Institutional Policies

The Department of Pediatrics falls under the institutional policies in the following areas. Specifics of the policy may be obtained through the Pediatric Training Director, the Dept. Chairman, or the GME Director or their offices.

The candidate for Pediatric Residency must possess skills in the following areas.

Subject: Selection of Residents

Intent: The Accreditation Council for Graduate Medical Education Institutional Requirement (I. B. 3. e.) and (II. A.) require written policies on the recruitment and appointment of residents.

Statement: Only residents eligible by ACGME requirements will be recruited and appointed.

Description: Resident Eligibility

Applicants with one of the following qualifications are eligible for appointment to University of Florida accredited residency programs:

  1. Graduates of medical schools in the United States and Canada accredited by the Liaison Committee on Medical Education (LCME).
  2. Graduates of colleges of osteopathic medicine in the United States accredited by the American Osteopathic Association (AOA).
  3. Graduates of medical schools outside the United States and Canada who meet one of the following qualifications:
    1. Have a currently valid certificate from the Educational Commission for Foreign Medical Graduates or
    2. Have a full and unrestricted license to practice medicine in an U.S. Licensing jurisdiction.
  4. Graduates of medical schools outside the United States who have completed a Fifth Pathway program provided by an LCME-accredited medical school.

Resident Selection

  1. The sponsoring institution must ensure that programs select from among eligible applicants on the basis of their preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities such as motivation and integrity. Programs must not discriminate with regard to sex, race, age, religion, color, national origin, disability, or veteran status.In selecting from among qualified applicants, it is strongly suggested that all programs participate in the National Resident Matching Program (NRMP). For programs that are not involved in the Match, program directors are encouraged to participate in “match” programs of the appropriate specialty societies.
  2. Programs participating in the NRMP must abide by all rules applicable.
  3. Programs’ compliance with residency eligibility selection rules will be confirmed in the periodic Internal Reviews.

Subject: Procedure for Grievance, Suspension, Nonrenewal or Dismissal

Intent: Each training program is responsible for the conduct of that training program and for the policy on defining satisfactory performance of the resident as a student. The sponsoring institution wishes to ensure that the application of such policies are not arbitrarily illegal, unjust or create unnecessary hardship. Therefore, a policy and procedure for addressing resident dissatisfaction is established (I.R. I. B. 3. e.) and (I.R. I. B. f. 4).

Policy

Statement: Context of the institutional and program requirements. Each program must develop fair and consistent standards for the residents. If a resident feels that a decision by the program violates standards of fairness then the resident is afforded a process whereby individuals outside the program may review such decisions.

Description: The position of the resident presents the dual aspect of a student in graduate training while participating in the delivery of patient care.

The University of Florida College of Medicine is committed to the maintenance of a supportive educational environment in which residents are given the opportunity to learn and grow. Inappropriate behavior in any form in this professional setting is not permissible. A resident’s continuation in the training program is dependent upon satisfactory performance as a student, including the maintenance of satisfactory professional standards in the care of patients and interactions with others on the health care team. The resident’s academic evaluation will include assessment of behavioral components, including conduct that reflects poorly on professional standards, ethics, and collegiality. Disqualification of a resident as a student or as a member of the health care team from patient care duties disqualifies the resident from further continuation in the program.

Grievances: A grievance is defined as dissatisfaction when a resident believes that any decision, act or condition affecting his or her program of study is arbitrary, illegal, and unjust or creates unnecessary hardship. Such grievance may concern, but is not limited to, the following: academic progress, mistreatment by any University employee or student, wrongful assessment of fees, records and registration errors, discipline (other than nonrenewal or dismissal) and discrimination because of race, national origin, gender, marital status, religion, age or disability, subject to the exception that complaints of sexual harassment will be reviewed by the Chair of the Sexual Harassment Committee. (as contained in the Housestaff Policy & Procedure Manual).
Prior to invoking the grievance procedures described herein, the resident is strongly encouraged to discuss his or her grievance with the person(s) alleged to have caused the grievance. The discussion should be held as soon as the resident becomes aware of the act or condition that is the basis for the grievance. In addition, or alternatively, the resident may wish to present his or her grievance in writing to the person(s) alleged to have caused the grievance. In either situation, the person(s) alleged to have caused the grievance may respond orally or in writing to the resident.

If a resident decides against discussing the grievance with the person(s) alleged to have caused such, or if the resident is not satisfied with the response, he or she may present the grievance to the Chair. If, after discussion, the grievances cannot be resolved, the resident may contact the Associate Dean of Graduate Medical Education (ADGME). The ADGME will meet with the resident and will review the grievance. The decision of the ADGME will be communicated in writing to the resident and constitute the final action of the University.

Suspension: The Chief of Staff of a participating and/or affiliated hospital where the resident is assigned, the Dean, the President of the Hospital, the Chair, or Program Director may at any time suspend a resident from patient care responsibilities. The resident will be informed of the reasons for the suspension and will be given an opportunity to provide information in response.

The resident suspended from patient care may be assigned to other duties as determined and approved by the Chair. The resident will either be reinstated (with or without the imposition of academic probation or other conditions) or dismissal proceedings will commence by the University against the resident within thirty (30) days of the date of suspension.

Any suspension and reassignment of the resident to other duties may continue until final conclusion of the decision-making or appeal process. The resident will be afforded due process and may appeal to the ADGME for resolution, as set forth below.

Nonrenewal: In the event that the Program Director decides not to renew a resident’s appointment, the resident will be provided written notice which will include a statement specifying the reason(s) for nonrenewal.

If requested in writing by the resident, the Chair will meet with the resident; this meeting should occur within 10 working days of the written request. The resident may present relevant information regarding the proposed nonrenewal decision. The resident may be accompanied by an advisor during any meeting held pursuant to these procedures, but the advisor may not speak on behalf of the resident. If the Chair determines that nonrenewal is appropriate, he or she will use their best efforts to present the decision in writing to the resident within 10 working days of the meeting. The resident will be informed of the right to appeal to the ADGME as described below.

Dismissal: In the event the Program Director of a training program concludes a resident should be dismissed prior to completion of the program, the Program Director will inform the Chair in writing of this decision and the reason(s) for the decision. The resident will be notified and provided a copy of the letter of proposed dismissal; and, upon request, will be provided previous evaluations, complaints, counseling, letters and other documents that relate to the decision to dismiss the resident.

If requested in writing by the resident, the Chair will meet with the resident; this meeting should occur within 10 working days of the written request. The resident may present relevant information regarding the proposed dismissal. The resident may be accompanied by an advisor during any meeting held pursuant to these procedures, but the advisor may not speak on behalf of the resident. If the Chair determines that dismissal is appropriate, he or she will use their best efforts to present the decision in writing to the resident within 10 working days of the meeting. The resident will be informed of the right to appeal to the ADGME as described below.

Appeal: If the resident appeals a decision for suspension, nonrenewal or dismissal, this appeal must be made in writing to the ADGME within 10 working days from the resident’s receipt of the decision of the person suspending the resident or the Chair. Failure to file such an appeal within 10 working days will render the decision of the person suspending the resident or the Chair the final agency action of the University.

The ADGME will conduct a review of the action and may review documents or any other information relevant to the decision. The resident will be notified of the date of the meeting with the ADGME; it should occur within 15 working days of the ADGME’s receipt of the appeal. The ADGME may conduct an investigation and uphold, modify or reverse the recommendation for suspension, nonrenewal or dismissal. The ADGME will notify the resident in writing of the ADGME’s decision. If the decision is to uphold a suspension, the decision of the ADGME is the final agency action of the University. If the decision is to uphold the nonrenewal or dismissal, the resident may file within 10 working days a written appeal to the Dean of the College of Medicine. Failure to file such an appeal within 10 working days will render the decision of the ADGME the final action of the University.>

The Dean will inform the ADGME of the appeal. The ADGME will provide the Dean a copy of the decision and accompanying documents and any other material submitted by the resident or considered in the appeal process. The Dean will use his or her best efforts to render a decision within 15 working days, but failure to do so is not grounds for reversal of the decision under appeal. The Dean will notify in writing the Chair, the ADGME, the Program Director and resident of the decision. The decision of the Dean will be the final agency action of the University. The resident will be informed of the steps necessary for the resident to further challenge the action of the University.

Subject: Guidelines for Technical Standards for Residency Training

Intent: The sponsoring institution supports the concept of reasonable accommodations to individuals with disabilities accepted to graduate medical education programs.

Policy

Statement: Each program is responsible for the development of technical standards necessary to complete their graduate medical education program. In general, individuals must have abilities and skills in five categories: observations, communication, motor, intellectual, behavioral and social. Individuals applying to a residency are encouraged to discuss disabilities with the program director during the interview process.

Description: Although each program may have specialized skills necessary to complete the program, (i.e. motor skills in surgery) the College of Medicine has adopted the following technical standards for medical school admissions and these should form guidelines for each program to develop specialty specific technical standards.

  1. Observation: The candidate must be able to observe demonstrations and experiments in the basic sciences, including but not limited to physiologic and pharmacologic demonstrations in animals, microbiologic cultures, and microscopic studies of microorganisms and tissues in normal and pathologic states. A candidate must be able to observe a patient accurately at a distance and close at hand. In detail, observation necessitates the functional use of the sense of vision and other sensory modalities.
  2. Communications: A candidate must be able to speak, to hear, and to observe patients in order to elicit information, describe changes in mood, activity, and posture, and perceive nonverbal communications. A candidate must be able to communicate effectively and sensitively with patients. Communication includes not only speech but reading and writing. The candidate must be able to communicate rapidly, effectively and efficiently in oral and written form with all members of the healthcare team.
  3. Motor:Candidates must have sufficient motor function to elicit information from patients by palpation, auscultation, percussion, and other diagnostic maneuvers. A candidate must be able to execute motor movements reasonably required to provide general care and emergency treatment to patients. Examples of emergency treatment reasonably required of physicians are: The administration of intravenous medication, the application of pressure to stop bleeding and the opening of obstructed airways. Such actions require coordination of both gross and fine muscular movements equilibrium, and functional use of the senses of touch and vision.As mandated by the ACGME program requirements, pediatrics residents must achieve competence with certain procedures.  Therefore a candidate must be able to execute motor movements required to perform the following procedures.  Basic and advanced life support, endotracheal intubation, placement of intraosseous lines, placement of intravenous lines, venipuncture, arterial puncture, umbilical artery and vein catherization, lumbar puncture, bladder catheterization, gynecologic evaluation, wound care, suturing, reduction and splinting of simple dislocations/fractures, subcutaneous, intradermal, and intramuscular injections.
  4. Intellectual-Conceptual, Integrative, and Quantitative Abilities:These abilities include measurement, calculation, reasoning, analysis and synthesis of complex information.
  5. Behavioral and Social Attributes: A candidate must possess the emotional health required for full utilization of his or her intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care of patients, and the development of mature, sensitive, and effective relationships with patients. Candidates must be able to tolerate physically taxing workloads and to function effectively under stress. They must be able to adapt to changing environments, to display flexibility, and learn to function in the face of uncertainties inherent in the clinical problems of many patients. Compassion, integrity, interpersonal skills, interest and motivation are all personal qualities that are assessed during the admission and education processes.

Subject: Impaired Physician

Intent: The sponsoring institution and each program is responsible for monitoring residents for signs of psychological and substance abuse problems and for initiating appropriate interventions.

Policy

Statement: The University of Florida College of Medicine will fully participate in the provisions of the Florida Medical Practice Act (F.S.458), the rules of the Board of Medicine, and Department of Professional Regulation. The College of Medicine supports the Florida Impaired Practitioners Program.

Description:

  1. Faculty, staff, peers, family or other individuals who suspect that a member of the housestaff is suffering from a psychological or substance abuse problem are obligated to report such problems. Individuals suspecting such impairment can either report directly to the Physician’s Recovery Network (PRN) or can discuss their concerns with the Program Director, Chairman, or Associate Dean of Graduate Medical Education.
    1. It is the intent of the sponsoring institution that all appropriate rules that govern the practice of medicine be strictly enforced.
    2. All referrals to the PRN are confidential and are evaluated by the professionals of the PRN. Decisions about intervention, treatment and after care are determined by the PRN.
    3. As long as the practitioner satisfactorily participates in the PRN program no regulatory action would normally be anticipated by the Board of Medicine.
    4. Resumption of clinical activity and residency program will be contingent upon the continued successful participation in the PRN and continuation of the resident in the program will be determined in consultation between the program director and the professionals at the PRN.
    5. Information on the Physician’s Recovery Network (PRN) and its program can be obtained by calling 1-800-888- 8PRN or by writing to the PRN at P.O. Box 1881, Fernandina Beach, Florida 32034.
  2. Each program will provide an educational program to their residents regarding substance abuse.
  3. Compliance with the above will be monitored in the internal review process.

    Impaired Practitioners Program Of Florida

    The Physicians Recovery Network (PRN)

    P.O. Box 1020

    Fernandina Beach, FL 32035-1020

    1-800-888-8PRN

    1-904-277-8004

    Physicians or osteopaths with a past or current history of drug or alcohol addiction must contact the PRN as soon a possible on or before arriving at your training program in Gainesville, FL. This is a confidential and professional organization that will help you stay clean and sober while maintaining your ability to practice medicine in our State.

    The purpose of the PRN Program is to ensure the public health and safety by assisting the ill practitioners who may suffer from one or more of the following:

    • Chemical dependency
    • Psychiatric illness
    • Psychosexual illness, including boundary violations
    • Neurological/cognitive impairment
    • Physical illness
    • HIV infections/AIDS
    • Behavioral disorders

    By supporting ill practitioners in regaining their health, PRN attempts to maintain the integrity of the healthcare team in its role in serving the public.

    You are treated with respect, confidentiality, and without discrimination. Recommendations by the PRN for any type of follow-up, counseling, testing, assessment, etc. is the privacy of you and the PRN in their Advocacy/Monitoring Contract.

    For further confidential information, resources, intervention, referral or treatment, feel free to contact Sharron Wallace at 265-0787, or Dr. Ken Thompson, Director of the Vista Professionals Recovery & Treatment Program at 338-0097, Ext. 7189.