When a fellow has an academic deficiency in terms of the ACGME core competencies (patient care, medical knowledge, interpersonal and communication skills, practice-based learning and improvement, systems-based practice, and professionalism) or with respect to a specific milestone, the first step will be a structured feedback session. Such sessions will include the fellow and the program director or designee, and may include one of the fellow’s faculty mentors.
If the academic deficiency is severe, or doesn’t respond to structured feedback, then a Letter of Deficiency (LOD) will be written. The LOD will provide the fellow with notice of the identified deficiency, the corresponding ACGME competencies at issue, and a timeline for correction. The fellow will then be expected to develop, with the relevant faculty, an independent learning plan to correct the deficiency.
If the fellow fails to correct the deficiency, further steps will be coordinated with the UW Health GME office. These may include revised LODs and learning plans, repetition of certain rotations, or rarely, extension of training or termination from the program.
Structured feedback and LODs are academic in nature and thus not appealable. They are generally not reported to outside agencies such as medical licensing boards and hospital credentialing committees, with the caveat that such agencies will occasionally request applicants to authorize the release of their entire training file. Extension of the duration of training and termination from the program are reportable and fellows may request third party review of such decisions per UW Health GME Policy 43.2, Academic Improvement.