The relationship between medical students, resident physicians or fellows, and their supervisors is a major determinant of the quality of medical education. When conflicts arise, it is essential to ensure that disputes are resolved fairly.
Retaliatory or punitive actions against those who raise complaints are unethical and are a legitimate cause for filing a grievance with the appropriate institutional committee.
Physicians who are involved in training or supervising medical students, residents, and fellows should ensure that institutional policies and procedures are in place to:
- Protect complainants’ confidentiality whenever possible, so long as protecting confidentiality does not hinder the subject’s ability to respond to the complaint.
- Carefully monitor employment and evaluation files to prevent possible tampering.
- Permit resident physicians and fellows to access their employment files and copy the contents, within the provisions of applicable law.
- Support medical students, residents, and fellows in fulfilling their responsibility to:
- Withdraw from care ordered by a supervisor when the trainee believes the order reflects serious errors in clinical or ethical judgment, or physician impairment, that could pose a risk of imminent harm to the patient or others, provided withdrawing does not itself threaten the patient’s immediate welfare.
- Communicate concerns to the physician issuing the orders and, if necessary, to the persons or institutional programs responsible for mediating such disputes, which may involve third parties.
AMA Principles of Medical Ethics: II, III, VII
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