S180 INTRODUCTION: The ABA has defined criteria in five domains by which residents may be considered clinically competent and be considered for certification as consultants in anesthesiology. Occasionally residents do not meet one or more of these criteria and the department's clinical competence committee (CCC) must determine an appropriate course of action. We looked at the current probation and remediation practices of the CCCs of Anesthesiology Residency Training Programs in the United States. METHODS: 144 surveys were sent to the Program Directors of all U.S. anesthesiology residency training programs. Questions addressed policies regarding unsatisfactory resident performance, including consequences and duration of any probation period, remediation plans and implementation, and appeals processes. RESULTS: 110 surveys were returned after one mailing. This represents 76% of all U.S. training programs. 89 programs (82%) have a formal probation policy although only 72 (65.45%) have a written policy and 65 (59%) routinely provide this policy to their residents. Several institutions are governed by university personnel policies that prohibit formally using the term "probation," but do have a period of close observation and scrutiny. Two institutions mentioned the involvement of the Dean of the Medical School and the Dean for Graduate Medical Education in their probation process. Only 52% of institutions inform the entire anesthesia faculty of a resident's probationary status. 70% offer a formal appeals process for the resident who has been placed on probation. Probation involves the creation of a written plan with specific goals delineated, a time course for them to be met and the consequences of failure, in the majority of the responding institutions. During this period remedial assignments or study plans may be given, one-on-one preceptors assigned, the resident's senior or "moonlighting" privileges may be revoked, extra time may be spent on specific clinical rotations or entire years be repeated. Probation is overseen by one or several of the groups indicated in Table 1.Table 1The duration of probation ranges from a 10 day suspension through an indefinite period, prior to the final 6 months of training. 18.5% of programs have a 3-6 month, 44.1%, a 6 month and 12.7%, a one year limit on the remediation period. 6.7% of programs place no time constraint on the duration of remediation. During the probation period 78% of programs evaluate a resident more frequently than their non-probation residents. These residents are evaluated daily (42.5%), weekly (12.6%), monthly (27.6%), quarterly (5.7%), variable frequency (11.5%) by faculty. DISCUSSION: Probation and remediation practices vary widely among the residency training programs surveyed. Surprisingly, many of the programs consider probation a means toward termination and only a few noted that therapeutic interventions and alternative forms of remediation drawn from outside of their own department were made available to the resident. In response to the changes in graduate medical education and resident quality, it may become necessary for CCC's to reevaluate or formalize their existing probation policies. The information reported from our survey may provide a framework for this endeavor.