Remediation and Progressive Performance Review

Resident Handbook

  1. Introduction
    1. Remediation may be imposed to advise a resident of his/her need to correct behavioral deficiencies including:
      • violations of NSHE or UNR Med policies,
      • 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 or Department Chair 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 for Graduate Medical Education.
    4. A period of remediation will begin as of the date of the Notice of Action if the resident consents to such action. If the resident does not consent, and appeals the decision, the effective date of the remediation will be on the date the decision becomes final. Length of remediation will be determined by the program director and departmental resident evaluation committee and MUST be reviewed minimally every three (3) months, during which a resident will receive his/her regular compensation.
    5. The Program Director or Department Chair 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 or Department Chair will make efforts to offer guidance, counseling and supervision to aid the resident in correcting the deficiencies with the acknowledged goal of retaining him/her 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. The Program Director will notify the resident of his/her right to request review of the decision to place him/her on remediation by the Resident Performance Review Committee (RPRC) and include a copy of the Due Process policy with the Notice of Action. Recommendations from the RPRC will be made to the departmental chair and his/her decision will be final.
    9. If it is determined that the resident successfully met the terms of the remediation period, the Program Director or the Department Chair 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.
    10. If it is determined that the resident has failed to meet the terms of a remediation period, the Program Director or the Department Chair will provide the resident a written notice to initiate procedures either to have the case reviewed by the Resident Performance Review Committee to recommend additional remediation or to recommend a notice of non-reappointment be given.
    11. The Program Director or Department Chair may recommend or institute other forms of discipline during a period of remediation, if just cause warrants such action.