2015 – 2016
UBC PGME Resident Manual
Resident Probation Letter and Outcome Form
PROBATION LETTER
Residency Training Program
University of British Columbia
This probation letter must be completed for every resident placed on probation in the Faculty of Medicine prior to
the start of probation. The requirements of probation are subject to the Faculty of Medicine’s Resident Evaluation
and Appeals Policy. It is further recommended that any resident placed on probation have access to a mentor who
is not involved in the resident's direct evaluation In appropriate circumstances, the Program Director should
arrange counselling for the resident. By signing this document (last page), the resident indicates that he/she
understands the goals and terms of the probation and the consequences of a failure to meet those terms.
Date
Dr.
PGY
resident in (program)
is hereby being placed on probation from
to
The reasons for being placed on probation are:
☐ Failure to achieve a satisfactory level of competence during the following rotations (specify
service, dates, etc.):
☐ Consistent difficulties identified throughout residency training in the following CanMeds
competencies:
☐ Medical Expert
☐ Manager
☐ Professional
☐ Communicator
☐ Health Advocate
☐ Collaborator
☐ Scholar
☐ Failure to meet and/or maintain the standards of the profession as described in the Faculty’s
Standards of Ethical and Professional Behaviour including, in particular, the following points:
The following specific weaknesses have been identified (add more as necessary):
1.
2.
3.
4.
5.
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Last Revised: April 28, 2015
.
2015 – 2016
UBC PGME Resident Manual
OBJECTIVES OF THE PROBATION
THE RESIDENT
During the probation period, Dr.
must:
1. Increase their reading in the area of
,
paying particular attention to the following:
☐ Basic science
☐ Management and approach
☐ Pathophysiology
☐ Therapeutics
☐ Evidence based medicine
☐ Clinical presentation
☐ Other (indicate)
Reading should be done from the following sources:
2. Improve their clinical performance by:
3. Improve the following professional behaviours (check all that apply):
☐ Interactions with patients
☐ Interactions with faculty and attending staff
☐ Interactions with peers
☐ Punctuality/Accessibility/Participation
☐ Interactions with allied health
☐ Sense of responsibility
professionals
☐ Other (indicate)
4. Participate in the examinations (specify type, frequency):
5. Meet with Dr.
at
(daily/weekly/monthly)
intervals during the probation period to discuss progress and ongoing objectives.
6. Other:
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Last Revised: April 28, 2015
2015 – 2016
UBC PGME Resident Manual
OBJECTIVES OF THE PROBATION
PROBATION SUPERVISOR RESPONSIBILITIES
During the probation period, Dr.
will:
1. Provide supervision of Dr.
from
during the probation period
to
.
2. Meet with Dr.
weekly (or specify other interval) to
review and discuss progress or lack thereof in attaining the objectives of the probation, keep
records of these meetings, and submit these weekly to the resident’s Program Director.
3. Help Dr.
in achieving the objectives of probation
by (check all that apply):
☐ Clarifying the difficulties the resident is having with knowledge base
☐ Providing extra teaching in clinical matters
☐ Providing supervision and training in procedural skills
☐ Counselling regarding attitudes
☐ Directing the resident to other specific sources of information on teaching
☐ Assessing the resident by means of
☐ Other (indicate)
4. Attest at the end of the probation period whether the resident has or has not met the objectives
of the probation period.
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Last Revised: April 28, 2015
2015 – 2016
UBC PGME Resident Manual
OUTCOME OF THE PROBATION
Upon completion of the probation period or at any time during the probation period, depending on the
resident’s performance, the following outcomes may occur as determined by the Residency Program
Director in consultation with the Residency Program Committee:
1. Reinstatement as a resident with training extended based on time lost due to unsatisfactory
performance.
2. An additional period of probation if, in the opinion of the Program Director, the resident has made
some progress in remedying the identified deficiencies but requires more time to fully meet the
expectations of the probation.
3. Dismissal from the program.
4. Other:
SIGNATURES
By signing this document, the resident indicates that he/she understands the goals and terms of the
probation period and the consequences of a failure to meet those terms. This does not in any way
preclude the resident from pursuing an appeal of a decision related to their probation period as provided
for in the Faculty of Medicine’s Resident Evaluation and Appeals Policy. An appeal must be submitted in
writing to the Program Director.
Signature of Resident:
Date:
Print:
Signature of Probation Supervisor:
Date:
Print:
Signature of Program Director:
Date:
Print:
Signature of PGME Associate Dean:
Date:
Print:
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Last Revised: April 28, 2015
2015 – 2016
UBC PGME Resident Manual
FINAL OUTCOME OF PROBATION
This form has been completed by the Program Director and has been ratified by the Residency Training
Committee at its meeting on (date)
.
Dr.
has completed probation from
Specific Objectives of the Period of Probation
(add additional pages as required)
1. Reading and demonstration of core knowledge
2. Clinical performance
3. Interactions with patients
4. Interactions with peers
5. Interactions with allied health professionals
6. Interactions with attending staff
7. Interactions with others
8. Punctuality/Accessibility/Participation
9. Sense of Responsibility
10. Other (specify):
New weaknesses identified since the period of probation began (if any):
1. 1
.
2.
3. 2
.
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Last Revised: April 28, 2015
☐
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Not
Resolved
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☐
Fails to Meet
Expectations
☐
☐
☐
☐
☐
1.
2.
3.
4.
5.
Partially
Resolved
Specific Areas of Weakness
Fully Meets
Expectations
Resolved
. The final outcome of the period of probation is as follows:
Exceeds
Expectations
to
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2015 – 2016
UBC PGME Resident Manual
Overall, the period of probation is considered
☐ Successful
☐ Unsuccessful
The result of the period of probation is:
☐ Reinstatement as a resident with training extended as recommended by the Program Director and
the Residency Program Committee based on time lost due to unsatisfactory performance.
The extended period of training will occur from
to
☐ An additional period of probation from
to
☐ Dismissal from program effective
☐ Other (indicate):
Comments by Program Director/Resident:
SIGNATURES
By signing this document, the resident indicates that he/she has met with the program director to discuss
the final outcome of the period of probation and has reviewed this document. This does not in any way
preclude the resident from pursuing an appeal of the final outcome of probation, according to the Faculty
of Medicine Policy on Evaluation.
Signature of Resident:
Date:
Print:
Signature of Remedial Supervisor:
Date:
Print:
Signature of Program Director:
Date:
Print:
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Last Revised: April 28, 2015