Resident Remediation: A Complete Guide for GME Programs
Resident remediation is one of the most challenging responsibilities in Graduate Medical Education. Program directors, coordinators, and faculty members are expected to protect patient care, support resident growth, meet ACGME requirements, and safeguard the program. At the same time, remediation is often misunderstood, inconsistently implemented, and emotionally complex for both faculty and residents.
This guide brings together the core concepts, strategies, and processes that help programs build strong, fair, and defensible remediation plans. Use this page as a central resource for understanding remediation, designing plans, documenting performance, and supporting residents through the process.
1. Understanding Resident Remediation
Remediation is a structured, time-limited process used to help residents close identified performance gaps. It is not punitive. It is a professional development tool rooted in clear expectations, documented evidence, data-driven goals, and consistent monitoring.
Topics in this section include:
• What remediation is and is not
• How remediation differs from informal feedback, coaching, and probation
• How the ACGME Milestones guide deficiency identification
• Early warning signs that a resident may require structured support
• Principles of fairness, clarity, and documentation
Related posts:
• 3 Simple Strategies to Documenting the Resident Remediation Process (Without Legal Headaches)
• Breaking the Taboo: How to Create a Culture That Embraces Resident Remediation
• When Faculty Disagree on Resident Remediation: How to Build Consensus and Move Forward
2. The ELEVATE Framework
Effective remediation plans follow a predictable structure. The ELEVATE framework provides a step-by-step method for building remediation plans that are organized, transparent, and defensible. Programs can use this approach to evaluate baseline performance, establish goals, align faculty expectations, track progress, and determine next steps.
Related posts:
• Key Data Points to Assess a Resident’s Baseline Performance
• 3 Strategies for Working with Difficult Residents
• 3 Ways to Involve Residents in Remediation
3. Building a Defensible Remediation Plan
A strong remediation plan is specific, actionable, and directly tied to the resident’s documented deficiencies. Effective plans include:
• A clear list of deficiencies mapped to Milestones
• Measurable, behavior-based goals
• A structured monitoring and feedback schedule
• Faculty alignment and shared expectations
• Transparent criteria for successful completion
• Planned steps if improvement does not occur
Related posts:
• Why the End of Resident Remediation Must Be Data-Driven
• 5 Ways Program Coordinators Make Resident Remediation Work
• The One Tiny Book That Changed How I Remediate Professionalism
4. Professionalism Remediation
Professionalism is one of the most common and complex areas to remediate. Behaviors are often subtle, inconsistent, or situational. This section provides guidance for identifying patterns, using objective data, writing behavior-based goals, maintaining boundaries, and monitoring professionalism over time.
Related posts:
• The One Tiny Book That Changed How I Remediate Professionalism
• Breaking the Taboo: How to Create a Culture That Embraces Resident Remediation
• How to Handle Emotional Breakdowns and Angry Residents During Remediation
5. Documentation, Risk, and Legal Protection
Faculty documentation is essential for fairness, clarity, and institutional protection. Clear, factual documentation ensures that expectations are communicated consistently and that the program is prepared for GMEC, DIO, or external review if needed.
This section includes guidance for:
• Writing clear, objective performance statements
• Avoiding vague or subjective language
• Maintaining a defensible paper trail
• Summarizing performance using Milestones
• Supporting faculty who are unsure how to document concerns
Related posts:
• 3 Simple Strategies to Documenting the Resident Remediation Process (Without Legal Headaches)
• Why the End of Resident Remediation Must Be Data-Driven
• When Faculty Disagree on Resident Remediation: How to Build Consensus and Move Forward
6. Monitoring Progress and Supporting the Resident
Remediation is not simply a document; it is a process. This section outlines how to structure check-ins, gather ongoing data, monitor progress across rotations, and support the resident while maintaining expectations for performance improvement.
Related posts:
• 3 Strategies for Working with Difficult Residents
• 3 Ways to Involve Residents in Remediation
• How to Handle Emotional Breakdowns and Angry Residents During Remediation
7. Escalation, Probation, and Next Steps
Not all residents improve with remediation alone. This section covers how and when to escalate the process, how probation differs from remediation, what to include when documenting lack of progress, and how to prepare for GMEC or institutional review.
Related posts:
• Resident Remediation vs. Probation: What’s the Difference and Why It Matters
• When Faculty Disagree on Resident Remediation: How to Build Consensus and Move Forward
• Why the End of Resident Remediation Must Be Data-Driven
8. Tools, Training, and Resources
Programs can deepen their understanding and improve their remediation processes through additional tools and training, including:
• ELEVATE: Remediation Fast Track
• Free introductory lesson
• Remediation Risk Assessment
• The Resident Remediation podcast
• Remediation Quick Tips
These resources help programs build consistent, defensible remediation processes without starting from scratch.
