# You are not the first. That’s the point. For residents, before anything happens. Probation. Administrative leave. A fitness-for-duty referral. A committee hearing where your lawyer must sit silently. A resignation deadline set for the morning. These follow a pattern, and the pattern has rules, deadlines, and defenses. Start your confidential intake: [https://www.residenthelp.org/intake](https://www.residenthelp.org/intake) Read My Story: [https://www.residenthelp.org/story](https://www.residenthelp.org/story) Intake and case review are free. We connect you with outside counsel at a reduced flat fee, with no hourly billing, within 48 hours. Not in trouble? Start your free Residency Record anyway: [https://www.residenthelp.org/record](https://www.residenthelp.org/record). - **172,746** physicians training in ACGME-accredited programs ([ACGME, AY 2025-26](https://www.acgme.org/about/overview/)) - **2,531** physicians in training left their programs before completing them in 2023-24, the latest year published ([ACGME Data Resource Book](https://www.acgme.org/globalassets/pfassets/publicationsbooks/2024-2025_acgme_databook_document.pdf)) - **322** were dismissed that year, and 938 more withdrew ([ACGME, 2023-24](https://www.acgme.org/globalassets/pfassets/publicationsbooks/2024-2025_acgme_databook_document.pdf)) - **180 days** is the general EEOC charge deadline, or 300 in many states. Discrimination claims expire while you’re still deciding what to do ([EEOC](https://www.eeoc.gov/time-limits-filing-charge)) ## Not in trouble? Good. Start your file anyway. Every resident who has contacted us so far reached out after dismissal, when the handbook had been revised, the evaluations were behind a disabled login, and the agreement was in a drawer at the hospital. The Residency Record is a free, private place to keep those documents now, with the dates that follow from your agreement. - A checklist of seventeen documents, with the ACGME requirement behind each - Private storage Resident Help cannot read - The latest non-renewal notice date under your institution’s policy - Every license, certification, and deadline, exported to your calendar Create your free account: [https://www.residenthelp.org/login](https://www.residenthelp.org/login) How the Residency Record works: [https://www.residenthelp.org/record](https://www.residenthelp.org/record) **Start with three** 1. **Your resident agreement.** Signed, with every addendum. ACGME requires it to cover pay, reappointment, due process, coverage, and leave. 2. **The GME handbook and due process policy.** The version in force this year. Disputes are judged against the one you were under, not the one posted later. 3. **Your evaluations, as they post.** Including the favorable ones. Two years of “meets expectations” changes how a sudden deficiency reads. Most residents can find all three in ten minutes while they still have access. ## Appeal windows in GME can be days, not weeks. Some institutions give a resident only a day or two to decide between resignation and dismissal. Mark the deadline on the intake form and we will triage it the same day. Save a copy of your contract, the institutional grievance and due process policy, and every written notice you have received. Policies change year to year, and the version in force on your dates is the one that matters. Start with a short form: [https://www.residenthelp.org/intake](https://www.residenthelp.org/intake) Know your rights first: [https://www.residenthelp.org/rights](https://www.residenthelp.org/rights) **Reach out at any of these moments** - You were placed on remediation or a performance improvement plan - You were told you are on probation, or that probation is being considered - You received a notice of non-renewal, suspension, or termination - You were asked to resign, sometimes within a day or two - You are worried about board eligibility or reporting obligations - You raised a concern about hours, safety, discrimination, or health and things changed after Earlier is easier, but later is never pointless. There is no stage where we would rather you had stayed silent. ## Promoted. Credentialed. Awarded. Dismissed in ninety days. A PGY-2 rated “Meets Expectations” in every domain stopped a procedure mid-shift because they were too fatigued to do it safely, the decision residents are trained to make. What happened next is why this organization exists. > I made a safety decision. I stopped a procedure on myself. That is supposedly the thing they teach us to do. > > From My Story Read the full story: [https://www.residenthelp.org/story](https://www.residenthelp.org/story) ## If any of these have started, the clock has too Each one has its own rules, and its own mistakes to avoid in the first 72 hours. ### A meeting with no stated subject Scheduled at an odd hour, with more people in the room than you expected. What you say is being recorded in someone’s notes. What you’re not told is deliberate. ### Sudden administrative leave “Paid leave” sounds harmless. It removes you from the building while a record is assembled without you, sometimes while you’re on protected medical leave. ### A fitness-for-duty or drug-test referral Forced medical exams have a federal legal standard: job-related, consistent with business necessity, based on objective evidence. Not vibes. ### A hearing where your lawyer can’t speak Short notice, no recording, no questions allowed. You can still preserve every objection in writing, if you know to do it before you walk in. ### Resign by tomorrow morning, or else A deadline, a promise about your file, and the documents you’d need to decide, withheld. Licensing boards will still ask about that resignation forever. ### Paperwork that appears after the decision Evaluations dated before events they describe. Summatives created after a dismissal. Metadata doesn’t lie, if you know to preserve it. Know your rights, with sources: [https://www.residenthelp.org/rights](https://www.residenthelp.org/rights) **A recent outcome:** In a matter we worked on, a program dismissed a resident before letting them finish a required evaluation and remediation. On a written appeal, the institution's appeal committee found due process had not been followed, and the dismissal was rescinded. [Read the case study](https://www.residenthelp.org/blog/case-study-dismissed-before-required-step-finished). Every matter turns on its own record, and prior results do not guarantee a similar outcome. ## Guidance you can act on this week ### [Your residency dismissal was rescinded on appeal. What now?](https://www.residenthelp.org/blog/residency-dismissal-rescinded-on-appeal-what-next) Practical Guidance A rescinded dismissal is a win, not the end. What to get in writing in the first days back: the return plan, the steps you were not allowed to finish, your pay and status, your record, and, on a J-1, your sponsor. ### [Intealth (ECFMG) and residency dismissal: a guide for IMGs](https://www.residenthelp.org/blog/intealth-ecfmg-residency-dismissal-img) Practical Guidance Every international medical graduate trains with Intealth, formerly known as ECFMG, in the background. For an IMG on an Intealth-sponsored J-1, a dismissal or a resignation in lieu of dismissal can end sponsorship on a short clock. What Intealth does, what it does not do, and what to do first. ### [Your residency program wants you to resign. Here is what a realistic outcome can look like.](https://www.residenthelp.org/blog/what-you-can-negotiate-when-your-program-wants-you-to-resign) Practical Guidance Most residents in this position are not choosing between winning and losing. They are choosing between a separation that follows them and one that does not. These are the terms that can be asked for, and the ones that rarely move the outcome. All posts: [https://www.residenthelp.org/blog](https://www.residenthelp.org/blog) ## Ten minutes now beats ten years of explaining a file you never read. The intake is confidential and costs nothing. And if you’re not the one in trouble, send this to the resident who is. They’ll know why you sent it. Start your confidential intake: [https://www.residenthelp.org/intake](https://www.residenthelp.org/intake) Or start your free Residency Record: [https://www.residenthelp.org/record](https://www.residenthelp.org/record) ## More guidance - [Facing dismissal from residency](https://www.residenthelp.org/dismissal): What usually happens, the deadlines already running, the due process you are owed, and help within 48 hours. - [Questions residents ask, answered](https://www.residenthelp.org/faq): Short answers to every question our guides cover, from resignation offers and appeal deadlines to accommodations and visas. - [Resign or be dismissed: what to do in the first 48 hours](https://www.residenthelp.org/blog/resign-or-be-dismissed-residency-first-48-hours): Programs often present resignation and dismissal as the only two choices, with a deadline measured in hours. The deadline is usually negotiable, the choices are usually not the only ones, and what you do before it expires shapes everything that follows. - [Deadlines you cannot miss after a residency dismissal or adverse action](https://www.residenthelp.org/blog/deadlines-after-residency-dismissal): An adverse action in residency starts several clocks at once. The internal ones are short and usually negotiable. The outside ones are long but unforgiving. This is the list, with what each clock runs from and which ones can be extended. - [Remediation, probation, non-renewal, dismissal: what each word actually means in GME](https://www.residenthelp.org/blog/remediation-probation-non-renewal-dismissal-what-each-means): Graduate medical education discipline runs on a ladder of terms that sound interchangeable and are not. Which word your program uses determines what rights attach, what gets disclosed later, and what to do next. - [Court decisions on resident dismissal and probation](https://www.residenthelp.org/cases): Published opinions every resident should know before a probation, dismissal, or forced-leave decision. --- Source: https://www.residenthelp.org Publisher: Resident Help (https://www.residenthelp.org) This website provides general information and is not legal advice. Using this site or submitting a form does not create an attorney client relationship.