Abstract
IntroductionAcademic Emergency Medicine (EM) departments are not immune to natural disasters, economic or political forces that disrupt a training program’s operations and educational mission. Due process concerns are closely intertwined with the challenges that program disruption brings. Due process is a protection whereby an individual will not lose rights without access to a fair procedural process. Effects of natural disasters similarly create disruptions in the physical structure of training programs that at times have led to the displacement of faculty and trainees. Variation exists in the implementation of transitions amongst training sites across the country, and its impact on residency programs, faculty, residents and medical students.MethodsWe reviewed the available literature regarding due process in emergency medicine. We also reviewed recent examples of training programs that underwent disruptions. We used this data to create a set of best practices regarding the handling of disruptions and due process in academic EM.ResultsDespite recommendations from organized medicine, there is currently no standard to protect due process rights for faculty in emergency medicine training programs. Especially at times of disruption, the due process rights of the faculty become relevant, as the multiple parties involved in a transition work together to protect the best interests of the faculty, program, residents and students. Amongst training sites across the country, there exist variations in the scope and impact of due process on residency programs, faculty, residents and medical students.ConclusionWe report on the current climate of due process for training programs, individual faculty, residents and medical students that may be affected by disruptions in management. We outline recommendations that hospitals, training programs, institutions and academic societies can implement to enhance due process and ensure the educational mission of a residency program is given due consideration during times of transition.
Highlights
Academic Emergency Medicine (EM) departments are not immune to natural disasters, economic or political forces that disrupt a training program’s operations and educational mission
At times of disruption, the due process rights of the faculty become relevant, as the multiple parties involved in a transition work together to protect the best interests of the faculty, program, residents and students
We report on the current climate of due process for training programs, individual faculty, residents and medical students that may be affected by disruptions in management
Summary
Academic Emergency Medicine (EM) departments are not immune to natural disasters, economic or political forces that disrupt a training program’s operations and educational mission. A sentinel case created enormous upheaval for faculty, residents and medical students and demonstrated the problems that can occur for lack of due process and a standardized approach to transitions for emergency medicine training programs. An academic group that administered an EM residency program since its inception lost its contract at the residency’s primary clinical site and was abruptly replaced.[1] In addition, at the time of preparation of this manuscript, the closing of a Philadelphia hospital is currently underway, which will affect an entire EM residency program as well more than 500 other trainees.[2] Previously, the largest hospital closure impacted approximately 350 trainees in New York City in 2010.3 Multiple stakeholders are affected when a major disruption occurs: the program itself, the institution’s graduate medical education (GME) enterprise (GME Committee and Sponsoring Institution), the EM trainees, as well as the patients in the community. Due process impacts each of the involved parties, and must be considered
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