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Key Words: Residents; Residency training; Resident remediation; Resident education; Professionalism; Pathology training; Pathology education
Am J Clin Pathol June 2014;141:784-790
DOI: 10.1309/AJCPSNPAP5R5NHUS
ABSTRACT
Objectives: To suggest a basic new approach for pathology training programs to consider when a resident requires remediation, probation, or dismissal.
Methods: Remediation, probation, or dismissal of the poorly performing pathology resident is one of the most difficult and challenging aspects of any pathology training program. The poorly performing resident requires extra time and resources from the faculty and the program and can be disruptive for the entire program. Effective remediation requires faculty development, a well-constructed remediation or probation plan, and documentation.
Results: Despite best efforts, not all remediation plans are successful and dismissal of the resident will need to be seriously considered.
Conclusions: Approaches to dealing with resident performance issues can be variable and need to be tailored to the issue being addressed.
One of the most difficult and important responsibilities of a pathology residency or fellowship program director is to ensure that upon graduation his or her residents or fellows are competent to enter practice without direct supervision. In addition, it is typically the program director who signs the various forms verifying competence and fulfillment of accredited training to allow the graduating resident or fellow to sit for his or her board examination, to obtain state licensure, and to obtain hospital credentialing and privileges. The program director may perform such verification procedures multiple times over years or decades for individual graduates.
To adequately assess and evaluate a resident's performance, close observation by multiple observers using multiple evaluation tools is required at multiple points during the training period. With the recent requirement by the Accreditation Council for Graduate Medical Education (ACGME) for every accredited training program to have a Clinical Competence Committee (CCC), the burden of responsibility for verifying the competence of residents and fellows will now be shared between the program director and the CCC. However, the program director's attestation and signature typically will remain the final and official verification on a graduate's paperwork.1 Through the use of the CCC, it is hoped that resident performance issues will be identified and addressed in a timely fashion, and that the unpleasantness of remediation, probation, or dismissal from the program,...