Pursuing Professional Accountability

Abstract

A problem resident (PR) is “one who fails to meet the standard of performance in one or more Accreditation Council for Graduate Medical Education (ACGME) competency.”^1(p201) Such residents consume substantial program director (PD) and staff time, adversely affect patient care, and disrupt team function.^2,3 Deficits may exist in all core competencies; this article focuses on the resident with behavioral problems. Quiz Ref ID This is defined by the American Medical Association³ as “personal conduct, whether verbal or physical, that negatively affects or potentially affects patient care including conduct that interferes with one's ability to work with members of a health care team” and by The Joint Commission as behavior that undermines a culture of safety.⁴ This behavior includes verbal outbursts, physical threats, refusing to perform tasks, or exhibiting an uncooperative attitude. Institutional leaders are required to have policies that address such behaviors whether caused by impairment due to substance abuse or other psychiatric disorder, external life stressors, personality characteristics, lack of training, or system factors.