“I matched!” is an Instagram moment for many medical students who land a spot in a residency program. It's a period that goes beyond the academic to the practical, giving residents the chance to work with practicing doctors and real patients.
It's also notoriously a brutally tough schedule with long hours and little sleep, all of which can lead to mistakes. While most occupations make allowances for missteps, regulatory bodies—driven by the legal system overall—hold physicians to one of the highest standards of any profession.
Any mistake on the part of a medical resident can be grounds for dismissal.
Dismissal From a Residency Program in Washington
Residents are in a unique position at this point in their careers: They are both learners and employees.
So, while they must abide by all policies imposed on everyone who works for the hospital or treatment facility, they also have rights as students under the institution's student code of conduct. When faced with a disciplinary action, these include the right to hire an attorney-advisor as a counselor on defense.
It can happen to a pea-green resident or one in the home stretch, but scrutiny typically intensifies the further along one gets in the program. Everything is under the microscope, including both professional and personal conduct, competency, and compliance with hospital regulations.
The Role of Ethics
Everyone wants to be able to trust their doctor. Training programs' reputations are built to a great degree on scrupulousness in how and when they convey professional and personal standards of conduct to their residents.
The American Medical Association (AMA) has been heavily involved, developing a national codification of medical ethics to enhance and maintain public health and standard of care.
Among others, they cite the following as examples of violations of ethical and professional violations:
- Improperly removing pharmaceuticals from a health care facility
- Inappropriate use of social media
- Engaging in bribery or kickback schemes
- Ignoring a conflict of interest in patient care decisions
- Being a subject of allegations of sexual misconduct or discrimination against colleagues or patients on the basis of race, sexual identity/orientation, religion, or national origin
- Being intoxicated or engaging in substance abuse while at work
- Inability, on a consistent basis, to manage the stresses of the profession, especially as they lead to medical errors or complaints from co-workers
A violation related to anything within the AMA's code can lead to a reprimand, sanctions, or dismissal from a program, having a major negative impact on a resident's future, both personal and professional.
The Role of Competency
Likewise, the Accreditation Council for Medical Education (ACGME) has weighed in strongly on ethics and competency in six significant areas:
- Professionalism. At the risk of loss of residency or license, it's essential for a resident to remain in compliance with ethical principles and to be considerate of the needs of the broad range of individuals with whom he or she interacts.
- Medical knowledge. This must go beyond the theoretical to an understanding of how classroom learning translates to practical care for patients.
- Patient care. It should (but cannot) go without saying residents must provide those under their care with compassion, high-quality medical attention, effectively treating whatever health issues they face.
- Practice-based learning and improvement. Continually evaluating personal performance and integrating feedback, a successful resident must strive to continually improve proficiency and expand skills over time.
- Interpersonal and communication skills. What used to be called bedside manner is now an expectation in every aspect of a practice. This means not just knowing the medical facts but effectively communicating about care to everyone from patients and their family members to nursing and administrative staff.
- Systems-based practice. State and national healthcare systems are complex and changing quickly. Residents are expected to develop and maintain an understanding of how systems impact healthcare delivery and patient care.
Disciplinary Boards
Every medical teaching institution has a disciplinary board to enforce against infractions of the hospital's policies on competency and ethics. They wield tremendous power over a resident's future as a doctor. While relatively minor violations might only lead to a written reprimand or probation, these can stay on record and follow a resident throughout his or her career.
More serious violations can lead to suspension and even dismissal.
Residents must gain a strong understanding of the policies at their teaching hospitals and be aware of every policy and their rights in the face of an enforcement action. Many residents under scrutiny incorrectly assume they must appear on their own before the board; this can result in a disappointing outcome with long-term consequences.
How Joseph D. Lento, Attorney-Advisor, Helps Medical Residents
Wherever you are in your residency path—be it as a first-year intern or winding up your third year—finishing your program with a clean record will have a huge impact on your career.
Even the most conscientious resident can make a misstep, and when that happens, it's important to have a skilled advisor to put the best foot forward.
Attorney-advisor Joseph D. Lento and his team have counseled hundreds of medical residents facing sanctions across the country. He understands the mechanisms and thought processes behind disciplinary boards and knows how to work effectively with them. He interacts with hospital general counsel with the goal of reaching a fair resolution.
Make sure your residency isn't derailed by a simple mistake. Call the Lento Law Firm today at 888-535-3686 or send a message through the online portal to learn more.
