TAGME Legal, Ethical, and Policy Frameworks in GME 2 — Questions and Answers
Question 1: What is the purpose of a program's 'non-retaliation' policy in the context of resident reporting?
- To prevent residents from sharing salary information
- To protect residents who report concerns, errors, or mistreatment from adverse consequences (Correct answer)
- To prohibit faculty from filing grievances
- To limit residents' ability to contact ACGME
Correct answer: To protect residents who report concerns, errors, or mistreatment from adverse consequences
Non-retaliation policies protect residents who report safety concerns, mistreatment, or policy violations from being penalized for speaking up.
Question 2: What does 'vicarious liability' mean for a Sponsoring Institution in the context of resident actions?
- The institution is not responsible for resident errors
- The institution may be held legally responsible for the actions of its resident employees (Correct answer)
- Only the attending physician bears liability for resident errors
- Liability is solely the resident's personal responsibility
Correct answer: The institution may be held legally responsible for the actions of its resident employees
Vicarious liability means the Sponsoring Institution can be held legally responsible for the negligent acts of its resident employees performed within the scope of their duties.
Question 3: What is the ACGME's requirement regarding program policies for professional conduct and civility?
- Programs may rely on informal norms alone
- Programs must have explicit, written policies on professional conduct, including anti-harassment and anti-discrimination (Correct answer)
- Policies are only required at the institutional level, not program level
- Conduct policies must be developed by residents themselves
Correct answer: Programs must have explicit, written policies on professional conduct, including anti-harassment and anti-discrimination
ACGME requires programs to have written policies addressing professional conduct, prohibiting harassment and discrimination, and establishing consequences for violations.
Question 4: What is the significance of 'progressive discipline' in GME programs?
- It rewards residents for academic progress
- It is a structured, escalating approach to addressing performance or conduct issues before resorting to dismissal (Correct answer)
- It requires residents to teach junior trainees as a remediation step
- It is a financial penalty system for policy violations
Correct answer: It is a structured, escalating approach to addressing performance or conduct issues before resorting to dismissal
Progressive discipline involves a series of escalating corrective steps — counseling, warning, probation — before dismissal, giving residents fair opportunity to correct issues.
Question 5: What must a program do before sharing a resident's evaluation information with a prospective employer?
- Nothing — evaluations are always shareable
- Obtain the resident's written consent, consistent with FERPA and institutional policy (Correct answer)
- Notify the ACGME of the information transfer
- Have the department chair approve the release
Correct answer: Obtain the resident's written consent, consistent with FERPA and institutional policy
Sharing educational records or evaluations typically requires the resident's written consent under FERPA and institutional privacy policies.
Question 6: What is a 'restrictive covenant' and are they commonly enforceable for resident physicians?
- A financial aid restriction; always enforceable
- A non-compete agreement restricting post-training practice location; enforceability varies by state (Correct answer)
- A requirement to repay training costs; never enforceable
- A HIPAA data sharing agreement; always enforced federally
Correct answer: A non-compete agreement restricting post-training practice location; enforceability varies by state
Restrictive covenants limit where a physician can practice after training; their enforceability depends heavily on state law, and many states limit or prohibit them for physicians.
TAGME Legal, Ethical, and Policy Frameworks in GME 2
What is the purpose of a program's 'non-retaliation' policy in the context of resident reporting?