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 also create program director problems for the involved resident.
Alleged Unprofessionalism
Professionalism is another ACGME core competency that can get the undesired attention of a program director and contribute to a resident's program director's problems. Professionalism is a broad subject overlapping performance. But unprofessional conduct can include failing to follow a supervisor's orders, disrespecting a supervisor, peers, or subordinate staff, disrespecting patients, failing to show up for assigned rounds, incomplete, inaccurate, or falsified documentation, and even poor dress, hygiene, and demeanor. Once again, when the resident is the allegation's subject, the program director can have obvious problems with the resident. But the resident's site supervisor or peers may instead be the ones alleged to have engaged in unprofessional conduct. Those cases can also cause program director problems for the resident who witnesses the unprofessionalism or is otherwise drawn into it.
Alleged Substance Abuse Issues
Substance abuse allegations can be another source of program director problems. Supervisors, resident peers, subordinate staff, patients, or other hospital personnel may claim to smell alcohol on a resident's breath or detect behavior and demeanor that suggests intoxication. Others may alternatively witness a resident's alcohol or drug use off-premises at resident or staff parties or social gatherings and raise concerns over an addiction or illegal activity. A drunk driving charge may also trigger program director problems involving allegations of the resident's substance abuse. And once again, substance abuse by other residents, supervisors, or staff can implicate a resident's own duty to report and protect. Beware substance abuse issues as a source for program director problems.
Bias and Discrimination
Unfortunately, program directors, site supervisors, and others involved in the resident program can also exhibit biases and even unlawfully discriminate against residents based on race, sex, age, disability, or other protected characteristics. When a resident finds no apparent reason for the resident's unfairly critical treatment by a director, supervisor, or others, the resident may suspect bias or discrimination. Off-color comments, inappropriate gestures, and negative body language and demeanor can contribute to a resident's impression that the director, supervisor, or others are exhibiting bias, especially if the resident simultaneously discerns disparate treatment in assignments and evaluations. Keep a lookout for evidence of bias and discrimination if you experience disparate treatment without other apparent explanations.
Program Director Solutions
Don't give up hope if you face program director problems threatening your residency program dismissal or non-renewal. You may have several attractive options to favorably resolve your program director problems with skilled and experienced attorney advisor representation. Sometimes, the solution involves additional documentation of the allegedly deficient resident's performance. Medical records, lab results, witness attestations, and even forensic consultant reviews can often show that the director's information was inaccurate or incomplete. Exonerating evidence is a powerful tonic for program director problems. Other times, the solution involves presenting mitigating evidence and explanations. The resident may have faced special challenges about which the director was unaware or unconvinced, additional evidence of which may explain away the director's concerns. Other times, the solution may involve the resident's reassignment to another supervisor or an affiliated facility where the resident doesn't face interpersonal challenges or suspected biases. And other times, the solution may involve the resident's additional training or other remedial education. If the director has legitimate performance concerns, the best course is sometimes to address them directly through specific performance-improvement plans. After all, a residency program is for training. Retain national medical resident attorney advisor Joseph D. Lento for creative, win-win solutions to your program director's problems.
Protective Procedures to Overcome Director Problems
Residents facing dismissal or non-renewal also generally have protective procedures to invoke that give them a fighting chance to defeat dismissal or non-renewal. Those procedures typically provide fair notice of the allegations leading to dismissal and a reasonable opportunity to contest the allegations before an impartial decision maker. Residency program protective procedures generally provide at least that basic due process. Duke University Hospital's above agreement of appointment, for example, assures the resident not only of adequate facilities, resources, support personnel, and equipment but also a "fair and consistent method" of reviewing a resident's concerns over inadequate support. The same agreement promises processes "for review of trainee's performance, deficiencies, or related issues of concern," especially "in connection with any adverse or remedial actions taken, or proposed to be taken" relating to the residency. Duke University Hospital's residency program also promises the resident a Corrective Action and Hearing Procedure when threatened with dismissal or non-renewal. Protective procedures may remove the final decision from the problem program director's hands, giving the resident a fair appraisal.
The Role of Attorney Advisor Representation
Dispute resolution procedures like the ones described immediately above, though, are not self-executing. A skilled and experienced medical resident attorney advisor plays several critical roles in strategically deploying those procedures. The attorney advisor should identify, gather, organize, and skillfully present the evidence that can carry the day with the program director or review committee. The attorney advisor can also communicate and negotiate diplomatically for early informal resolution while hearing procedures are pending. For residents who have already lost their residency dismissal or non-renewal hearing, the attorney advisor may appeal the decision as program and school procedures permit. For residents who have already exhausted all formal procedures, medical resident attorney advisor Joseph D. Lento has the national reputation and relationships to reach and negotiate with medical school general counsel, outside retained counsel, and other oversight officials for special alternative relief. Civil litigation in the courts may also be an option, although alternative special relief can be much quicker and more effective in restoring and retaining the resident's professional reputation and relationships.
Premier Attorney Advisor Representation Available
You know what you have at stake in completing your medical residency. You know that without doing so, your medical licensure, medical practice, and medical career are at risk. Dismissal from one medical residency program can also lead to serious challenges in gaining entry into another program. Medical residency program director problems, when not properly resolved, can also affect your professional reputation and relationships. Premier medical resident attorney advisor Joseph D. Lento and the Lento Law Firm medical resident defense team are available for nationwide representation. Let attorney advisor Lento help you overcome your program director problems to preserve your residency and medical career. And if you must withdraw from your residency, attorney advisor Lento can help you do so on the best possible terms so that you can undertake and complete another residency. Get the representation you need for your best outcome to medical residency program director problems. Call 888-535-3686 or go online now.
