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Resident Probation, Suspension and Termination (Corrective Action)

Policy Purpose:

The purpose of this GME policy is to define the circumstances which may result in probation, suspension or termination from a residency program and to establish fair policies and procedures for academic or other disciplinary actions taken against residents.

The position of a resident physician presents the dual role of the physician in both residency training and direct patient care. When the academic and/or professional activities, conduct or demeanor of a resident interferes with the discharge of assigned duties or the discharge of duties of other Mount Carmel employees or jeopardizes the well-being of patients or employees, Mount Carmel through its administration, reserves the right to institute appropriate corrective measures up to and including termination.

Definitions:

Corrective Action: the initiation of probation, suspension or termination as defined below.

Informal Counseling: a documented, but informal discussion with a resident where the resident is advised, before the initiation of formal action, of academic performance or behavioral conduct that does not meet performance expectations.

Probation: a period of time in which a resident is given the opportunity to remediate academic performance or behavioral conduct that does not meet the performance expectations of the program.

Suspension: a period of time in which a resident is temporarily removed from program duties. Suspensions are paid and benefits will remain in effect during the suspension. Time spent on suspension may not be counted toward the completion of program requirements.

Suspension Pending Investigation: a period of time in which a resident is temporarily removed from program duties while an event/situation is investigated. Suspensions pending investigation are paid and benefits will remain in effect during the investigation. Suspension pending investigation is not a formal corrective action.

Termination: the condition in which a resident's participation in a residency program is ended. Credit is awarded pursuant to the applicable RC requirements. Termination also results in the immediate termination of the resident’s Agreement of Appointment.

Policy Implementation:

Each Program Director, in consultation with the Designated Institutional Official/DME and the residency’s Clinical Competency Committee, as appropriate, must implement the GME policy and procedures for corrective actions within his/her respective program. Initiation of corrective action must follow the guidelines listed below. Corrective action may be progressive, in that it follows the order of probation, suspension and dismissal; however, the particular corrective action imposed shall be based on individual circumstances and depending upon the severity of an incident or extenuating circumstances, corrective action may begin at any stage, including dismissal. A resident who receives corrective action has the right to appeal such action according to the GMEC policy on Grievance Procedures and Due Process.

Procedure:

Causes for Corrective Action:

The following is a list of resident actions and behaviors, which may result in corrective action, up to and including termination for the first offense. The list is not exhaustive and other actions or behaviors may lead to corrective action, up to and including dismissal.

  • failure to meet the performance expectations of an individual rotation;
  • failure to meet the performace expectations of the program;
  • failure to comply with the policies and procedures of the Graduate Medical Education, Mount Carmel Health System, and/or the residency program;
  • academic and/or behavioral misconduct that infringes on the principles and guidelines set forth by Graduate Medical Education and/or the residency program;
  • breach or violation of patient confidentiality;
  • harassment or abuse of patients, other residents or Mount Carmel employees;
  • documented and recurrent failure to complete medical records in a timely and appropriate manner;
  • illegal conduct;
  • conviction of a criminal offense related to healthcare fraud or exclusion, debarment, sanction or other declaration of ineligibility for participation in a federal or state healthcare program;
  • unethical conduct;
  • if a resident is deemed an immediate danger to patients, himself or herself or to others;
  • if a resident fails to comply with the medical licensure laws of the State of Ohio; or
  • misrepresentation of information in the residency appointment application.

Probation

  1. Prior to placing a resident on probation, the Program Director shall inform the Designated Institutional Official/DME and provide written documentation regarding the event prompting probation.
  2. When a resident is placed on probation, the Program Director shall meet with the resident to discuss the reason(s) for probation, the remedial action required by the resident, the dates of the probationary period, and the consequences of failing to successfully remediate. Within five (5) working days, the Program Director shall then provide the resident with a summary of the meeting, including the reason(s) for probation, the remedial action required by the resident, the dates of the probationary period, and the consequences of failing to successfully remediate.
  3. At the end of the probationary period, the Program Director shall meet again with the resident to review his/her performance during the probationary period. Based upon the resident’s performance during probation, a resident may be:
    • continued on probation;
    • removed from probation;
    • placed on suspension; or
    • dismissed from the residency program
    The resident shall be notified in writing of the results of this performance review.
  4. Copies of the written documentation regarding probation shall be maintained in the resident's program file
  5. No resident shall be advanced to the next PGY level or afforded a new Agreement of Appointment while on probation. Any new Agreement of Appointment signed while a resident is on probation shall be null and void. Unless the resident is dismissed due to lack, of progress, the resident's Agreement of Appointment shall be extended based on the period of probation.

Suspension

  1. Prior to suspending a resident, the Program Director shall inform the Designated Institutional Official/DME and provide written documentation regarding the event prompting suspension.
  2. When a resident is suspended, the Program Director shall meet with the resident to discuss the reason(s) for suspension, the measures necessary to assure resolution of the problem(s), the dates of suspension, the consequences of non-compliance, and whether additional training time is necessary to make up the days on suspension. Within five (5) working days, the Program Director shall then provide the resident with a summary of the meeting, including the reason(s) for suspension, the measures necessary to assure resolution of the problem(s), the dates of suspension, the consequences of non-compliance, and whether additional training time is necessary to make up the days on suspension.
  3. During the suspension, the resident will be placed on “administrative leave,” with pay.
  4. Copies of the written documentation regarding suspension shall be maintained in the resident's program file.
  5. No resident shall be advanced to the next PGY level or afforded a new Agreement of Appointment while on suspension. Any new Agreement of Appointment signed while a resident is on suspension shall be null and void. The resident's Agreement of Appointment shall be extended based on the period of suspension.

Dismissal

  1. Prior to dismissing a resident, the Program Director shall inform the Designated Institutional Official/DME and provide written documentation regarding the event prompting dismissal.
  2. When a resident is dismissed, the Program Director shall provide the resident with a written letter of termination stating the reason for the termination and the date the termination becomes effective.
  3. A copy of the termination letter shall be maintained in the resident's program file.

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