When Faculty Disagree on Resident Remediation: How to Build Consensus and Move Forward

If you’ve ever sat in a CCC meeting and felt the tension rise when faculty can’t agree about resident remediation, you’re not alone. One person says, “I’ve seen improvement.” Another says, “Not even close.” And suddenly, every eye in the room is on you to decide what happens next.

Sound familiar? Let’s talk about it.

Why Faculty Disagreement Happens

First, disagreement is normal. In fact, it’s inevitable. But in remediation, it can stall the whole process if you’re not ready for it.

Here’s the thing---most of the time, faculty aren’t disagreeing about whether a concern exists. They usually agree the resident has deficiencies. What they don’t agree on is how much improvement has happened or whether the remediation plan is actually working.

And that difference usually comes down to one thing: data gaps.

A Case Example: Improvement vs Risk

Let’s say you have a PGY-1 on remediation for deficiencies across all six core competencies.

• One faculty member works with the resident for a week on a low-complexity surgical service. The resident presents cases smoothly, organizes treatment plans, and looks… fine. Faculty report: “I think they’re improving.”
• Meanwhile, in the clinic, faculty have directly observed the same resident over multiple weeks. They see documentation errors, gaps in reasoning, patient confusion, even near misses that could have led to harm without close supervision.

So, who’s right? The surgical attending or the clinic preceptors?

The answer: both. Each faculty member reported what they saw. The problem isn’t disagreement. The problem is incomplete data.

The Real Mistake Programs Make

Here’s where programs go wrong: trying to resolve the disagreement too quickly.

If your CCC is split, this isn’t the time to vote or “go with the majority.” This is the time to pause and investigate further. Ask:

• Who observed what, and for how long?
• Were observations made in different settings?
• Were expectations clear and consistent?

Without answers, you’re making decisions on shaky ground.

Strategy 1: Use a 360-Degree Data Approach

To move forward, you need more than one person’s perspective. At least three faculty with direct observation should contribute, and that’s just the baseline. Build a bigger picture with:

• Faculty observations across settings
• Upper-level resident input (since they supervise PGY-1s often)
• Nursing staff and medical assistant feedback
• Resident self-assessments
• Chart reviews
• Standardized patient encounters or OSCEs

In my own program, I won’t hesitate to schedule standardized patients for a single resident if I need better data. One week on a single service doesn’t tell the whole story.

Strategy 2: Set Standards Before the Meeting

Walk into your CCC with clear expectations already defined. That means:

• Anchoring your plan to milestones or sub-competencies
• Defining what measurable growth looks like
• Separating effort from outcomes (trying is nice, but remediation requires actual improvement)

Avoid vague statements like, “They’re trying really hard,” or, “They’re better than before.” Those don’t help your CCC make fair, defensible decisions.

Strategy 3: Pause When You Don’t Have Enough Data

This one is hard to hear but important: if you don’t have enough data, hit pause.

Extending the remediation plan to gather more structured observation is not failure. It’s integrity. It’s fairness. It’s how you protect both the resident and your program.

The absolute worst thing you can do is make a final decision based on partial information.

If your CCC has ever split on whether a remediation plan is working, chances are you’ve got a data gap. The question is whether your process would hold up if challenged. Find out with the free Resident Remediation Risk Assessment — it only takes a few minutes and shows you where the gaps may be in your approach. →Take the Assessment

Recap: Building Consensus When Faculty Disagree

When disagreement shows up, don’t panic. Instead:

1. Pause and investigate. Dig into why the opinions differ.
2. Look at where the data came from. Who observed, where, and for how long?
3. Fill in the gaps. Collect more data if needed.
4. Revisit expectations. Make sure “progress” is defined clearly.

This process isn’t about who’s right. It’s about getting it right.

Final Thoughts

Faculty disagreement is not a problem to avoid. It’s a signal to slow down and strengthen your data discipline. Encourage your CCC to think in measurable terms, not general impressions. Anchor to milestones, compare progress to baseline, and remember: pausing is not failing your resident. It’s protecting them and your program by making sure you’re making the right decision.

So next time you’re in a CCC meeting and the room splits on remediation, don’t rush to resolution. Investigate, gather data, and build consensus the right way.

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Written by Dr. Nicole McGuire (Doc Mac), Education Specialist at Union Hospital Family Medicine Residency and Founder of Doc Mac Learning. Through her ELEVATE framework, she helps residency programs create remediation plans that are fair, defensible, and effective.

👉 Want more tools to make remediation fair, defensible, and effective? Grab the free lesson from the ELEVATE Remediation Fast Track course here.