Figure 1.

Typical Remediation/Probation pathway. In addition to this pathway based on repeated clinical performance issues, suspension may happen at any step along the way. Suspension occurs when there is a significant patient care issue or professionalism breach. Depending on the issue this may lead directly to residency termination or feed into the above pathway at any step along the way. A resident has a right to appeal any time along this pathway. Appeals generally have 3 increasingly formal tiers. The first appeal is generally at the residency program committee level, the second at the postgraduate dean level and the third at the dean or university senate level. Appeals must allow for the resident’s version of events to be heard. Legal representation almost always occurs at the third level of appeal and may occur sooner.