University at Buffalo (UB), and its affiliated entities, University Medical Resident Services, P.C. (UMRS) and University Dental Resident Services, P.C. (UDRS) are committed to supporting the teaching programs and educational goals of the State University of New York at Buffalo Schools of Medical and Biomedical Sciences and Dental Medicine (University). University at Buffalo (UB), UMRS and UDRS have an obligation to the University, the affiliated teaching hospitals, their employees, patients, and the community, to promote and nurture a safe and productive work environment. Resident health and welfare are fundamental to the delivery of quality care to patients, indispensable to the education of trainees, and essential for a safe and constructive work environment. Resident behaviors that compromise this obligation, interfere with learning, and/or pose a danger to patient care violate generally accepted standards of medical care in this community, and define resident impairment. Such behaviors warrant immediate intervention and/or disciplinary action.
Impairment is defined for purposes of this policy as any damage or decline in physical or cognitive function due to: (1) medical or psychiatric illness, or (2) abuse of alcohol, illegal prescription drugs, prescription drugs, illicit drugs or other substances.
This policy applies to all residents enrolled in University at Buffalo (UB) sponsored residency and fellowship training programs.
The policy will be administered by the applicable program director (or his/her designee), as the designated University at Buffalo (UB) official, in consultation with the Office of Graduate Medical Education and the Medical Directors of University at Buffalo (UB) affiliated hospitals where an involved resident is engaged in training.
All residents agree, as a condition of resident status, to undergo a clinical examination, arranged by their program director, to evaluate impairment. Such clinical examinations may include collection of a urine sample. Residents also agree to adhere to the currently established procedures for identification, treatment, monitoring, and return to work due to suspected or proven impairment.
All residents further agree to comply with all applicable affiliated teaching hospital policies throughout their term of employment.
Residents are prohibited from:
Medications legally prescribed for the resident may be used as directed. Any resident in possession of a legally prescribed controlled substance must report such possession to the Employee Health Services Office in the hospital in which the resident is training upon receipt of such prescription.
A resident who violates this policy must self-report such violations to his/her program director (or the program director’s designee), or the Lead Physician, Resident and Fellow Employee Health. Residents may also self-report a suspected impairment issue to the Committee for Physicians Health.
Any resident or faculty member who has reason to believe that a resident possesses, sells, and/or uses any substance in violation of this policy or is otherwise impaired or potentially impaired, shall report such knowledge or evidence to the program director or his/her designee.
The goals of this policy are to:
Listed below are signs and symptoms of impairment. Isolated instances of any of these may not impair ability to perform adequately, but if they are noted on a continued basis or if multiple signs are observed, reporting may be indicated. The signs and symptoms may include:
The following services are available to residents:
A list of these resources is available on the UB GME Resident Well-Being page
All faculty and residents possess a duty to report to an appropriate supervisor, in confidence, concerns about possible impairment both in themselves and in others. If a resident is observed and/or suspected to be impaired while engaged in the performance of his or her duties, the following actions should occur:
The University is eager to assist residents with impairment problems and encourages any resident with impairment problems to contact their Program Director, GME employee health provider (COEM), or the Committee for Physician’s Health (CPH). Residents will not be subject to punitive actions for voluntarily acknowledging an impairment problem. (Note, however, that this will not excuse violations of other policies for which the resident/fellow is subject to disciplinary action.)
The Committee for Physician’s Health (CPH) is a division of the Medical Society of the State of New York. CPH provides non-disciplinary, confidential assistance to residents (as well as physicians, medical students, and physician’s assistants) experiencing problems from stress and difficult adjustment, emotional, substance abuse and other psychiatric disorders, including psychiatric problems that may arise as a result of medical illness. CPH provides support and referrals to those participating in the program, but also to those calling in with concerns about physicians including healthcare coworkers, colleagues, and family members. The Committee recommends evaluation, treatment and/or other assistance to our participants, and monitors for progress in recovery from illness. In this way, they can also provide strong advocacy on behalf of the participant to continue their practice as a physician or physician-in-training.
Established: 1998
Reviewed by GMEC: 3/98; 3/03; 1/10; 05/12; 1/13; 1/17; 10/21; 6/22 ; 11/24