Applies to: WSU Elson S. Floyd College of Medicine Graduate Medical Education (GME)
Sponsoring Institution and all accredited post-graduate medical training programs (i.e. residency or fellowship) and non-accredited clinical fellowship programs sponsored by the College of Medicine.
Date: January 17, 2023
1.0 Policy Statement
It is the WSU College of Medicine GME policy to assure consistent standards and processes for appointment renewal and promotion of residents and fellows.
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.
Clinical Competency Committee
A required body comprising three or more members of the active teaching faculty who is advisory to the program director and reviews the progress of all Trainees in the program.
Designated Institutional Official (DIO)
The individual in a sponsoring institution who has the authority and responsibility for oversight and responsibility of all of the ACGME accredited programs.
Due Process
A mechanism by which Institutional and Program Policies are outlined for the adjudication of Trainee complaints and grievances; a process by which an individual who is aggrieved has an opportunity to have another inquiry/re-evaluation to assure that a corrective action was fair and reasonable.
Program Director
The individual designated with authority and accountability for the operation of a residency/fellowship program.
Promotion
Progressing within a GME program to a more advanced training level or toward completion of the program generally requiring demonstration of increasing competency, and ability to function with progressive independence and assumption of greater responsibility.
Trainee
A physician in training at an ACGME accredited graduate medical education program, the term includes Interns, Residents, and Fellows or other trainee enrolled in an educational program whose education falls under the purview of the College of Medicine Office of Graduate Medical Education.
3.0 Responsibilities
GMEC and DIO
4.0 Procedures
Each training program shall have a comprehensive Trainee evaluation system in place. through the course of training, a Trainee is expected to acquire increasing competence in the discipline in which he/she is training. Promotion to the next level of training is based on the achievement of program specific competence and performance parameters. These can include specific cognitive, clinical, technical, interpersonal and communication skills, professional behaviors and ethical conduct as determined by the program and/or the sponsoring institution, such as level appropriate completion of curricular objectives, mastery of clinical materials and/or technical skills, and requirement of completion of certification examinations.
Promotion/Appointment Renewal
The Program Director, in collaboration with the Clinical Competency Committee (CCC), will make decisions regarding each Trainee’s promotion to the next year of training. Those decisions will be based on the evaluation criteria developed by the program and ACGME Milestones. While it is expected that Trainees will be promoted to the next level of responsibility annually, Trainees that fail to meet the program’s criteria for promotion will not be advanced solely on the basis of time served.
Each program must have a policy regarding the promotion of Trainees to a higher level of training that is made known to faculty and Trainees, including the criteria for promotion and/or renewal of a Trainee’s appointment. Promotion will be dependent upon meeting the academic standards and curricular requirements of the program, performance evaluations, and an assessment on the ACGME core competencies (Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, Practice-Based Learning and Improvement, Systems-Based Practice) and the Trainee’s readiness to advance to the next phase or year of post graduate training. The Program Director will also consider the appropriate program and institutional guidelines set by the Residency Review Committee (RRC), specialty board guidelines, institutional resources, and the merit of the individual.
Programs must communicate to Trainees expectations of performance/achievement required for advancement to the next PGY level. This can be done through appropriate written program curricula (paper or electronic) which are reviewed with Trainees at the beginning of their training and during semi-annual evaluations.
Prior to considering promotion, the Program Director, after consultation with the DIO, may offer a Trainee additional time in any given Post Graduate Year to allow the Trainee to achieve the required level of proficiency for promotion. A Trainee accepting this condition must be given a written summary of deficiencies, a delineation of the remediation program and the criteria for advancement.
Failure to Promote
A decision by the program to not promote a Trainee to the next level of training will necessarily be accompanied by one of two recommendations:
- Retain the Trainee at the current level of training for a specified period of time
prior to re-evaluation, and/or until competency level is achieved, or - Dismiss the Trainee from the training program (non- renewal). In either instance,
the Trainee has the right to appeal this decision, as outlined in the ESFCOM GME
Corrective and Disciplinary Action Process policy.
If a decision is made to not promote the Trainee and retain the Trainee in the current level of training, the Trainee shall receive at least 60 days advance written notice of the on promotion prior to the end of the appointment period.
Non-Renewal
In situations where a Trainee is not making adequate progress towards advancement to the next level of training, the program may decide against renewal of the trainee’s agreement. In this situation, it is expected that the Trainee will receive at least 90 days advance written notice. If the reason for non-renewal occurs within the 90 days prior to the end of the current contract, it is expected that the program will provide the Trainee with as much written notice of its intent not to renew as the circumstances will reasonably allow. Prior to considering a non-renewal or termination, the Program Director must consult with the DIO.
Non-Renewal by Trainee
If the Trainee intends not to seek continued appointment, Trainee shall provide the Program Director with written notice; not less than 90 days prior to the agreement term date.
Termination of Trainee
Per the Physician in Training Agreement, a Trainee may be terminated for cause. Causes include but are not limited to gross failure to perform duties, illegal conduct, unethical conduct, and/or any negligent act.
As with all actions adversely affecting a physician in training, the trainee has the right to appeal this decision as outlined in the College of Medicine Corrective and Disciplinary Action Process policy.
5.0 Related Policies
N/A
6.0 Revision History
GMEC Approval: May 24, 2018
Revision/Review Date(s): October 19, 2021, January 17, 2023
Responsible Office: WSU College of Medicine Sponsoring Institution
Policy Contact: Designated Institutional Official
Supersedes: N/A