UNM HSC will strive to provide a safe and health work environment and will comply with city, state, and federal health and safety laws.
If the performance of a Houseofficer is believed to be unsatisfactory in domains that include, but not limited to, clinical skill, medical knowledge, ethics, professionalism, attendance, or compliance with institutional policies or the law, the Program Director must notify the Houseofficer in writing of the specific areas of unsatisfactory performance. Examples of ethical misconduct include, but are not limited to harassment, patient abandonment, abuse of prescribing privileges, and unlawful discrimination. If the performance of the Houseofficer is unsatisfactory, the Houseofficer may be placed on remediation. Remediation is not an adverse action, and is not appealable or grievable.
If the seriousness of the problem dictates immediate action, the Program Director may summarily suspend the Houseofficers, pending notification of the Associate Dean for Graduate Medical Education, and full investigation of the issue. The Houseofficer will be placed on probation for a specified period of time. The Program Director will designate a period of probation during which the Houseofficer must correct the deficiencies or be dismissed. The probationary period together should not be less than 30 days in length nor should normally exceed six months. The Program Director will meet with the Houseofficer regularly (at least every three months) during this period to formally review progress.
At the end of the probation period, the Program Director will review the Houseofficer’s progress and determine whether satisfactory improvement has been made. Feedback may be solicited from faculty and the Houseofficer’s peers. If improvement has been satisfactory, the Houseofficer may be continued on probation for a specific period of time not to exceed six months. If the Houseofficer’s performance again becomes unsatisfactory during this period, the Houseofficer may be dismissed without an additional probation period even if the probation extended beyond a contract year. The Office of Graduate Medical Education must be notified by the Program Director before the dismissal process can begin.
To appeal probation, non-renewal of contract, or dismissal, see the grievance procedure.
The University of New Mexico is an environment for the pursuit of its educational mission free of illegal drugs and the illegal use of alcohol.
Duty hours are defined by the ACGME as all clinical activities related to the residency program, i.e. patient care (both inpatient and outpatient), administrative duties related to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled academic activities such as conferences. Duty hours do not include reading and preparation time spent away from the duty site.
Each program has a written statement concerning the Houseofficer’s duty hours which will be in compliance with their RRC requirements. The ACGME Duty Hours Requirements, which are minimum duty hour standards for all residency and fellowship programs (unless granted program specific exemptions by the ACGME and by UNM) are as follows: Houseofficers work week which must not exceed eighty hours averaged over a four-week period, inclusive of all in-house call activities. Houseofficers must receive one day off in seven from all educational and clinical responsibilities averaged over a four week period, inclusive of call. One day is defined as one continuous 24-hour period free of all clinical, educational, and administrative activities. In-house call is to be no more frequent than every third night averaged over a four-week period. There must be 10-hour period provided between all daily duty periods and after in-house call. Continuous on-site duty, including in-house call, must not exceed 24 consecutive hours. Houseofficers may remain on duty for up to 6 additional hours to participate in didactic activities, transfer care of patients, conduct outpatient clinics and maintain continuity of medical and surgical care (unless further limited by the relevant program requirements). No new patients may be accepted after 24 hours of continuous hours on duty.
At this time, no UNM residency or fellowship programs have been granted exemption from these minimum standards. Specific RRC duty hour regulations (e.g., Internal Medicine, Emergency Medicine) may be more restrictive than the duty hours standards described above, and those residency programs must have departmental duty hours policy compliant with the standards of their RRC.
Each program shall distribute a copy of the departmental duty hour policy to all Houseofficers physicians and faculty. It is the primary responsibility of the sponsoring program to assure compliance with RRC duty hour regulations regardless of the Houseofficer’s rotation on or off of the service.
The duty hour policy promotes the educational environment, supports the physical and emotional well being of Houseofficers, and provides for patient safety.
All University of New Mexico ACGME accredited programs, as well as the dental program, must achieve and maintain compliance with the resident duty hour regulations for their respective RRC. The Office of Graduate Medical Education will regularly monitor resident duty hours for compliance with the institutional duty hour limitations and RRC regulations. The following policy outlines the procedures that will we used by the institution.
Houseofficers may report duty hour violations on any rotation at the following reporting site: http://hsc.unm.edu/som/GME/hours.cfm. This site provides complete confidentiality of the Houseofficer who is making the report.
Each program will have a procedure of evaluation of each Houseofficer’s performance which will be in agreement with the specific Residency Review Committee requirements. Formative performance evaluations will be done on a formal basis at a minimum of every six (6) months. Evaluations should be written and must be discussed with and acknowledged by the Houseofficer. Such evaluation shall include:
Final summary evaluates are performed by each training program at the conclusion of training. The summary evaluation will include the following statement "I verify that during, (his/her) participation in the residency program in (specialty) sponsored by the University of New Mexico School of Medicine, (name of resident/fellow) has demonstrated sufficient professional ability to practice competently and independently in the specialty of (name of specialty)." A copy of the final summative evaluation of competency is retained by the program as well as the Office of GME. The institution strongly supports and endoreses the use of New Innovations Electronic Evaluation System. A copy of any evaluation shall be accessible to the Houseofficer on-line and placed in his or her file within a reasonable time after completion of a rotation. Houseofficers shall have the right to review any evaluation with the Program Director, Chair, or designee of this or her program.
The University is committed to high ethical standards of professional conduct on the part of its community including students, faculty, and employees. Houseofficers are treated as faculty in these procedures. Accordingly, harassment of any type will not be tolerated.
