Fit for Duty Evaluation Policy

1. Introduction:
   Fit for duty evaluations are used to determine if a resident/fellow's performance is being affected by impairment that includes but is not limited to medical, mental health or substance abuse problems. The purpose of the fit for duty evaluation is to determine the resident/fellow's ability to perform his/her clinical duties and responsibilities safely; meaning that he/she is not a danger to patients, colleagues or self.
2. Procedure:
   
   1. An attending, peer, other personnel working with the resident/fellow or clinical competency committee identifies a resident/fellow as having serious academic or behavioral deficiencies and reports findings to the program director.
   2. The program director will discuss the identified issues with the Associate Dean for Graduate Medical Education/DIO.
   3. If it is agreed that a fit for duty evaluation is needed, the resident/fellow may be placed on administrative leave until the evaluation is done.
   4. The associate dean for GME/DIO will contact the Employee Assistance Program director or designee who will do an initial interview with the resident/fellow and determine if an additional evaluation is needed.
   5. The program director and/or the associate dean for GME/DIO will share the information with the evaluator(s) selected to perform the fit for duty evaluation.
      
      1. This is not a confidential session between the resident/fellow and a counselor, in that this is considered an academic referral and therefore, will not be subject to the same privacy rules as occurs in a therapeutic relationship.
      2. A report will be generated to inform the program director and the associate dean for GME/DIO if a resident/fellow can safely return to work.
      3. The resident/fellow may be referred to the appropriate professional (physician, masters of social work, psychologist, etc.).
      4. Costs for the evaluation will be addressed at the level of the office of Graduate Medical Education.
   6. If the resident/fellow being evaluated is determined to be fit to return to work, the evaluator will make an effort to contact the associated dean for GME/DIO and/or the program director as soon as that determination is made, which may be prior to writing the report so that scheduling plans can be made for the resident/fellow.
   7. If the resident/fellow is identified as not fit for duty, the evaluator will contact the associate dean for GME/DIO and the program director. Notification may take place prior to writing the report in order to plan for the absence of the resident/fellow.
      
      1. Once the written report is received, the program director in consultation with the associate dean for GME/DIO will determine the status of the resident/fellow in the program.
      2. This could result in termination, medical leave of absence, or personal leave of absence.
      3. In order for reinstatement into a program, a fit for duty report must be submitted to the program director and the associate dean for GME/DIO.
      4. A resident/fellow who continues to be "unfit for duty" after 90 days is in jeopardy of losing his/her position.
   8. A resident/fellow who refuses a fit for duty evaluation will not be allowed to work as a resident/fellow and will be terminated from the program.

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