Applies to: Residents in the WSU Internal Medicine Residency – Everett program.
Date: May 16, 2023
1.0 Policy Statement
The WSU College of Medicine Internal Medicine Residency Program-Everett (WSU IMR Everett) defines the Academic Status categories and facilitates development of an Individualized Learning Plans (ILP) to support each resident in achieving the level of competence commensurate with independent practice.
2.0 Definitions
Accreditation Council for Graduate Medical Education (ACGME)
Accredits Sponsoring Institutions and residency and fellowship programs, confers recognition on additional program formats or components, and dedicates resources to initiatives addressing areas of importance in graduate medical education.
Academic Status
An indication of a trainee’s progression towards competency based on observed performance through the program’s assessment system. There are five categories of Academic Status, each with an associated Individualized Learning Plan (ILP).
- On Track: The resident who demonstrates the expected trajectory of competence is deemed to have an Academic Status of On Track.
- Targeted Development: The resident who does not demonstrate the expected level of competence but is anticipated to improve with a lower level of support is deemed to have an Academic Status of Targeted Development.
- Remediation: The resident who does not demonstrate the expected level of competence and is anticipated to require a higher level of support and/or resources (see Procedure section below) is deemed to have an Academic Status of Remediation.
- Probation: See WSU GME Institutional Grievance Policy
- Suspension/Termination: See WSU GME Institutional Grievance Policy
Reportable
When a resident is deemed in Good Standing, the associated Individualized Learning Plan will not be reported in the final summative evaluation or in letters of recommendation for fellowship applications. The program may be required to report the Academic Status of Remediation and Probation with supporting documentation upon request of state medical licensing boards.
Resident File
See WSU GME Resident File Policy
3.0 Responsibilities
Clinical Competency Committee, Program Director, DIO
4.0 Procedures
WSU IMR Everett utilizes a competency-based evaluation system that is designed to provide a comprehensive and holistic assessment of resident progress within the 6 ACGME Core Competencies. Evaluations collected from across the program will inform the resident’s development and progression along the Internal Medicine Milestones for each Core Competency. As defined by the ACGME, these Milestones are arranged into levels “…synonymous with moving from novice to expert resident in the specialty…”
Promotion to the next academic year/level is in part determined by the resident’s performance in the ACGME Core Competencies:
- Medical Knowledge
- Patient Care
- Professionalism
- Practice-based Learning and Improvement
- System-based Practice
- Interpersonal and Communication Skills
View level-specific performance on individual sub-competencies.
Resident performance in each Core Competency will be assessed by the Clinical Competency Committee (CCC) and the Program Director during the Semi-Annual Review. During this review, both quantitative and qualitative data from all assessment modalities—including formal and informal evaluations—are considered. The CCC will make recommendations to the Program Director (or designee) regarding resident progression and performance, which the Program Director will use to determine the resident’s Academic Status and corresponding type of ILP (see below for description). The Semi-Annual Review culminates in a scheduled meeting wherein the Program Director or designee shares the Academic Status and ILP with the resident.
Procedure regarding details of each category of Academic Status and associated Individual Learning Plan (ILP) is found in Appendix A.
5.0 Related Policies
- IM Everett Renewal and Promotion Policy
- WSU GME Corrective and Disciplinary Action Process Policy
- WSU GME Promotion and Appointment Renewal Policy
6.0 Revision History
GMEC Approval: May 16, 2023
Revision/Review Date(s):
Responsible Office: WSU Internal Medicine Residency – Everett
Policy Contact: Program Director, Program Administrator
Supersedes: N/A
Appendix A
Procedure regarding details of each category of Academic Status and associated Individual Learning Plan (ILP)
Academic Status
There are five categories of Academic Status with an associated Individualized Learning Plan (ILP), where applicable:
Good Standing
| Academic Status | Individualized Learning Plan (ILP) |
|---|---|
| On Track | Individualized Education Plan (IEP) |
| Targeted Development | Academic Enhancement Plan (AEP) |
| Remediation | Individualized Remediation Plan (IRP) |
Disciplinary
| Academic Status | Individualized Learning Plan (ILP) |
|---|---|
| Probation | Performance Improvement Plan (PIP) |
| Suspension / Termination | N / A |
A resident may move between the categories of Academic Status during their training, informed by the program’s assessment system described below. Additionally, the resident may enter any of the listed Academic Status categories depending on the nature and extent of deficiency identified. Academic Status will further determine the type of ILP and the support that is necessary for the resident to achieve the expected level of competence.
Categories of Academic Status & Individualized Learning Plan
On Track | Individualized Education Plan
The resident who demonstrates the expected trajectory of competence is deemed to have an Academic Status of On Track. This resident is assigned an Individualized Education Plan (IEP) to promote continued growth and pursue “stretch goals.” The IEP is reviewed and discussed, at minimum, during the resident’s subsequent Semi-Annual Review.
Targeted Development | Academic Enhancement Plan
The resident who does not demonstrate the expected level of competence but is anticipated to improve with a lower level of support is deemed to have an Academic Status of Targeted Development. This resident is assigned an Academic Enhancement Plan (AEP) to address
the area(s) of deficiency.
Academic Enhancement Plan
Procedure
- The resident has been identified by the CCC in consultation with the Program Director as having a specific knowledge, skill, behavior, or performance deficit in one or more of the ACGME Core Competencies and/or is not progressing as expected.
- The aim of an AEP is to address any gaps in knowledge, skills, or behaviors and facilitate course correction over a fixed duration determined by the CCC and the Program Director.
- The AEP will culminate in review of formative assessments to determine one of the following outcomes:
- Sufficient progress in the area(s) of deficiency with a recommendation for change of Academic Status to On Track.
- Insufficient progress in the area(s) of deficiency with a recommendation for change of Academic Status to Remediation.
Potential Consequences
May lead to Individualized Remediation Plan (IRP)
Reportable?
No
Remediation | Individualized Remediation Plan
The resident who does not demonstrate the expected level of competence and is anticipated to require a higher level of support and/or resources (see Procedure section below) is deemed to have an Academic Status of Remediation. This resident is assigned an Individualized Remediation Plan (IRP) to address the area(s) of deficiency.
Individualized Remediation Plan
Procedure
- The resident has been identified by the CCC in consultation with the Program Director as having a significant deficiency in one or more of the ACGME Core Competencies in a manner that requires more support and/or resources than can be provided through an AEP.
- An IRP may be instituted de novo when the area(s) of deficiency are significant or following insufficient progress during an AEP
- The aim of an IRP is to specifically identify and remediate area(s) of deficiency in relevant ACGME Core Competencies over a fixed duration determined by the CCC, and to facilitate return to the expected trajectory of competence.
- The IRP will culminate in a summative assessment period to determine the following outcomes:
- On Track, institute IEP
- Targeted Development, institute AEP
- Remediation, extend IRP
- Probation*
- Termination
*Failure to address the knowledge, skill, or behavior deficit may lead to Academic Status of Probation.
Potential Consequences
- Removal from non-clinical duties
- Adjustment of schedule including potential reduction in number of elective rotations
- Away rotations not generally permitted, but requests that are consistent with the goals of an individual resident’s remediation plan will be considered on a case-by-case basis
- Delayed promotion and/or prolongation of training time
Reportable?
May be reportable to certain state medical licensing boards upon request.
Probation and Termination
The resident who is placed on an AEP or IRP and fails to remediate and/or address specific area(s) of deficiency may be placed on Probation or Suspension/Termination. Please Refer to the Institutional Grievance Policy.
Impact of Standardized Testing on Academic Status
A Trainee must have passed USMLE Step 3 or COMLEX Level 3 before April 1 of their PGY2 year to be considered for promotion to a PGY3 year. (See Renewal and Promotions Policy) Programmatic funding for USMLE Step 3 and COMLEX Level 3 is only available for the first attempt. If after two years of training a resident fails to have a passing grade on USMLE Step or COMLEX Level 3, the trainee will be placed on Probation. At that time the resident will be required to meet with program leadership to discuss the associated Performance Improvement Plan (PIP) and the timing of repeat examination. Failure of USMLE Step 3 or COMLEX Level 3 after three attempts will result in termination.