Residency Program Director Issues

Medical residency program directors can make or break a medical residency. Most residency program directors have their residents' best interests at heart. But every program director owes a substantial obligation to the public, the medical profession, medical school, and hospital or another medical facility where they serve to ensure patient safety and professional operations. Those substantial obligations give program directors substantial control and authority over medical residents. And when a medical resident and program director don't get along, the resident, not the director, is the one whose reputation, relationships, and career are going to suffer. When program director problems threaten a medical residency, national medical resident attorney representation can make the difference in preserving the residency and medical career to follow. Retain national medical resident attorney advisor Joseph D. Lento and the Lento Law Firm's medical resident defense team for your best outcome to medical residency program director problems.

Medical Residency Requirements

A residency program is no walk in the park. Your medical residency program will require you to meet national residency program standards. Your program very likely requires you to meet the national Accreditation Council for Graduate Medical Education (ACGME) core competencies published in its Guidance Statement. The ACGME accredits residency programs, meaning that residents in those programs must meet ACGME standards covering medical knowledge, care, professionalism, communication, continuous learning, and systems practice. Residency programs routinely tie their resident contracts to those requirements. For example, the Duke University Health System's agreement of resident appointment conditions both residency continuation and renewal on "satisfactory completion of all training components," "satisfactory academic progress as mandated by the Program and the Institution," "full compliance with the terms of this Agreement," and "satisfactory performance evaluations and documentation of passage of appropriate licensing examinations."

Program Director Authority

The above accreditation requirements give a medical residency program director all the authority the director needs to review, evaluate, and terminate or non-renew a medical resident in the director's program. When program directors discern problems with a resident's performance, behavior, or character, serious consequences right up to termination and non-renewal of the residency may follow. For example, the University of Connecticut School of Medicine's Graduate Medical Education Policies and Procedures Manual provides for probation, remedial training, loss of privileges, reassignment, and even residency termination and non-renewal. For another example, the Professional Conduct Policy for residents at Oregon Health and Science University's School of Medicine does likewise. You must maintain a good relationship with your medical residency program director if you are to avoid the risk of program director problems. Program directors have the authority to terminate and non-renew residents. And they do use that authority at the resident's substantial peril.

Program Director Problems

Despite their national standardization, residency programs and hospitals differ pretty widely. So do residency program directors. Some program directors are born educators, stable in their demeanor and resident relationships, and wise about resident challenges, learning, and capabilities. Other program directors are, instead, superior clinicians who may lack strong education, administrative, or interpersonal skills. Not all program directors are secure, stable, and fair-minded individuals. They are, after all, human. Some program director problems come out of the blue without an apparent source other than possibly a clash of personalities. Often, though, program director problems find a source in false, exaggerated, or even credible allegations that patients, supervising physicians, subordinate staff, or other residents make about the resident facing program director problems. Consider the following examples of typical program director problems. Retain national medical resident attorney advisor Joseph D. Lento and the Lento Law Firm's medical resident defense team to help you address any of these program director problems.

Alleged Performance Problems

Your program director may well consider clinical care to be the highest priority competency among the several ACGME competency standards. Above all, your program director needs to avoid patient injury or death due to substandard resident care. And so, performance problems, including poor clinical care or lack of required clinical skills and knowledge, can be a prime source for program director problems. Not all performance allegations are credible. Patients, especially, can misunderstand and misrepresent a resident's care when complaining to a program director. Subordinate staff or even fellow residents may do likewise. And residents are learning. Reasonable program directors should expect growth in resident knowledge and skills. But performance issues, real or exaggerated, can seriously disrupt a resident's relationship with a wary program director. Beware of performance issues undermining your program director's confidence in you.

Alleged Personal Misconduct

Allegations that the resident committed some form of personal misconduct can be another source of program director problems. The allegations or credible concerns may have to do with the resident's violence or threats of violence, theft of pharmaceuticals, damage to personal property or hospital equipment, patient privacy violations, misuse of hospital computers for personal matters, or even pornography. Personal misconduct narratives can also include allegations of sexual misconduct, bankruptcy, creditor lawsuits, other financial impropriety, or even criminal charges for domestic violence or other dangerous or threatening behavior. When the resident is the allegation's subject, the program director can obviously have a problem with the resident. But in some cases, the resident is simply a witness to the personal misconduct of site supervisors, residency peers, subordinate staff, or other hospital personnel. Those cases can