Your institution has to have a written grievance and due process policy. Find it today.

The single most useful thing you can do in the first hour after a program raises a formal concern is to download your own paperwork. Not to read the law, and not to draft an argument. Just to collect the documents, because in most matters the outcome turns on whether the institution followed its own written process.

What you are looking for

Accredited sponsoring institutions are required by the Accreditation Council for Graduate Medical Education (ACGME) to maintain written policies covering how residents and fellows submit and process grievances, and covering adverse actions such as suspension, non-promotion, non-renewal, and dismissal. In the 2025 Institutional Requirements, the due process obligation sits in Section 4.4.b., which covers suspension, non-renewal, non-promotion, and dismissal regardless of when the action is taken during the appointment period, and the grievance procedure obligation sits in Section 4.5. Section numbers move between revisions, so cite the version that was in force during your training year rather than whatever is posted today.

Collect these, as PDFs, saved somewhere that is not your work account:

1. Your residency or fellowship agreement, including any appendices
2. The institutional graduate medical education policy manual
3. The grievance policy and the due process or adverse action policy
4. Every written notice, evaluation, and summative evaluation you have received
5. Any agreement you are being asked to sign

Why the version matters

Policies get revised between academic years. If your program applies a 2026 procedure to a 2025 event, that gap is worth knowing about. Residents in online communities give this same advice for a practical reason: once a dispute starts, the intranet link you relied on can change, and you may lose easy access to your institutional account.

Read for procedure, not for fairness

When you read the policy, do not start with whether the accusation is fair. Start with the mechanics, because those are the parts a reviewer can check against a calendar:

• Who has authority to impose this specific action
• What notice you are entitled to, and in what form
• How many days you have to appeal, and when the clock starts
• Whether the appeal is a fresh hearing or a review of a record
• Whether you may bring an advisor or counsel, and whether that person may speak
• Who sits on the reviewing committee, and whether anyone on it was involved in the original decision

About the ACGME complaint route

The ACGME also maintains a formal complaint process for concerns that a program is not in substantial compliance with requirements. It is worth understanding what that process does and does not do before using it, since it addresses program compliance rather than resolving an individual employment or academic dispute. If you are considering it, talk it through with someone first.

If this is happening to you

Gather the documents, note every date, and reach out. Early conversations are the easy ones, and there is no version of this where we would rather you waited.