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Academic Deficiency Policy

Each program director is responsible for assessing and monitoring a resident’s/fellow’s academic and professional progress in the areas of:

  • Medical Knowledge
  • Clinical Competence in Patient Care
  • Interpersonal and Communication Skills
  • Professionalism (includes absence of impairment)
  • Attitudes
  • Practice-Based Learning and Improvement
  • Systems-Based Practice
  • Adherence to program, departmental, institutional and hospital policies and procedures

Failure to perform adequately in any of these areas may result in corrective action, up to and including termination.  If a resident/fellow is not progressing appropriately, the program has a responsibility to inform the resident/fellow of the deficiency and provide him/her with an opportunity to correct the deficiency.  At times it is possible and appropriate for the program to provide extra assistance or educational experiences for the resident/fellow to aid in this.  It is ultimately the resident’s/fellow’s responsibility to take the steps necessary to meet expectations.

Notice of Deficiency (STRUCTURED FEEDBACK)

General: All residents and fellows should be provided routine verbal and written feedback that is consistent with their educational program.  Some examples of feedback techniques include verbal feedback (from supervising faculty and program director), rotation evaluations, semi-annual evaluations, summative evaluations, as well as input from patients, ancillary staff or the program’s clinical competence committee. Feedback regarding serious deficiencies should be outlined for the resident/fellow, either in an evaluation form or a letter of concern.

Letter of Deficiency: If the program director determines that the deficiency is significant enough to warrant something more than routine feedback or a letter of concern, the program director may elect to issue a “Letter of Deficiency.”  This letter provides the resident/fellow with a) notice of the deficiency; and b) an opportunity to correct the deficiency.  As much as possible, a Letter of Deficiency should describe the observed deficiency(ies), and the expected academic standard.  The Letter of Deficiency should also include a timeline for reassessment or reevaluation.

A Letter of Deficiency must be cosigned by the program director and the DIO/chair of the GMEC.

The program director will continue to provide the resident/fellow with feedback consistent with the Letter of Deficiency.  At each designated period of reassessment, the program director will notify the resident and the DIO/Chair of GMEC in writing that the Letter of Deficiency has been continued or resolved.


Failure to Correct the Deficiency (ACTIONS)

 If the program director determines that the resident/fellow has failed to satisfactorily correct the deficiency and/or improve his/her overall performance to an acceptable level, the program director, with input from the clinical competence committee,  may elect to take further action which may include one or more of the following steps:

  • Non-promotion to next PGY level
  • Repeat of a rotation(s) that extends the required period of training
  • Non-renewal of resident’s/fellow’s contract
  • Termination from the residency/fellowship program
  • Suspension (other than for contractual or employment obligations)

A decision not to promote a resident/fellow to the next PGY level, to extend a resident’s/fellow’s defined period of training, to not renew a resident/fellow’s contract, and/or to terminate the resident’s/fellow’s participation in a residency/fellowship program (Action(s)) may require disclosure to others upon request, including but not limited to privileging hospitals, licensure or specialty boards.

If a resident/fellow is subject to an Action, he/she must be notified of this in writing, such notification must be signed by the Program Director and the DIO/Chair of GMEC. Any resident/fellow who is not being promoted, or whose contract is not being renewed should be notified of this in writing pursuant to the time period set forth in his/her resident agreement.

A non-renewal or termination of contract must be reported to the Illinois Department of Financial and Professional Regulation by the institution and program.


Due Process and Request for Review:

A resident/fellow who is subject to an Action may request a review of the decision as described in the Due Process and Resident Complaint Policy.  A copy of the Due Process and Resident Complaint Policy should be given to any resident/fellow who is subject to an Action.

 Last Approval Date:  September 21, 2018

 Effective Date: September 21, 2018