Pursuing professional accountability: an evidence-based approach to addressing residents with behavioral problems.
OBJECTIVE
To develop an evidence-based approach to the identification, prevention, and management of surgical residents with behavioral problems.


METHODS
The American College of Surgeons and Southern Illinois University Department of Surgery hosted a 1-day think tank to develop strategies for early identification of problem residents and appropriate interventions. Participants read a selection of relevant literature before the meeting and reviewed case reports.


METHODS
American College of Surgeons headquarters, Chicago, Illinois.


METHODS
Medical and nursing leaders in the field of resident education; individuals with expertise in dealing with academic law, mental health issues, learning deficiencies, and disruptive physicians; and surgical residents.


METHODS
Evidence-based strategies for the identification, prevention, and management of problem residents.


RESULTS
Recommendations based on the literature and expert opinions have been made for the identification, remediation, and reassessment of problem residents.


CONCLUSIONS
It is essential to set clear expectations for professional behavior with faculty and residents. A notice of deficiency should define the expected acceptable behavior, timeline for improvement, and consequences for noncompliance. Faculty should note and address systems problems that unintentionally reinforce and thus enable unprofessional behavior. Complaints, particularly by new residents, should be investigated and addressed promptly through a process that is transparent, fair, and reasonable. The importance of early intervention is emphasized.
Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL 62794, USA. hsanfey@siumed.edu
Hilary
H
Sanfey
Debra A
DA
Darosa
Gerald B
GB
Hickson
Betsy
B
Williams
Ranjan
R
Sudan
Margaret L
ML
Boehler
Mary E
ME
Klingensmith
Debra
D
Klamen
John D
JD
Mellinger
James C
JC
Hebert
Kerry M
KM
Richard
Nicole K
NK
Roberts
Cathy J
CJ
Schwind
Reed G
RG
Williams
Ajit K
AK
Sachdeva
Gary L
GL
Dunnington
D000328:Adult; D002983:Clinical Competence; D019317:Evidence-Based Medicine; D006801:Humans; D007087:Illinois; D007396:Internship and Residency; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy*; D020380:Needs Assessment; D010815:Physician Impairment