second rotation was at the Research Campus of Intermountain Healthcare’s Primary Children’s Medical Center (PCMC). It was a residential and day treatment setting for latency age group (usually 8-13 years old) children with psychiatric disorders. The program was run by Kirk Simon, who was also the rotation supervisor. Dr. Simon was trained as a triple board physician, meaning that he trained in a combined pediatrics, psychiatry and child psychiatry program. Simon was also working at a behavioral health institute in Syracuse Utah and did not spend much time in supervision. I started off the rotation evaluating cases on my own with little supervision from Simon and the team enjoyed my being on the rotation for a total of three months. I absolutely loved working with kids on that rotation. There was also a counselor who was guiding me through the process of supervision on some aspects of play therapy. The counselor also gave me great reviews as did the team during my time at the rotation on the Research campus.
My third rotation was at the Primary Children’s Medical Center (PCMC). It is a tertiary care hospital for children. I was to do the rotation for a total of 4 months. The program director Doug Gray had emailed me after I matched into the University of Utah in the NRMP fellowship match and before I started the program in Salt Lake City. I was given a “choice” to do either 3 or 4 months only on this rotation and I chose 4 months. Retrospectively thinking, I think it was a fine manipulation. I thought it might give me a lot of experience with doing consults on children and adolescents with medical illnesses in an inpatient setting, and it did, but not entirely satisfactorily, which I brought up in monthly child psychiatry meetings. On a separate note, I have to mention here that during the beginning of this rotation I was given a renewal contract for the subsequent year that was signed by the program director for the training program in child psychiatry at the University of Utah (Gray) and director of Graduate Medical Education (GME) for the University of Utah (Smith). I signed the contract and handed it over. However, it did not go into my training file, like many of the other communications and evaluations. This, I would say, is deliberate and cunning way to cover up evidence. Anyhow, I did not have any knowledge of what was or was not going into my training file. On the rotation at PCMC, I worked alongside a psychology intern, Hyo Bae, and occasionally also did consults on kids at the University Hospital which was close by. I subsequently discovered that at times there would be no supervisor to supervise me on certain days when I had consults at the University Hospital burns ward. My first month there started slow. I had almost an entire week without patients. Actually we did not have any consults for an entire 4 days in a row, which was quite surprising, to me as I had thought that it would be quite busy. The rotation supervisors were Dr. Rich Martini – who had at the time recently moved from Chicago and was a psychiatrist trained in child and adolescent psychiatry and Dr. Deirdre “Dedee” Caplin who was a PhD psychologist. Caplin was also associated with the Pediatrics residency program as well as the triple board program at the University of Utah but worked at the Intermountain facility i.e. PCMC due to having privileges there as well. My evaluating supervisor at the end of the rotation was Dr. Giles, who was trained as a triple boarded physician. However I was told at the beginning of my rotation during one of the monthly child psychiatry residency meetings that the evaluator during my rotation would be Dr. Martini. The consult liaison service also had two other psychologists on the service – one that was an intermountain employee, Nancy Cantor, and the other psychologist, Kimberlee Roy, who was supposedly another supervisor that was an employee of the University of Utah, like the rest of the supervisors. Like I mentioned at the outset of this paragraph, Nancy Cantor did not have privileges at the University of Utah’s University Hospital. This was an issue during the days when this person was on the Consult Liaison service, as the supervisor, and could not supervise me on cases at the University Hospital. There were some alleged deficits in my “performance” that were recognized during my second month on the rotation and Gray prepared a plan of action. I did not agree with the plan which was later on called the Corrective Action Plan. I also did not sign the document. However I complied with and showed improvement through the end of the rotation on all areas that were mentioned in the document. Dr. Giles also agreed about the improvements made and considered them satisfactory, during all the supervisory sessions which we had regularly, on a weekly basis. Also during the discussion about my rotation at the end of the rotation period, on the last day of the rotation (April 30, 2011), Dr. Giles gave me a positive review and I was convinced that I did well enough to clear the rotation.
I moved on to my last rotation which was at the University of Utah Neuropsychiatric Institute (UNI) inpatient unit for children and adolescents with acute psychiatric issues. This was the only rotation in which I was going to work in a University of Utah healthcare facility – and for just 2 months, during my first year of child psychiatry training. This was something that I had not imagined would happen before matching into the program at the University of Utah, and this was not what I thought I had signed up for. I worked with two supervisors Drs. Kirsti Kleinschmit and Thomas Conover – both triple boarded physicians. A week through my rotation on May 8, 2011 Gray came to the unit and gave me the probation letter (which was however dated May 2, 2011) taking me aside and in the presence of Dr. James Ashworth, chief of the division of child psychiatry, being present in the room. I was shocked and they both offered me pens to sign the document, did not give me enough time to read through it and I was compelled to sign the document. I was never given a reason why I was going on probation. In the tense situation, I asked if I would be able to take my board examination in general adult psychiatry as scheduled since I did not want any extensions in the academic year to affect my ability to sit for the boards. Gray told me that I would be able to take the board exam as scheduled and being on probation would not affect my being able to take the boards. Both Gray and Ashworth asked for sexual favors and harassed me with negative consequences if I did not comply. Gray had been making sexually inappropriate gestures during my previous meetings with him but I ignored them as being a part of his personality/approach towards trainees, however that was not the case. When I refused both forced me into signing the probation document, as an alternative to sexual favors, under duress and intimidation.
I have very little to say about the sexual harassment part and I do not even like talking about it, let alone putting it on paper. However, I have mustered the strength to be able to do so and the following paragraph alludes to what exactly happened during the meeting with Gray and Ashworth.
It was a very small room with two chairs a table for a telephone and a table lamp and a two seater sofa. I was asked to sit on the sofa and Ashworth was already there when Gray took me into the room from the inpatient psychiatric unit for children and adolescents at UNI. Gray held the door open for me and ushered me to sit on the sofa. I did not carry anything with me and left me clipboard in the MD room in the inpatient unit. Gray did most of the talking and started out by saying that I was not meeting the expectations of the residency program and that I had two options. This was when Ashworth and Gray exchanged glances and said that they would like their penises sucked and wanted a “blow-job” from me. Gray also made a specific gesture of anal sex using his hands, putting his right thumb into partially flexed fingers in his left hand (the tip of the pointer and the thumb making a hole” and saying “maybe also this.” I shook my head and grimly said “No.” Gray said that “the other option for you would be to sign ‘this’ document. This would mean that you are on probation from now onwards with possible outcomes that are listed at the end of the document, with your rights that are listed at the very end.” My question was “What does it mean when I am on probation? And whether I can take my board examination in general adult psychiatry as scheduled.” Gray and Ashworth nodded saying “yes, it would not have anything to do with your taking the board exam”, after which I asked for a pen looking at the document since I fumbled in my pockets and remembered that I had left my pen on my clipboard in the inpatient rotation. I was offered pens by both Gray and Ashworth. I then signed the document and handed over the pen back. Gray seemed happy and asked me to leave to India or to California where I was fully licensed as a physician as I was in Utah. Ashworth asked me if I had any questions afterwords and I said “No” in a state of shock and held the door open for them to walk out. I walked out after them. I went back into the inpatient unit and into the MD room, took some time to compose myself and told Kristi Kleinschmit, my rotation supervisor for the month, who was in the room for social workers, as to what had happened. I do not remember having gotten an empathic response. I requested to talk about it thereafter and even during that meeting it seemed to evoke no questions about what actually happened in the little closeted room. Kleinschmit did not seem to care, and was responding to me like the situation was jamais vu.
I informed both Kleinschmit and Conover about the probation since they both needed to know as my rotation supervisors. They would not ask me further questions. Kleinschmit came up with a list of things that I had to work on and reviewed it with me every week for the rest of the month and said that I was making progress. Conover also met with me for regular supervision till the end of the rotation. Conover had good feedback to give and said that I was doing very well on many aspects of the alleged deficits that I had. I had to give weekly Clinical Skills Examinations (CSEs) and did well on different components in different CSEs that were conducted by different attending psychiatrists to maintain objectivity. We (the first and second year child psychiatry trainees) were told, in regular monthly lunch meetings, that the CSEs would not be used negatively and that any negative CSEs would not be used in Residency Training Committee (RTC) decisions and that they would not go into the training files.
I had requested to go on vacation to India combining the vacation time I had left for that academic year with some vacation time from the next academic year. Gray had approved the vacation time I had requested and was aware of my visa situation since I was asked to give an explanation and I did for wanting to go on vacation to India. I had requested to have the RTC decide on my probation earlier since I was going on vacation and it could only be moved up to a date that was after my scheduled departure to India on vacation. I was told that I would know about the decision as soon as I landed in India but never did, though I ended up departing a day later from the states as my flight schedule was changed. The RTC decided to not renew the contract for the subsequent academic year or extend my contract to improve on any remaining deficits that they could identify. Repeated attempts to appeal the decision by e-mailing both Gray and Dr. Smith, the director for Graduate Medical Education (GME) at the University of Utah, fell to deaf ears. They did not respond to me or redirect me to a formal appeals process. Then finally when I heard back from them, I was told that the deadline for the appeal was up and that they would not entertain any appeal anymore. I was left with the option of filing a complaint of discrimination with the Office of Equal Opportunity and Affirmative Action (OEO/AA) of the University of Utah. The case was closed by the office of the president of the University of Utah, the same University that employs their own OEO/AA.
The legislature, executive and judiciary in the state of UTAH, I believe is intermingled and the temple of the University of Utah has an active role in the policies and procedures as well as “execution” of all activities. I hope that you all understand, they also have a footing in many parts of the world including INDIA, which severely threatens the secular nature of the Indian setup and brings in fundamentalist ideologies.
Thank you for your understanding, patient reading and I look forward to hearing from you. Take care and have a lovely day!
DR. SUSHIL KUMAR SOMPUR VASANTHKUMAR
M.B. B.S., M.D.(PSYCHIATRY), M.H.A., F.I.P.S.
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