Academic Action Policy

Graduate Medical Education (GME) is an organized program of learning through which residents and fellows progress as they demonstrate competence.

This policy outlines procedures for Academic Actions (Promotion, Letters for Improvement, Non-promotion, Non-renewal, and Academic Dismissal). This policy applies to all accredited residency and fellowship programs sponsored or administered by the University at Buffalo.

General Statements

  1. Evaluation and feedback are each an essential part of resident and fellow education. These include, but are not limited to, verbal and written feedback, written evaluations, semi-annual reviews with Program Directors or their designees, and assessments conducted by Clinical Competency Committees (CCC). When deficiencies in performance are not corrected in response to evaluation and feedback, a Letter for Improvement or other Academic Action is necessary.
  2. Residents/fellows are appointed for a one year term. Each Program must have a policy with criteria for promotion and renewal, as required by the Accreditation Council for Graduate Medical Education (ACGME).
  3. All Academic Action decisions are made by the Program Director in consultation with Program faculty, as appropriate.
  4. The Designated Institutional Official (DIO) or designee must be consulted prior to all Academic Actions except Promotion.
  5. Residents and fellows must be notified in writing of Academic Actions other than Promotion, using the delivery method(s) that the Program Director or designee believes are most likely to be received by the resident/fellow (e.g. hand delivery; certified mail, return receipt requested; or electronic mail, read receipt requested). This written notice should also be reviewed with the resident/fellow in person by the Program Director or designee where practicable.
  6. Written notices of Non-promotion, Non-renewal, and Academic Dismissal must include: reason(s) for action; effect on length of training and board eligibility (where applicable); and a statement that the resident/fellow has the right to request a review under the UB GME Academic Action and Misconduct Review Policy.
  7. Copies of Academic Actions will be maintained in the resident’s/fellow’s Program file, with an additional copy provided to the GME office.

Academic Actions

Promotion

The Program Director, in consultation with Program faculty and/or CCC as appropriate, shall determine whether each resident/fellow has met the Program’s standard for promotion to the next level of training. Promotion decisions should be consistent with accreditation and other pertinent guidelines (such as certifying board requirements).

Letters for Improvement

Letters for Improvement are issued to residents/fellows who have uncorrected deficiencies in performance following verbal or written feedback or assessments.

  • A Letter for Improvement is prepared by the Program Director or designee. It is intended to amplify a message of concern, describe deficiencies in performance, and provide the resident/fellow with an opportunity to correct deficiencies. A Letter for Improvement shall also identify a timeframe for the preparation of a resident/fellow response in the form of a personal learning plan. As educational feedback, a Letter for Improvement is not subject to review under the UB GME Academic Action and Misconduct Review Policy.
  • Residents/fellows are required to prepare a written proposal for a personal learning plan in response to a Letter for Improvement. This practice is designed to encourage a lifetime of self-directed learning as a physician. The proposed personal learning plan should address all deficiencies identified in the Letter for Improvement, be completed within the time specified, and be presented to the Program Director or designee.
  • Where appropriate, the Program Director should review and discuss the proposed personal learning plan with the resident/fellow (preferably during an in person meeting), and shall modify it as necessary. The final personal learning plan will address all concerns in the Letter for Improvement and should include:
    • Learning activities (e.g. clinical assignments; readings; presentations);
    • Timeframe/deadlines/plan duration; and
    • Plan(s) for feedback and evaluation (e.g. faculty mentor, supervising/evaluating faculty, evaluation tools, and frequency of formal reviews of progress).
  • Personal learning plans are not subject to review under the UB GME Academic Action and Misconduct Review Policy, unless they result in an extension of training that is longer than thirty days or impacts board eligibility.
  • Failure to successfully complete the personal learning plan may result in the issuance of an additional Letter for Improvement or other Academic Action.

Non-promotion

Non-promotion of a resident/fellow extends or repeats a resident’s/fellow’s level of training. Since promotion is not automatic, residents/fellows who have not made satisfactory progress or successfully completed the requirements of a given level of training may be required to extend or repeat all or a portion of a level of training.

Non-renewal

Non-renewal is a decision not to extend a resident’s/fellow’s appointment in the Program past the current term. Non-renewal is used when Academic Dismissal is not warranted for residents/fellows who have failed to correct identified deficiencies and/or demonstrate required skills, knowledge, or behaviors required to progress to the next level of responsibility. Residents/fellows considered for Non-renewal must have been previously provided with one or more personal learning plans in connection with a Letter for Improvement.

Academic Dismissal

Academic Dismissal of a resident/fellow may occur at any point in the academic year. Academic Dismissal is used when immediate action is warranted for residents/fellows who have failed to correct identified deficiencies and/or demonstrate required skills, knowledge, or behaviors. Residents/fellows considered for Academic Dismissal must have been previously provided with one or more personal learning plans in connection with a Letter for Improvement.

Review Process

Residents/fellows are entitled to review of Non-promotion, Non-renewal, and Academic Dismissal, as well as personal learning plans that extend training as described in the UB GME Academic Action and Misconduct Review Policy.

Established: 2008
GMEC Approved Date: January 17, 2017