Impaired Physician Policy

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 as any damage or decline in physical or cognitive function due to: (1) medical or psychiatric illness, (2) abuse of alcohol, illegal prescription drugs, prescription drugs, illicit drugs or other substances, or (3) fatigue.  Fatigue is a temporary impairment relieved by adequate rest.  Impairment due to fatigue is addressed in the Duty Hours policy and is not covered by this policy or the applicable procedures attached hereto.   

Scope and Administration

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.  

Substance Abuse Policy

Residents are prohibited from:

  1. providing patient care or performing other training-related responsibilities while in an impaired state resulting from the use of alcohol, a controlled substance, an illegal substance, or any other substance, including but not limited to non-prescription drugs;
  2. selling or using alcohol, controlled substances, illegal substances or any other substances in violation of any applicable State or Federal law; and
  3. possessing any illegal substances. 

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 Director of Employee Health Services of the University at Buffalo.  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.  

Established:  1998
Reviewed by GMEC: October 19, 2021