Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

ABSTRACT

It is important that residency programs identify trainees who progress appropriately as well as identify residents who fail to achieve Milestones as expected so they may be remediated. The process of remediation varies greatly across training programs, due in part to the lack of standardized definitions for good standing, remediation, probation, and termination. The purpose of this educational advancement is to propose a clear remediation framework including definitions, management processes, documentation expectations and appropriate notifications.

Informal remediation is initiated when a resident’s performance is deficient in one or more Milestones but not significant enough to trigger formal remediation. Formal Remediation is when deficiencies are significant enough to warrant formal documentation because informal remediation failed or because issues are substantial. The process includes documentation in the resident’s file and notification of the Graduate Medical Education office, however, the documentation is not disclosed if the resident successfully remediates. Probation is when a resident is unsuccessful in meeting the terms of formal remediation or if initial problems are so significant to warrant immediate probation. The process is similar to formal remediation but also includes documentation extending to the final verification of training and employment letters. Termination involves other stakeholders and is when a resident is unsuccessful in meeting the terms of probation or if initial problems are so significant to warrant immediate termination.