Resident Physician Disciplinary Issues

By the time you have graduated from medical school and matched into a residency program or scrambled into one of the few positions left, you’ve invested a lot of your time, your money, and your life into your career.  This is just as true for post-graduate fellows.

It can be devastating when you are threatened with disciplinary measures like remediation, probation, suspension, non-renewal, or dismissal from your program.  Residents struggle everyday with the question: “What can I do if I’ve been dismissed from my program?”  Even some seemingly minor discipline may be reportable to third-parties, which can adversely impact your career.  Dealing with the allegations being made against you can be personally and professionally devastating on top of balancing your already demanding schedule, but there are a number of ways you can protect yourself.  You do have rights as a resident physician or fellow.

If your program is accredited by the Accreditation Council for Graduate Medical Education (known to most of us as the ACGME) (or the American Osteopathic Association (AOA) prior to their merger into the Single Accreditation System), they are required to provide a minimum amount of due process to residents and fellows who are subject to disciplinary action.  Each institution’s own policies and your training contract may provide additional rights.  This means that the program must give you the opportunity to present your side of the story, in most cases, to a panel consisting of members of the medical staff and usually other residents who do not have a conflict of interest regarding the matter at issue.

As our blog articles discuss, the internal due process appeal and any accompanying negotiation can be very valuable to resolving the dispute, and there are many things to consider in a very short period of time.  Competent representation by an attorney that knows the relevant standards is critical to making the most of those opportunities.  The strategies vary according to each case, and the approach to allegations of unprofessionalism or deficiencies in interpersonal and communication skills can be much different than rebutting issues of medical knowledge or patient care/patient safety.  We have represented and successfully improved the standing of over 50 residents and fellows across the country in programs large and small, from many different medical specialties, each with their own unique clinical, educational, and accreditation issues.

Occasionally, when internal due process and negotiation is not enough to resolve the dispute, it is necessary for residents to protect their rights in court.  Our attorneys have not only engaged in this litigation, but they closely monitor how courts around the country assess these cases.  Because residency is a unique hybrid of employment and education, our understanding of the legal strategies that have the best chance of success is particularly important.

We also have experience with related matters like rebutting allegations by the National Resident Matching Program (NRMP) that a resident has violated the match agreement in some way, defending medical students against academic dishonesty charges, and advocating for nursing students in academic matters.

Representative Cases

The results in each case are dictated by many factors unique to that case, but these are a sampling of the actions we have taken and the results we have achieved for our clients:

  • Successfully advocated for the reinstatement of an osteopathic surgery resident who was dismissed wrongfully on the basis of his in-training exam score (the resident went on to pass the Boards that the program tried to prevent the resident from taking for fear of failure).
  • Negotiated the rightful payment of a $130,000+ bonus that an employer sought to deny a high-performing physician based on a misinterpretation of the employment contract.
  • Prevailed in convincing a family medicine residency program to reverse the dismissal of a resident for reasons that appeared to be based on her pregnancy rather than her performance.
  • Sued a top-tier teaching hospital and, on the eve of trial, obtained a settlement that reinstated a previously fired surgical resident to good standing and allowed the resident to reapply (successfully) to another residency program.
  • Obtained the first-ever reversal of a resident’s dismissal through due process at a large metropolitan teaching hospital.
  • Succeeded in advocating for dismissals to be reversed, and other disciplinary measures to be reduced or delayed.
  • Negotiated the reconsideration of career-altering discipline to allow residents to avoid the adverse effects of unfair criticism.
  • Advocated for a medical resident in an arbitration with the NRMP over whether the resident violated the Match Participation Agreement.

Brown, Goldstein & Levy attorneys can assist with the seasoned advice they have provided to so many resident physicians and fellows, medical students, and nursing students.

Greg Care
Andy Levy