Becoming a doctor is a challenging process that requires dedication, skill, and the ability to work under difficult conditions. Getting into medical school is also challenging. Those who are talented and fortunate to get into residency programs can continue working toward their goals. Sometimes, residents can be wrongfully terminated from their programs and are left feeling shocked.
Some of the main reasons why medical residents are terminated from their programs include unsatisfactory work, unfavorable evaluations from supervisors, and being unable to complete residency requirements. The allegations could be fair or unjust. In addition to that, the panel who made the determination may not have followed the proper procedures when making their decision.
Accredited medical residency training programs use the Accreditation Council for Graduate Medical Education (ACGME)’s set of six ACGME Core Competencies to evaluate residents. These Core Competencies are used to measure residents’ abilities to administer high levels of patient care. These skills focus on diagnosing and treating illnesses, using strategies to improve patient health, and providing resources to prevent diseases. They also include physical treatment as well as emotional support for patients, their families, and their support systems.
The Core Competencies include:
- Practice-based learning and improvement
- Patient care and procedural skills
- Systems-based practice
- Medical knowledge
- Interpersonal and communication skills
The majority of disciplinary actions will be based on a resident’s actual or perceived shortcomings in one of those six core competencies. A resident may first face a reprimand, probation, suspension, non-renewal into the program, or a termination. If a medical resident suspects they were wrongfully terminated, they should speak to a lawyer about their options.
What Should I Do After Receiving a Disciplinary Notice?
A medical resident who is in danger of any disciplinary action can start building their case by understanding how the program’s internal disciplinary program works. There may be a small panel of individuals who make the decisions, and it may be possible to work with a neutral intermediary. A medical resident should avoid signing any documents until they consult with an experienced physician lawyer.
The program’s manual will explain the methods that are used in the disciplinary program, and if they are not followed correctly, the resident might be able to use that to help build a case. The information should describe the procedures that the panel must use to make a determination and arrive at their final decision, as well as ways the resident can make an appeal after the hearing.
The ACGME emphasizes the importance of mediation when issues come up and recommends that residency program directors teach residents about proper conduct rather than punish them. The firing of a resident should always be the last resort.
How can I Appeal the Decision?
The residency program is required to have a way for its trainees to seek out reviews of panel disciplinary decisions. These will vary and apply to the types of decisions that may be appealed, how the request is handled, and deadlines. Be aware that these deadlines are often short and can be as little as 72 hours. This information can usually be found quicker by contacting the Office of Graduate Medical Education (GME).
Filing an appeal must be done before the deadline, since it will likely be assumed that the resident concedes to the disciplinary actions if the appeal is not filed in time. The resident should also read carefully through all of the documents that the panel has prepared. This should provide all of the reasons and supporting information that contributed to their decision. It may be possible to find clear evidence elsewhere that contradicts the panel’s findings.
The panel’s supporting documents can include annual evaluations, rotation evaluations, memos, emails, reasons for discipline, and details about remediation efforts. Residents can seek out support to challenge those evaluations. This can be done by gathering together test scores, awards, and letters of support from co-residents, attendings, and nurses. The resident might also obtain a copy of their personnel from the hospital or school’s Human Resources (HR) department.
When challenging a decision or working on an appeal, remaining professional is of the utmost importance. Professionalism should remain a priority. Residents may be devasted when their careers are threatened, but being emotional can only make matters worse.
What About Due Process?
Medical residents who are informed of terminations will be understandably upset. They have been handed down decisions that can ruin their careers, often without clear understandings of what happened. Academic due process is usually carried out by educational institutions with the professional judgment in the hands of the academic faculty. However, the ACGME has acknowledged two U.S. Supreme Court cases that are noted in the Clinical Competency Committee Guidebook.
Based on those decisions, the ACGME recognizes that disciplinary actions have to be based on a careful and methodical process. The determinations have to be rational, fair, and conscientious, and not impulsive or subjective. Panel members are required to review the resident’s complete academic record in view of the broader context of the resident’s overall performance.
In addition, any negative findings that lead to possible disciplinary actions have to be communicated clearly to the resident. A Notice of Deficiency must be sent out first with a clearly defined process for the trainee to address and correct the problem. The ACGME also points out that the goal of the evaluative process is to provide helpful feedback to residents that explains any strengths and deficiencies. This feedback can then be used as an opportunity to improve the resident’s skills.
When residency programs neglect to adhere to their stated policies and procedures, they may well be in violation of the basic elements of due process. The problem could be due to one-panel member, the whole panel, or be rooted in the program itself. If due process is not being followed and the resident is wrongfully terminated, they may not know where to turn.
Should I Sign a Last Chance Agreement?
Some residency programs may offer a resident a last chance agreement in lieu of termination. However, signing the agreement might be a mistake, and one should not sign it without getting legal advice first. The agreement may be worded to look as though the resident will be permitted to resign and find another residency program. However, there could be clauses in the agreement that limit the resident’s options once the document is signed.
Additionally, there may be a deadline to sign the last chance agreement, which can put even more pressure on the resident. Accepting this offer could be detrimental to a resident’s future career options and could also affect their rights. Even when there is a short window of time, contacting a physician lawyer might be the best decision. Some residents are able to resign from their program and enter a new one, but this also requires careful consideration and legal guidance.
Philadelphia Physician Lawyers at Sidney L. Gold & Associates, P.C. Help Medical Residents Recover After Wrongful Termination
If you are a resident facing disciplinary action, you need a lawyer who is highly experienced in physician law. Do not wait to contact the knowledgeable Philadelphia physician lawyers at Sidney L. Gold & Associates, P.C. We understand your situation, and we will know if your rights have been violated. Complete our online form or call us at 215-569-1999 for a free consultation. Located in Philadelphia, we serve clients throughout Wilkes-Barre, Scranton, Northeast Philadelphia, Bucks County, Chester County, Delaware County, and Montgomery County.