Why Don't We Dismiss Residents?

摘要

Thearticle The Hidden Costs of Failing to Fail Residents~(1) in the June 2011 issue of the Journal of Graduate Medical Education might be better titled W hy Don't We Dismiss Residents? The article by Drs Roberts and Williams is a carefully considered discussion of the problems inherent in dealing with poor resident performance. To assure the public that trainees have acquired the knowledge, skills, and attitudes to independently practice medicine, the Accreditation Council for Graduate Medical Education (ACGME) and its Review Committees have developed more specific requirements and have substantially increased the need for documentation. Increased analysis of resident performance has uncovered more resident performance issues. It is not clear whether we are seeing more unprofessional behavior in physicians~(2)~(,)~(3) because residents currently in training are different from those from earlier generations, or that as supervisory faculty, we may have missed or overlooked some of these deficiencies in the past. There is some evidence in recent years that we are seeing more unprofessional behavior in physicians.~(2)~(,)~(3)The concept of failure is extremely important. Residents who do not demonstrate competence to the level of the program's academic and professional standards should not be advanced. There is merit in providing residents the opportunity to remediate. Repetition of clinical rotations for residents with academic difficulty can be beneficial for residents to develop into practicing physicians.