Residency Discipline

The Department of Surgery has policies and procedures for the adjudication of complaints against surgical residents that could result in disciplinary action. Any occurrence which the Advisory Committee views as serious and needs disciplinary actions is addressed as outlined in Article XVI in the CIR Collective Bargaining Agreement with the City of New York and Health and Hospitals Corporation.

1. What are favorable attributes of surgical residents?
These include:
• Competence
• Compassion
• Care
• Honesty
• Responsibility
• Punctuality
• Reliability
• Accountability
• Good judgment
• Communication skills
• Initiative
• Curiosity/ Innovation
• Leadership and self confidence

2. Agreement to obey Hospital and Department of Surgery regulations

By signing the Residency contract of appointment, the surgical resident understands and agrees to abide by and obey all Hospital and Department of Surgery policies and regulations which include:
• Confidentiality of patients' records
• Punctuality on reporting to duty
• Prompt completion of patient records on admission
• Daily follow-up and discharge
• Timely reporting of mortalities, complications and adverse dug reactions
• Immediate dictation of all operative procedures
• Abstinence from the use of illegal drugs and involvement in illegal activities
• Respect for all hospital personnel, and patients and their families
Failure to comply with above may constitute grounds for suspension or other disciplinary actions.

3. Resident Evaluation

Residents are evaluated individually twice a year by the Residency Advisory Committee. This exercise includes assessment of academic performance as reflected by objective scores in the in-service training exami¬nations, evaluation of patient management with review of particular patient charts, review of operations performed and demonstrated surgical skills, consideration of teaching and supervision of junior resi¬dents and the monthly evaluation of residents by the Chiefs of service or divisions as directed by the Department. In addition, these sessions provide the resident with the opportunity to give his/her as¬sessment of the surgical program, individual attendings and residents. Residents can express their opinions on any subject during the meeting with the Residency Advisory Committee without fear of intimidation or retaliation. Additionally, residents are expected to review their evaluation and acknowledge this by signing the copy in the file.

4. Resident's Grievances and Complaints

Residents are encouraged to present their grievances and complaints to chief residents, resident mentor, sectional chiefs, or as the last resort to the Director of Surgery. Complaints and grievances can also be discussed with the Residency Advisory Committee. Residents are assured that their grievances and com¬plaints will be given the desired attention.

5. Educational Activities

Residents are expected to achieve academic excellence and surgical technical expertise. The
surgical program is designed to expose all residents to varied operative experiences, academic
teaching, discussions, and exchange of ideas during the weekly Director's Grand Rounds, Basic
Science Lecture Series,Tumor Board and Journal Club Meetings. Residents are required to attend
and to actively partici¬pate in assigned operations and discussions at these meetings.

6. Disciplinary Measures

For good interpersonal relationships and the proper functioning of the Department of Surgery, there are situations for which corrective measures and/or disciplinary actions must be enforced. These circum¬stances include the following:

a. Absence from Grand Rounds, Basic Science Lectures and assigned operations without the Director’s
permission will lead to a letter of warning. Repeated offences will be considered by the Residency Advisory Committee for appropriate disciplinary action, which includes possible suspension/probation.

b. Any resident who after repeated warnings continues to be late or absent
from the required
morning and/or evening ward rounds, clinics or operating room sessions will be reprimanded by the Director of Surgery after due consideration of the case by the Residency Advisory Committee.

c. Residents are required to complete on-line within 24hrs their medical records including history and physical, resident’s admitting notes, progress notes, pre and post operative notes, operative reports and clinic visit notes. Any resident with incomplete records beyond the specified time will be disciplined.

d. A resident with poor clinical performance and/or poor In-Service Training Examination scores may be required to undertake remedial training as recommended by the Residency Advisory Committee. . He/she may not be allowed to progress to the next PGY level until he/she has demonstrated to the Committee evidence of improved/corrected performance.

e. All operative procedures should be dictated immediately as stated above.

f. Some of the grounds for dismissal or non-renewal of agreement of
appointment include:

1. Inappropriate behavior to hospital personnel or patients
2. Unlawful use of drugs
3. Conviction by a court of law for criminal activities;
4. Repeated suspension despite adequate counseling
5. Non compliance with the general competencies.

g. A resident who is being considered for remedial training or non-renewal of appointment will be given written notice of intent as stated in the collective bargaining agreement between CIR and HHC

h. All letters of warning, reprimand, suspension or dismissal will become
permanent records in the resident’s file.

i. Resident dismissal

Before resident dismissal:

1. Just cause and due process must be followed
2. Misdeeds of residents must be documented
3. Resident must be given a warning letter
4. Probation over specific time period if applicable must be
undertaken.
5. Appeal Committee must review the case
6. Counseling of resident may be undertaken

Termination of appointment may occur with involvement of the following:

1. Appeal directly to Residency Review Committee for
reconsideration of its decision
2. Designated Institutional Officer (DIO) and GME Chairman
3. Hospital lawyer
4. Hospital Risk Management
5. CIR
6. The Labor Relations Office
7. Commendation

After each period of evaluation by the Residency Advisory Committee, a letter of commendation will be sent to residents with outstanding or excellent performance.