This policy was developed for SIU Medicine. SIU Medicine collectively applies to the SIU School of Medicine (SIU SOM), including the Federally Qualified Health Center (FQHC), and SIU HealthCare (SIU HC). These entities are collectively referred to as SIU in this document.

This document applies to SIU staff, faculty, trainees, agents, officers, directors, interns, volunteers, contractors, and any other individual or entity engaged in providing teaching, research and health care items and services at SIU. These individuals are collectively referred to as SIU personnel in this document.


The term “resident” is inclusive of all trainees at SIU SOM, whether training in a residency or fellowship program.  The term “program” is inclusive of all SIU residency or fellowship programs, whether accredited or non-accredited.


The purpose of this document is to outline expectations regarding resident recruitment practices, evaluation of resident performance, and promotional consideration.



Programs must engage in recruitment practices that focus on mission-driven, ongoing, systematic recruitment and retention of a diverse and inclusive workforce of residents, faculty, and other members of their academic community,  The School of Medicine will participate in the National Resident Matching Program as an Institution.

The selection of residents in each program shall be carried out by the Residency Program Director with the assistance of the teaching staff.  Programs will select applicants who are eligible for appointment to accredited residency programs.  (See Policy on Resident Eligibility and Employment Authorization)

Programs will select applicants on the basis of their preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities such as motivation, integrity and coachability.  Programs will not discriminate with regard to race, religion, national origin, citizenship, sex, age, disability, sexual orientation or other factors prohibited by law.  


Each residency program must demonstrate that it has an effective plan for assessing resident performance throughout the program and for utilizing the results to improve resident performance.  

This plan should include: 

  1. The use of assessment methods that produce an accurate assessment of residents’ competence in patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. 
  2. Input and guidance from the Clinical Competency Committee (CCC). 
  3. Assessment of residents’ achievement of specialty-specific Milestones. 
  4. Mechanisms for providing regular and timely performance feedback to residents that includes at least: 
    1. Regular verbal and written Feedback 
    2. Written semiannual evaluation that is communicated to each resident in a timely manner
    3. Maintenance of a record of evaluation for each resident that is accessible to the resident 
    4. A process that uses the results of multiple assessment instruments and evaluators to achieve progressive improvements in residents’ competence and performance, and to appropriately allow for the assumption of graded responsibility and authority.  Appropriate sources of evaluation include faculty, patients, peers, self, and other professional staff.

With input from the CCC, the program director must provide a final evaluation for each resident who exits the training program early or completes the program.  The evaluation must, for graduating residents, verify that the resident has demonstrated the knowledge, skills, and behaviors necessary to enter autonomous practice.  The final evaluation must be shared with the resident on completion of the program and become part of the resident’s permanent record maintained by the institution. 


The responsibility given to residents in patient care should depend upon each resident’s knowledge, problem-solving ability, manual skills, experience, and the severity and complexity of each patient’s needs.  The privilege of progressive authority and responsibility, conditional autonomy, and a supervisory role in patient care delegated to each resident must be assigned by the program director and faculty members. The program director must evaluate each resident’s abilities based on specific criteria.  When available, evaluation should be guided by specific national standards.


Each program must establish written policies describing the program requirements for promotion to the next level of training. The program director, with input from the program’s CCC, will determine at least annually whether each resident has progressed satisfactorily to advance to the next level of training and/or demonstrated the skills necessary to supervise junior residents.
For all programs, the criteria for advancement is based upon the following broad parameters, all of which need to be judged as competent for each level of advancement. More detailed program-specific criteria and requirements for promotion will be delineated by individual programs.

 PGY 1 to PGY 2: 

  1. Acceptable progress in specialty-specific competencies and Milestones 
  2. Acceptable progress in the program goals and objectives and other program-specific criteria and requirements for promotion 
  3. Ability to meet the Work Hours and Additional Physical Requirements as outlined in Appendix A of the Agreement with Physician, with or without reasonable accommodations 
  4. Ability to fulfill essential role functions and competency requirements as outlined in Attachment 1: Resident Essential Role Functions, appropriate to the level of training, with or without reasonable accommodations
  5. Compliance with all contractual requirements
  6. Ability to supervise/teach appropriate learners
  7. Ability to act with limited autonomy

PGY 2 to PGY X: 

  1. Items 1-5 above
  2. Ability to act with increasing autonomy 

PGY X to Graduation: 

  1. Items 1-5 above
  2. Ability to act autonomously

Program policies with respect to promotion/non-promotion to the subsequent year of training shall comply with all ACGME Institutional, Common and Program Requirements, and be in accordance with the Academic Deficiency Policy. The decision for promotion or non-promotion shall be made by the Residency Program Director with consultation from the CCC.  A decision to withhold advancement or deny reappointment shall be taken only after documented counseling of the resident apprising them of the reason for such potential action, and documentation that the deficiencies have not been sufficiently corrected within a reasonable time.   If a resident believes that they have been dealt with unfairly in the above process, redress may be sought through the Due Process and Resident Complaint Policy.


Dismissal, non-renewal of contract or non-promotion of a resident whose performance is unsatisfactory will be communicated in writing to the resident in accordance with GMEC policies on academic deficiencies and corrective action.  Appeals of dismissal actions shall be handled through the Due Process and Resident Complaint Policy.