TO: Problem Resident Workshop Small Group Leaders
FROM: Mark A. Levine, M.D.
DATE: March 3, 2010
RE: Problem Resident Workshop
First let me express my sincere appreciation to you all for volunteering to participate in
this year’s Chief Resident Workshop on the Problem Resident. You are all very
“seasoned” small group leaders for this workshop, and your skills as facilitators along
with your ability to creatively use the materials I provide will lead to a successful
As you know, there is no one correct way to present this workshop. There is a
tremendous opportunity for flexibility and innovation. There is, though, an incorrect
way, namely by turning the workshop into a lecture and not creating an atmosphere
conductive to participation and lively discussion (I am confident that none of you could
allow this to happen). The skillful use of the four case scenarios provided along with the
use of one to two flip charts to record major themes and discussion points will assure a
Attachments to this email include: PowerPoints for the four problem resident case
scenarios; texts for the cases and question sets; and brief faculty instruction guides
presenting some of the key concepts.
As additional and very concise and helpful background reading material for small group
leaders, I highly recommend opening your APDIM Toolkit for IM Education Programs to
pgs. 105-112, A Systematic Approach to Residents with Problems. This really is core
reading for this session.
There is absolutely no firm requirement that a workshop leader use all four cases, but it
does seem true that the cases lend themselves well to broad discussions about recognizing
and characterizing problems, differentiating cognitive vs. non-cognitive and
professionalism problems, understanding situations where remediation may work vs.
those where probation may be the only solution. For many of the participants this is an
eye opening exercise and they are somewhat awestruck but also a bit intimidated by it all.
Especially because they can quickly lose track of the fact that the Program Director,
Residency Evaluation (or Clinical Competence) Committee, Chair of Medicine and
others may all be heavily involved and this is not a primary or sole responsibility for just
the chief residents themselves. So it is often helpful to discuss the roles of “program
administration” and the varied roles the chief resident plays especially in identification,
observation, and documentation of problems and participation in the carrying out of
remediation and other management plans. Emphasize that the chief resident is a key link
to the Program Director, Evaluation Committee and the problem solving process as well
as often part of the remediation process.
In terms of logistics, each of you should be bringing a laptop computer loaded with the
four slide sets. Should this be a problem for anyone, please inform myself and Kyle
Hayden so that we can problem solve. All rooms will have a flip chart. The audience
will be quite heterogeneous, and the residency training programs represented will span
university, VA, community, and multi-specialty clinic. Certain cases may be more
familiar or relevant to certain chiefs, but everyone in the room will have experiences that
will prove to be of general interest to the larger group.
Keep in touch between now and the meeting if there are issues, concerns or questions.
Our session runs from 1:30 p.m. to 3:00 p.m. on Monday, April 26, 2010. I would like to
have anyone with questions or desire to obtain more ideas convene in the area by the
APDIM registration desk between 12:30 p.m. and 1:00 p.m.
Thanks once again for being part of such an important component of the chief residents