A model for instituting a comprehensive program of remediation for at-risk residents

Residents who are performing below a level appropriate for their stage of training pose challenges for the departments and institutions that train them. This problem may be encountered all over the United States and in every area of medicine. However, programs designed to help these residents improve and overcome their deficits have not yet been described in the literature. This article offers a model for instituting a comprehensive program of remediation into a residency training program. A sample letter of notification outlining such a program is included, which can be modified for use by other programs. Possible barriers as well as strategies to guide the successful development and implementation of a remediation program are discussed. The model provides a guide and tools to assist program directors and others involved in medical education in creating and tailoring a remediation program that suits the needs of the at-risk resident as well as the program and institution.