1. September 24, 2015 Scott Smith Associate General Counsel University of Utah

2.  Your PGY-1 Garcia is showing signs of poor performance and it’s only September. She has missed some educational conferences without explanation and you are hearing from your chief residents that she has had contentious arguments with nurses on the unit where she rotates.  What are you options?

3.  It is now January of 2016. Back in September, you worked with Dr. Smith in GME and with OGC to issue a corrective action letter to the resident. She did not appeal (because corrective action cannot, by policy, be appealed) but submitted a response to her file where she blamed the nurses for the arguments and said she had some family issues that had gotten in the way of the educational conferences.  The performance issues persist. What are your options?

4.  In late January of 2016, you meet with PGY-1 Garcia to discuss needed improvements. During that meeting she reveals that she has been struggling with some undisclosed medical issues and that these may be tied to the stress she is exhibiting at times at work.  What should you do?

5.  It is now May of 2016. Following your January meeting, Garcia’s performance improved but now in May the concerns have arisen again, and she has received a lot of 1s and 2s on attending evaluations. You feel that her scores in one rotation suggest that she did not grasp the material sufficiently.  What are your options?

6.  Your PGY-3 resident Williams has been one of your better residents for the past few years. However, he has recently missed a few shifts without notice and people have reported to you that he seems to be acting “strangely” when he comes to work. What should you do?

7.  It’s a few months after your initial meeting with Williams. You issued him a corrective action for coming to work unable to work, with difficulty remaining alert and maintaining a conversation. He now reveals that he has been taking a lot of pain pills because of a back injury he suffered during the summer.  What are your options?

8.  It’s now a few months later. Williams has returned from his medical leave of absence and presented a letter from his physician stating he was fit for duty. The same behavior happens again – Williams has come to work with bloodshot eyes and slurred speech.  What are your options?

9.  Let’s assume you placed Williams on probation for the remainder of his training and he has now appealed that probation. What should you do?

10.  Let’s assume that Williams turned things around and completed his training. Now you receive a letter from FCVS and from a potential employer asking you to evaluate Williams on a scale of 1-5 in various categories. Questions include: was this resident ever disciplined while in your training program?

11.  Before you have responded to the inquiry, Williams emails you asking you to send him a complete copy of his academic record. What should you do? What can you send him?