For residents, before anything happens
Probation, administrative leave, a fitness-for-duty referral, a committee hearing: each one is decided on paper, and the paper is usually written by the other side. The Residency Record is a free, private, dated file that belongs to you. Most residents never need it. The ones who do need it to already exist.
Resident Help is not a law firm and does not provide legal advice. Creating a Record or submitting an intake does not create an attorney-client relationship.
172,746
physicians training in ACGME-accredited programs (ACGME, AY 2025-26)
2,531
physicians in training left their programs before completing them in 2023-24, the latest year published (ACGME Data Resource Book)
322
were dismissed that year, and 938 more withdrew (ACGME, 2023-24)
180 days
is the general EEOC charge deadline, or 300 in many states. Discrimination claims expire while you’re still deciding what to do (EEOC)
Each one has its own rules, and its own mistakes to avoid in the first 72 hours. Some programs give a resident only a day or two to decide. Put the deadline on the intake form and we will triage it the same day.
Scheduled at an odd hour, with more people in the room than you expected. What you say is being recorded in someone’s notes. What you’re not told is deliberate.
“Paid leave” sounds harmless. It removes you from the building while a record is assembled without you, sometimes while you’re on protected medical leave.
Forced medical exams have a federal legal standard: job-related, consistent with business necessity, based on objective evidence. Not vibes.
Short notice, no recording, no questions allowed. You can still preserve every objection in writing, if you know to do it before you walk in.
A deadline, a promise about your file, and the documents you’d need to decide, withheld. Licensing boards will still ask about that resignation forever.
Evaluations dated before events they describe. Summatives created after a dismissal. Metadata doesn’t lie, if you know to preserve it.
A recent outcome
In a matter we worked on, a program dismissed a resident before letting them finish a required evaluation and remediation. On a written appeal, the institution’s appeal committee found due process had not been followed, and the dismissal was rescinded. Read the case study.
Every matter turns on its own record, and prior results do not guarantee a similar outcome.
Every resident who has contacted us so far reached out after dismissal, when the documents they needed were already out of reach. The Residency Record is a free, private place to keep them now, with the dates that follow from your agreement.
Start with three
Your resident agreement
Signed, with every addendum. ACGME requires it to cover pay, reappointment, due process, coverage, and leave.
The GME handbook and due process policy
The version in force this year. Disputes are judged against the one you were under, not the one posted later.
Your evaluations, as they post
Including the favorable ones. Two years of “meets expectations” changes how a sudden deficiency reads.
Most residents can find all three in ten minutes while they still have access.
A PGY-2 rated “Meets Expectations” in every domain stopped a procedure mid-shift because they were too fatigued to do it safely, the decision residents are trained to make. What happened next is why this organization exists.
I made a safety decision. I stopped a procedure on myself. That is supposedly the thing they teach us to do.From My Story
Practical Guidance
A rescinded dismissal is a win, not the end. What to get in writing in the first days back: the return plan, the steps you were not allowed to finish, your pay and status, your record, and, on a J-1, your sponsor.
Practical Guidance
Every international medical graduate trains with Intealth, formerly known as ECFMG, in the background. For an IMG on an Intealth-sponsored J-1, a dismissal or a resignation in lieu of dismissal can end sponsorship on a short clock. What Intealth does, what it does not do, and what to do first.
Practical Guidance
Most residents in this position are not choosing between winning and losing. They are choosing between a separation that follows them and one that does not. These are the terms that can be asked for, and the ones that rarely move the outcome.
The intake is confidential and costs nothing. And if you’re not the one in trouble, send this to the resident who is. They’ll know why you sent it.