Evaluation and Remediation Strategies for Struggling Residents Within Oral & Maxillofacial Surgery Residency Programs

Several studies have evaluated resident and trainee remediation strategies across various surgical subspecialties. However, limited research exists on this topic within the Oral and Maxillofacial Surgery (OMS) literature. The purpose of this study was to identify cross-sectional patterns of evaluation and remediation strategies for underperforming OMS residents in the United States.

A cross-sectional cohort study was conducted using a 22-question survey administered to OMS residency Program Directors of all programs approved by the Commission on Dental Accreditation (CODA) within the United States. The predictor variables included the demographics and resident assessment methods of responding programs. The outcome variables included the results of remediation strategies and corrective action plans for residents identified as struggling over the preceding 10 years. Responses were anonymized, and descriptive statistics were used to analyze the collected data.

Completed surveys were obtained from 29 (29%) CODA-approved programs. Twenty-five of 29 (86%) programs reported placing 64 residents on corrective action plans. Nine of 29 (31%) programs reported that 14 residents were dismissed during that period. The most common deficiencies in residents requiring corrective action plans were cognitive skills (37.9%), clinical skills (20.7%), and interpersonal skills (20.7%). Residents were almost always given a warning prior to initiating remediation or probation (96.6%), with verbal (46.4%) and written (53.4%) warnings being used with nearly equivalent frequency. Remedial action most often included general counseling (15.9%), more frequent feedback sessions (15.9%), assignment of a mentor (15.2%), didactic remediation (13.3%), psychiatric/psychologic counseling (11.26%), and lengthened training time (6.6%). Most programs reported utilization of a formal remediation protocol (75.9%) and 85.7% of programs subjectively felt their process was effective. Almost one-quarter of respondents (24.1%) stated that no formal remediation protocol exists at their institution.

Most OMS programs utilized some form of remediation protocols, but their usage was inconsistent and infrequent. The evaluation and remediation processes among OMS residency programs have significant variability, relying heavily on program or institution-specific protocols.