RESIDENCY AGREEMENT THIS AGREEMENT is made this _____ ...
RESIDENCY AGREEMENT THIS AGREEMENT is made this _____ ...
RESIDENCY AGREEMENT THIS AGREEMENT is made this _____ ...
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<strong>RESIDENCY</strong> <strong>AGREEMENT</strong><br />
<strong>THIS</strong> <strong>AGREEMENT</strong> <strong>is</strong> <strong>made</strong> th<strong>is</strong> _____ day of _________________, 20__ by Oakwood<br />
Healthcare, Inc. a Michigan nonprofit corporation (“Oakwood”) and ____________________<br />
_____________________ ,M.D.,(“Resident”). The term of th<strong>is</strong> Agreement shall be from July1,<br />
__________ through June 30, __________ .<br />
Section 1 Appointment. Oakwood offers to Resident and Resident accepts appointment as<br />
House Officer Year ________in the Oakwood _______________________ Residency Program<br />
under the terms and conditions of th<strong>is</strong> Agreement. Resident must meet Oakwood’s requirements<br />
for credentialing and employment as specified in the Resident Handbook. The Resident<br />
Handbook <strong>is</strong> available at www.oakwood.org under the link for Programs and Services- Medical<br />
Education - Resident Policies.<br />
Section 2<br />
Oakwood’s Obligations.<br />
2.1 Teaching Staff. Oakwood will supply a teaching staff and a physical environment<br />
conducive to improving the Resident’s medical knowledge and skills. Oakwood shall orient the<br />
Resident to the facilities, philosophies, rules, regulations, and policies of Oakwood and the<br />
Institutional and Program Requirements of the ACGME and RRC.<br />
2.2 Superv<strong>is</strong>ion. Oakwood will provide superv<strong>is</strong>ion to Resident when Resident <strong>is</strong><br />
carrying out patient care responsibilities, in accordance with superv<strong>is</strong>ion guidelines developed<br />
from time to time by the Resident’s Program Director.<br />
2.3 Support. Oakwood shall facilitate the Resident’s access to counseling and<br />
psychological support services, when, in the d<strong>is</strong>cretion of the Resident’s Program Director, the<br />
Resident requires such counseling and psychological support. See Oakwood’s Resident policy<br />
regarding counseling and support in the Resident Handbook. Also see: Oakwood’s Resident<br />
policy regarding physician impairment and Oakwood’s Human Resources Policy and Procedure<br />
Manual regarding the Oakwood Fitness for Duty policy.<br />
2.4 Benefits. Oakwood shall provide the Resident with the following compensation<br />
and benefits:<br />
2.4.1 Compensation of $_______________ per year, payable throughout the<br />
term of th<strong>is</strong> Agreement in equal installments on a bi-weekly bas<strong>is</strong>.<br />
2.4.2 The fringe benefits, including health and d<strong>is</strong>ability benefits, are described<br />
in the House Officer Benefit Information Packet contained in the Resident Handbook. For<br />
convenience, a summary of the fringe benefits <strong>is</strong> attached to th<strong>is</strong> Agreement.<br />
2.4.3 Laboratory coats, free of cost, for Resident's use while fulfilling h<strong>is</strong>/her<br />
obligations under th<strong>is</strong> Agreement.<br />
2.4.4 Sleeping quarters for Resident's use when Resident <strong>is</strong> required to remain
on Oakwood prem<strong>is</strong>es to fulfill h<strong>is</strong>/her obligations under th<strong>is</strong> Agreement.<br />
2.4.5 Fifteen (15) paid vacation days per year. The Resident must submit<br />
requests for vacation time in writing to the Program Director and the Medical Education Office<br />
at least one month in advance of the requested vacation time. All requests for vacation time<br />
must be approved by the Program Director and the Medical Education Office. On certain<br />
clinical rotations, a "no vacation" policy may apply.<br />
2.4.6 Ten (10) paid sick days per year. In order to receive compensation for<br />
sick days, the Resident must notify the Program Director of h<strong>is</strong>/her illness before or at the<br />
earliest possible time on the sick day. If the Resident uses more than two (2) sick days in any 30<br />
day period, the Resident must obtain a return to work release from a physician. The release must<br />
be submitted to Oakwood Human Resources. Unused sick days shall not carry over into a<br />
subsequent contract year and Resident shall not receive compensation for sick days, which are<br />
not used within a contract year.<br />
2.4.7 Three (3) personal days per year with pay, provided the Resident obtains<br />
the approval of the Program Director and the Medical Education Office prior to the personal day<br />
and provided the reason for and use of personal day(s) <strong>is</strong> in accordance with Oakwood policy<br />
2.4.8 Professional, Personal, Maternity, Paternity, or Adoption leave of absence<br />
in accordance with Oakwood's Leaves of Absence Policy, as described in the Resident<br />
Handbook. If Resident does not qualify for a leave of absence under Oakwood’s Leaves of<br />
Absence Policy, a leave of absence may be granted by the Program Director and the Director of<br />
Medical Education at their d<strong>is</strong>cretion. The Directors will generally follow the Specialty Board<br />
Certification Requirements when making th<strong>is</strong> determination. The foregoing notwithstanding, an<br />
unpaid leave of absence cannot be granted unless approved by the Oakwood Human Resources<br />
Department.<br />
2.4.9 Professional Liability insurance to cover Resident's acts or om<strong>is</strong>sions<br />
performed within the scope of Resident's obligations under th<strong>is</strong> Agreement and within the scope<br />
of Resident's limited license to practice medicine, with built-in tail coverage for a period of not<br />
less than five (5) years. No professional liability insurance will be provided to the Resident for<br />
any acts or om<strong>is</strong>sions performed outside the residency program, including activities specifically<br />
approved by the Program Director such as, but not limited to moonlighting activities. The<br />
details of the malpractice coverage shall be provided to Resident in an annual letter from<br />
Oakwood’s Corporate R<strong>is</strong>k Management.<br />
2.4.10 Reimbursement for continuing medical education conference expenses,<br />
books, professional dues, and license fees in accordance with the Educational Allowances<br />
Policy, which <strong>is</strong> attached to and incorporated into th<strong>is</strong> Agreement as Exhibit 1. To receive<br />
reimbursement under th<strong>is</strong> section, the Resident must submit to the Director of Medical Education<br />
receipts for all expenses to be reimbursed.<br />
2.4.11 A meal allowance, for meals while on duty, will be provided bi-weekly in<br />
accordance with Exhibit 1. The amount will be added to Resident’s paycheck.<br />
2
2.4.12 A one-time, interest-free loan of up to $2,000.00. Any funds borrowed<br />
under th<strong>is</strong> Section shall be repaid in regular equal installments automatically deducted from the<br />
Resident's paycheck over a six (6) month period.<br />
2.4.13 Oakwood reserves the right to modify the plan of benefits set forth at any<br />
time. The Resident will be notified of any change in the plan of benefits.<br />
2.5 Duty hour assignments shall be in compliance with state, federal and ACGME<br />
requirements as described in the Resident Handbook.<br />
2.6 Oakwood shall notify Resident as soon as possible if the Resident training<br />
program <strong>is</strong> to be reduced in size or closed. See the Resident Handbook.<br />
2.7 Upon sat<strong>is</strong>factory completion of the Program and its requirements, the Resident’s<br />
responsibilities, and termination of House Staff status, Oakwood shall furn<strong>is</strong>h to the Resident a<br />
Certificate of Completion for the Program.<br />
Section 3<br />
Resident's Obligations.<br />
3.1 Personal Plan. With guidance from the Oakwood teaching staff, the Resident<br />
shall develop a personal program of self-study and professional growth. The Resident shall<br />
demonstrate competency in patient care, medical knowledge, interpersonal and communication<br />
skills, practice based learning and improvement, professional<strong>is</strong>m, and systems based practice by<br />
program completion.<br />
3.2 Patient Care Responsibilities. Under the superv<strong>is</strong>ion of Oakwood teaching staff,<br />
the Resident shall participate in the safe, effective and compassionate care of Oakwood's patients<br />
at a level commensurate with the Resident's level of advancement in the Residency Program.<br />
3.3 Institutional Policies. At all times while fulfilling h<strong>is</strong>/her obligations under th<strong>is</strong><br />
Agreement, the Resident shall adhere to all applicable Oakwood rules, regulations, policies,<br />
procedures and guidelines, including, but not limited to, the Resident Handbook, the Oakwood<br />
Human Resources Policy and Procedure Manual, and the Oakwood Medical Staff Bylaws, Rules<br />
and Regulations and Oakwood’s Compliance and Business Practices policies. The Resident also<br />
must adhere to the applicable policies, rules, regulations, procedures and guidelines of any non-<br />
Oakwood institution or facility where Resident <strong>is</strong> assigned under th<strong>is</strong> Agreement. Additionally,<br />
the Resident shall adhere to all applicable state, federal and local laws, as well as standards<br />
required to maintain accreditation by the JACHO, the ACGME, the RRC; and any other relevant<br />
accrediting, certifying, or licensing organization, including the State of Michigan Medical Board.<br />
3.4 Compliance Reporting. The Resident shall report immediately a) to Oakwood’s<br />
Compliance Office and/or Legal Affairs Department any inquiry by any private or governmental<br />
attorney or investigator or b) to Oakwood’s Public Relations Department any inquiry by any<br />
member of the press. The Resident understands that Oakwood encourages the Residents full<br />
cooperation with any governmental investigation or inquiry. The Resident agrees not to<br />
3
communicate with any inquiring private attorney or members of the press except to refer such<br />
private attorneys to the Compliance Office and/or Legal Affairs Department and to refer the<br />
press to the Public Relations Department. Also see Oakwood’s Code of Conduct and Code of<br />
Ethics policies.<br />
3.5 Drug Testing Policy. Resident acknowledges and agrees that h<strong>is</strong>/her acceptance<br />
into the Residency Program <strong>is</strong> conditioned on Resident submitting to a drug test prior to<br />
beginning the Residency Program. Testing will be done in accordance with the Pre-Placement<br />
Testing procedure described in the Fitness for Duty prov<strong>is</strong>ion of the Oakwood Human Resources<br />
Policy and Procedure Manual. Refusal to submit to drug testing will result in the immediate<br />
termination of th<strong>is</strong> Agreement. A substantiated positive drug test may result in immediate<br />
termination of th<strong>is</strong> Agreement.<br />
The foregoing notwithstanding, Resident will be required to submit to alcohol/drug testing<br />
whenever reasonable cause ex<strong>is</strong>ts to believe that the Resident’s ability to fulfill h<strong>is</strong>/her<br />
obligations under th<strong>is</strong> Agreement may be impaired by alcohol and/or drugs. A positive test<br />
result will be handled in accordance with the guidelines set forth in Oakwood’s Human<br />
Resources Policy and Procedure Manual.<br />
3.6 Educational and Scholarly Activities. The Resident shall participate fully in the<br />
educational and scholarly activities of h<strong>is</strong>/her program and, as requested by the Resident's<br />
Program Director and department, assume responsibility for teaching and superv<strong>is</strong>ing other<br />
residents and medical students.<br />
3.7 Medical Staff Activities. The Resident shall participate in Oakwood programs<br />
and activities that involve the Oakwood Medical Staff, including but not limited to quality<br />
assurance and patient safety programs.<br />
3.8 Licensure. Resident shall obtain a full license or a limited postgraduate license to<br />
practice medicine in the State of Michigan prior to providing patient care under th<strong>is</strong> Agreement.<br />
Resident shall provide the Medical Education Office with a copy of h<strong>is</strong>/her license, and shall<br />
notify the Program Director immediately in the event that the Resident's license expires without<br />
renewal or <strong>is</strong> restricted, suspended, revoked or limited in any manner. Resident shall not provide<br />
patient care under th<strong>is</strong> Agreement until Resident has presented a copy of h<strong>is</strong>/her license to the<br />
Medical Education Office.<br />
3.9 Medical Records. The Resident shall completely document the care rendered to<br />
patients in the medical record for each patient for which the Resident provides care in<br />
accordance with all Oakwood policies, rules, and regulations, including the Oakwood Medical<br />
Staff Bylaws and Rules and Regulations.<br />
3.10 Presence in House. The Resident shall at all times be present in the areas and<br />
during the hours to which he/she <strong>is</strong> assigned to patient care responsibilities, except when<br />
prevented from doing so by personal illness, injury or some other reason for which the Resident<br />
has obtained the prior approval of h<strong>is</strong>/her Program Director. The Resident must notify h<strong>is</strong>/her<br />
Program Director of all absences and shall, if at all possible, find a replacement resident to<br />
assume h<strong>is</strong>/her responsibilities for the duration of the absence.<br />
4
3.11 Full-Time Commitment and Moonlighting Policy. The Resident shall devote<br />
h<strong>is</strong>/her efforts full-time to fulfilling of the Resident's obligations under th<strong>is</strong> Agreement. The<br />
Resident shall obtain the prior written consent of the Program Director before engaging in any<br />
professional activities outside of the Residency Program. Oakwood’s policy on moonlighting by<br />
Residents <strong>is</strong> available from the Program Director. Oakwood’s policy on moonlighting <strong>is</strong><br />
available from the Resident’s Program Director and in the Resident Handbook.<br />
3.12 Notices. Immediately upon receipt of a notice of a possible or confirmed quality of care<br />
<strong>is</strong>sue involving the Resident from the Michigan Peer Review Organization or other agency, or a<br />
notice of claim or possible claim alleging medical malpractice or professional m<strong>is</strong>conduct, or its<br />
equivalent, the Resident shall immediately provide the Program Director with a copy of the<br />
notice and shall cooperate with Oakwood in preparing a response to the notice.<br />
3.13 Committees. The Resident shall participate in Oakwood's institutional<br />
committees and councils, especially those related to patient care review activities, medical/legal<br />
<strong>is</strong>sues, socioeconomic <strong>is</strong>sues, ethics, cost containment and educational programs when requested<br />
to participate by the Program Director or by the Medical Education Office.<br />
3.14 Program Evaluation. The Resident shall participate in evaluation of the quality of<br />
education provided in the Oakwood Residency Program when requested to participate by the<br />
Program Director or the Medical Education Office.<br />
3.15 Oakwood Property. The Resident shall return at the same time as the expiration<br />
or termination of th<strong>is</strong> Agreement all Oakwood property, including, but not limited to books,<br />
equipment, paper, PDAs; complete all necessary records; and settle all professional and financial<br />
obligations.<br />
Section 4<br />
Evaluation and Advancement.<br />
4.1 Evaluation . Resident shall be evaluated in writing and the Resident’s<br />
performance reviewed with him/her in accordance with the Policy on Resident Evaluation and<br />
Promotion, described in the Resident Handbook.<br />
4.2 Advancement. Resident shall advance to the next level in the Oakwood<br />
Residency Program only when, in the opinion of the Program Director, the Resident has sat<strong>is</strong>fied<br />
the evaluation criteria described in the Resident Handbook. The Program Director shall provide<br />
the Resident with written notice of advancement or failure to advance no later than March 1 of<br />
the contract year, unless, at that time, Resident <strong>is</strong> in a formal corrective action plan (see Section<br />
4.3 of th<strong>is</strong> Agreement).<br />
4.3 Corrective Action. If the Program Director believes corrective action <strong>is</strong> necessary<br />
to address any difficulties or deficient areas in the Resident's performance noted during the<br />
evaluation process or during the course of the Resident's performance of h<strong>is</strong>/her obligations<br />
under th<strong>is</strong> Agreement, the Program Director may take corrective action to address the difficulty<br />
or deficiency in accordance with the Due Process Policy and Procedure described in the Resident<br />
5
Handbook.<br />
Section 5<br />
Summary Suspension.<br />
5.1 Right to Suspend. Other prov<strong>is</strong>ions of the Agreement notwithstanding, the<br />
Oakwood Board of Directors, the Resident's Program Director, or the Director of Medical<br />
Education may summarily suspend the Resident from the Oakwood Residency Program, in<br />
accordance with the Due Process Policy and Procedure described in the Resident Handbook.<br />
The person or body initiating a summary suspension shall provide the Resident with immediate<br />
written notice of the summary suspension, and, if initiated by the Board of Directors, shall also<br />
provide the Program Director and the Director of Medical Education with notice of the<br />
suspension.<br />
Section 6<br />
Termination.<br />
6.1 Termination by Oakwood. Oakwood may terminate th<strong>is</strong> Agreement if Oakwood<br />
determines in its sole d<strong>is</strong>cretion that the Resident has failed or <strong>is</strong> unable to perform h<strong>is</strong>/her duties<br />
under th<strong>is</strong> Agreement in accordance with applicable standards of medical practice, has failed to<br />
comply with Oakwood policies, procedures, rules or regulations, or has breached th<strong>is</strong><br />
Agreement. Oakwood shall not be required to take any corrective action under Section 4.3 prior<br />
to terminating the Agreement in accordance with th<strong>is</strong> Section. Through the Director of Medical<br />
Education, Oakwood shall provide the Resident with written notice of the termination, which<br />
notice shall specify the date of termination and the reasons for the termination. Termination of<br />
th<strong>is</strong> Agreement shall constitute d<strong>is</strong>m<strong>is</strong>sal from the Oakwood Residency Program.<br />
Section 7<br />
Reconsideration.<br />
7.1 Right to Reconsideration. The Resident may request reconsideration of a<br />
summary suspension under Section 5, termination of th<strong>is</strong> Agreement under Section 6, or any<br />
corrective action taken by Oakwood under Section 4.3. Requests for reconsideration must be<br />
<strong>made</strong> in writing to the Director of Medical Education and in accordance with the Due Process<br />
Policy and Procedure described in the Resident Handbook.<br />
Section 8 D<strong>is</strong>crimination and Harassment. It <strong>is</strong> the policy of Oakwood that all residents<br />
have the right to work in an environment free from d<strong>is</strong>crimination, which encompasses freedom<br />
from harassment. It <strong>is</strong> the policy of Oakwood not to tolerate d<strong>is</strong>crimination or harassment on the<br />
bas<strong>is</strong> of race, color, religion, sex, national origin, age, d<strong>is</strong>ability, marital status, veteran status,<br />
height, or weight. No member of Oakwood’s community--employee, physician, volunteer,<br />
guest, applicant, or vendor—may d<strong>is</strong>criminate against or harass any person. Furthermore, no<br />
member of Oakwood’s community <strong>is</strong> expected to tolerate any form of d<strong>is</strong>crimination or<br />
harassment. The Oakwood policies prohibiting d<strong>is</strong>crimination and harassment are available in<br />
the Oakwood Human Resources Policy and Procedure Manual.<br />
Any complaints of d<strong>is</strong>crimination or harassment brought by or against any Resident shall be<br />
handled in accordance with Oakwood’s corporate policy, which <strong>is</strong> available to the Resident in<br />
the Oakwood Human Resources Policy and Procedure Manual.<br />
6
Section 9<br />
D<strong>is</strong>pute Resolution.<br />
9.1 Resident Grievance Procedure. Oakwood has establ<strong>is</strong>hed a procedure that will<br />
provide an assessment and resolution of Resident concerns. The Resident Grievance Procedure<br />
<strong>is</strong> available to all Residents who have concerns or <strong>is</strong>sues related to the interpretation, application,<br />
or breach of a policy, practice, or procedure in their educational program. The Resident<br />
Grievance Procedure <strong>is</strong> the sole and complete mechan<strong>is</strong>m for resolution of Resident concerns.<br />
The procedure <strong>is</strong> described in the Resident Handbook. The foregoing notwithstanding, the<br />
Resident Grievance Procedure may not be utilized to address <strong>is</strong>sues related to summary<br />
suspension under Section 5, termination of th<strong>is</strong> Agreement under Section 6, or any corrective<br />
action taken by Oakwood under Section 4.3; The Due Process Policy and Procedure (described<br />
in the Resident Handbook) must be utilized in th<strong>is</strong> instance.<br />
Section 10 Entire Agreement - Modification, Governing Law. Th<strong>is</strong> Agreement constitutes<br />
the entire agreement between Oakwood and the Resident with respect to the subject matter of the<br />
Agreement, and supersedes any and all other agreements, either oral or in writing, between the<br />
parties with respect to th<strong>is</strong> subject matter. No modification of or addition to th<strong>is</strong> Agreement<br />
shall be valid unless it <strong>is</strong> in writing and signed by the Director of Medical Education and the<br />
Resident. Michigan Law governs th<strong>is</strong> Agreement. If any prov<strong>is</strong>ion of th<strong>is</strong> Agreement cannot be<br />
enforced, the remainder of the Agreement shall remain in full force and effect and shall be<br />
interpreted in a manner which best fulfills the intent of the Agreement.<br />
I AGREE THAT:<br />
1. I WILL ONLY access information I need to do my job.<br />
2. I WILL NOT show, tell, copy, give, sell, review, change or trash any confidential<br />
information unless it <strong>is</strong> part of my job. If it <strong>is</strong> part of my job to do any of these tasks, I will<br />
follow the correct department, hospital, and/or institutional procedure (such as shredding<br />
confidential papers before throwing them away).<br />
3. I WILL NOT m<strong>is</strong>use or be careless with confidential information.<br />
4. I WILL KEEP my computer password secret and I will not share it with anyone.<br />
5. I WILL NOT use anyone else’s password to access any Oakwood system.<br />
6. I AM RESPONSIBLE for any access using my password.<br />
7. I WILL NOT share any confidential information even if I am no longer an Oakwood<br />
employee.<br />
8. I KNOW that my access to confidential information may be audited.<br />
9. I WILL tell my superv<strong>is</strong>or if I think someone knows or <strong>is</strong> using my password.<br />
10. I KNOW that confidential information I learn on the job does not belong to me.<br />
11. I KNOW that Oakwood may take away my access at any time.<br />
12. I WILL protect the privacy of our patients and employees.<br />
13. I WILL NOT make unauthorized copies of Oakwood software.<br />
14. I AM RESPONSIBLE for my use or m<strong>is</strong>use of confidential information.<br />
15. I AM RESPONSIBLE for my failure to protect my password or other access to<br />
confidential information.<br />
Failure to comply with th<strong>is</strong> agreement may result in the termination of employment at<br />
Oakwood and/or civil or criminal legal penalties. By signing th<strong>is</strong> Residency Agreement, I<br />
7
agree that I have read, understand and will comply with th<strong>is</strong> confidentiality agreement in<br />
addition to all the other terms. I understand that my training program may require that I<br />
participate in providing clinical care at any hospital, facilities and/or programs. Th<strong>is</strong><br />
statement <strong>is</strong> to authorize Oakwood to provide any information including, but not limited<br />
to, information from my personnel file as maintained by the Medical Education<br />
Department at Oakwood, insurance and claims h<strong>is</strong>tory information, and any other<br />
information relating to my service as a Resident at Oakwood to these facilities.<br />
OAKWOOD HEALTHCARE, INC.<br />
RESIDENT<br />
Signed:<br />
Resident<br />
Date<br />
PROGRAM DIRECTOR<br />
Signed: _____________________________________<br />
Program Director<br />
Date<br />
Signed:<br />
Mark D. Hann<strong>is</strong>, M.D.<br />
Director of Medical Education<br />
EXHIBIT 1<br />
SUMMARY OF EDUCATIONAL ALLOWANCES<br />
8
YEAR OF<br />
ON CALL<br />
TRAINING<br />
WEEKLY<br />
MEALS<br />
paid biweekly<br />
CONFERENCE<br />
ALLOWANCE<br />
PROFESSIONAL<br />
DUES<br />
MEDICAL<br />
LICENSE<br />
BOOK<br />
ALLOWANCE<br />
1 $37.20<br />
(28.95 + 8.25<br />
for taxes)<br />
$400<br />
and<br />
3 days<br />
$105 $165 $200<br />
2 $32.00<br />
(24.96 + 7.04<br />
for taxes)<br />
$1000<br />
and<br />
5 days<br />
$105 $165 $300<br />
3 $32.00<br />
(24.96 + 7.04<br />
for taxes)<br />
$1200<br />
and<br />
5 days<br />
$105 $165 $400<br />
4 $32.00<br />
(24.96 + 7.04<br />
for taxes)<br />
$1200<br />
and<br />
5 days<br />
$105 $165 $500<br />
9
Policies on Allocation of Book Funds<br />
1. Prior approval by Program Director and the Director of Medical Education <strong>is</strong> required.<br />
2. Book allotment may be spent on books, journals, audio tapes, video tapes and/or CME oriented medical software.<br />
3. Book allotment may not be spent for conferences.<br />
4. Book allotment may not be carried over from year to year.<br />
5. Residents should not purchase books without prior approval and expect to be reimbursed.<br />
Policies on Conference Allowance<br />
1. Prior approval by Program Director and the Director of Medical Education <strong>is</strong> required at least 45 days prior to the start of<br />
conference. A xerox copy of program <strong>is</strong> required.<br />
2. An average of 4 hours of CME per day of conference <strong>is</strong> required for approval.<br />
3. Conferences must take place in the continental United States or Canada.<br />
4. Conference allowance may be carried over from year to year.<br />
5. Conference allowance in whole or part may be spent as a book allowance.<br />
6. Conference days may not be carried over from year to year.<br />
7. Conference funds may be utilized for specialty Board certification fees with prior approval.<br />
8. Conference days may still be used for approved conferences even if the resident has expended all of their conference allowance for<br />
books or Board certification fees.<br />
Policies on Professional Dues<br />
1. Dues must be spent on the primary organization of the resident's training program (i.e., ACP, AAFP, ACOBGYN, etc.)<br />
2. Prior approval <strong>is</strong> required by the Program Director and the Director of Medical Education.<br />
3. Dues allotment may not be carried over from year to year.<br />
4. Dues allotment may not be spent for any other purpose.<br />
Policies on Medical License Fee Allowance<br />
1. Prior approval of Program Director and the Director of Medical Education <strong>is</strong> required.<br />
2. Medical license allowance may not be carried over from year to year.<br />
3. Medical license allowance may not be spent for any other purpose.<br />
10
Medical Education<br />
Committee Policy<br />
Draft: _________________<br />
Approved: June 15, 2006<br />
Rev<strong>is</strong>ed: ________________<br />
Medical Education Policy for Counseling & Support Services<br />
Personal <strong>is</strong>sues that sometimes emerge during residency include stress due to work problems,<br />
conflict between personal demands, family life, and professional workload, and<br />
psychological/psychiatric problems. In these and other situations, Medical Education recognizes<br />
the benefit of mental treatment and counseling in supporting residents’ personal and professional<br />
growth. Medical Education has identified a number of internal resources and will ass<strong>is</strong>t<br />
residents desiring confidential treatment outside of the Oakwood Healthcare System (see<br />
attached).<br />
11
In-Network Resources for Residents<br />
Oakwood Employee Ass<strong>is</strong>tance Program (EAP)<br />
Oakwood’s EAP provides brief, confidential assessment and treatment services for employees/residents<br />
experiencing work or family related stress or substance use concerns at no charge. For individuals<br />
requiring longer-term treatment, EAP staff will help facilitate referral to a qualified community provider.<br />
Medical Education may initiate a Superv<strong>is</strong>or Formal Referral for evaluation and treatment of possible<br />
emotional, substance-related, and learning problems. EAP staff may also serve as a lia<strong>is</strong>on between<br />
Medical Education and community providers. Oakwood EAP <strong>is</strong> located in Suite 235, Village Plaza.<br />
Linda Cunin, ACSW, CEAP, <strong>is</strong> the Program Director (313-791-4855; 800-327-1127). Additional<br />
information <strong>is</strong> available on Oaknet.<br />
APEX Behavioral Health<br />
APEX <strong>is</strong> OSHCare’s contracted mental health and substance use provider. APEX has approximately 20<br />
psychiatr<strong>is</strong>ts and 70 psycholog<strong>is</strong>ts, social workers, couples and family therap<strong>is</strong>ts on staff at seven<br />
locations. Residents must contact Value Options for approval of mental health/substance use services<br />
(877-813-5362). Jill Blackson, ACSW, <strong>is</strong> the Project Manager for APEX. She <strong>is</strong> available to help<br />
residents select a therap<strong>is</strong>t or psychiatr<strong>is</strong>t for confidential treatment (734-405-0175, ext 111). To<br />
schedule an appointment at the Westland office, call 734-729-3133. The Dearborn office number <strong>is</strong> 313-<br />
271-8170. Web-address <strong>is</strong>: www.APEXBehavioralHealth.com. HAP subscribers should call 800-422-<br />
4641 or check the website: www.hap.org.<br />
Medical Education Ombudsperson<br />
Residents with a sensitive concern or grievance may contact the Medical Education Ombudsperson for<br />
confidential guidance and support. Residents may also elect to communicate their concerns anonymously.<br />
Ms. Marilyn Kostrzewski (313-593-7692) and Dr. Lyle Victor (313-593-8620; P: 1270) serve in the role.<br />
Medical Education Counseling & Support Team (C&ST)<br />
The Medical Education C&ST serves as an adv<strong>is</strong>or to the Director of Medical Education, residency program<br />
directors and faculty, and to residents on <strong>is</strong>sues of work and family stress, mental health and substance use concerns,<br />
spiritual and ethical <strong>is</strong>sues, and residency performance problems. Residents may elect to contact members of the<br />
C&ST for confidential guidance, short-term counseling, and referral. The C&ST will not enter into open-ended<br />
treatment relationships with residents. Contact persons are as follows:<br />
Larry F<strong>is</strong>chetti, PhD (734-727-1067; P: 1241)<br />
Father Richard Leliaert, PhD (734-937-1500 x112)<br />
Audrey Newell, MD (P: 2617)<br />
Linda Cunin, ACSW, CEAP (313-791-4855; 800-327-1127)<br />
Ms. Marilyn Kostrzewski (313-593-7692)<br />
Spiritual Support Services<br />
Reverend Tony Marshall <strong>is</strong> the Manager of Spiritual Support Services for Oakwood. A number of full-time<br />
chaplains and many active volunteers representing a variety of religious traditions provide spiritual support and<br />
counseling in Oakwood’s various venues. Reverend Marshall can direct your to a chaplain or lay min<strong>is</strong>ter to address<br />
your concerns in a manner cons<strong>is</strong>tent with your spiritual beliefs and/or religious affiliation (313-593-7202).<br />
Oakwood Staff Development<br />
Oakwood Healthcare System offers a variety of online and scheduled group courses to help employees<br />
and residents develop their effectiveness as members of healthcare teams and organizations. These<br />
12
courses can help residents meet expectations in a number of the ACGME General Competencies<br />
including Systems-Based Practice. To review offerings, go to the Oaknet website and click on Training.<br />
For online courses, click on the link to HealthStream; for scheduled group courses, click on Oakwood<br />
Leadership Development.<br />
OUT-OF-NETWORK RESOURCES FOR RESIDENTS<br />
For some residents, the added assurance of confidentiality may outweigh the costs of seeking out-ofnetwork<br />
assessment, mental health treatment, or substance abuse services. Should Medical Education<br />
require an evaluation by an out-of-network provider, Dr. Hann<strong>is</strong> has arranged for Medical Education to<br />
help offset the costs of services. In these situations, Medical Education may request consent for some<br />
communication with out-of-network providers; these plans should be <strong>made</strong> explicit and an agreement<br />
reached before entering into treatment. Residents who choose to seek out-of-network ass<strong>is</strong>tance on their<br />
own accord will be liable for the cost of treatment unless prior agreement for Medical Education support<br />
<strong>is</strong> obtained through their program director or the Director of Medical Education.<br />
Private Mental Health Assessment and Consultation<br />
Roger Lauer, PhD, <strong>is</strong> a psycholog<strong>is</strong>t. H<strong>is</strong> clinic provides neuropsychological assessments, cognitive and<br />
learning assessments, and coaching for residents experiencing attentional, learning, and other<br />
performance problems. Contact information <strong>is</strong> as follows:<br />
1955 Pauline Boulevard, Suite 100A<br />
Ann Arbor, Michigan 48103<br />
734-994-9466<br />
www.rogerlauer.com<br />
Joel Young, MD, <strong>is</strong> a psychiatr<strong>is</strong>t with a special interest in the assessment and treatment of adult<br />
attentional and learning problems. H<strong>is</strong> clinic provides psychopharmacologic treatment and cognitive<br />
training. Debra Luria, PhD, RN, a psycholog<strong>is</strong>t working with Dr. Young, provides intellectual and<br />
neuropsychological assessment services and related counseling. Contact information <strong>is</strong> as follows:<br />
441 S. Liverno<strong>is</strong>, Suite 205<br />
Rochester Hills, Michigan 48307<br />
248-608-8800<br />
www.rcbm.net<br />
Darren Fuerst, PhD, <strong>is</strong> a neuropsycholog<strong>is</strong>t in the DMC’s Adult Neuropsychology Program. Dr. Fuerst<br />
has offices in the University Health Center and the DMC Health Care Center in Novi. Dr. Fuerst provides<br />
assessment of cognitive learning, and psychiatric conditions. As needed, he will facilitate referrals for<br />
treatment to other mental health providers.<br />
Adult Neuropsychology Program<br />
University Health Center 4-J<br />
4201 St. Antoine<br />
Detroit, Michigan 48201<br />
313-745-8958/313-745-1784<br />
Learning Styles, Test-Taking, and Coaching<br />
As was noted previously, the staff of Oakwood’s EAP facilitates referrals to community providers for<br />
assessment of learning difficulties. Tim Dey, MD, <strong>is</strong> an alternative, independent source of learning<br />
13
assessment and consultation services for residents experiencing academic difficulties. He also provides<br />
tutoring to help residents prepare for standardized exams and coaching on <strong>is</strong>sues of professional<strong>is</strong>m and<br />
life goals. Dr. Dey will arrange to meet with residents at h<strong>is</strong> office or other convenient location. (Office:<br />
313-383-0582)<br />
Conversation and Pronunciation<br />
Residents for whom Engl<strong>is</strong>h <strong>is</strong> a second language may benefit from extra coaching in correct<br />
pronunciation. “Conversation and Pronunciation” <strong>is</strong> taught by Mary Assel, PhD, Co-Director, Engl<strong>is</strong>h<br />
Language Institute, Henry Ford Community College. Beyond pronunciation, Dr. Assel’s course provides<br />
instruction in common Engl<strong>is</strong>h speech idioms. Dr. Assel can be reached at 313-317-1559. Her email<br />
address <strong>is</strong>: massel@hfcc.edu.<br />
Ms. Judy Raven of the Accent Reduction Institute <strong>is</strong> a speech and language therap<strong>is</strong>t. Ms. Raven has<br />
extensive experience tutoring physicians to improve their Engl<strong>is</strong>h pronunciation and grammar in support<br />
of doctor-patient communication. Ms. Raven can meet residents in their work settings. Her organization<br />
has also developed procedures for d<strong>is</strong>tance learning. Ms. Raven can be contacted at 734-665-2915. The<br />
web-address <strong>is</strong>: www.lessaccent.com.<br />
The Dearborn Speech and Sensory Center provides accent reduction services. Lori Shaffer, MA, CCC-<br />
SLP, <strong>is</strong> a speech and language patholog<strong>is</strong>t and director of the center. Clients are seen individually and in<br />
small groups. For information, call 313-359-4659 or v<strong>is</strong>it the center’s website:<br />
www.dearbornspeechandsensory.com.<br />
Substance Use Assessment and Treatment1<br />
Michigan’s Health Professional Recovery Program (HPRP; 800-453-3784; www.hprp.org) provides<br />
confidential assessment and treatment services. For professionals found to be impaired by substance use,<br />
confidentiality <strong>is</strong> maintained while the individual faithfully pursues treatment to d<strong>is</strong>charge. By law,<br />
impaired professionals who fail to comply with treatment will be reported to the Michigan Department of<br />
Consumer and Industry Services (HPRP: 800-453-3784). Western Michigan Addiction Consultants<br />
(WEMAC) also provides confidential assessment and treatment services tailored to the medical<br />
profession. The same prov<strong>is</strong>ions apply regarding confidentiality and reporting of individuals who are<br />
impaired and fail to comply with treatment. Thomas Haynes, MD, <strong>is</strong> Medical Director of WEMAC<br />
(WEMAC: 616-365-8800).<br />
1 Note that under the Michigan Public Health Code, licensed health professionals are required to file a report with the<br />
Department of Community Health—Bureau of Health Professions if there <strong>is</strong> reason to believe another licensed health<br />
professional has a mental health- or substance use-related impairment that limits h<strong>is</strong> or her ability to practice in a manner<br />
cons<strong>is</strong>tent with the minimal standards of acceptable and prevailing practice. A referral or self-referral to HPRP sat<strong>is</strong>fies the<br />
reporting requirement. If, as a result of an assessment, a health professional <strong>is</strong> found to suffer impairment, a treatment plan will<br />
be proposed. The results of the assessment and all treatment records will be expunged five years after the successful completion<br />
of treatment. A report <strong>is</strong> forwarded to the Department of Community Health—Bureau of Health Professions only if the referred<br />
health professional refuses to comply with an assessment or treatment plan or <strong>is</strong> deemed to be a threat to public health, safety, or<br />
welfare.<br />
14
Maternity, Paternity and Adoption Leave<br />
General Guidelines:<br />
1. Due to the specific character<strong>is</strong>tics of residency training and the impact of a resident's absence<br />
on patient care and the training of fellow residents, notification of the Program Director of<br />
pregnancy should occur as soon as possible. Th<strong>is</strong> should ordinarily be at least 5 months<br />
prior to a resident's or spouse's estimated "due date."<br />
2. Specific requirements of each specialty training program governs the amount of time<br />
permitted away from continuous residency training per year. Therefore, specific makeup<br />
time may be required before the resident advances to the next training level and the<br />
projected date of completion of the residency extended. Th<strong>is</strong> can also affect eligibility<br />
for Board exams.<br />
3. With adequate advance notice, efforts to rearrange rotations will be directed towards: a)<br />
early scheduling of demanding rotations, b) elective rotations near "due date." Adjustments<br />
in on-call responsibilities will be negotiated with the Program Director. The goals will be to<br />
maintain patient care, provide a reasonable workload for a pregnant resident, and avoid<br />
unacceptable increases in other residents workloads. Specific arrangements may include<br />
"make-up call" before or after the leave period.<br />
4. Moonlighting will not be approved by the Program Director during maternity/<br />
paternity/adoption leave.<br />
Maternity Leave:<br />
1. Time away from residency training for maternity leave can cons<strong>is</strong>t of both paid and unpaid<br />
leave. The ordinary period of leave for pregnancy and delivery <strong>is</strong> up to 6 weeks.<br />
2. The resident <strong>is</strong> eligible to apply for time off under the Family Leave Act (FMLA) which<br />
allows the resident up to 12 weeks of time off, under the FMLA. If the resident would like<br />
to apply for FMLA , it <strong>is</strong> important to meet with your program director to determine the<br />
effect of the FMLA on the projected date of completion of the training program and human<br />
resources to determine how much will be covered under the sick and vacation time.<br />
15
Maternity, Paternity, Adoption Leave Page 2 of 2<br />
3. Childbirth <strong>is</strong> treated the same as d<strong>is</strong>ability due to other medical conditions. The<br />
determination of d<strong>is</strong>ability <strong>is</strong> <strong>made</strong> by the resident's personal physician. If the resident<br />
would like to apply for a medical leave of absence, they will be required to use accrued sick<br />
and vacation time prior to the 14 days not covered by short term d<strong>is</strong>ability.<br />
4. The resident must obtain a physician's certification stating that she may return to work<br />
without restrictions prior to returning to work.<br />
Paternity Leave:<br />
1. A resident may elect to take up to 5 working days of paid leave within the first four weeks of<br />
(the birth) life of h<strong>is</strong> baby or the first four weeks of adoption. If a resident would like paid<br />
leave, th<strong>is</strong> time will be composed of available vacation or sick days. If all available days are<br />
expended, th<strong>is</strong> leave may be taken as unpaid leave.<br />
In order to take such leave, the resident must:<br />
A. Give advance notice to the Program Director as in "Guidelines" above.<br />
B. Obtain approval of superv<strong>is</strong>ing faculty and Program Director.<br />
C. Arrange coverage for any on-call responsibilities and scheduled out patient<br />
responsibilities, (acceptable to the Program Director.)<br />
Adoption/Father as Primary Care Taker:<br />
1. A female resident adopting a child, or a male resident, who will be primary or sole caretaker<br />
or a new child may take a maximum of four weeks leave to begin within one week of birth<br />
or adoption.<br />
2. The paid portion of th<strong>is</strong> leave will be composed of available vacation or sick days with any<br />
remainder being unpaid.<br />
3. The scheduling, notification and leave guidelines are the same as for maternity leave above.<br />
16
DUTY HOURS AND WORK ENVIRONMENT<br />
Medical Education will ensure that our GME programs provide appropriate superv<strong>is</strong>ion for all<br />
residents, as well as a duty hour schedule and work environment that <strong>is</strong> cons<strong>is</strong>tent with proper<br />
patient care, the educational needs of residents and the applicable program requirements.<br />
Duty Hours:<br />
Medical Education will ensure that each residency program establ<strong>is</strong>hes formal policies<br />
governing resident duty hours that foster resident education and facilitate the care of patients.<br />
The educational goals of the program and learning objectives of residents will not be<br />
comprom<strong>is</strong>ed by excessive reliance on residents to fulfill institutional service obligations.<br />
However, duty hours will reflect the fact that responsibilities for continuing patient care are not<br />
automatically d<strong>is</strong>charged at specific times. Program will ensure that residents are provided<br />
appropriate backup support when patient care responsibilities are especially difficult or<br />
prolonged.<br />
Resident duty hours and on-call time periods must not be excessive. The structuring of duty<br />
hours and on-call schedules must focus on the needs of the patient, continuity of care, and the<br />
educational needs of the resident. Duty hours must be cons<strong>is</strong>tent with the Institutional and<br />
Program Requirements that apply to each program.<br />
Work Environment:<br />
Medical Education will provide services and develop systems to minimize the work of residents<br />
that <strong>is</strong> extraneous to their educational programs, ensuring that the following conditions are met:<br />
1. Residents on duty in the hospital will be provided adequate and appropriate food services<br />
and sleeping quarters.<br />
2. Patient support services, such as intravenous services, phlebotomy services, and<br />
laboratory services, as well as messenger and transporter services, will be provided in a<br />
manner appropriate to and cons<strong>is</strong>tent with educational objectives and patient care.<br />
29
Duty Hours and Work Environment Page 2 of 2<br />
3. An effective laboratory, medical records and radiological information retrieval system<br />
will be in place to provide for appropriate to and cons<strong>is</strong>tent with educational objectives<br />
and patient care.<br />
4. Appropriate security and personal safety measures will be provided to residents in all<br />
locations including but not limited to parking facilities, on-call quarters, hospital and<br />
institutional grounds and related clinical facilities, (i.e., medical office building).<br />
Compliance Office<br />
If you have any questions or concerns regarding your duty hours, work environment, ethical<br />
conduct, or compliance with the law, please contact the Business Practice and Compliance<br />
Office hotline at 877-OAK-LINE. The use of these resources, in the interest of quality patient<br />
services and achieving clinical excellence, <strong>is</strong> encouraged. Attached you will find a complete<br />
description of the compliance hotline.<br />
30
Residency Closure and Reduction<br />
Oakwood Healthcare, from time to time, may reevaluate the types and sizes of its residency<br />
programs. An adv<strong>is</strong>ory group including stakeholders from residency programs, medical staff and<br />
admin<strong>is</strong>tration, will review pertinent information and make recommendations regarding such<br />
closures or size reductions to the Medical Education Committee and Oakwood admin<strong>is</strong>tration.<br />
Final dec<strong>is</strong>ions are the responsibility of Oakwood’s Governing Board and its Executive Council.<br />
If Oakwood determines that it <strong>is</strong> necessary to reduce the size of a residency program or to close a<br />
residency program, Oakwood shall inform the DIO, GMEC, program director and residents<br />
within 30 days of the final dec<strong>is</strong>ion. In the event of such a reduction or closure, Oakwood will<br />
make every effort to allow residents already in the program to complete their education. If any<br />
residents are d<strong>is</strong>placed by the closure of a program or reduction in the number of residents,<br />
Oakwood shall make every effort to ass<strong>is</strong>t the residents in identifying a program in which they<br />
can continue their education.<br />
31
Physician Impairment<br />
Refer to human resources policy on Fitness for Duty (see below).<br />
Resident acknowledges and agrees that h<strong>is</strong>/her acceptance into the residency program <strong>is</strong><br />
conditioned on resident submitting to a drug test prior to beginning their residency program.<br />
Refusal to submit to drug testing will result in the immediate termination of their agreement.<br />
If the test <strong>is</strong> positive, the resident shall be given the opportunity to d<strong>is</strong>cuss the test results and to<br />
submit information demonstrating authorized use of the drug(s) in question. A substantiated<br />
positive drug test will result in immediate termination of their agreement.<br />
The foregoing notwithstanding, resident will be required to submit to alcohol/drug testing<br />
whenever reasonable cause ex<strong>is</strong>ts to believe that the resident’s ability to fulfill h<strong>is</strong>/her<br />
obligations under their agreement may be impaired by alcohol and/or drugs. A positive test<br />
result will be handled in accordance with the guidelines set forth in Oakwood’s Human<br />
Resources Policy and Procedure Manual.<br />
And also refer to the contract, Section 3 Resident’s Obligation, number 3.4.<br />
32
Moonlighting<br />
1. Only physicians with permanent licenses are allowed to provide patient care without<br />
superv<strong>is</strong>ion.<br />
2. All significant extracurricular activity (moonlighting, secondary employment, additional<br />
education or training), by residents in Oakwood educational programs requires written<br />
approval by the program director. Residents must submit a written request describing the<br />
activity and track the number of hours per month that they are working outside the<br />
educational program. Resident’s should be in good standing in their program.<br />
3. In programs where moonlighting <strong>is</strong> allowed, residents can moonlight no more than 80<br />
hours per calendar month of extracurricular activities. Residents may not exceed<br />
ACGME duty hour standards when training and moonlighting work hours are combined.<br />
Program directors must actively track and report these resident activities to Medical<br />
Education Committee. Each program will determine rotations during which residents<br />
may moonlight.<br />
4. It <strong>is</strong> not a requirement for residents to moonlight.<br />
5. Residents are not allowed to moonlight when simultaneously performing any training<br />
duties.<br />
6. Residents cannot be on call and/or moonlighting more frequently than every third day.<br />
7. It <strong>is</strong> the resident’s responsibility to abide by th<strong>is</strong> policy when performing duties outside<br />
the training program. The following sanctions may be imposed if the resident violates<br />
the above rules: probation, suspension and/or termination from the program.<br />
8. Residents are only covered by malpractice insurance when performing their resident<br />
training duties. Malpractice coverage for moonlighting must be secured through their<br />
moonlighting employer or site.<br />
38
Resident Evaluation and Promotion Policy<br />
1. Residents must be evaluated in writing and their performance reviewed with them<br />
verbally upon completion of each rotation. During their rotation residents should receive<br />
feedback regarding their progress and performance.<br />
Programs should assess resident competencies in all 6 domains with at least one approach<br />
in addition to global/end-of-rotation clinical ratings. Recommended methods are direct<br />
observation and concurrent evaluation (and other focused assessment methods), 360-<br />
degree evaluation involving non-MD members of the care team, patients and their<br />
families, checkl<strong>is</strong>t evaluation of quality improvement projects, and cognitive tests.<br />
Standards that describe different levels of performance and interventions to ass<strong>is</strong>t<br />
evaluators in the use of standards are expected.<br />
2. Residents must receive a written summary of the residency program’s evaluation of their<br />
clinical competence at least twice a year. Th<strong>is</strong> written summary must include a summary<br />
of performance compared to PGY level expectations for each of the six general<br />
competency areas (patient care, medical knowledge, practice-based learning and<br />
improvement, interpersonal and communication skills, professional<strong>is</strong>m, and systemsbased<br />
practice).<br />
The residency program on or before November 15th and June 15th will generate written<br />
summative evaluations of each resident for each training year. Written performance<br />
improvement plans, expected remediation, or formal corrective action plans will be<br />
documented. Residents will be notified in writing if they are not eligible for a new<br />
contract in the next academic year on or before March 1 unless the resident <strong>is</strong> in or starts<br />
a remediation program after that date. Also, the resident will be notified if their contract<br />
<strong>is</strong> subject to successful completion of a corrective action plan or other remediation.<br />
3. Residents must maintain ACLS certification to be promoted to the next postgraduate<br />
year. Individual programs may require additional training.<br />
4. Residents must maintain a log of invasive procedures superv<strong>is</strong>ed by attending staff. The<br />
residency program must review logbooks at the time of the semiannual evaluation.<br />
39
Evaluation, Promotion, and Retention Page 2 of 2<br />
5. A permanent record of all semiannual evaluation summaries and procedures logged will<br />
be maintained for each resident. The residency program must maintain a summary of<br />
counseling provided for residents, as well as any corrective action plans or remediation<br />
recommended and their outcomes. Such records must be available in the resident’s file<br />
and accessible to the resident and other authorized personnel (see Resident File Access,<br />
Retention, and Verification Policy).<br />
6. The program director must prepare a written overall evaluation of the resident’s clinical<br />
competence at the conclusion of the resident’s training in that Oakwood residency<br />
program (either termination or successful completion) which will be maintained in the<br />
resident file.<br />
Th<strong>is</strong> summative evaluation must include:<br />
• A summary of performance in each of the six general competency areas compared<br />
to expectations for that PGY level,<br />
• A l<strong>is</strong>ting of all procedures logged and a summary of competence with each<br />
procedure,<br />
• A summary of the residents performance regarding other program expectations<br />
such as scholarly activity and quality improvement/patient safety projects, and<br />
• Eligibility for board certification or transfer to another program.<br />
7. In the event of an adverse annual evaluation, the resident must be offered an opportunity<br />
to address the stated deficiencies or m<strong>is</strong>conduct with a clinical competence committee<br />
constituted by the residency program. Academic due process must be followed as<br />
described in sections four (4) through seven (7) of the resident contract.<br />
8. Upon successful completion of training every resident will receive a certificate verifying<br />
success completion signed by the CEO, Chairman, Board of Trustees, Chief of Staff,<br />
Director of Medical Education, Chief of Service, and Program Director of the residency.<br />
A copy of th<strong>is</strong> certificate will be marked “copy” and placed in the resident’s permanent<br />
file.<br />
9. In addition, residents must have taken USMLE Part III by June 30 of their first<br />
training year at Oakwood. Residents are required to turn in written confirmation of the<br />
results of Part III to their program director. If the resident does not take USMLE Part III<br />
by June 30 of their first year, they will be suspended. Residents on suspension must take<br />
USMLE Part III by November 1 of their PGY II year or they will be terminated.<br />
Residents who fail USMLE Part III on their first taking will enter a Corrective Action<br />
Plan and must pass Part III by March 1 of their PGY II year or they will be notified of no<br />
contract renewal for the PGY III. Exceptions to th<strong>is</strong> policy can only be granted by the<br />
GMEC.<br />
Oakwood Hospital’s Medical Education realizes the above exceeds some specialty board requirements. USMLE<br />
Part III <strong>is</strong> required for permanent licensure in most states and Oakwood believes th<strong>is</strong> policy <strong>is</strong> in the resident’s best<br />
long-term interest. If the resident has difficulty passing USMLE Part III, remediation plans should be d<strong>is</strong>cussed with<br />
the program director.<br />
40
Corrective Action<br />
Due Process Policy and Procedure<br />
If the Program Director believes corrective action <strong>is</strong> necessary to address any difficulties or<br />
deficient areas in the Resident's performance noted during the evaluation process or during the<br />
course of the Resident's performance of h<strong>is</strong>/her obligations, the Program Director may take any<br />
one or more of the following corrective actions designed to address the difficulty or deficiency:<br />
‣ Informal counseling and opportunities for residents to correct deficiencies should be<br />
documented by the program director prior to considering a major corrective action,<br />
unless a major work infraction or a violation of GMEC policy <strong>is</strong> the concern.<br />
‣ Place the Resident on probation, during which time the Resident will be expected to<br />
increase h<strong>is</strong>/her effort to improve performance.<br />
‣ Require the Resident to seek counseling and/or psychological support services.<br />
‣ Require the Resident to seek the ass<strong>is</strong>tance of an impaired physician committee, or other<br />
similar committee or organization within or outside Oakwood, designed to address the<br />
needs of impaired professionals.<br />
‣ Require the Resident to spend additional time at the Resident's present level in the<br />
Oakwood Residency Program.<br />
‣ Require the Resident to take a leave of absence with or without pay.<br />
‣ Restrict the Resident's activities outside the Oakwood Residency Program for which the<br />
Resident receives compensation.<br />
The Program Director shall notify the Resident in writing of any corrective action taken and<br />
shall specify in the notice the period of time during which the corrective action shall remain in<br />
effect and how and when such action will be reviewed and/or lifted.<br />
Programs should have the Evaluation Committee review and approve resident corrective action<br />
plans. The Evaluation Committee should also review resident d<strong>is</strong>agreements. The<br />
reconsideration procedure <strong>is</strong> only for written corrective action plans, suspensions,<br />
probations or terminations.<br />
41
Summary Suspension<br />
Right to Suspend - Other prov<strong>is</strong>ions, the Oakwood Board of Directors, the Resident's Program<br />
Director, or the Director of Medical Education may summarily suspend the Resident from the<br />
Oakwood Residency Program, if in the opinion of the person or entity initiating the summary<br />
suspension, such suspension <strong>is</strong> or may be necessary in order to avoid an adverse effect on patient<br />
care. The person or body initiating a summary suspension shall provide the Resident with<br />
immediate written notice of the summary suspension, and, if initiated by the Board of Directors,<br />
shall also provide the Program Director and the Director of Medical Education with notice of the<br />
suspension.<br />
Effect of Suspension - Immediately upon receipt of a notice of summary suspension, the<br />
Resident shall be relieved of all patient care obligations. The Resident Agreement shall<br />
terminate immediately if the Resident fails to request reconsideration of the summary suspension<br />
or the summary suspension <strong>is</strong> upheld after reconsideration.<br />
Termination<br />
Termination by Oakwood - Oakwood may terminate the Resident’s Agreement if Oakwood<br />
determines in its sole d<strong>is</strong>cretion that the Resident has failed or <strong>is</strong> unable to perform h<strong>is</strong>/her duties<br />
under th<strong>is</strong> Agreement in accordance with applicable standards of medical practice, has failed to<br />
comply with Oakwood policies, procedures, rules or regulations, or has breached th<strong>is</strong><br />
Agreement. Oakwood shall not be required to take any corrective action prior to terminating the<br />
Agreement. Through the Director of Medical Education, Oakwood shall provide the Resident<br />
with written notice of the termination, which notice shall specify the date of termination and the<br />
reasons for the termination. Termination of th<strong>is</strong> Agreement shall constitute d<strong>is</strong>m<strong>is</strong>sal from the<br />
Oakwood Residency Program.<br />
Reconsideration<br />
Right to Reconsideration - The Resident may request reconsideration of a summary suspension,<br />
termination of their Agreement, or any corrective action taken by Oakwood. Requests for<br />
reconsideration must be <strong>made</strong> in writing to the Director of Medical Education within 10 calendar<br />
days of the date of notification to the resident of the action. The request for reconsideration must<br />
specify the action which <strong>is</strong> to be reconsidered. A proper request for reconsideration shall stay<br />
any action being reconsidered, except summary suspension. If the Resident fails to request<br />
reconsideration of an action, the action shall become immediately final.<br />
Reconsideration Committee - Upon receipt of a proper and timely request for reconsideration,<br />
the Director of Medical Education shall appoint a committee to undertake the reconsideration.<br />
The Director of Medical Education will act as chairman of the Reconsideration Committee<br />
unless the Resident requests that the Director of Medical Education d<strong>is</strong>qualify himself from<br />
appointing and serving as chairman of the Reconsideration Committee. The request for<br />
d<strong>is</strong>qualification must be <strong>made</strong> in writing at the time the request for reconsideration <strong>is</strong> <strong>made</strong>. If<br />
the Director of Medical Education d<strong>is</strong>qualifies himself, the Chief of Staff will appoint the<br />
Reconsideration Committee and act as its chairman. In addition to the chairman, the<br />
Reconsideration Committee will cons<strong>is</strong>t of two individuals selected from the Medical Education<br />
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Committee, two individuals selected from the Medical Staff, two residents, and one individual<br />
selected from Oakwood Admin<strong>is</strong>tration. A majority of the physicians serving on the<br />
Reconsideration Committee shall be from departments other than the department in which the<br />
Resident <strong>is</strong> in training. The individual serving as chairman of the Reconsideration Committee<br />
shall be responsible for appointing members to the committee in accordance with th<strong>is</strong> Section.<br />
Notice of Meeting - The chairman of the Reconsideration Committee shall set a date for the<br />
committee to meet that <strong>is</strong> within fourteen (14) calendar days of the date upon which the Resident<br />
submitted the written request for reconsideration. At least seven (7) calendar days prior to the<br />
scheduled Reconsideration Committee meeting, the chairman shall provide the Resident and all<br />
members of the Reconsideration Committee with written notice of the date, time, and place of<br />
the meeting, delivered personally or by certified mail, return receipt requested.<br />
Conduct of the Meeting - The Resident may appear at the Reconsideration Committee meeting,<br />
and may ask one medical staff or faculty member to appear at the meeting with him/her to<br />
provide counsel and/or to speak on the Resident's behalf. Legal counsel shall not be permitted to<br />
attend the meeting with or on behalf of any party or the Reconsideration Committee. The<br />
chairman shall conduct the meeting, and shall request the Resident to present any information<br />
the Resident feels <strong>is</strong> relevant to the committee's reconsideration of the matter. The<br />
Reconsideration Committee meeting shall in no manner constitute a hearing. After the Resident<br />
has presented h<strong>is</strong>/her information, the chairman shall excuse the Resident and the Resident's<br />
medical staff representative, and the committee shall deliberate the matter in private.<br />
Committee Dec<strong>is</strong>ion - The Reconsideration Committee shall make a dec<strong>is</strong>ion either to uphold or<br />
to overturn the action being reconsidered. The dec<strong>is</strong>ion of the Reconsideration Committee need<br />
not be unanimous; the majority dec<strong>is</strong>ion of the committee rules. Within seven (7) days of the<br />
committee's meeting, the Reconsideration Committee chairman shall provide the Resident and<br />
the Director of Medical Education with the written dec<strong>is</strong>ion of the committee, which shall<br />
include the Committee's rationale for its dec<strong>is</strong>ion. Delivery of notice of the dec<strong>is</strong>ion to the<br />
Resident shall be by personal delivery or by certified mail, return receipt requested. The<br />
dec<strong>is</strong>ion of the Reconsideration Committee shall be final. The Resident shall be entitled to only<br />
one reconsideration of any summary suspension action, termination action, or any corrective<br />
action.<br />
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Grievance Procedure<br />
The purpose of th<strong>is</strong> policy <strong>is</strong> to define the usual process at Oakwood for residents to<br />
communicate substantive <strong>is</strong>sues and concerns to the programs and institution’s admin<strong>is</strong>tration. It<br />
also defines the mechan<strong>is</strong>ms for an official, impartial hearing of concerns that are not resolved<br />
through usual, initial communications with admin<strong>is</strong>tration. The intent <strong>is</strong> to provide the due<br />
process and an appeal mechan<strong>is</strong>m in instances where th<strong>is</strong> <strong>is</strong> needed.<br />
1. Residents who have concerns or <strong>is</strong>sues related to the interpretation, application, or breach<br />
of any policy, practice, or procedure in their educational program, or Medical Education<br />
in general should:<br />
a) first d<strong>is</strong>cuss them with their program director,<br />
b) if reasonable d<strong>is</strong>cussion with the program director does not lead to<br />
resolution of the concern the resident(s) should bring the <strong>is</strong>sue to the attention of<br />
the Medical Education office,<br />
c) if reasonable d<strong>is</strong>cussion with the Director of Medical Education does not resolve<br />
the <strong>is</strong>sue, a formal grievance may be sent in written form to the Medical<br />
Education Committee.<br />
2. Resident(s) w<strong>is</strong>hing to resolve a specific grievance will forward their complaint in<br />
writing (addressed to the Medical Education Committee), to the Director of Medical<br />
Education. The resident(s) concerned, or their colleagues representing them - such as the<br />
chief resident(s), will then be scheduled to present a summary of the complaint to the<br />
Medical Education Committee at its next meeting. Legal representatives will not<br />
participate in or be present during Medical Education Committee or subcommittee<br />
deliberations.<br />
3. If residents desire confidentiality in forwarding the grievance to the Director of Medical<br />
Education or in its presentation to the Medical Education Committee/ subcommittees,<br />
they should contact the Medical Education Committee Confidant whose name and<br />
number are posted in the Medical Education area and in the resident’s lounge.<br />
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5. Upon hearing the summary of the complaint, the Medical Education Committee will<br />
nominate a subcommittee to review that specific complaint. The subcommittee must be<br />
<strong>made</strong> up of Medical Education Committee members and include:<br />
<br />
<br />
<br />
<br />
<br />
two residents<br />
two faculty (one from the program from which the complaint<br />
emanated and one not)<br />
a medical staff physician that <strong>is</strong> not a Medical Education faculty<br />
a chairperson who cannot also simultaneously fill one of the above<br />
positions<br />
a non-voting admin<strong>is</strong>trative resource person<br />
The chairperson will be nominated and elected by the Medical Education Committee.<br />
6. The Grievance Subcommittee will meet within two weeks to consider resolution for the<br />
complaint. Residents, program directors, and the Director of Medical Education will<br />
submit documentation they feel <strong>is</strong> important to the subcommittee secretary prior to the<br />
first meeting. The subcommittee chairperson may request additional documentation, as<br />
they or the subcommittee feels necessary.<br />
7. The subcommittee will, at the designated time and place, hear the resident(s) concerned<br />
present the details of their complaint and their proposed solutions in full. Other<br />
concerned parties may also present their views on the <strong>is</strong>sues to the subcommittees at that<br />
time. Having heard the resident(s) and other parties concerned, they will then be excused<br />
from the meeting.<br />
8. The subcommittee will then immediately deliberate behind closed doors, without<br />
interference or participation by anyone other than subcommittee members.<br />
9. The subcommittee will have the fiduciary responsibility to make a final recommendation<br />
regarding resolution of the complaint. Th<strong>is</strong> will be expected at the time of the first<br />
meeting. In rare circumstances, at the chairperson’s d<strong>is</strong>cretion, the subcommittee may<br />
elect to obtain additional information and meet again in one week to finalize their<br />
recommendation(s) for resolution of the complaint.<br />
10. The final recommendation(s) of the Grievance Subcommittee will be d<strong>is</strong>tributed by the<br />
chairperson to the Medical Education Committee, the resident(s) concerned, and the<br />
Director of Medical Education within 3 work days.<br />
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11. The subcommittee’s final recommendation(s) for resolution of the complaint are not<br />
necessarily final and binding:<br />
<br />
<br />
<br />
Those recommendations requiring financial remuneration are subject to review<br />
and approval by Oakwood Healthcare System. Th<strong>is</strong> review will be executed by<br />
OHS admin<strong>is</strong>tration within two weeks of the subcommittee’s recommendations.<br />
Resident(s) concerned with the complaint may choose to appeal the<br />
subcommittee’s recommendation(s). The appeals process <strong>is</strong> outlined<br />
below.<br />
In all other cases, the subcommittee’s recommendations are final and<br />
binding, and the Medical Education Committee will effect the<br />
recommendations of the subcommittee or direct the Director of Medical<br />
Education to do so.<br />
12. If the resident(s) appeal the subcommittee’s recommendations, they will submit in<br />
writing their appeal to the Medical Education Committee, including specific reasons why<br />
the feel an appeal <strong>is</strong> necessary despite the Grievance Subcommittee’s deliberations. The<br />
Medical Education Committee will consider th<strong>is</strong> request for appeal and vote to:<br />
a) retain the subcommittee’s recommendations, or<br />
b) nominate a Grievance Appeals Committee.<br />
If the Medical Education Committee votes to retain the subcommittee’s<br />
recommendations, they are final and binding.<br />
13. In case of appeal, if the Medical Education Committee elects to nominate an Appeals<br />
Subcommittee, the constituents will be from the same groups as outlined for the<br />
Grievance Subcommittee, but new persons will be nominated first from the Medical<br />
Education Committee. If an appropriate member <strong>is</strong> not available from the Medical<br />
Education Committee, nonmembers will be nominated. In addition to the constituents<br />
outlined for the Grievance Subcommittee, an admin<strong>is</strong>trator from OHS will be nominated<br />
to the Appeals Subcommittee, as will a program director or leader from an outside<br />
institution.<br />
14. The Appeals subcommittee will follow the same process as outlined above for the<br />
Grievance Subcommittee. The Grievance Appeals Subcommittee recommendations for<br />
resolution of the complaint are final and binding on all parties.<br />
51