The challenge of problem residents

Abstract

Internal medicine residency training is demanding and residents can experience a wide variety of professional and personal difficulties. Residency programs everywhere have had and will continue to have problem residents. Training programs should be equipped to effectively identify and manage residents who experience problems. Previous articles that have been published on the topic of problem residents primarily addressed concerns such as impairment due to depression and substance abuse. The content of this article is derived from a comprehensive review of the literature as well as other data sources such as interviews with program directors and workshops at national professional meetings. This article focuses primarily on four issues related to problem residents: their identification, underlying causes, management, and prevention. The study attempts to be evidence-based, wherever possible, highlighting what is known. Recommendations based on the synthesis of the data are also made. Future ongoing studies of problem residents will improve our understanding of the matters involved, and may ultimately lead to improved outcomes for these trainees.

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Promoting Success: A Professional Development Coaching Program for Interns in Medicine

“…10 Programs for residents who need remediation have been described in published reports. [11][12][13] This approach, however, may neglect residents who are meeting or exceeding expectations, but may not reach their optimal potential. Research has shown that involving all residents in a structured program was useful in developing awareness of academic accomplishment, interpersonal communication skills, and professional behaviors.…”

A framework to teach self-reflection for the remedial resident

“…How big is the problem? The prevalence of residents requiring remediation varies by country, specialty and program, ranging from 5.8% to 9.1% (Yao & Wright 2001;Ratan et al 2008). There is scant literature focused on describing programs designed to improve resident performance (Ratan et al 2008).…”