Wright State University School of Medicine
Sponsored Graduate Medical Education Programs
Resident Manual

Item 503
Impaired Resident
Revised July 1996

1. Residents are not permitted to participate in any residency or fellowship program activities while under the influence of any substance which impairs the ability to practice.

2. The School of Medicine (SOM) intends to comply completely with federal, state, or local laws related to the sale, possession, use or distribution of drugs or alcohol. Any violations by a participant will be interpreted as failure to comply.

3. Failure to comply with (1) and (2) may result in:

• referral to an approved treatment center,
• disciplinary action by the program including suspension, termination, or non-reappointment,
• notification to civil authorities of the violation, or
• notification to the Ohio State Medical Board.

4. Under the Ohio Revised Code, physicians are required to report physician colleagues, whom they suspect to be impaired, to the Ohio State Medical Board unless they enter treatment voluntarily. Program directors should not report impaired residents who enter treatment voluntarily. Program directors must report impaired residents who refuse to enter treatment. A list of approved treatment providers should be obtained by the program director from the Board. (Contact the State Medical Board, 77 South High Street, 17th Floor, Columbus, Ohio 43266-0315; telephone number 614-466-3934). An impaired physician is one who cannot practice according to acceptable and prevailing standards of care because of habitual or excessive use or abuse of drugs, alcohol, or other substances that impair the ability to practice (ORC 4731.22 (B)(19),(26)). Upon probable cause the Board may mandate a mental or a physical examination of any physician. Failure to submit to examination constitutes an admission of the allegations. If a physician is found to be impaired after the examination, the physician will be required to submit to treatment as a condition for initial, continued, reinstated or renewed medical licensure.

5. All professionals who have concerns about a resident's compliance with Items (1) and (2) above are encouraged to report to the program director in accordance with the following conditions:

• if the resident's behavior and/or physical appearance suggest substance abuse;
• if the resident does not practice according to acceptable and prevailing standards of care;
• if a violation of a federal, state or local law related to the sale, possession, use or distribution of drugs or alcohol becomes known;
• if information is requested by the program administrators; and
• when required by applicable codes of professional conduct. It is the ethical responsibility of any physician who knows of an apparent problem in a colleague to take assertive action, to seek treatment or rehabilitation for the fellow physician.

6. Consultation Process

a. After observations, consideration of related reports and assessments, and confidential discussion with the director of medical education (DME) of the sponsoring hospital, the residency program director makes a decision whether consultation for a resident is necessary. This decision can include the temporary relief of the resident from training and institutional duties.

b. The case is referred in confidence to a standing Resident Effectiveness Subcommittee of the Graduate Medical Education Committee (GMEC) comprised of:

• the director of the Psychiatry Residency Program (or designee) as chair
• a member of the GMEC designated by the GMEC chair
• a senior resident on the GMEC designated by the GMEC chair

c. In each individual case, the Resident Effectiveness Subcommittee will be augmented by three specific members:

• the chair of the Physician Effectiveness Committee of the sponsoring hospital
• the chair of the Physician Effectiveness Committee of the occurrence hospital
• the senior resident preferably from the sponsoring hospital in a program that is different from that of the reviewed resident

d. The review and consultation of the subcommittee will produce specific recommendations that will be transmitted in confidence from the chair of the subcommittee to the reviewed resident's program director.

• Administrative details of the rehabilitation program will be the responsibility of the residency program director.
• Rehabilitative details and monitoring of the remedial program will be the responsibility of the subcommittee chair.
• Compliance of the reviewed resident in the rehabilitation program will eliminate the need for discovery outlined in items 3 and 4 above. Failure to comply as determined jointly by the subcommittee and the resident's program director will mandate a report of the case to the State Medical Board.

e. The above consultation procedure may also be implemented for a resident whose function is impaired by physical, mental or emotional disability.

7. A resident may be given a leave of absence or may utilize sick leave while under the care of an approved treatment center on the same basis as other illnesses.

8. In affiliated hospitals, the directors of medical education are responsible for interpretation of their institution's policies related to the consumption of alcohol on premises. Residents having questions about the institution's policies should contact the DME.

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