The following are steps taken when an issue regarding a resident comes before the House Staff Evaluation Committee. Steps 3 to 13 follow one another only when the problem is not ameliorated during an earlier intervention.

1. A problem involving a resident is brought up before the House Staff Evaluation Committee, either by a member of the Committee or by an invited faculty member.
2. The problem is discussed, with members of the Committee contributing their knowledge of the problem. Depending on the severity of the problem and whether or not similar issues for this resident have been dealt with in the past, the Committee can table further discussion unless the problem recurs, or it can go on to step 3.
3. A member of the Committee is assigned to speak to the resident, outlining the issue and hearing the resident's response. The trainee is told he or she can respond in writing to the Committee as well, and the suggestion is made that the resident contact his or her adviser about the problem. All evaluations and memos regarding the problem are made available to the resident and to his or her adviser. The Committee member records the encounter and presents the account to the Committee.
4. If the problem persists, the Program Director has a private meeting with the resident and discusses the problem with him or her. If appropriate, vocational or psychiatric counseling is suggested and/or arranged with the resident's permission. Close supervision, with rotation change if necessary, is arranged for the next or next few rotations. Formal probation is imposed when appropriate.
5. The resident is asked to appear before the Committee to state his or her case and to hear the Committee's position.
6. The resident is told he or she can continue to appeal in writing and in person before the Committee.
7. The resident is continually warned of possible actions by the Committee, including non-renewal of a contract and not being awarded credit for the year of training in question, and is informed by a principal of the Committee when such actions are taken.
8. A letter warning of the possibility of dismissal from the program is written, informing the resident of which actions or omissions can lead to that result.
9. When the Committee believes that such an action or omission has taken place, a meeting is convened to discuss the event. The resident can, if he or she wishes, address the Committee at the meeting. The Committee can decide to recommend dismissal, usually by individual vote.
10. The Program Director consults with the Department Head, and, if they concur, the resident is informed of the decision at a meeting with the Program Director and the Chairman of the Committee.
11. The resident may appeal the decision in writing to the Department Head within 14 days following dismissal or other disciplinary procedure, the latter including probation, suspension, non-renewal of contract, or dismissal. The hearing, before a committee of three department faculty members not including members of the Evaluation Committee, the Department Head or the Program Director, will take place no later than 10 days following the receipt of the resident's request. The resident and the Program Director will make presentations to the committee members. The Department Head will be bound by the committee's vote, with the resident receiving a written copy of the decision within 10 days of the hearing.
12. The resident may appeal the committee decision to the Associate Dean for Graduate Medical Education in writing within ten days. The Associate Dean will decide the appeal within 30 days.
13. The resident may appeal the Associate Dean's decision to the Dean of the College of Medicine in writing within 10 days of the Associate Dean's decision. The Dean will render a decision within 30 days of receipt of the resident's appeal. This decision will be final.

Revised 4/28/04, 6/28/04