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 resident with notice of the identified deficiency, the corresponding ACGME competencies at issue, and a timeline for correction. The resident will then be expected to develop, with the relevant faculty, an independent learning plan to correct the deficiency.
If the resident 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 also generally not reported to outside entities such as state medical licensing boards, or hospital credentialing committees.
Persistent academic deficiencies that require extension of the duration of training and/or termination from the program are reportable to outside entities. Residents may request third party review of such decisions per UW Health GME Policy 43.2, Academic Improvement.
Latest revision: 08/07/2023
Jamie Elliott, MD, PhD