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

Item 606

Revised July 1999

The following information pertains to residents enrolled in the Wright State University School of Medicine (WSUSOM) and Affiliated Hospitals Graduate Medical Education Programs who are active duty military officers assigned to Wright-Patterson Medical Center (WPMC).

Salary Levels
Salary is determined by federal statute and varies according to rank and time in service.

Benefits
Insurance
Professional liability. Liability coverage is provided by the hospital at which the resident performs the patient care. While performing duties within the scope of their residency at WPMC, liability is covered by the Federal Tort Claims Act and provides coverage on an occurrence basis rather than a claims-made basis.

Disability. The Military Disability System is based on public law and provides comprehensive benefits. Members of the armed forces are also covered by the Social Security Disability System.

Medical/Dental. Active duty military officers receive comprehensive medical and dental benefits. Outpatient medical and dental care are provided at no charge. Inpatient care is charged at the rate of $7.50 per day. Comprehensive mental health services ranging from counseling to psychiatric care are provided without fee from the WPMC Mental Health Clinic.

Family members are provided medical insurance through TRICARE, which provides a choice of an HMO, PPO, or fee for service plan. Family members must be enrolled in DEERS to be eligible for medical benefits. The HMO benefit (TRICARE Prime) requires additional enrollment to that plan and assignment to a Primary Care Manager. There is no cost to enroll, but varying co-pays and deductibles apply depending on the choice of plan. Information about TRICARE can be obtained from the TRICARE Service Center at 1-800-941-4501.

Family Dental insurance is provided through United Concordia. Coverage for one family member is $8.53 per month; coverage for two or more family members if $21.33 per month. Information about Dental Insurance can be obtained from the Contract Management Office at 937-257-9166.

Life. Active duty military personnel are automatically provided Serviceman's Group Life Insurance (SGLI) in the amount of $200,000 for a fee of $16 per month deducted from military pay. Lesser amounts must be requested in writing at the Military Personnel Flight.

Leaves
Educational. Educational leave is subject to program director approval. Short courses of study and educational meetings required by the approved curriculum document will be funded. Other requests for paid or permissive TDY will be considered on an individual basis and managed in accordance with Air Force regulations.

Vacation. Vacation time is governed by the individual program. "Military Leave" is earned at a rate of 30 days per calendar year. Active duty members must be on Military Leave when on vacation regardless of whether they are at WPMC or a civilian hospital and must follow Air Force regulations pertaining to Leave. Military Leave may exceed the amount of vacation time allowed by the individual program and may be carried forward to the next duty assignment.

Sick Leave. Active duty members have unlimited sick leave. However, if they miss more than one duty day, they must be placed on "Quarters" or "Convalescent Leave" through a military medical provider.

Parental Leave of Absence. Convalescent leave for maternity purposes is determined by the medical provider and is generally for 6 weeks after delivery. Air Force Regulations do not provide for "Family" or "Parental" leave other than maternity leave. Military members may use their earned Military Leave for this purpose. Advance Leave may be granted if necessary.

Personal Leave of Absence. Federal regulations prohibit active duty military members from taking unpaid leave. If a leave of absence is granted from the residency program, the military resident must report to their Squadron Commander for duties to be performed during the leave of absence. If a period of absence is of such a length as to require the training program to be extended, this request must be coordinated through the WPMC Director of Medical Education who must obtain permission from the Air Force for this extension. The need for program extensions will be determined by the program director based upon the specialty board requirements for months of training needed for board eligibility and by ACGME specified required rotations.

Meals. Meals are on a cash basis. Food service is provided for breakfast, lunch, and dinner 7 days per week. Air Force regulations prohibit the hospital from providing food items free of charge to the residents' lounge.

Parking. Parking is free. Hospital staff, including residents, are not allowed to park in lots immediately adjacent to the hospital (adjacent to the pharmacy entrance and the emergency room entrance) or in any lots marked as patient parking.

Other Benefits. Sleep rooms are provided for residents required to provide in-hospital overnight call. A resident lounge and kitchen are provided. A small health club open 24 hours/day and located in the hospital is available to all residents free of charge.

Outside Employment
Active duty military residents are not allowed to pursue outside employment.

Medical Licenses
Active duty military physicians may obtain a medical license from any state or US jurisdiction. Air Force regulations (AFI 44-119) require residents to take the licensure exam and obtain a medical license when first eligible. This is usually after completion of the first post-graduate year of training. Addresses of various state medical licensing boards may be obtained from the Graduate Medical Education Office at WPMC.

Discrimination/Harassment Policy
The Air Force has a strict policy against discrimination and sexual harassment. Such behavior will not be tolerated, practiced, or condoned, and will be met with administrative or judicial action. The Air Force has a well organized program to investigate and act when such behaviors are reported or discovered through monitoring activities. If a resident believes he/she has been the subject of sexual harassment or discrimination, the resident may report it to the Wright-Patterson Residency Program Director or Director of Medical Education, or to the Flight Squadron or Medical Center Commander. Additionally, the resident may report the event directly to the Social Actions Office for Wright-Patterson AFB (937-257-5028) who will conduct the official investigation.

Standards of Professional Appearance

26 March 1998

MEMORANDUM FOR RESIDENTS AND MEDICAL STUDENTS

1. This is a brief reminder to residents and medical students that they are expected to maintain standards of professional appearance whether they are rotating at civilian or military institutions. By nature of standard regulations with which military institutions are required to comply, this memo will attempt to clarify those regulations combined with the Wright State University School of Medicine (WSUSOM) policy.

2. It is clearly stipulated in the WSUSOM Resident and Fellow Manual that "...white coats should always be worn on duty within the hospital...." (Item 211, Support - Uniforms) with the exception, of course, when in surgery and wearing scrubs. Wright-Patterson Medical Center (WPMC) policy as outlined in a policy letter from 74 MDG/CC dated 3 July 1996 states "Residents on call may change into scrubs prior to retiring for the night, but will wear a uniform (appropriate professional attire for civilians) on the shifts prior to and after their night call duties. Civilian residents will wear appropriate professional attire to and from work."

a. Providers rotating duties between performing invasive procedures (i.e., Cath Lab, Angio, etc.) and clinic duties in the same duty day may wear scrubs in the clinic with a white lab coat.

b. When leaving the section to perform patient-related duties, personnel wearing scrubs will wear appropriate cover garments.

c. Personnel not having enough time to eat outside the duty section may wear scrubs, with an appropriate cover garment, to get carry-out food at the dining hall, snack bar, or BX. However, those who are actually dining must wear an authorized uniform.

d. Personnel authorized the wearing of scrubs will wear appropriate identification IAW MDGI 36-2903, para. 3.1.1. This includes not only the surgical scrub uniform, but all cover garments as well.

3. The Professional Education Committee of Wright-Patterson Medical Center does appreciate the differences between "regular call-duty," "from home call," and "emergency call." Anytime hours have been scheduled, whether in-house or from home, personnel are expected to wear appropriate attire. If called at home unexpectedly, appearance and the urgency of arrival must be considered.

a. Sheer clothing, open-toed shoes/sandals, sweatshirts or sweatpants, and shorts are considered improper attire. Jeans are discouraged.

b. CLEAN lab coats are mandatory for all residents and medical students.

4. Each flight may have additional requirements that pertain to individual flight needs. These requirements will be considered above and beyond those listed above.

5. This policy should not be viewed as a burden but as an opportunity to demonstrate that we meet and/or exceed any expectations for our performance. Remember that you are all under constant scrutiny by many people. Disrespect for professional obligation is a bad reflection upon the individual as well as their peers, the residency program, and the Air Force.

6. Thank you for your attention and consideration in these matters. If you have any questions, please contact Ms. Coffield, Chief of Graduate Medical Education, at 257-9346.

KATHLEEN S. BOHANON, Col, USAF, MC
Chief, Medical Staff

Residency Closure/Reduction Policy
In the event that either a WSU SOM Integrated GME program or the Air Force intends to close or reduce the size of a residency program, the residents so affected will be notified as soon as possible. In the event of such a reduction or closure, every effort consistent with the requirements of the US Air Force will be made to allow the residents already in the program to complete their education. If any residents are displaced by such closure or reduction, the program director will make every effort to assist the residents in enrolling in a program in which they can continue their education.

Disciplinary Action
Through affiliation agreements established between Wright-Patterson Medical Center and Wright State University School of Medicine (WSUSOM), military residents are enrolled in the WSUSOM Integrated Graduate Medical Education Program. In addition to maintaining academic good standing, enrollment in this program is contingent upon the military resident maintaining his or her status as a member of the Armed Forces.

As military officers, residents are under continual obligation to demonstrate the highest standards of conduct, integrity, and officership. At all times, military residents are subject to and must comply with the Uniformed Code of Military Justice (UCMJ), Department of Defense Instructions, Directives, and Regulations, and Air Force Directives and Instructions. In addition, while enrolled in the WSUSOM Graduate Medical Education Program, military residents are also subject to WSUSOM policies. When adverse actions are taken by faculty against military members on purely academic grounds, faculty shall comply with the due process policies established by WSUSOM and the due process standards of AFI 41-117, Medical Service Officer Education.

Military Disciplinary and Administrative Actions. Occasionally, a military resident's conduct or medical/mental health condition may render the member unfit for continued service. In such cases, military disciplinary and administrative policies shall be followed to address the situation. As examples, these situations include, but are not limited to, violations of the UCMJ or other military regulations, unsatisfactory compliance with military weight and fitness standards, and development of medical or mental health conditions that disqualify the resident for world wide duty. In the event a member is discharged, retired, or placed in a no pay status as the result of military disciplinary or administrative action, WSUSOM shall be notified and the resident will be automatically disenrolled from the Graduate Medical Education Program. WSUSOM due process policies do not apply in this situation. Due process and appeals of such military actions are outlined in DoD and AF policies.

The fact that military disciplinary or administrative actions are taken against a member does not preclude appropriate academic action. Certain offenses or medical/mental health condition may implicate both a military resident's fitness for continued military service and his or her potential for successfully completing the academic program. In such cases, both military disciplinary or administrative actions and academic actions may be done concurrently.

Wright-Patterson Medical Center
Resident Issue Resolution Policy

This policy applies to military residents assigned to Wright-Patterson either in a freestanding or integrated residency program, and to civilian residents while rotating at Wright-Patterson. It is Medical Center policy residents shall have their issues addressed and resolved in a professional manner and without fear of intimidation or retaliation.

Residents should first address their issues within their academic program using the various resources available, such as their program director or associate program director, faculty advisor or other faculty member, chief resident, department chairperson/flight commander, or education committee for that program. If a degree of anonymity is desired, the residents may address their concerns through their chief resident or resident representative to their program's education committee.

In the event the resident's issues are not resolved within the academic program, or if the resident feels intimidation or realization may occur if his or her issues are brought to the attention of their program, the resident may present their issues to the following:

The director of Medical Education (DME) at Wright-Patterson, or of the hospital at which the resident is rotating.

The Professional Education Committee (PEC) at Wright-Patterson. The issue may be presented directly by the resident or through the resident representative to the PEC.

The Resident Life Committee of DAGMEC (Dayton Area Graduate Medical Education Consortium) via any staff or resident member of that committee. This committee may then forward it to the Executive Committee of the GMEC (Graduate Medical Education Committee of DAGMEC) if they cannot satisfactorily obtain resolution.

If the resident desires a significant degree of anonymity, the resident may ask the resident representative of the GMEC to address the issue on his or her behalf.

If the resident desires complete anonymity, he or she may submit an anonymous written communication to any of the above mentioned personnel. However, this may significantly hamper the fact-finding and issue resolution processes and should be used only as a last resort. If a resident feels so threatened as to need to use anonymous written communication, it is the responsibility of the DME to evaluate the climate within the involved residency program.

If the issue involves substantial academic issues that cannot be resolved thorough the above listed mechanisms, the resident may file a formal complaint with their program's accrediting body (ACGME for physician residents, ADA for dental residents, and APA for psychology residents).

Military residents have the following other options for issues arising at Wright-Patterson:

For issues involving sexual harassment or discrimination, the resident may file a complaint with the WPAFB Social Actions, who will investigate that complaint.

Military residents may use their military chair of command: Flight Commander, Squadron Commander, and Group Commander.

Military residents may take their issue to the WPAFB Inspector General, or to their congress person.

Note: "Resident manual" = WSU Resident and Fellow Manual; AFI = Air Force Instruction 

Benefit, condition, policy	In resident agreement or Air Force policy?		Review benefit, condition or policy in:
Financial Support for the Resident	Yes		Pay chart from AF Finance Office
Vacation Policies	Yes		Resident manual; AFI 36-3003
Professional Liability Insurance	Yes		Resident manual; title 28 USC sec. 2679
Professional Liability Insurance (Tail Coverage)	Yes		Resident manual; title 28 USC sec. 2679
Disability and Health Insurance	Yes		Resident manual; TRICARE Handbook. AFI 36-3212
Professional Leave of Absence Benefits	Yes		Resident manual; AFI 41-117
Parental leave of Absence Benefits	Yes		Resident manual; AFI 41-117
Sick Leave Benefits	Yes		Resident manual; AFI 36-3003
Leave of Absence Policy	Yes		Resident manual; AFI 41-117
Policy on Effect of Leave for Satisfying Completion of Program	Yes		Resident manual; AFI 41-117
Conditions for Living Quarter, Meals, Laundry	Yes		Resident manual
Counseling, Medical, Psychological Support Services	Yes		Resident manual
Policy on Physician Impairment and Substance Abuse	Yes		Resident manual AFI 41-117, 44-119
Residents' Responsibilities	Yes		AFI 41-117, ¶34.1
Duration of Appointment	Yes		WSUSOM GME agreement
Conditions for Reappointment	Yes		WSUSOM GME agreement
Policy on Professional Activities Outside of Program	Yes		Resident Manual; AFI 44-102
Grievance Procedures	Yes		Resident Manual; AFI 41-117, UCMJ
Policies on Gender or Other Forms of Harassment	Yes		Resident Manual; AFI 36-2701, Chap 7; Mandatory 12 hr course in Equal Opportunity during orientation
Residency Closure/Reduction Policy	Yes		Resident Manual

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