Remediation and Progressive Performance Review

Original Approval: 7/1/2017

Revision Date: 9/1/2025

1. Introduction
   1. Remediation may be imposed to advise a resident of his/her need to correct behavioral deficiencies including:
      1. violations of NSHE or UNR Med policies,
      2. violations of rules of a training site, rules or statutes governing conduct of physicians practicing in the State of Nevada following a finding that the act, failure to act or omission by that resident is serious enough to place the resident on remediation.
   2. Remediation may be imposed to advise a resident of deficiencies in academic performance below a minimally acceptable standard at his/her level of training.
   3. These remediation procedures apply only to residents after they have been accepted and begin participating in a residency program. The terms of any remediation established as a condition of acceptance into a residency program will be specifically set forth in the resident's initial employment agreement. In such an event, the contractual provisions will govern.
2. Procedures
   1. Following a determination by the Program Director and Chair that an act, failure to act or omission by a resident is serious enough to place the resident on remediation, the Program Director or Department Chair will notify the resident in a private meeting of the decision to impose remediation.
   2. Informal remediation by agreement may only be imposed once to resolve a deficiency of or a complaint against a resident. Thereafter, it must be referred to the Resident Performance Review Committee under the Due Process policy. Informal remediation is not required before referring a matter to the Resident Performance Review Committee.
   3. The Program Director will provide the resident with a written Notice of Action stating that the resident has received a notice of the intention to place him or her on remediation, which must include an explanation of the specific basis for the decision. Copies of all Notices of Action must be provided to the Associate Dean/ DIO for Graduate Medical Education.
   4. A period of remediation will begin as of the date of the Notice of Action.  Length of remediation will be determined by the program director and departmental resident evaluation committee and MUST be reviewed.
   5. The Program Director will provide the resident with clearly written requirements to improve the resident's performance and state the terms of the remediation. The Associate Dean for Graduate Medical Education will be informed of the plan and will have the opportunity to provide input into the remediation plan.
   6. During the remediation period, the Program Director will make efforts to offer guidance, counseling and supervision to aid the resident in correcting the deficiencies with the acknowledged goal of retaining them in the program. It will, however, remain the resident's responsibility to correct the deficiencies.
   7. The resident's personnel records will reflect all periods during which he/she was on remediation.
   8. If it is determined that the resident successfully met the terms of the remediation period, the Program Director will provide the resident with a written notice of successful completion of remediation, place a copy of such notice in the resident's personnel file, and forward a copy of the notice to the Associate Dean for Graduate Medical Education.
   9. If it is determined by the program director, in consultation with the CCC, that the resident has failed to meet the terms of a remediation period. The Program Director will provide the resident a written notice of failure and recommend additional remediation or initiate a written notice of non-reappointment.

   10. The Program Director may recommend or institute other forms of discipline during a period of remediation, if just cause warrants such action.