PSYCHIATRY RESIDENCY PROGRAM

Criteria and Processes for Academic Actions of Reappointment, Evaluation,Promotion, and other Disciplinary ActionsIn compliance with the UAMS COM GME Committee policy on Evaluation andPromotion, the following guidelines apply:ReappointmentEducational appointments to the Psychiatry Residency program are for a term notexceeding one year. The resident agreement of appointment, which outlines the generalresponsibilities for the College of Medicine and for the resident, is signed at thebeginning of each term of appointment. Renewal of the resident agreement ofappointment for an additional term of education is the decision of the Program Directorand the Department Chair. Promotion to the next level of training is dependent upon theresident performing at an acceptable level and meeting the requirements for clinicalcompetence for that post graduate year (PGY). Please see the document, Goals andObjectives for Each Post Graduate Year, which follows this policy statement.It is the intent of the Program to develop physicians clinically competent in the field ofPsychiatry. Physicians completing the program will be eligible for certification by theAmerican Board of Psychiatry and Neurology with an ultimate goal of a 100% pass rateon this examination.Clinical competence requires:1. Patient Care that is compassionate, appropriate, and effective for the treatmentof health problems and the promotion of health2. Medical Knowledge about established and evolving biomedical, clinical, andcognate (e.g. epidemiological and social-behavioral) sciences and theapplication of this knowledge to patient care.3. Practice-Based Learning and Improvement that involves investigation andevaluation of their own patient care, appraisal and assimilation of scientificevidence, and improvements in patient care.4. Interpersonal and Communication Skills that result in effective informationexchange and teaming with patients, their families, and other healthprofessionals.5. Professionalism as manifested through a commitment to carrying outprofessional responsibilities, adherence to ethical principles, and sensitivity to adiverse patient population.6. Systems-Based Practice as manifested by actions that demonstrate anawareness of and responsiveness to the larger context and system of healthcare and the ability to effectively call on system resources to provide care thatis of optimal value.11

Evaluation and PromotionDuring the residency period, the above elements of clinical competence will beassessed in writing frequently by direct faculty supervisors with subsequent reviewby the Program Director. Evaluations by peer resident physicians, patients,nursing staff and other paramedical personnel may be included at less frequentintervals. A resident will meet with the Program Director or other designee twice ayear to review results of evaluations, in-service scores, and clinical exercises. Asummary of the evaluations will be reviewed and signed by the resident. Theevaluations will be maintained in confidential files and only available to authorizedpersonnel. Upon request, the resident may review his/her evaluation file at any timeduring the year.Reappointment and promotion to a subsequent year of training require satisfactoryratings on these evaluations and on the recommendation of theCompetency/Promotions Subcommittee of the Residency Education Committee.A resident receiving any unsatisfactory evaluation during the year may beimmediately reviewed by the Program Director and any written recommendationsmade to him/her may include:1. specific corrective actions2. repeating a rotation3. psychological counseling4. academic warning status or probation5. suspension or dismissal, if prior corrective action, academic warning and/orprobation has been unsuccessful.The resident may appeal an unsatisfactory evaluation by submitting a writtenrequest to appear before the department’s Competency/Promotions Subcommitteeof the Residency Education Committee in a meeting called by the Program Director.The Committee will review a summary of the deficiencies of the resident, and theresident will have the opportunity to explain or refute the unsatisfactory evaluation.After review, the decision of this Committee is final.At the completion of the residency program, the Program Director will prepare afinal evaluation of the clinical competence of the resident. This evaluation willstipulate the degree to which the resident has mastered each component of clinicalcompetence – patient care, medical knowledge, practice-based learning andimprovement, interpersonal and communication skills, professionalism, andsystems-based practice. It will also include any special accommodations theresident may have had which could affect or limit the resident’s scope of practice.In this evaluation the Program Director will verify that the resident “hasdemonstrated sufficient professional ability in Psychiatry to practice competentlyand without supervision”. This evaluation will remain in the resident’s permanent fileto substantiate future judgments in hospital credentialing, board certification,agency licensing, and in the actions of other bodies.12

Academic and Other Disciplinary Actions (in accordance with UAMS COM GMEPolicy on Disciplinary Actions)Probation/Suspension/DismissalActions of Probation/Suspension/Dismissal will follow the guidelines in the GMECommittee Policy on Academic and Other Disciplinary Actions policy as follows.1.A resident may be placed on probation by the Program Director for reasonsincluding, but not limited to any of the following:a. failure to meet the performance standards of an individual rotation;b. failure to meet the performance standards of the program;c. failure to comply with the policies and procedures of the GME Committee,the UAMS Medical Center, or the participating institutionsd. misconduct that infringes on the principles and guidelines set forth by thetraining program;e. documented and recurrent failure to complete medical records in a timelyand appropriate manner;f. when reasonably documented professional misconduct or ethical chargesare brought against a resident which bear on his/her fitness to participate inthe training program.2.When a resident is placed on probation, the Program Director shall notify theresident in writing in a timely manner, usually within a week of the notification ofprobation. The written statement of probation will include a length of time in whichthe resident must correct the deficiency or problem, the specific remedial steps andthe consequences of non-compliance with the remediation.3.Based upon a resident’s compliance with the remedial steps and other performanceduring probation, a resident may be:a. continued on probation;b. removed from probation;c. placed on suspension; ord. dismissed from the residency program.1.SuspensionA resident may be suspended from a residency program for reasons including, butnot limited, to any of the following:a. failure to meet the requirements of probation;b. failure to meet the performance standards of the program;c. failure to comply with the policies and procedures of the GME Committee,the UAMS Medical Center, or the participating institutions;d. misconduct that infringes on the principles and guidelines set forth by thetraining program;e. documented and recurrent failure to complete medical records in a timelyand appropriate manner;f. when reasonably documented professional misconduct or ethical chargesare brought against a resident which bear on his/her fitness to participate inthe training program;13

g. when reasonably documented legal charges have been brought against aresident which bear on his/her fitness to participate in the training program;h. if a resident is deemed an immediate danger to patients, himself or herselfor to others;i. if a resident fails to comply with the medical licensure laws of the State ofArkansas.2. When a resident is suspended, the Program Director shall notify the resident with awritten statement of suspension to include:a. reasons for the action;b. appropriate measures to assure satisfactory resolution of the problem(s);c. activities of the program in which the resident may and may not participate;d. the date the suspension becomes effective;e. consequences of non-compliance with the terms of the suspension;f. whether or not the resident is required to spend additional time in trainingto compensate for the period of suspension and be eligible for certificationfor a full training year.A copy of the statement of suspension shall be forwarded to the Associate Dean forGraduate Medical Education and the Director of Housestaff Records.3. During the suspension, the resident will be placed on “administrative leave”, with orwithout pay as appropriate depending on the circumstances.4. At any time during or after the suspension, the resident may be:a. reinstated with no qualifications;b. reinstated on probation;c. continued on suspension; ord. dismissed from the program.Dismissal1. Dismissal from a residency program may occur for reasons including, but not limitedto, any of the following:a. failure to meet the performance standards of the program;b. failure to comply with the policies and procedures of the GME Committee,the UAMS Medical Center, or the participating institutions;c. illegal conduct;d. unethical conduct;e. performance and behavior which compromise the welfare of patients, self,or others;f. failure to comply with the medical licensure laws of the State of Arkansas;g. inability of the resident to pass the requisite examinations for licensure topractice medicine in the United States, if required by the individualresidency program.14

2. The Program Director shall contact the Associate Dean for GME and provide writtendocumentation which led to the proposed action.3. When performance or conduct is considered sufficiently unsatisfactory that dismissalis being considered, the Program Director shall notify the resident with a writtenstatement to include:a. reasons for the proposed action,b. the appropriate measures and timeframe for satisfactory resolution of theproblem(s).4. If the situation is not improved within the timeframe, the resident will be dismissed.5. Immediate dismissal can occur at any time without prior notification in instances ofgross misconduct including, but not limited to theft of money or property; physicalviolence directed at an employee, visitor or patient; use of, or being under theinfluence of alcohol or controlled substances while on duty, patient endangerment,illegal conduct.6. When a resident is dismissed, the Program Director shall provide the resident with awritten letter of dismissal stating the reason for the action and the date the dismissalbecomes effective. A copy of this letter shall be forwarded to the Associate Dean forGME and the Director of Housestaff Records.A resident involved in the disciplinary actions of probation, suspension and dismissal hasthe right to appeal according to the GME Committee policy Adjudication of ResidentGrievances.15

Psychiatry Residency ProgramGOALS AND OBJECTIVES FOR EACH POST GRADUATE YEARAt the completion of PGY-1 the resident must have:Patient Care demonstrated the ability to perform an initial psychiatric evaluation demonstrated the ability to perform a mental status examination demonstrated the ability to diagnose and treat basic medical problems demonstrated the ability to diagnose and treat basic neurological problemsMedical Knowledge shown basic understanding of the major psychiatric diagnoses shown basic understanding of psychotropic medicationsPractice-based Learning and Improvement demonstrated ability to present cases in conference review and support theclinical decisions madeInterpersonal and Communication Skills demonstrated ability to function in an interdisciplinary team demonstrated the ability to communicate effectively with patients and familiesProfessionalism demonstrated an appropriate level of professional behavior demonstrated a high level of ethical behaviorSystems-based Practice successfully completed 12 months of PGY-1 rotationsAs demonstrated by: Supervisor evaluation Patient log PRITE Core didactic attendance Semi-annual review Scored Clinical Interviewing16

At the completion of PGY-2 the resident must have:Patient Care demonstrated the ability to perform emergency, admission, and consultationpsychiatric examinations demonstrated the ability to perform a mental status examination, including:o assessment of suicide risko assessment of homicide risko cognitive evaluation demonstrated the ability to diagnose and treat acute psychotic agitation demonstrated the ability to diagnose and treat acute alcohol withdrawal demonstrated competence in biopsychosocial case formulation demonstrated the ability to perform an initial geriatric psychiatric evaluation demonstrated the ability to mange common psychiatric diagnoses in the geriatricpopulation demonstrated the ability to perform an initial child ps

teaching rotations in the Psychiatry Residency Manual. Residents must successfully complete all residency assignments for the prescribed 48 months of education as dictated by the Residency Review Committee for Psychiatry. Residents must satisfactorily demonstrate competency as defined by t