Resident had two issues:

1. Failed a rotation, necessitating that the resident redo the rotation

2. Had a minor legal issue, for which, we placed the resident on probation 

The resident is not “owning up” to the behavior and feeling like he/she is the victim; he/she feels like he/she is being singled out. Question was how to engage him/her better and that he/she take responsibility for the incidents. 

Remediation Committee Assessment:

Thank you for providing this consult! Getting a resident to take ownership of their deficiencies and performances lapses and to see the potential value of remediation can be a challenge though is vitally important. It is critically important the remediation be framed to the resident not only as a educational experience for a learner but also as a job-related deficiency coming from their manager. Put more simply, continued refusal to engage with residency leadership in the setting of a formal performance review is not a tenable option.

One suggestion is ensuring that the resident has a trusted faculty advocate of his/her choosing, distinct from the residency leadership, who can attend the remediation meetings and also counsel the resident through the process. The program chief residents may also be a useful resource for several reasons. First, they are the liaisons between the residents and the residency leadership. Secondly their role allows them to reinforce the standard appropriate expected resident behavior while remaining  less intimidating than the residency leadership. Finally, if you have had a resident in the past with similar challenges who successfully remediated, you could suggest that your current resident reach out to that graduate (with permission from the graduate first, of course) and discuss their journey. We have seen success with this approach...a non-threatening discussion that provides perspective. In addition, if part of the remediation plan involves soliciting feedback, comments, or performing tasks with different evaluators, then consider allowing the resident to select some of their own evaluators (ie, ⅓ or ⅖). This will increase their buy in to the process and help them feel less he/she is being targeted.