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Policy Purpose

Per ACGME requirements (II.D.), as the Sponsoring Institution, Mount Carmel Health System ("MCHS"), must have written policies and procedures for resident recruitment and appointment and must monitor each program for compliance. These appointment requirements must be addressed as follows:

Procedure:

MCHS, in conjunction with the residency program director, will provide the resident physicians with a written agreement of appointment/contract outlining the terms and conditions of their appointment to a program.

The resident agreement/contract must contain or provide a reference to the following items: resident responsibilities; duration of appointment; financial support; conditions for appointment, reappointment, non-renewal and non-promotion; grievance procedures and due process.

MCHS and the program directors must ensure that resident physicians are informed of and adhere to established educational and clinical practices, policies, and procedures at all sites where resident physicians are assigned.

Initial Appointments and Reappointments

Appointments to a graduate medical education residency program sponsored by MCHS are limited to a one-year term. Initial appointment does not guarantee subsequent reappointment or promotion. Each residency program shall determine the criteria for promotion and/or renewal of a resident's/fellow's appointment.

Non-Promotion 

The residency program reserves the right to deny promotion of a resident to the next training level. In such instances, the resident may be required to satisfactorily remediate a full or partial year of training. MCHS will issue a contract extension commensurate with the remediation period. A resident accepting this condition must be given a written summary of deficiencies, a delineation of the remediation program and the criteria for advancement.

Promotion will be based on performance evaluations and an assessment of the resident’s readiness to advance to the next year of post graduate training (including, but not limited to, attainment of the ACGME

Competencies at the respective level of education, achievement of specialty specific milestones, experience, demonstrated ability, clinical performance, and professionalism). In the event the residency program elects not to promote her/him to the next training level, the program shall provide the resident with one hundred and twenty (120) days (4 months) advance written notice prior to the expiration of the current contract agreement. If the primary reason(s) for the non-promotion occur(s) within the 120 days (4 months) prior to the end the current agreement, the program should provide the resident with as much written notice of the intent not to promote as circumstances will reasonably allow prior to the expiration of the agreement. The resident has the right to initiate the grievance procedure following the Resident Grievance Policy.

Non-Renewal 

The residency program reserves the right to not renew appointment. In the event the residency program elects not to renew appointment, the program shall provide the resident with one hundred and twenty (120) days (4 months) advance written notice prior to the expiration of the current contract agreement. If the primary reason(s) for the non-renewal occurs within the 120 days (four months) prior to the end of the agreement, the resident must be provided with as much written notice of the intent not to renew the contract as the circumstances will reasonably allow, prior to the end of the agreement. The resident has the right to initiate the grievance procedure following the Resident Grievance Policy. 

Resignation and Termination

A resident physician may resign from the sponsoring Residency Program with a thirty-day (30) notice of his or her intent to resign. The Resident must submit his/her resignation to the Program Director in writing. The 30-day notice may be waived at the discretion of the Program Director. All conditions of appointment will terminate on the effective date of the resignation.

A resident physician’s appointment may be terminated at any time by Hospital upon notice to the resident due to the reasons that may include, but are not necessarily limited to the following: (i) academic corrective action; (ii) the Resident’s breach of the Graduate Medical Education Agreement, Resident Physician Policies, or any Hospital policy; (iii) the Resident’s failure to comply with applicable laws; (iv) the Resident’s failure to progress in medical knowledge and/or procedural skills, as determined by the Residency program; (v) the Residency Program Director and faculty’s determination that the Resident constitutes a threat to patient safety. Termination must be addressed in accordance with the Resident Probation, Suspension, and Termination (Corrective Action) Policy.

Grievance/Appeal Procedure and Due Process

All residency programs must encourage and ensure fair, efficient, and equitable solutions for problems/issues that arise from the decision to not promote, not to renew, or to terminate a resident’s contract agreement. The MCHS Resident Grievance Policy contains the procedure to provide a forum for the fair resolution of grievances regarding a resident’s clinical and educational performance, conduct, or eligibility to continue in one of MCHS' Graduate Medical Education Residency Training Programs.

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