George Indest HeadshotBy George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Here are some tips to set the record straight on various inaccurate information I have heard from physicians in medical residency programs in representing them in appeals of disciplinary actions including suspension and terminations.

1. Nothing you tell your Program Director, advisor, mentors, attendings, senior resident, or co-resident is confidential. Go ahead and pour your heart out about all of your problems and concerns, but none of it is confidential, even if you said it was “in confidence.” What is confidential: what you tell your priest or religious adviser (preacher, rabbi, imam) and what you tell your own personal physician or psychotherapist (unless you have signed a waiver) that you have hired and you are paying. Anyone else, it is not confidential. So if you tell your program director you were raped when you were younger, not confidential. If you tell your senior resident you suffer from panic attacks, not confidential. You tell your attending that you had cancer ten years ago, not confidential. This applies no matter what “magic words” you attach to it.

2. Take and use whatever time period is offered to you to retain counsel and prepare. If you are given ten (10) days to file an appeal or a request for hearing, take the full ten (10) days. Do not file it on the same day. Otherwise, you are using up valuable preparation time that you cannot get back.

3. Make sure that whatever you are required to file is actually received by the due date indicated. If a request for a hearing must be filed within fifteen (15) days, that means that it must be received within the fifteen days. Check after you send it or deliver it to make sure it has been successfully received.

4. It is never too early to hire an attorney. Hire an attorney to represent and advise you at the first sign of trouble. However, you must be sure to hire an attorney who is experienced in representing residents and fellows in disputes with graduate medical education programs. An experienced attorney can help you prepare any written submissions you make, organize your response and any documents you care to submit, and otherwise assist you in identifying what is relevant and what is not relevant.

5. Always read your program’s graduate medical education (GME) manual, residency manual, due process policy or whatever handbook or manual contains your hearing and appeal rights. Be familiar with them and follow them.

6. If you are given remedial actions you must take, documents your completion of each one. Whether the requirement you must perform is in a corrective action plan (CAP), a remediation letter, or a probation letter, document your completion of it in writing and report it to whatever authority gave you the requirement. Send a courtesy copy (“cc”) to your program director.

7. Make sure any correspondence you send to anyone is complete, correct and in the form of a professional business letter. Make sure it meets all of the requirements of a professional business letter. This is especially true for rebuttals, appeals, hearing requests, etc. What, you don’t know what this is? Then go online and Google it. Your letter should look very similar to any letter you received from your program director or institution. Be sure it has all of your return contact information on it as well as a date. Do not start your letter with “Hi,” “Hello,” or “Good day.” Do place a reference (“Re:”) line or subject line on your letter that states what the subject of your letter is.

8. Do not be afraid to appeal, file a discrimination complaint or exercise any of your legal rights. Often I hear from residents, after they are already terminated from their program, that they are afraid to get a lawyer involved. I usually ask: “What are you afraid of? What is the worst that can happen? You have already been terminated.” Remember, also, that if your program retaliates against you for exercising any of your rights, that is illegal. The ACGME would like to hear about that and in almost all cases, you will then have a legal cause of action upon which you can sue the program.

Contact a Health Care Attorney Experienced in the Representation of Medical Resident Physicians, Fellows, Medical Students, Dental Students and Residents, Pharmacy Students and Residents, Mental Health Counselor Interns, and other health professionals. The attorneys of The Health Law Firm, also represent those applicants accused of irregular behavior by the National Board of Medical Examiners (NBME), the United States Medical Licensing Examination (USMLE) Secretariat, and the Educational Commission for Foreign Medical Graduates (ECFMG), in responses, hearings and appeals, including on charges of “unprofessional conduct” and “improper behavior.”

The Health Law Firm and its attorneys have experience representing such individuals and those in graduate medical education programs in various disputes regarding their academic and clinical performance, allegations of substance abuse, failure to complete integral parts training, alleged false or incomplete statements on applications, allegations of impairment (because of abuse or addiction to drugs or alcohol or because of mental or physical issues), because of discrimination due to race, sex, national origin, sexual orientation, and any other matters.

To contact The Health Law Firm please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. The Health Law Firm, 1101 Douglas Ave., Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.


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