Medical College of Georgia
School of Medicine
Medical College of Georgia
Graduate Medical Education Policies and Procedures
Office of Primary Responsibility: Graduate Medical Education
HS Policy 21.0
Appropriate Treatment of Medical Students and Residents
1.0 Purpose
To establish guiding principles for the appropriate treatment of medical students and residents at the Medical College of Georgia
The Medical College of Georgia is a learning community comprised of students, interns, residents, fellows, faculty, other health care professionals, and staff whose goal is to enable each learner to achieve an education to his/her fullest potential, while providing quality patient care. A cornerstone of the educational community is the expectation that learners will be treated appropriately and with dignity. The guiding principle of professional behavior of Medical College of Georgia is the absolute requirement of “respect for other persons.” In our diverse learning community, respect is to be demonstrated toward all individuals, regardless of race, ethnicity, national origin, gender, sexual orientation, or religion. Such a learning environment includes honest and constructive corrective feedback. Such feedback should be provided in a helpful, specific and accurate manner, focused on behaviors, and, when negative, given privately and respectfully.
Those providing feedback should do so mindful of the goal of helping the learner to improve. Those receiving feedback should do so graciously, with the assumption that it is given generously and in good faith. When inappropriate treatment is perceived to have occurred, learners must be able to communicate their concerns free from the fear of retribution. Academic growth often occurs best when the learner is challenged. Heated discourse and conflict are part of the academic environment of openness, and can be conducted in a civil and respectful way.
1.1 Responsibilities of the Faculty
- demonstrate the professional virtues of fidelity, compassion, integrity, courage, temperance and altruism
- maintain high professional standards in all interactions with patients, colleagues, and staff
- ensure that all components of the medical students’ and residents’ educational program are of high quality
- nurture the medical students’ and residents’ intellectual and personal development and achievement of academic excellence
- respect medical students and residents as individuals, without regard to gender, race, national origin, religion, or sexual orientation
- support the medical students and residents’ well being
- be intolerant of abuse or exploitation of the medical students and residents
- encourage medical students and residents who experience mistreatment or who witness unprofessional behavior to report the facts immediately to appropriate faculty or staff; treat all such reports as confidential as possible and do not tolerate reprisals or retaliations of any kind
1.2 Responsibilities of the Medical Students and Residents Procedure
- demonstrate the professional virtues of fidelity, compassion, integrity, courage, temperance and altruism
- embrace the highest standards of the medical profession & maintain high professional conduct in all interactions with patients, colleagues, & staff
- strive to acquire the knowledge, skills, attitudes, and behaviors required to fulfill all educational objectives established by the faculty
- respect faculty members, students, residents, patients and medical staff as individuals, without regard to gender, race, national origin, religion, or sexual orientation
- demonstrate accountability and responsibility in the educational program and in the care of patients
Definitions
Mistreatment is behavior that adversely affects the
learning environment and negatively impacts the learner/faculty relationship.
Inappropriate and unacceptable behaviors promote an atmosphere in which abuse is
accepted and perpetuated in the learning environment. In general, actions taken
in good faith by faculty to correct unacceptable performance is not considered
mistreatment. Pointing out during rounds, conferences, operating rooms, or other
settings that a learner is not adequately prepared for his/her assignments or
required learning material is not mistreatment unless it is done in an
inappropriate manner.
The following are some specific illustrations of behaviors that would promote
appropriate treatment of medical students and resident, and behaviors that would
be considered inappropriate:
Examples of appropriate behavior include:
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Conducting all interactions in a manner free of bias or prejudice of any kind
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Providing a clear description of expectations by all participants at the beginning of all educational endeavors, rotations and assignments
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Encouraging an atmosphere of openness in which students and residents will feel welcome to offer questions, ask for help, make suggestions and disagree
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Providing timely and specific feedback in a constructive manner, appropriate to the level of experience/training, and in an appropriate setting, with the intent of guiding students and residents towards a higher level of knowledge and skill
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Focusing such feedback on observed behaviors and desired outcomes, with suggestions for improvement
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Encouraging an awareness of faculty responsibilities towards all individual learners in a group setting
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Providing an educational experience of the highest quality, along with the time, preparation and research necessary to achieve that goal
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Basing rewards and grades on merit, not favoritism
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Focusing constructive criticism on performance rather than personal characteristics of the student or resident
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All staff at MCG affiliated hospitals are expected to adhere to the expectation to treat students and residents with dignity and respect.
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The acknowledgement by learners of course or rotation expectations and the responsibility for fulfilling those requirements to the best of one’s ability • Asking for feedback from professors, interns, residents nurses, and attending physicians as appropriate
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The acceptance of feedback provided by faculty in an objective manner and the incorporation of such feedback into future efforts so as to achieve the desired educational outcome
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An understanding that feedback is given with the intention of helping to further the student’s and resident’s progress in meeting course and/or rotation expectations
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Promptly and properly addressing, through appropriate administrative avenues, of any incidents and circumstances that fall outside the tenets set forth here
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An honest and earnest effort to provide constructive criticism—written, verbal or otherwise-- to peers and supervisors, when such feedback is likely to enhance their colleague’s skill as a physician
Examples of inappropriate treatment include:
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Questioning or otherwise publicly addressing students or residents in a way that would generally be considered humiliating, dismissive, ridiculing, berating, embarrassing or disrespectful by others
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Asking students or residents to perform personal chores (e.g., buying lunch, running errands)
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Telling inappropriate stories or jokes (e.g., ethnic, sexist, racist)
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Behaving in an aggressive manner (e.g., yelling, throwing objects, cursing, threatening physical harm) that creates a hostile learning environment • Assigning tasks or denying educational opportunities with the intent of punishment
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Making disparaging comments about students, residents, faculty, patients or staff
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Touching students or residents in a sexual manner
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Taking credit for a student’s or resident’s work
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Intentional neglect
Under no circumstances will the Medical College of Georgia consider it acceptable practice for faculty to demonstrate bias, prejudice, exclusion, or other unprofessional behavior such as humiliation towards our medical students or residents. Such unacceptable behavior includes the creation of a concern of “retaliation” by faculty for the filing of a complaint for unprofessional behavior.
Likewise, students and residents must appreciate that the provision of constructive feedback in a professional and objective manner by faculty is a desirable means of providing them with guidance in the learning process – such feedback is encouraged and in the best interests of our educational system for both medical students and residents.
Exclusions from this Policy
Specifically, this policy is not intended to include complaints of sexual
harassment or complaints of discrimination on the basis of disability, race,
color, sex, creed, veteran’s status, age, martial or parental status or national
origin. MCG has specific campus policies to address these complaints.
2.0 Procedure for Reporting and Dealing with Allegations of Mistreatment that
Involves Residents
Residents must pursue violations of this policy in accordance with the following procedure:
Step 1
When it is felt that an incident of mistreatment has occurred, the parties
directly involved should try to resolve the matter themselves. Many such
situations are amenable to resolution in this manner. However, it is
acknowledged that this informal approach may fall short at times, because of
reluctance of the medical student with a complaint to directly interact with the
accused, intransigence of the accused or differing perceptions of the incident
by the parties involved. In such cases, the following steps shall be taken:
Step 2
When the matter cannot be resolved in Step 1, the resident should follow the
training program's procedure for addressing concerns in a confidential and
protected manner. Usually the procedure involves seeking assistance from the
faculty advisor or Program Director. The medical student’s faculty advisor or Program
Director may be able to resolve the matter by counseling the resident with a
complaint on appropriate steps to take, by directly intervening with the
accused, or by referring the matter to the next stage. When the situation is
elevated to Step 2, anonymity of the resident and the accused can no longer be
maintained. Nevertheless, confidentiality is critical, and no information may be
given to those that are not directly involved in the process.
Step 3
If the matter cannot be resolved at Step 2, the faculty advisor, Program
Director or the accuser (or a combination thereof) should directly consult the
Chair of the Department. In the case where the accused is a faculty member, the
Chair of the involved department should be notified so he/she can be involved in
any discussions with the accused if appropriate. In a case where the accused is
the Chair of a department, the Dean and Senior Associate Dean for Graduate Medical Education and VA Affairs should be notified.
Step 4
It is anticipated that most situations will be resolved in Steps 1, 2, or 3. For
those unusual cases that are not resolved, the resident should discuss the
problem with the Senior Associate Dean for Graduate Medical Education and VA Affairs.. If the accused
is outside the College of Medicine the Senior Associate Dean for Graduate Medical
Education and VA Affairs will communicate the problem to the accused’s supervisor, and they
will work together to determine the appropriate procedure for resolution.
2.1 Procedure Reporting and Dealing with Allegations of Mistreatment that Involves Medical Students
Step 1
When it is felt that an incident of mistreatment has occurred, the parties
directly involved should try to resolve the matter themselves. Many such
situations are amenable to resolution in this manner. However, it is
acknowledged that this informal approach may fall short at times, because of
reluctance of the student with a complaint to directly interact with the
accused, intransigence of the accused or differing perceptions of the incident
by the parties involved. In such cases, the following steps shall be taken:
Step 2
When the matter cannot be resolved in Step 1, the student is urged to seek the
counsel of their faculty advisor. The student’s faculty advisor may be able to
resolve the matter by counseling the student on appropriate steps to take, by
directly intervening with the accused, or by referring the matter to the next
stage. When the situation is elevated to Step 2, anonymity of the resident and
the accused can no longer be maintained. Nevertheless, confidentiality is
critical, and no information may be given to those that are not directly
involved in the process.
Step 3
If the matter cannot be resolved at Step 2, the faculty advisor and student
should directly consult the Chair of the Department. In the case where the
accused is a faculty member, the Chair of the involved department should be
notified so he/she can be involved in any discussions with the accused if
appropriate. In a case where the accused is the Chair of a department, the Dean
and Associate Dean for Student Affairs should be notified.
Step 4
It is anticipated that most situations will be resolved in Steps 1, 2, or 3. For
those unusual cases that are not resolved, the student should discuss the
problem with the Associate Dean for Student Affairs. If the accused is outside
the College of Medicine the Associate Dean for Student Affairs will communicate
the problem to the accused’s supervisor, and they will work together to
determine the appropriate procedure for resolution.
2.2 Protection from Retaliation
Every effort will be made to protect alleged victims of mistreatment from retaliation if they seek redress. Retaliation will not be tolerated. To help prevent retaliation, those who are accused of mistreatment will be informed that retaliation is regarded as a form of mistreatment. Accusations that retaliation has occurred will be handled in the same manner as accusations concerning other forms of mistreatment.
2.3 Malicious Accusations
A complainant or witness found to have been dishonest or malicious in making the allegation of mistreatment may be subject to disciplinary action.
2.4 Education
Education is the cornerstone in the prevention of medical student and resident
mistreatment. A thorough and on-going effort should be made to inform all
involved individuals about the appropriate treatment of medical students and
residents, and of this policy dealing with alleged mistreatment. To that end,
the following notification mechanisms will be utilized:
Medical Students
A written copy of the policy regarding appropriate treatment of medical students
will be included in packet of information provided to students at Freshman
Orientation. A discussion of mistreatment in general will take place each year
during freshman and junior orientations, which will be presented to the
matriculating students by the Associate Dean for Student Affairs. During the
orientation, students meet with their faculty advisors and their advisors will
also be provided a copy of the policy. Students also have a formal orientation
to their clinical years and the policy will be reiterated during junior
orientation by the Associate Dean for Curriculum.
Residents
This policy will be included in the School of Medicine GME Resident Handbook
located on the GME website (www.mcg.edu/resident)
and a hard copy will be provided to each incoming and returning resident with
their agreement of appointment. A discussion of mistreatment in general, as well
as of the policy in particular, will take place each year at Housestaff
Orientation/Registration. Each Program Director will be encouraged to include
this policy in their individual residency-training program’s handbook.
Faculty
An informative written message will be sent each year from the Dean’s office to
all department chairs and program directors asking them to convey this
information to all teaching faculty and to ensure that all teaching faculty are
aware of the College’s philosophy on the appropriate treatment of resident and
of this policy.
Nurses
An informative written message will be sent each year from the Dean’s Office to
the individual in charge of nursing at each of the major participating
institutions utilized by our residents. They will be asked to make this
information, and this policy in particular, known to the nurses in their
institution by whatever means they feel the most appropriate.
Approved by School of Medicine Graduate Medical Education Committee, Curriculum Oversight Committee, Executive Committee, and MCG Legal Office (July 2007)
Effective 7/07 Revised 10/07