General Policies & Procedures: Impaired Resident/Fellow Policy, Graduate Medical Education in the Medical School at the University of Minnesota

University of Minnesota Medical School (UMMS)
Graduate Medical Education (GME) Administration

Policy
An impaired trainee shall be defined as any trainee who, by virtue of physical disability, mental illness, psychological impairment, chemical substance abuse or misconduct, is unable to safely care for patients, perform duties normally expected of a trainee physician or engage in peer interaction necessary for patient care.

This must be documented by written reports from at least two individuals (patients, faculty, trainees or others) who have firsthand knowledge of an incident involving the trainee.  Consultation with appropriate outside agencies may also be utilized. The final decision of what constitutes inability to perform duties shall rest with the program director.

The remedial measures in dealing with the impaired trainee require identification and immediate institution of an appropriate treatment program.  There must be available methods that identify stressors and factors within the environment that could cause problems, and personality traits that could put the trainee at risk.

Procedure
There should be regular monitoring of trainee performance by the program directors and the faculty.  When a suspicion of impairment is detected, an in-depth interview with the trainee by the program director and one other faculty member shall be carried out.  Mutually agreeable resources may be utilized to establish the fact and severity of the impairment.

As soon the program director is aware of a problem with resident/fellow impairment, an immediate method of handling the problem should be determined.

The program director and the trainee, after discussion, will formulate a plan for reduction, and/or elimination, of the impairment.  The plan should stipulate specific goals and objectives.  If agreement is reached, the program director and the trainee both sign the plan.  The original is kept in the resident/fellow's file, copies are sent to the trainee, the program director, and the department chair. There shall be a periodic review of the impairment by the program director.

If a leave of absence is involved in the plan, it must meet the criteria stated in the regulations of the appropriate Specialty Board.

If the program director and the trainee cannot agree on either the fact of the impairment or plan for remediation of the impairment, then the regular dismissal policies and procedures of the Medical School may be utilized.

If required, reporting of the impaired physician to the Board of Medical Examiners shall be carried out under the provisions of State of Minnesota Statutes Chapter 147.