How resident unprofessional behavior is identified and managed: a program director survey

Area of Science:

• Medical Education
• Professionalism in Medicine
• Residency Training

Background:

• Unprofessional behavior among medical residents presents challenges in graduate medical education.
• Identifying and managing resident professionalism issues is crucial for patient safety and program integrity.

Purpose of the Study:

• To investigate how program directors identify and manage unprofessional resident behavior.
• To understand the conditions under which professionalism concerns are communicated to future employers.

Main Methods:

• A web-based survey was distributed to 241 directors of US obstetrics and gynecology residency programs.
• A 58% response rate was achieved, with 141 program directors providing data.

Main Results:

• 84% of program directors identified professionalism problems through personal communication.
• Interventions included expectation setting (95%), counseling (68%), probation (59%), and dismissal (30%).
• Most directors found remediation challenging, and 42% only disclosed concerns to employers upon request.

Conclusions:

• Resident unprofessional conduct is a frequent issue for program directors, complicated by challenging remediation processes.
• Program directors are willing to report concerns to employers, though some hesitate to do so proactively.