Enacted 01/15/2025 by Emory University School of Medicine, Graduate Medical Education Committee
Scope:
Applies to all Emory University School of Medicine (“EUSOM”) residents and fellows (“Residents”) in Accreditation Council for Graduate Medical Education (“ACGME”) accredited and non-accredited/non-standard programs as appointed through the House Officer Contract issued by the EUSOM Graduate Medical Education Office (“GME Office”). Only Emory Residents currently training in a residency or fellowship program may utilize this Grievance Policy.
Once the grieving Resident's participation in the relevant Emory GME training program ends via expiration of training contract or otherwise, the resident's right to initiate or utilize this Grievance Procedure ends, and the Grievance Procedure immediately terminates regardless of any pending status of the grievance process. If the Resident's participation in the Emory GME program ends while the grievance is being considered at any step outlined below, that consideration will immediately terminate, and any decision reached by the immediately prior decisionmaker in the Grievance Procedure will be the final, non-appealable resolution of the grievance. A former Resident is not eligible to utilize this Grievance Procedure.
Background:
In accordance with Section IV of the ACGME Institutional Requirements, EUSOM must have a policy that outlines the procedures for submitting and processing Resident grievances at the program and institutional level and that minimizes conflicts of interest.
Definition:
A grievance is defined as a concern raised by the grieving Resident regarding personnel or training decisions by the residency program that impact the resident (including but not limited to the resident’s receipt of discipline, non-promotion, or a decision to not offer training in a subsequent year).
This Grievance Procedure does not address concerns considered elsewhere within Emory, including but not limited to (1) contractual termination of a Resident during the contract period (Section 34 of Emory GME House Staff Policies and Procedures Manual); (2) allegations of violations of Emory University Policy 1.3: Equal Opportunity and Discriminatory Harassment Policy; (3) allegations of violations of Emory University Policy 8.2: Sex and Gender-Based Harassment and Discrimination Policy; and (4) allegations of HIPAA violations and/or privacy breaches.
Policy:
A Resident who wishes to raise a grievance related to a qualified concern as outlined in the definition section may utilize the procedure outlined below. Residents and Program Directors are encouraged to resolve differences through collegial discussion and negotiation. However, the procedure as set forth provides for those instances in which assistance in resolving conflict is needed.
The Grievance Procedure includes an Informal Resolution Process and a Formal Resolution Process. Each of these processes is explained below. The Resident must utilize the Informal Resolution Process first, and then, if needed, advance to the Formal Resolution Process. Once a Resident has utilized the process outlined in the procedure, the Resident cannot re-initiate the process for the same issue.
EUSOM prohibits retaliation against any Resident who, in good faith, reports a grievance or participates in the review or resolution of a grievance under this policy.
The Associate Dean for Graduate Medical Education or designee is responsible for the administration of the Grievance proceedings. All correspondence regarding the Grievance should go to the Associate Dean of GME or designee unless otherwise specified.
Procedure: Informal Resolution Process
A Resident with a grievance shall notify the Associate Dean for GME in writing, of the grievance including all pertinent information and evidence that supports the grievance. The Associate Dean for GME will review the grievance to determine (a) whether the grievance request meets the criteria outlined herein; and (b) if so, whether there has already been an appropriate attempt within the Resident’s Department to resolve the concern in a manner of impartiality that that satisfies the intent of the Informal Resolution Process. If so, the grievance would move directly to the Formal Resolution Process.
If the grievance has not yet been addressed within the Resident’s Department, the Program Director may be the Informal Resolution Process decisionmaker. If the Program Director is included in the grievance, the Chair of the Department is the Informal Resolution Process decisionmaker. If the Chair is included in the grievance, the Associate Dean for GME or designee is the Informal Resolution Process decisionmaker.
The Resident shall provide the Informal Resolution Process decisionmaker all pertinent information and evidence that supports the grievance and they shall set a mutually convenient time to meet to discuss the grievance to attempt to reach a resolution. The Informal Resolution Process decisionmaker may request additional relevant information or schedule additional meetings either with the Resident or with others during the Informal Resolution Process to attempt to resolve the grievance. The aggrieved Resident and the Informal Resolution Process decisionmaker should make a good faith effort to resolve the grievance at this program level.
The Informal Resolution Process of this grievance procedure shall be deemed complete when the Informal Resolution Process decisionmaker informs the aggrieved resident, in writing, of their decision concerning the grievance. A copy of this decision shall be sent to the Program Director, Department Chair, and Associate Dean for GME.
Formal Resolution Process
Upon completion of the Informal Resolution Process, if the aggrieved Resident is unsatisfied with the decision, they may choose to proceed to the Formal Resolution Process. The Formal Resolution Process has an initial phase overseen by the Associate Dean of GME (or designee) and may go to a final stage for determination by the Dean of EUSOM.
Formal Resolution Process Initial Phase:
The aggrieved Resident must start the Formal Resolution Process by presenting their grievance, in writing, along with all pertinent information and evidence related to the grievance, to the Associate Dean for GME within fifteen (15) calendar days after receipt of determination from the Informal Resolution Process decisionmaker. A Resident's failure to submit the grievance within the fifteen-day deadline will result in the Resident's waiving their right to proceed further with this grievance procedure. In this situation, the decision of the Informal Resolution Process decisionmaker would be final.
The Associate Dean for GME or designee will be the decisionmaker for the initial Formal Resolution Process. Designees could include, but is not limited to, the Assistant Dean for GME or Executive Associate Dean for Medical Education.
Upon timely receipt of the written Grievance, the initial Formal Resolution Process decisionmaker will contact the aggrieved Resident to set a mutually convenient time to meet to discuss the Resident's grievance. The initial Formal Resolution Process decisionmaker will review and carefully consider the material presented by the Resident and the information shared by the resident during their discussion. In addition, the initial Formal Resolution Process decisionmaker may engage in any further investigation and gather and review any additional information they believe to be appropriate and relevant when considering the Resident's grievance. The Initial Formal Resolution Process decisionmaker’s review shall be limited to determining whether the action or decision made by the program or Program Director that is the subject of the grievance was rational and had a reasonable basis given the information available at the time the action was taken, or decision was made. Ultimately, the initial Formal Resolution Process decisionmaker will provide the aggrieved Resident with a written grievance determination within a reasonable period after the meeting. A copy of this decision shall be sent to the Program Director, Department Chair, and Associate Dean for GME.
Formal Resolution Process Final Phase:
An aggrieved Resident who is unsatisfied with the grievance determination in the Initial Phase of Formal Resolution Process may seek a final review from the Dean of EUSOM by submitting all grievance-related material to the Dean of EUSOM within fifteen (15) days after receipt of determination from the Initial Phase of the Formal Resolution Process decisionmaker. A Resident's failure to submit the grievance within the fifteen-day deadline will result in the Resident's waiving their right to proceed further with this grievance procedure. In this situation, the decision of the Initial Phase of the Formal Resolution Process decisionmaker would be final.
In the Final Phase of the Formal Resolution Process, the Dean shall serve as the decisionmaker. The Dean will review the matter and may choose to appoint an ad hoc Grievance Committee to review the matter in an advisory capacity.
If the Dean convenes an ad hoc Grievance Committee, it shall be comprised of at least two faculty members from SOM Departments not involved in the grievance and at least one resident who is not in the Department of the aggrieved Resident. A quorum shall be three (3) committee members. The ad hoc Grievance committee shall hold a meeting and review relevant information provided by interested individuals, including but not limited to the Resident and the Resident’s training program, as soon as feasible. This meeting may be attended by the Assistant or Associate Dean for GME as non-voting members, if they were not a prior decisionmaker. The ad hoc Grievance Committee will meet with the Resident during a portion of its meeting, and may also choose to meet with others, including but not limited to the Resident’s training program leadership. The Resident’s written grievance and the written determinations of prior grievance decisionmakers considering this issue shall be shared with the ad hoc Grievance Committee in advance of this meeting. The aggrieved Resident and the other individuals involved who are invited to attend the meeting may be asked to answer questions or present any other evidence concerning the grievance. Before, during, and after the meeting, the committee may gather and review additional relevant information pertaining to the dispute. When the committee is utilized, its written recommendation is sent to the Dean in an advisory capacity as the Dean makes the final decision. Upon receiving the advice of the ad hoc Grievance Committee, the Dean may choose to engage in additional independent investigation, including but not limited to meeting with the Resident. Ultimately, the Dean will render a decision and inform the aggrieved Resident, Program Director, Department Chair, and Associate Dean of GME in writing of the decision.
If the Dean chooses not to engage an advisory ad hoc Grievance Committee, the Dean will meet with the Resident, review the material provided by the Resident in support of the Resident’s grievance, and review the prior determinations of the prior grievance decisionmakers. The Dean may also choose to review information the Dean requests from the Resident’s training program and any other information that the Dean deems relevant. The Dean may also choose to meet with and interview any other relevant individual, including but not limited to the Resident’s training program leadership. Ultimately, the Dean will render a decision and inform the aggrieved Resident, Program Director, Department Chair, and Associate Dean of GME in writing of the decision.
The decision of the Dean is final, and the entire Grievance Procedure terminates upon the Dean’s rendering of a decision.