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 fellow 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 fellow 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 fellows. If a fellow feels that a decision by the program violates standards of fairness then the fellow is afforded a process whereby individuals outside the program may review such decisions.

Description

The position of the fellow 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 fellows are given the opportunity to learn and grow. Inappropriate behavior in any form in this professional setting is not permissible. A fellow’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 fellow’s academic evaluation will include assessment of behavioral components, including conduct that reflects poorly on professional standards, ethics, and collegiality. Disqualification of a fellow as a student or as a member of the health care team from patient care duties disqualifies the fellow from further continuation in the program.

Grievances

  • A grievance is defined as dissatisfaction when a fellow 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 fellow 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 fellow becomes aware of the act or condition that is the basis for the grievance. In addition, or alternatively, the fellow 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 fellow.
  • If a fellow decides against discussing the grievance with the person(s) alleged to have caused such, or if the fellow 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 fellow may contact the Associate Dean of Graduate Medical Education (ADGME). The ADGME will meet with the fellow and will review the grievance. The decision of the ADGME will be communicated in writing to the fellow and constitute the final action of the University.

Suspension

  • The Chief of Staff of a participating and/or affiliated hospital where the fellow is assigned, the Dean, the Pfellow of the Hospital, the Chair, or Program Director may at any time suspend a fellow from patient care responsibilities. The fellow will be informed of the reasons for the suspension and will be given an opportunity to provide information in response.
  • The fellow suspended from patient care may be assigned to other duties as determined and approved by the Chair. The fellow 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 fellow within thirty (30) days of the date of suspension.
  • Any suspension and reassignment of the fellow to other duties may continue until final conclusion of the decision-making or appeal process. The fellow 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 fellow’s appointment, the fellow will be provided written notice which will include a statement specifying the reason(s) for nonrenewal.
  • If requested in writing by the fellow, the Chair will meet with the fellow; this meeting should occur within 10 working days of the written request. The fellow may present relevant information regarding the proposed nonrenewal decision. The fellow may be accompanied by an advisor during any meeting held pursuant to these procedures, but the advisor may not speak on behalf of the fellow. If the Chair determines that nonrenewal is appropriate, he or she will use their best efforts to present the decision in writing to the fellow within 10 working days of the meeting. The fellow 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 fellow 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 fellow 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 fellow.
  • If requested in writing by the fellow, the Chair will meet with the fellow; this meeting should occur within 10 working days of the written request. The fellow may present relevant information regarding the proposed dismissal. The fellow may be accompanied by an advisor during any meeting held pursuant to these procedures, but the advisor may not speak on behalf of the fellow. If the Chair determines that dismissal is appropriate, he or she will use their best efforts to present the decision in writing to the fellow within 10 working days of the meeting. The fellow will be informed of the right to appeal to the ADGME as described below.

Appeal

  • If the fellow appeals a decision for suspension, nonrenewal or dismissal, this appeal must be made in writing to the ADGME within 10 working days from the fellow’s receipt of the decision of the person suspending the fellow or the Chair. Failure to file such an appeal within 10 working days will render the decision of the person suspending the fellow 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 fellow 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 fellow 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 fellow 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 fellow 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 fellow of the decision. The decision of the Dean will be the final agency action of the University. The fellow will be informed of the steps necessary for the fellow to further challenge the action of the University.