Background:
This plan is specific for Redacted, MD as it pertains to deficiencies identified early in his training period. Through continuous direct observation in the Emergency Department the Faculty have identified significant deficiencies, that left uncorrected, will result in the failure of his promotion to the EM-2 year. He is operating at a level significantly below that of his peers in terms of his patient care, development of a coherent/cogent treatment plan, utilization management, recognition of acuity, significance of pathology, task execution, and time management. He was placed on this corrective action plan on ZZZ with the following items identified as areas to improve upon.
Previously Documented Directly Observed Competency Based Remediable Issues
Patient Care:
- Inability to interpret common diagnostic tests (Improvement)
- Inability to process and develop a differential diagnosis and treatment plan in a complicated medical patient (Improvement)
- Inability to multi-task at a level equal to his peers resulting in a mandated decreased level of responsibility by the Program Director (3 rooms max) (Improvement, still below peers)
- Failure to recognize or understand (potential or actual) severe patient acuity (Improvement)
- Poor time management (Improvement, still below peers)
Medical Knowledge:
- Remedial understanding of common clinical situations (Improvement)
- Failure to recognized and interpret pathology (Improvement)
Interpersonal and Communication Skills:
- Disorganized, incomplete, and inadequate explanations to Faculty during patient presentation (Improvement)
Systems Based Practice:
- Inability to identify proper disposition of a patient based on acuity. (Both ICU, floor, and discharge.) (Improvement)
- Poor resource utilization (Improvement, still below peers)
Practice-Based Learning and Improvement:
- Significant difficulty when attempting to synthesize the medical literature and apply it to a specific clinical situation. (Improvement)
- Student level knowledge concerning the development of a treatment plan (No Improvement)
- Very poor organization and task oriented/directed thinking. (Improvement)
Professionalism:
- The Faculty recognizes Dr. Redacted’s positive attitude and no significant deficiencies in Professionalism have been identified. Dr. Redacted’s excellent attitude and desire to improve has been noted throughout this process.
Update:
Dr. Redacted is showing signs of global improvement (although still significantly behind his peers). We have discussed options for the future and he will repeat his EM-1 year (as he is no way developed adequate skills/competencies to function at the EM-2 level).
In addition he will be required to remediate his Pediatric Emergency rotation in Oklahoma City as a result of the Faculty consensus evaluation. (see comments below). It should be noted that the PEM Faculty were not aware of Dr. Redacted’s remediation status prior to or during his rotation.
Review of Time line & Consequences of Success/Failure:
- In our initial discussion the initial time line of 6 months was given (from ZZZ) for the attainment of the measurable goals
- Dr. Redacted understands that this time line is flexible
- Success: Corrective action is completed and Dr. Redacted will be promoted to the EM-2 year.
- Failure: Continuation of the EM-1 year and a re-examination and determination by the entire Faculty of deficiencies and a re-establishment of a new corrective action plan
Summary of the Meeting and Action Items:
- Dr. Redacted will repeat his XXX (Rotation Type) month in XXX (Program Location), scheduled for XXX.
- He will not be promoted to the EM-2 year until all deficiencies have been corrected and will repeat his EM-1 year.
- Dr. Redacted was in agreement of and supported this plan and again expressed his interest in completing the residency.
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