Pre-Employment Drug Testing Policy For Residents and Fellows


This policy outlines the procedure for pre-employment drug testing of residents and fellows, applicable to all accredited residency and fellowship programs, sponsored or administered by the office of Graduate Medical Education (GME) of the University at Buffalo (UB). The safety and security of our community and the patients served by UB residency and fellowship programs are our highest priority.


All residents and fellows entering residency or fellowship programs, sponsored or administered by GME or UB, on or after June 24, 2019, will be subject to a pre-employment (post-offer) drug test. This includes any prior UB resident or fellow who has had a break in service and is returning to their program on or after this date. Results of drug tests for these residents or fellows must be available to GME prior to the first day of their program as a prerequisite to employment and participating in the program. A resident or fellow who refuses to undergo such testing is ineligible for employment and to participate in the program.

Residents and fellows must complete all necessary onboarding documentation relating to pre-employment drug test including; electronic application, consent or necessary releases, to initiate the background check.

There is an affirmative duty for residents and fellows to notify the GME Designated Institutional Official of adverse results from subsequent drug tests after the initial drug test for employment is completed. There is also an affirmative duty for residents and fellows to report any adverse information resulting from subsequent drug tests obtained at any site during their employment as a resident or fellow under UB GME sponsored training program

Failure by a resident or fellow to disclose an adverse record resulting from a subsequent drug test to the GME Designated Institutional Official within five calendar days may result in corrective action, up to and including immediate dismissal from their training program. The facts and circumstances of each case will determine what, if any, action is taken, up to and including immediate dismissal, as appropriate.


See Appendix A below:

A.  Requirement: Applicants to all residency and fellowship programs sponsored or administered by GME or UB will be notified in writing of the requirement for pre-employment drug testing at the time of interview; and further, that a conditional offer of employment by University Medical Resident Services, P.C. and University Dental Resident Services, P.C. (UMRS/UDRS) may be rescinded by the applicant’s failure to comply with UMRS/UDRS pre- employment drug testing. Residents and fellows returning from a break in service will be notified of the requirement to comply with this testing prior to their return to the program.

B.  Timeframe: Within sixty (60) days after applicable match process, residents and fellows will be notified in writing about presenting to a drug collection facility designated by a third party screening services vendor approved by GMEC (Screening Vendor), to submit a urine sample for drug testing. For programs not participating in a matching process, the residents and fellows will be so notified in their conditional offer of employment.

C. Consent: Screening Vendor shall obtain and document consent for the drug test from the resident or fellow. If the resident or fellow is not in close proximity to an approved drug collection facility at the time the drug testing is requested, an alternate site will be designated.

D.  International Medical Graduates: International residents and fellows must schedule their screening upon arrival at UB and reporting to GME, prior to starting the program.

E. Testing & Review: The urine test will be performed at a certified lab as designated by Screening Vendor. All positive tests will be reviewed by a certified Medical Review Officer (MRO), or their qualified designee. The presence of any illegal drugs constitutes a positive test. The presence of any legal drugs for which there is not a prescription also constitutes a positive test. Marijuana use, whether for medical purposes or not, shall not be considered for the pre- employment test.

F. Positive Confirmatory Test Results: The MRO will contact any resident or fellow who has a positive confirmatory test. Should resident or fellow wish to challenge the results of a positive confirmatory test, the MRO will notify the Screening Vendor which will send the original sample to another lab for re-testing. The results of that re-test will be considered final.

G. Validity of Specimen: If the testing process cannot be performed because of an issue with the validity of the specimen or any other reason, including an error in collection process, the MRO will determine if the test is cancelled, adulterated, or substituted. The MRO will decide whether the test should be repeated. If a Dilute Negative result is received, it will be retested in accordance with the Screening Vendor’s procedures. The result of the retest following a Dilute Negative result shall be final.

H. Advisory Review Committee: The MRO or designee will notify GME whether each resident and fellow failed or passed the drug test using a standard form. Any confirmed positive results will be referred to the Advisory Review Committee, presently consisting of the following individuals or their designee:

  • GME Director of Human Resources
  • GME Resident & Fellow Ombudsman
  • GME Lead Physician for Resident Employee Health Services (EHS)
  • Program Director Advisory Council (PDAC) representative
  • Graduate Medical Education Committee (GMEC) hospital representative from each affiliated health system, designated by the Designated Institutional Official.    
This Committee will review the results on a case by case basis, with the Program Director and other individuals deemed appropriate, as well as any corroborating evidence from the resident or fellow’s Board of Medicine application and a statement from the resident or fellow addressing the result if they submit one, to determine whether or not to recommend approval for the resident or fellow to participate in the program. The Committee’s recommendation shall be made to the Designated Institutional Official. It is acknowledged, the hospital where the resident or fellow is to rotate doesn’t have to accept that rotation or financial responsibility for that payline(s); if they don’t agree with the DIO decision.

UB Affiliated health system representative on the GMEC shall have access to the results of the background checks and drug tests performed on all residents and fellows, during their employment with UMRS/UDRS.

I. Final Decision: The final decision on whether to allow the resident or fellow to participate in the program shall be in the sole and exclusive judgment of the Designated Institutional Official.

J. Rescind Offer: If the Designated Institutional Official determines not to approve a resident or fellow to participate in the program, the offer of employment and participation in the program will be rescinded as follows:

i.  for those residents and fellows who came to UMRS/UDRS though the Match, GME must request a Match waiver prior to rescinding the offer of employment; and

ii.  for all other residents and fellows, GME shall advise the individual in writing that its conditional offer of employment is rescinded.

K. Recordkeeping: Urine drug test results, held outside of Screening Vendor’s recordkeeping system, will be retained in a confidential electronic record.

L. Record Request: The resident or fellow will be provided a copy of the drug test results upon request.

Appendix A:

Zoom image: Pre-Employment Drug Testing Decision Tree This is a graphic of the decision tree for use in pre-employment drug testing.

Pre-Employment Drug Testing Decision Tree

Established: 2020
GMEC Approved Date: February 16, 2021