Where you are, and what comes next

Residency discipline follows a sequence. It does not always start formally, and it does not always end with a hearing, but almost every matter we see moves through the same four phases. Knowing which one you are in tells you three things: what your program owes you right now, what to do this week, and when a lawyer starts to matter.

Find your phase below. If you are not sure, start a free, confidential intake and describe the last thing your program put in writing.

Phase	You are here if	What attaches
1. Before the plan	A meeting with no stated subject, informal counseling, a committee referral, a leave, nothing formal yet	Your program's policies and your file. No formal due process yet.
2. Remediation or probation	A performance improvement plan, remediation plan, or probation is in force	A written record you help build. Usually no hearing right.
3. Appeal	A written notice of suspension, non-renewal, non-promotion, or dismissal	Due process under your institution's policy, on a short clock.
4. After the internal process	The appeal is over or not worth pursuing, or you have been offered a resignation or separation	Outside paths on their own clocks, often more than one.

Phase 1: Before the plan

You are here if nothing formal has been issued, but the attention has changed. A meeting is scheduled with no subject. You have been counseled, formally or informally. You have been referred to the Clinical Competency Committee, placed on administrative leave, or sent for a fitness-for-duty evaluation. Or you are not in trouble, and want to make sure you never are.

What your program owes you. Written criteria for promotion and renewal, a written grievance procedure, and a due process policy for the serious actions. The ACGME requires your institution to have all three. Find yours today, and read it for the mechanics: who decides, what notice you get, how many days you have.

What to do this week.

• Save your agreement, the handbook and due process policy in force this year, and every evaluation, to a personal account. The free Residency Record is built for this.
• Start a dated log of every conversation. One line per event.
• Before any meeting, read what to say at a first meeting with your program.
• If a leave or evaluation is involved, ask in writing what policy it falls under and what ends it.

How we help. We review what you have, for free, and tell you plainly what the program can and cannot do next. Most residents in phase 1 do not need a lawyer yet. What they need is to know which rights attach to which action, and to have the file ready before anyone else writes it for them.

Guides for this phase: what each disciplinary term means, the patterns we see, get your file before you leave, who to contact above your program director, FMLA and leave, requesting an accommodation.

All phase 1 guides.

Phase 2: Remediation or probation

You are here if a performance improvement plan, remediation plan, or probation is in force. The program has put in writing that it believes your performance is below expectations and will measure you against a plan.

What your program owes you. A plan you can actually complete: named deficiencies, completion criteria, review dates, and who decides. Remediation is usually framed as academic and usually carries no hearing right, so the protection at this phase is the record, not a panel. A plan that is specific and achievable is a plan. A plan with vague standards, impossible timelines, or language that changes after you sign is often a checkpoint on the way to phase 3, and should be treated that way.

What to do this week.

• Get the plan in writing and read exactly what it requires. See the first week on a PIP.
• Sign as acknowledgment of receipt, not agreement with facts you dispute, with a written reservation if needed.
• Complete every task the plan requires, on time, and keep your own dated proof. A missed reflection log is the easiest failure to manufacture.
• Calendar the grievance deadline in your handbook, often ten business days from the plan.
• If you raised a concern before the plan arrived, read a PIP after a mistreatment report.

How we help. We review the plan and your file, help you respond in writing, and hold the program to its own policy and its own completion criteria. If the plan reads like a path to dismissal, we say so, and we connect you with independent counsel while there is still time to shape the record. If you are offered a last chance agreement, get advice before you sign it.

All phase 2 guides.

Phase 3: Appeal

You are here if you have received written notice of suspension, non-renewal, non-promotion, or dismissal. These are the actions the ACGME requires due process for, and your institution's policy sets a deadline, often days, for a written appeal or a hearing request.

What your program owes you. Written notice of intent before non-renewal, non-promotion, or dismissal. The appeal or hearing your policy describes. Reviewers who did not make the original decision, under a policy that minimizes conflicts of interest. Access to the evaluations and documents the decision relied on. See what your program owes you and whether a resident can be dismissed without a hearing.

What to do this week.

• Find the deadline and the clock it runs from. If it is days away, read your appeal deadline is days away and ask for an extension in writing today.
• File the request on time, with a demand for your file. Use the grievance and appeal letter template.
• Map each step the policy requires against what was actually done, with dates.
• Prepare for the hearing: how a GME due process hearing works. If lawyers are barred from the room, the case is built on paper.
• If you are on a J-1 or H-1B, get immigration advice the same week. See Intealth (ECFMG) and residency dismissal.
• Do not resign to make it stop before you have had advice. See phase 4.

How we help. We review the notice and the policy, find every deadline, and tell you what the appeal turns on. This is the phase where a lawyer matters most, and we connect you with independent counsel within 48 hours, at a reduced flat fee. Counsel helps with the written statement, the exhibits, the extension request, and the objection to the panel, even where counsel cannot speak at the hearing. See how to appeal a residency dismissal. Appeals can succeed: a dismissal rescinded on appeal.

All phase 3 guides.

Phase 4: After the internal process

You are here if the appeal is over, or is not worth pursuing, or the program has offered a resignation, an election, or a separation. The internal process has reached its end. What remains are outside paths, each with its own purpose and its own clock. Often more than one applies, and some of these clocks were already running during phase 3.

Path	What it decides	The clock
Negotiated separation	How the exit is labeled, what the summative says, training credit, pay, and what gets reported	Before you sign anything
ACGME complaint	Whether the program or institution complies with accreditation requirements. It does not reinstate a resident.	Current or immediately preceding academic year
EEOC charge	Employment discrimination. A required step before a federal discrimination suit.	180 days from the act, or 300 where a state or local agency applies, whatever your appeal is doing
Litigation	Claims under your contract, your institution's policy, or discrimination law, through a lawyer	Varies by state and claim. Measured in years.

What to do this week.

• If you have been asked to resign, read what resignation changes and the first 48 hours before you answer. Ask for the documents and more time in writing.
• Know what can be negotiated: your record, the exit label, the summative, training credit, pay, and reporting.
• File the internal grievance on time even if you plan to leave. It preserves the record every outside path relies on.
• Check the outside clocks now: ACGME report or EEOC charge, and every deadline after a dismissal.
• Learn what follows you: what the NPDB actually reports, training verification, and board eligibility clocks.

How we help. We help you see every path side by side, with its clock, before you choose. For a negotiated separation, we connect you with independent counsel who handles the terms, so what follows you is accurate and complete. For an EEOC charge or litigation, counsel who has read your file decides whether and when to file. Ask whether counsel would take the matter on contingency, and we tell you plainly when that is worth exploring. We do not predict outcomes in either direction. We do make sure no clock runs out while you are deciding.

All phase 4 guides.

The one rule that applies in every phase

The matter will be decided on paper, and most of that paper is written by the other side. At every phase, the thing you can control is the record: what you asked for in writing, what you saved, and what you did on time. Start the record now, whichever phase you are in. Start a free, confidential intake, or begin a free Residency Record if nothing has happened yet.

Every matter turns on its own record, contract, and policies, and a similar sequence can end differently. This is general information, not legal advice.

Resident Help is not a law firm, and submitting an intake does not create an attorney-client relationship. If your situation needs a lawyer, we will tell you and help you find one.