Removal of Learners from/Reinstatement to a Teaching Service

PGME Committee approval : 2  December 2021
Faculty Council approval: 1 February 2022

Removal of Learners from/Reinstatement to a Teaching Service [PDF-114kB]

A. Background & Purpose:

Clinical teaching faculty members in the Faculty of Medicine normally participate in the education of learners as part of the University’s educational mandate.  

However, having learners assigned to one’s clinical service is a privilege, not a right.  Occasionally, that privilege may be modified or removed from a faculty member or a group of faculty members in the interest of ensuring a safe, professional, respectful, inclusive and harassment-free environment.  Usually, faculty members who have learners removed from their clinical service will have the opportunity to remediate.  Upon successful remediation, faculty members may have the opportunity to supervise learners again. 

The purpose of this Guideline is to ensure a safe and positive learning environment for learners and a fair process for Faculty Members.  It confirms the circumstances and process by which learners may be removed from and reinstated to a particular clinical service and/or faculty member. 

B. Application:

This Guideline applies to all undergraduate and postgraduate training programs within the Faculty of Medicine and to non-Dalhousie learners undertaking electives within the framework of those programs. 

C. Definitions:

In this Guideline: 

1. “Associate Dean” means the Associate Dean of Postgraduate OR Undergraduate Medical Education (PGME or UGME), as applicable.

2. “Committee” means an ad hoc committee of Faculty Council, established in accordance with section E.2. 

3. “Day” means calendar day.

4. “Department Head” means the Head of the University Department in which the faculty member has his or her primary academic appointment.

5. “Faculty Member” means an individual who holds an academic appointment to Dalhousie’s Faculty of Medicine, or more than one such individual, as applicable.

6. “Learner” refers to a student registered in a postgraduate OR  undergraduate medical program, regardless of university.

D. Guidelines: 

1. Any removal of and/or reinstatement of learners to a Faculty Member must be addressed under this Guideline.

2. The Associate Dean or Department Head may remove learners from a Faculty Member when he or she has reasonable grounds to believe that the conduct of the Faculty Member places learners at physical or emotional risk, in accordance with the Procedures.   For Faculty at New Brunswick sites, this decision will be made in consultation with the Medical Education Site Director for the relevant site and the relevant postgraduate Program Director or Associate Dean for UGME, Dalhousie Medicine New Brunswick, as applicable.

3. The Committee will be established to address all issues in connection with the removal and/or reinstatement of learners, in accordance with section E.2. 

4. Committee decisions will be binding on the Faculty Member, applicable training programs and affected learners. 

5. Committee decisions to remove learners and not to reinstate learners may be appealed by a Faculty Member to the Vice-President Academic and Provost or designate in accordance with the Procedures.  For greater certainty, the terms of remediation and/or reinstatement cannot be appealed.

6. All information and material disclosed under this Guideline will be held in confidence except to the extent that disclosure is necessary:

    a. to effectively implement the Committee’s remediation and/or reinstatement plans; or

    b. to address risks to health and safety. 

7. Nothing in this Guideline is intended to interfere with a Department or Division Head's ability to manage a Faculty Member's performance.

8. There will be no retaliation against any person for participating in or complying with any aspect of this Guideline.  

E. Administrative Structure:

1. Authority: This Guideline is administered by the Faculty of Medicine, through the Associate Dean.

2. The Committee:

    a. The Committee is responsible for:

        i. assessing whether the decision to remove learners was reasonable;

        ii. establishing the terms of remediation, if applicable;

        iii. assessing whether a Faculty Member has been successful in complying with the terms of remediation, if applicable; and

        iv. determining whether and on what conditions learners may be reinstated. 

    b. Members of the Committee, appointed by Faculty Council on the recommendation of the Associate Dean, will comprise:

        • One program director OR clerkship director (as applicable);

        • One faculty member from a different Department or Division than the Faculty Member in question; and

        • One resident from a substantively comparable residency training program; OR

        • One medical student representative.

3. Conflicts of Interest:  Where the Associate Dean is unable to discharge his or her responsibilities under this Guideline due to a potential conflict of interest, as defined by the University Guideline on Conflict of Interest, his or her responsibilities under this Guideline may be assigned to the Senior Associate Dean or designate. 

4. Record-keeping:   Records of processes undertaken and decisions made under this Guideline will be kept separate from other university records and will be maintained and stored securely and confidentially under the care and control of the Dean’s Office.  Documents evidencing the final resolution of the matter will be provided to the Associate Dean.

F. Procedures:

1. Removal of learners 

a. The Associate Dean or Department Head may remove  learners from the clinical service of a Faculty Member where there are reasonable grounds to believe that the conduct of the Faculty Member places learners at physical, or emotional, risk.  Learners may be removed upon consideration of the following:

    i. the particulars of why learners should be removed; 

    ii. alternate solutions that have been attempted, if any; 

    iii. the past record of the Faculty Member in educational activities, including learner evaluation forms and letters of complaint (anonymous or not); and 

    iv. any other relevant facts or supporting documentation. 

b. Before removing learners, the Associate Dean and Department Head will consult with each other as soon as possible to ensure appropriate measures are in place to address impacts on patient care.

c. The Associate Dean will then notify the relevant Faculty Member in writing of the removal of learners, including the basis for doing so.  The Associate Dean will also inform the Dean of the Faculty of Medicine.  The Associate Dean will inform the learners of their removal and make any necessary arrangements for alternate service assignments.  

d. Where removal is required urgently for immediate resident safety reasons, the Associate Dean or Department Head will inform the Faculty Member verbally with written notification consistent with section F.1.c. to follow within 2 Days.  

e. A faculty member who has had residents removed from their service will automatically be precluded from supervising undergraduate learners at any level, and vice-versa. The Associate Dean, PGME will notify the Associate Dean, UGME of any withdrawal of residents from the service of a faculty member. Similarly, the Associate Dean will immediately advise the Associate Dean, PGME of any faculty member who has had learners withdrawn from his/her service.

2. Appointment of the Committee

a. Within 7 Days of the learners' removal, the Associate Dean will ask Faculty Council to appoint a Committee in accordance with section E.2. The Associate Dean will provide the Committee and Faculty Member with materials that support his or her decision to remove the residents.   

b. The Committee will make best efforts to ensure that it meets with the Faculty Member within 30 Days of being appointed.  

c. The Committee may invite any person to the meeting who they believe has pertinent information and request they provide relevant documentation.  

d. All written submissions and documentation, except for that of the Faculty Member, must be provided to the Committee at least 20 Days before the meeting.  The Committee will provide the Faculty Member with copies of all materials that will be considered at the meeting and advise the Faculty Member who will be attending the meeting as soon as possible thereafter.  

e. The Faculty Member may make written and/or verbal submissions to the Committee.  The Faculty Member’s written submissions must be provided to the Committee at least 7 days prior to the meeting.   

f. At least 5 days prior to the meeting, the Committee will:

i. Provide the Program Director OR Clerkship Director and Department Head with copies of all materials that will be considered at the meeting; and

ii. Provide other persons attending the meeting with all or part of the materials that will be considered at the meeting which the Committee deems is relevant to their participation in the meeting.

g. Following the meeting, the Committee will deliberate in camera. In extraordinary circumstances, the Committee may find the Faculty Member is not capable of being remediated and may decide not to reinstate learners on any terms.   In all other circumstances, the Committee will prepare a remediation plan that includes at least the following: 

    i. identified areas to remediate;

    ii. specific remediation activities;

    iii. expected outcomes of remediation; 

    iv. the time frame for elements of the remediation, including completion     (not to exceed 12 months);

    v. an outline of methods of evaluation to be used and indicators of success; 

    vi. confirmation of who will be responsible for evaluation of specific  remediation activities; 

    vii. a monitoring system to support success; and 

    viii. possible consequences if the Faculty Members fails to satisfactorily complete the remediation.

h. The Committee must provide written reasons for their decision, including the remediation plan, if any, to the Faculty Member, his or her Department Head or designate and the Associate Dean. 

3. The remediation period

a. The implementation of a remediation plan may be supported by the Office of Continuing Medical Education and Faculty Development if requested by the Faculty Member or his or her Department Head or designate.  Any associated costs will be borne by the Faculty Member.  

b. The Associate Dean and Department Head will be provided with copies of all evaluations carried out during the remediation period. 

4. Consideration of reinstatement of learners 

a. No later than 30 Days after the expiry of the remediation period, the Associate Dean will provide the Committee with a written assessment of the Faculty Member's compliance with, and success in, the remediation plan.  

b. The Committee will then follow steps F.2.b. – F.2.f. of the Procedures, with necessary changes in points of detail. 

c. Following the meeting, the Committee will deliberate in camera.  They will prepare a written decision with reasons which includes at least the following:

    i. A summary of the facts and arguments;

    ii. The extent to which the Faculty Member complied with, and was  successful in, the remediation plan;    

    iii. Whether an extension of the remediation period is required;

    iv. Whether learners should be reinstated to the Faculty Member’s clinical service; and

    v. If learners are to be reinstated, the terms of such reinstatement, if any. 

d. The Committee must provide their written decision to the Faculty Member, his or her Department Head or designate and the Associate Dean. 

5. Appeals

a. Decisions to remove learners and not to reinstate learners may be appealed by a Faculty Member in writing to the Vice-President, Academic and Provost within 30 Days of delivery of the Committee’s decision.  

b. The Vice-President, Academic and Provost or designate will consider the appeal and provide a written decision with reason within 60 Days of receiving the appeal.

c. The decision of the Vice-President, Academic and Provost or designate is final.