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Contract:

Graduate Trainee Benefits and Responsibilities

This document describes generally your responsibilities and benefits as a Resident ­(hereinafter “Graduate Trainee”) for the one year beginning July 1, 2008 .  It also describes certain of the Hospital’s responsibilities and includes certain policies applicable to Graduate Trainees.

Engagement:
The Hospital hereby engages the Graduate Trainee as a program year 2 ­­­trainee in the Harvard Combined Orthopaedic Residency Program in Orthopaedic Surgery.  The Graduate Trainee acknowledges that this engagement is subject to the bylaws, policies and procedures of the Hospital’s Medical/Professional Staff and the Department of Orthopaedic Surgery, and is contingent upon:

• successful completion of the Hospital and Department credentialing process, and appointment by the Board of Trustees;
  
  
• compliance with the attached USMLE completion requirements policy;
  
  
• fulfillment of the medical licensure requirements of the Massachusetts Board of Registration in Medicine;
  
  
• maintenance of an appropriate appointment to the Medical/Professional Staff.

Graduate Trainee Responsibilities:
1. The graduate trainee shall:

• provide patient care, under appropriate supervision, as assigned by the training program director or his/her designee, consistent with the educational goals of the program and the highest standards of patient care ("patient care" includes responsibility for associated documentation in the medical record, which should be completed in a timely fashion, and attendance at patient care rounds as assigned);
  
  
• make appropriate use of the available supervisory and support systems, seeking advice and input from the attending staff physician/s when and as appropriate, and in accordance with the attached Hospital Guidelines for Supervision of Residents and Clinical Fellows;
  
  
• participate fully in the educational and scholarly activities of the training program as specified by the training program director, including attendance at didactic conferences and other responsibilities which may include a research project, completion of examinations, maintenance of procedure logs or other items;
  
  
• develop a personal program of learning to foster continued professional growth, with guidance from the teaching staff;
  
  
• assume responsibility, as called upon, in teaching more junior trainees and medical students, within the scope of the training program;
  
  
• participate in improving the quality of education provided by the training program, in part by submitting at least annually confidential written evaluations of the faculty, the program and the overall educational experience;
  
  
• adhere to established practices, procedures and policies of the Hospital, the Hospital’s Medical/Professional Staff, the Department and affiliated training sites;
  
  
• participate in institutional programs, councils or committees and other medical staff activities, as appropriate;
  
  
• abide by the institutional and program-specific Resident Duty Hours Policies and, as scheduled by the program director, accurately report his/her duty hour;
  
  
• comply with institutional requirements for annual health and safety training, vaccinations and TB testing.

2. Prior to completion of the program the Graduate Trainee shall satisfy the following requirements, and provide written documentation to the training program director, where appropriate:

1. all United States Medical Licensing Examination requirements (see attached policy), or acceptable equivalent examination/s;
2. all published program and/or ACGME requirements for board or other certification;
3. any other requirements for obtaining a full medical license.

These are conditions for issuance of a certificate of completion of the training program.

Program Responsibilities:
The Hospital will provide:

1. a suitable academic environment for educational experience in the Graduate Trainee’s specialty or subspecialty area;
2. a training program that strives to meet and exceed the standards of the Essentials of Accredited Residencies prepared by the Accreditation Council for Graduate Medical Education, when such Essentials apply;
3. upon satisfactory completion of the training program, documentation of completion.

The Department of Orthopaedic Surgery will provide information relating to access to eligibility for certification by the relevant certifying board, including specialty board examinations.

• Adverse Action Process
  
  
• Trainee Leave
  
  
• Moonlighting (i.e., Professional Activities Outside the Educational Program)
  
  
• Redress of Grievance
  
  
• USMLE Completion Requirements
  
  
• Hospital Guidelines for Supervision of Residents and Clinical Fellows

• Graduate Trainee Adverse Action Process
  
  
• Graduate Trainee Leave
  
  
• Graduate Trainee Redress of Grievance
  
  
• Graduate Trainee Moonlighting (i.e., Professional Activities Outside the Educational Program).

2. There are Partners/Hospital policies prohibiting sexual and other forms of harassment and providing a process by which allegations of workplace harassment may be reviewed. The Hospital also has a policy regarding physician impairment due to substance (drug or alcohol) abuse. These policies will be provided to a matriculating graduate trainee on or about the start of the academic year or sooner, upon request, and are, along with several other important policies as currently in effect, included in the Partners House Officers' Manual*.

3. During the term of this contract, the Graduate Trainee will not engage in any professional activities outside the scope of this training program:  that is, moonlighting is prohibited.

4. In the event of an inconsistency or conflict between any Graduate Trainee policy and the Medical/Professional Staff bylaws of the Hospital, the Graduate Trainee policy shall prevail and apply.

Professional Liability Insurance:
1. The Hospital shall provide appropriate professional liability coverage consistent with the coverage provided for other medical/professional practitioners.  This coverage presently is provided through the Controlled Risk Insurance Company, Ltd. (CRICO).  The coverage limits are currently $5 million per claim and $10 million annual aggregate per physician.

2. This coverage provides legal defense and protection against awards from claims for which the Graduate Trainee would be liable even when reported or filed after the completion of training if the alleged acts or omissions occurred within the scope of the education program.

3. Insurance provided by the Hospital generally applies only to activities performed within the scope of the training program and approved affiliations, and to certain moonlighting activities, as defined by CRICO, if (a) in compliance with the attached Graduate Trainee Moonlighting Policy and (b) approved in writing by the Department Chief or his/her designee.

4. The CRICO program requires, among other things, that physicians report incidents and claims to the Hospital’s Risk Management Office.

5. Graduate Trainees shall not be liable in a suit for damages as a result of an act or omission related to rendering care in an emergency under the Commonwealth of Massachusetts “Good Samaritan” law.

Release of Information:
The Graduate Trainee understands and agrees that, should another institution, organization or individual to which the Graduate Trainee has applied for a position request a reference from the Hospital, the Hospital may share any and all appropriate information that it possesses concerning the Graduate Trainee, including information relating to any discipline, suspension or termination from the Program or the Hospital, or perceived inability to practice within commonly accepted standards of care.  The Graduate Trainee hereby authorizes the Hospital to release such information under these circumstances at any time, provided such information is given in good faith and without malice.

Conditions for Re-engagement and Continuation in the Program:
1. This term of engagement expires at the end of the period defined above, unless sooner terminated in accordance with applicable policies.  The engagement will be renewed by written notification to the Graduate Trainee upon successful evaluation by the training program director and/or Department Chief as to the Graduate Trainee’s ability to continue with the Program, and satisfaction of the other conditions as stated below:

• Re-appointment to the Staff and maintenance of appropriate appointment; and
  
  
• Successful completion of the assigned post-graduate level of the training program, as determined by the training program director.  In making this determination the training program director may consider input from supervising attending physicians, chief residents and others who have worked closely with the Graduate Trainee during the period of this engagement.  The training program director may also consider the results of an in-training examination, where applicable.  The Graduate Trainee must, at a minimum, have completed responsibilities as appropriately assigned within the scope of the training program and attained the knowledge and skill necessary to progress to the next level of post-graduate training.

2. In instances where (i) this engagement will not be renewed (other than by mutual agreement or program completion), or (ii) the program director has determined that the Graduate Trainee should not be promoted to the next level of training,

• the Graduate Trainee will be given written notice no later than four months prior to the agreement termination date shown above, unless the primary reason/s for and/or the decision to not renew or promote occurs within the last four months of the term of this agreement, in which case the Graduate Trainee will be provided with as much advance written notice of the intent to not renew or promote as the circumstances will reasonably allow, and
  
  
• the Graduate Trainee may request a hearing in accordance with the attached Adverse Action Process.

Note:  The Partners House Officers’ Manual* contains a copy of the bylaws of the Medical/Professional Staff and institutional policies regarding residency reduction/closure, duty hours, contracts and other policies of interest to Graduate Trainees.
*http://www.partners.org/departments/teaching/gme/homdir.htm

SIGNED:

______________________________________________________
Graduate Trainee (type in name here)

____________
Date

_______________________________________________________
James H. Herndon, MD, Training Program Director: 

____________
Date

Attachments:
Attachments:

• Current Graduate Trainee policies regarding:
  1. Adverse Action
  2. Leave
  3. Professional Activities Outside the Educational Program (Moonlighting)
  4. Redress of Grievance
  5. USMLE Completion Requirements
     
     Hospital Guidelines for Supervision of Residents and Clinical Fellows
     
     Summary of benefits
     
     Academic Year 2008-09 schedule of Partners Resident Salaries by Post-Graduate Year
     
     
     
     
     
     
     
     
     

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Last Updated: September, 2008