Resident Handbook

Graduate Medical Education

Salary | Policies & Procedures | Resident/Fellow Benefits | General Info

2025-2026 Resident/Fellow Salaries

PGY I	$61,621.00
PGY II	$63,463.00
PGY III	$65,734.00
PGY IV	$68,247.00
PGY V	$70,748.00
PGY VI	$73,432.00

Resident-Fellow Contracts

Policies & Procedures

ABUSE OF INFORMATION TECHNOLOGY RESOURCES
(Approved 5/23/2024 by GMEC)

Purpose
To clearly outline the consequences of the acquisition and use of technology to access unauthorized areas, to obtain information to which a resident has not been given permission, or to use IT resources in a manner that does not comply with laws and regulations, university policies, and contractual obligations.

Policy

New and ongoing technology and software advances can be used to improperly access secure hospital areas, HIPAA-protected health information, or personal or private information belonging to others. Each Quillen College of Medicine trainee is responsible for their actions including the inappropriate use of information technology (IT) resources.

Policy Activities
Technology advances continue at a rapid pace with many being used to assist clinicians in their care of patients such as electronic medical records and artificial intelligence to assist in diagnosis and treatments. Other technologies can be acquired and/or utilized that can subject trainees to personal harm or legal consequences.

Examples of IT resources or data abuse and violations of policy include, but are not limited to:
- Unauthorized access to or unauthorized use of Ballad Health, VA Medical Center, ETSU Health, QCOM, or ETSU information technology sites or resources
- Use of resources in violation of any applicable law or regulation
- Security breaches, intentional or otherwise, resulting in unauthorized access, use, or acquisition of personal or patient data or locations, including accessing one's own medical record
- Installation, distribution, or intentional use of malicious software
- Breach of confidentiality rules
- Unauthorized access to IT resources
- Unauthorized use of IT resources
- Dissemination, hosting, or posting obscene material
- Use of implantable devices to gain access to secure areas in clinical sections or educational sites to which routine resident/fellow access has not been made available
For additional information and details please review the Accessible Use of Information Technology Resources policy located at: Acceptable Use of Information Technology Resources.pdf

Use of Artificial Intelligence
There is an increasing presence of artificial intelligence (AI) being used in medicine, science, and education. Many faculty and trainees are exploring its use within the academic setting; however, AI should not be used as a substitute for trainees' own analytical or clinical thinking or used in completing one's own assignments or tasks.
- Trainees may not use AI for any submitted assignments.
- Trainees may not use AI for any individual or group assignments.
- Trainees may not use AI for examinations of any type.
Reporting Violations
Suspected violations should immediately be reported to either the Office of Graduate Medical Education or to the appropriate department for handling the alleged offense. Any trainee found to violate this policy will be referred to the appropriate institutional or college of medicine disciplinary process according to whether the violation(s) are of institutional or college of medicine policy. A trainee may be subject to immediate dismissal from their training program dependent upon the egregiousness of the offense and/or subject to legal action dependent upon the violation.
ACCOMMODATION FOR DISABILITIES POLICY

IR IV.I.4. ETSU Policy PPP-45
(Approved 7/12/2002, Revised/Approved 8/23/2018, 1/26/2023 by GMEC)

Purpose
The purpose of this policy is to outline the process whereby a resident or fellow in a Graduate Medical Education (GME) Program sponsored by East Tennessee State University, Quillen College of Medicine may request accommodations for a disability.

Policy
It is the policy of East Tennessee State University, James H. Quillen College of Medicine to provide reasonable accommodations as necessary for qualified individuals with disabilities who are accepted in to our post-graduate training programs. We will adhere to all applicable federal and state laws, regulations, and guidelines with respect to providing reasonable accommodations as required in accordance with the policies and procedures of the University.

University Policies and Procedures may be accessed at:
ETSU's Disability Services

East Tennessee State University is in compliance with the requirements of: Title VII of the Civil Rights Act of 1964: Title IX of the Educational Amendments of 1972: Section 504 of the Rehabilitation Act of 1973; the Americans with Disabilities Act of 1990; regulations of the Internal Revenue Service; and all other applicable federal, state and local statutes, ordinances and regulations.

The Graduate Medical Education Office will work with the University Office of Disability Services in determining if a resident has a disability and what accommodations may be reasonable and necessary for the College of Medicine to provide. Residents will still be required to meet all program educational requirements with or without accommodations as they must be able to demonstrate proficiency in all of the ACGME defined competencies and programs must certify that they are able to enter autonomous practice in the specialty in which they have been trained competently. This includes the ability to perform the required technical and procedural skills of the specialty. Patient safety must be assured as a top priority in these determinations. Residents must request accommodations in writing to the Program Director. At that time the resident will be required to provide medical verification of a medical condition that he or she believes is a disability to the Office of Disability Services. The resident is responsible for the costs of obtaining verification. Disability Services will notify the Program Director and the Designated Institutional Official of their termination.

Any resident or fellow seeking accommodation should contact the East Tennessee State University Disability Services Office, Suite 390, D.P. Culp Center, Johnson City, TN, 37614, (423) 439-8346 or ETSU Disability Services
ALERTNESS / FATIGUE MITIGATION POLICY

IR III B.5.a (2)
(Approved 7/1/2017, Revised/Approved 2/1/2018, Reviewed/Approved 12/1/2022 by GMEC)

Purpose
The purpose of this policy is to set institutional standards of recognition of the signs of Fatigue Mitigation for residents/fellows in compliance with the policies of the Accreditation Council for Graduate Medical Education.

Policy
East Tennessee State University, Quillen College of Medicine ensures that all residency/fellowship programs provide education for their faculty, residents and fellows to recognize the signs of fatigue and sleep deprivation, provide education in alertness management and fatigue mitigation processes, and must adopt and apply policies to prevent and counteract the potential negative effects on patient care and learning such as back-up call schedules and strategic napping. Education in recognizing sleep deprivation and fatigue mitigation is provided to all new incoming residents as part of the annual new resident institutional orientation. As part of onboarding, all incoming trainees are required to complete online training modules on fatigue. This education module addresses the hazards of fatigue and ways to recognize and manage sleep deprivation.

All residency and fellowship programs must provide education specifically addressing the signs of fatigue/sleep deprivation and the effects on patient care and clinician health. The program must specifically address fatigue mitigation techniques including but not limited to strategic napping and good sleep hygiene. Appropriate facilities must be available to permit sleeping while on in-house call and strategic napping as required.

The program director must monitor duty hours and adjust schedules as necessary to mitigate excessive service demands and/or fatigue. The program director must also monitor the need for and ensure the provision of backup support systems when patient care responsibilities are unusually difficult or prolonged. In accordance with duty hours and transition of care requirements, programs must have a process in place to ensure continuity of care in the event that a resident may be unable to perform patient care duties due to fatigue, illness or other impairments.

Taxi services are available to all residents/fellows who feel that he/she cannot drive home safely due to fatigue or excessive sleepiness. Information on taxi service is available via our GME website, and the resident management system and disseminated by program administrators. This is at no cost to the resident/fellow.
AUTHORSHIP POLICY

CPR IV.B.
(Approved 10/26/2017, Revised/Approved 10/24/2019, Revised/Approved 10/24/2024 by GMEC)

Every manuscript and/or abstract that is sent out under the auspices of ETSU and/or Quillen College of Medicine must have a GME faculty member or ETSU QCOM faculty member in good standing as a co-author. This faculty need not be the corresponding or first author, however, the faculty author should have the credentials and be in a position to take responsibility for the scientific, procedural (e.g., IRB) methodological, etc. soundness of the submission.

It is the responsibility and duty of the program director to make this requirement known to residents/fellow and GME faculty alike.

This policy should be reviewed and documented at regular intervals along with other GME and program policies. The program director should monitor compliance with this policy during portfolio review at semi-annual evaluations. Any resident/fellow who fails to follow this policy shall be subject to the full range of disciplinary options available to the program director from verbal warning, letter of focused improvement, probation and termination for severe or repeated violations.
CLINICAL EXPERIENCE AND EDUCATIONAL WORK HOURS POLICY (previously known as Duty Hours)

IR IV.K.
(Approved 7/1/2017, Revised/Approved 12/5/2019, Reviewed/Approved 12/5/2024 by GMEC)

Clinical and educational work hours must be limited to no more than 80 hours per week 1 averaged over a 4-week period, inclusive of all in-house clinical and educational activities, clinical work done from home, and all moonlighting.

Residents must have eight hours off between scheduled clinical work and education periods. There may be rare circumstances, after handling off all other responsibilities, when on their own initiative, may elect to remain or return to the clinical site in the following circumstances: to continue to provide care to a single, severely ill or unstable patient, to give humanistic attention to the needs of a patient or patient's family, or to attend unique educational events. This must occur within the context of the 80-hour and the one-day-off-in-seven requirements.

A Review Committee may grant rotation-specific exceptions for up to 10 percent or a maximum of 88 clinical and educational work hours to individual programs based on a sound educational rationale. In preparing a request for an exception, the program director must follow the clinical and educational work hour exception policy from the ACGME Manual of Policies and Procedures.

Residents must be scheduled for a minimum of one day in seven free of clinical work and required education (when averaged over four weeks). At-home call cannot be assigned on these free days.

Clinical and educational work periods for residents must not exceed 24 hours of continuous scheduled clinical assignments. Up to four hours of additional time may be used for activities related to patient safety such as providing effective transitions of care, and/or resident education. Additional patient care responsibilities must not be assigned to a resident during this time.

Residents must have at least 14 hours free of clinical work and education after 24 hours of in-house call. Residents must not be scheduled for more than six consecutive nights of night float.

Residents must be scheduled for in-house call no more frequently than every third night (averaged over a four-week period). Time spent in the hospital by residents on at-home call must count towards the 80-hour maximum hour limit. The frequency of at- home call is not subject to the every-third-night limitation, but it must satisfy the requirements for one-day-in-seven free of duty, when averaged over 4 weeks. At-home call must not be frequent or taxing as to preclude rest or reasonable personal time for each resident.

Residents in the final years of education (as defined by the Review Committee) must be prepared to enter the unsupervised practice of medicine and care for patients over irregular or extended periods (within the context of the 80 hour, maximum duty length and 1 day off in 7 standards).

Clinical and educational experiences are monitored by each residency/fellowship p program and by the GME office. Confirmed work hour violations are subject to review and possible action.
CLOSURE AND REDUCTION POLICY

IR IV.O., IV.O.1.2
(Approved 7/1/2007, Revised/Approved 2/1/2018, Reviewed/Approved 1/26/2023 by GMEC)

Purpose

The purpose of this policy is to provide guidance should it be necessary for a reduction in the size of an ACGME - accredited graduate medical education program sponsored by East Tennessee State University's Quillen College of Medicine or the closure of a program or closure of Quillen College of Medicine.

Policy
In the event East Tennessee State University's Quillen College of Medicine intends to reduce the number of positions or close a residency or fellowship training program, the College of Medicine will:

Notify the GMEC, DIO, and affected residents and fellows as soon as possible when it intends to reduce the size or close one or more Programs.

The GMEC has responsibility for oversight of all processes related to the reduction or closure of Programs, participating sites, and the Sponsoring Institution.

If reasonably possible, reductions will be made over a period of time to allow all residents to complete training within their Program or complete training at Quillen College of Medicine, provided educational opportunities consistent with accreditation continue to exist.

In the event that an ACGME action or decreased financial or educational resources force the closure of a training program at Quillen College of Medicine and it is not possible for continued training at the affected programs; then the programs with oversight by the GMEC, will assist residents in enrolling in another ACGME accredited program in which they can continue their education.

A list of all approved programs can be found on the ACGME website, which will serve as a resource to identify programs that may be able to accept permanent transfers. Receiving programs must appoint transferring residents to approved positions. Permanent increases in resident complement requests should be made through each program's respective ACGME Review Committee, on the ACGME's Accreditation Data System.

Disruptions in Patient Care or Education

The process for the temporary or permanent transfer of residents due to a substantial disruption in patient care or education are detailed in the Quillen College of Medicine Graduate Medical Education Disruptions in Patient Care or Education Policy. Examples of an extraordinary circumstances include an abrupt closure of a hospital, a natural disaster, or a catastrophic loss of funding.
CONSENSUAL RELATIONSHIPS POLICY

ETSU Policy PPP-80
(Approved 11/22/2019, Reviewed/Approved 3/9/2023 by GMEC)

Purpose:

The purpose of this policy is to address one type of conflict of interest, consensual relationships involving students. In context to Graduate Medical Education

Policy:

The educational mission of East Tennessee State University (ETSU) requires that the relationship between faculty and students be professional in nature. Similarly, the University is committed to protecting the integrity and objectivity of its staff members in the performance of their duties. ETSU deems it fundamental that every faculty and staff member maintain a professional relationship with every student of the University so that professional responsibilities may be carried out in an atmosphere free of conflicts. This policy works in conjunction with ETSU's Conflict of Interest Disclosure Review Committee policy, PPP-72.

This policy applies to sexual or amorous relationships, regardless of who initiates the relationship, the employee is responsible for complying with this policy.
Nothing in this policy should be construed as prohibiting the spouse of a faculty or staff member from enrolling as a student. Nothing in this policy should be construed as prohibiting the spouse of a student from accepting employment as a faculty or staff member.
Complaints concerning sexual harassment directed at a student, faculty, or staff member are resolved under PPP-80, Discrimination and Harassment - Complaint and Investigation Procedure.

a. Should an amorous or sexual relationship in violation of this policy lead to a sexual harassment or discrimination charge, the Office of University Compliance investigates and resolves the charge in accordance with PPP-80.
b. In cases where a reporting party alleges both unwanted sexual behavior and a consensual sexual relationship with an evaluative authority, the two complaints will be considered separate allegations.

Undergraduate Students
Any sexual or amorous relationship between an undergraduate student and a faculty or staff member is prohibited at East Tennessee State University.

Graduate Students
Any sexual or amorous relationship between a graduate student and a faculty or staff member with evaluative authority over that student is prohibited at East Tennessee State University.
Intimate relationships between a faculty or staff member with evaluative authority over a student create a conflict of interest due to the inherent inequality of power in such situations. Such relationships may also adversely affect faculty, staff, and students who are not direct parties of the relationship itself, leading them to believe there is favoritism even if there is not.

Relationships Between Employees
Sexual or amorous relationships between faculty members, faculty and staff members, or staff members, where one person exercises evaluative or supervisory authority over the other are prohibited.

Past and/or Preexisting Relationships
A faculty or staff member who has had a past or preexisting sexual or amorous relationship with a student is prohibited from exercising evaluative authority over that student.

Violations of Policy
Violations of this policy by employees shall result in disciplinary action, up to and including termination.
SUBSTANTIAL DISRUPTIONS IN PATIENT CARE OR EDUCATION POLICY (Disaster and Extraordinary Circumstances)
IR IV.N.
(Approved 7/12/2007, Revised/Approved 2/22/2018, Reviewed/Approved 1/26/2023 by GMEC)

Purpose:

In the event of a substantial disruption(s) in patient care or education, or a disaster or catastrophic event altering the ability of East Tennessee State University's College of Medicine and the ACGME-accredited graduate medical education programs sponsored by Quillen College of Medicine to support its residents and fellows, the policies and procedures in this Substantial Disruptions in Patient Care of Education Policy apply.

Definition Disaster: An event or set of events causing significant alteration to the residency experience at one or more residency programs.
Extraordinary Circumstances: A local event (such as hospital-declared disaster for an epidemic) that affects resident education or the work environment but does not rise to the level of an ACGME-declared disaster in the ACGME Policies and Procedures, 25.00.

Policy:

East Tennessee State University, Quillen College of Medicine, acknowledges its ongoing support of graduate medical education in the face of any disaster (natural or otherwise) that interrupts the hospital/clinic-based educational process. This ongoing support consists of the following commitments:
- The Dean and College of Medicine administration, working with the graduate medical education affiliated hospitals, will strive to ensure financial and logistical support of residents until normal educational site(s) resume clinical activity.
- The Office of Graduate Medical Education will maintain contact with all residents during any times of disruption, and provide assistance toward resuming the educational experience as soon as possible. To fulfill this commitment, resident demographic data will be collected and electronically secured off-site from the College of Medicine/University campus.
- The Office of Graduate Medical Education, working with the various departments and training programs, will coordinate efforts to provide an alternate educational venue that is convenient and provides appropriate educational experience when necessary.
A. Disaster Response
During a disaster or other substantial disruption in patient care, Program Directors or their designees, working with Program Site Directors (as applicable) shall take immediate accountability of the location and safety of all Program resident(s) affected by the disaster or interruption. Program Directors will contact the DIO to confirm the safety of all residents. All ACGME Requirements continue to apply.

The Program Director and/or designated Site Director at each participating site will be responsible for determining the operational status of each participating site and advising the Program Director or DIO, as applicable, of any necessary relocation or resident education and patient care activities as a result of the disaster or disruption. The DIO, working with the affected Program Director, the Quillen College Medicine Office of Graduate Medical Education ("Office of GME") and the GMEC will assess what steps need to be taking to assist any residents who are facing a potential disruption in their training.

The GMEC shall oversee any Program closures or Program reductions consistent with the Quillen College of Medicine Institutional and/or Program Closure/Reduction Policy and shall review and approve any major changes to a Program's structure or duration of education, including a change in the designation of a Program's primarily clinical site. If the request is associated with a declaration of extraordinary circumstances, below, ACGME Review and Recognition Committees expedite review of ACGME-accredited program requests to add or delete participating sites or change program educational formats.

Programs will focus on strategies to utilize the existing Ballad Health System and the Veterans Affairs Health System to provide temporary clinical settings for displaced residents. If these regional clinical sites are not available, the Program Director and Chair, along with the Graduate Medical Education Office, will strive to place residents in an educationally rewarding environment as close to this region as possible.

The various programs will coordinate their efforts with the appropriate Residency Review Committee and the ACGME to ensure an approved experience for displaced residents. In the aftermath of the disruption of graduate medical education, the College of Medicine will work to restore the clinical teaching environment as soon as possible so that residents may return to their pre-disaster hospital/clinic setting.

B. Extraordinary Circumstances
In response to circumstances that significantly after the ability of Quillen College of Medicine and its programs to support graduate medical education, the ACGME may invoke the Extraordinary Circumstances Policy. Examples of extraordinary circumstances include the abrupt closure of a hospital, a natural disaster, or a catastrophic loss of funding.

The ACGME may invoke the Extraordinary Circumstances Policy at the request of the DIO. The ACGME may also invoke the Extraordinary Circumstances Policy in response to verified public information or on the basis of other information received by the ACGME. The ACGME President and Chief Executive Officer, consults with the ACGME Board Chair to determine if sponsoring institution's ability to support graduate medical has been significantly altered.

If the ACGME invokes its Extraordinary Circumstances Policy, a notice will be posted on the ACGME website with information relating to the ACGME's response to the extraordinary circumstance(s) and relevant ACGME contact information upon invocation of the Policy.

The DIO, or designee(s), on behalf of the Quillen College of Medicine, once the Extraordinary Circumstances Policy is invoked, shall:
1. Within ten (10) day of the invocation of the policy, contact the ACGME President and Chief Executive Officer, or designee, to provide information regarding then available and known major changes to the Sponsoring Institution and its Programs resulting from the extraordinary circumstance;
2. Within thirty (30) days of the invocation of the policy, unless another due date is approved by the ACGME, provide a plan describing the continuation of residents' educational experiences and any major changes to the Sponsoring Institution and its Programs, to the ACGME President or Chief Executive Officer, consistent with the applicable ACGME requirements;
3. Arrange timely reassignments of residents, including their temporary or permanent transfers to other ACGME-accredited programs, and ensure that residents are prospectively informed of the estimated duration of any temporary transfer to another ACGME-accredited program; and
4. Ensure that residents receive timely, continual information regarding reassignment, transfer assignments and/or major changes to ETSU's Quillen College of Medicine or its programs.
DELINQUENT MEDICAL RECORDS POLICY

CPR IV.B.1.e).(1).(f)
(Approved 7/12/2007; Revised/Approved 2/16/2015, Revised/Approved 9/15/2021 by GMEC)

Residents are expected to maintain comprehensive, timely and legible medical records. A resident who is identified as having delinquent medical records (any record considered delinquent by hospital bylaws) will be notified and given five (5) days to report to the hospital to complete the records. Any records not available to the resident at that time will become the responsibility of the attending physician of record. If the resident is on leave and/or cannot receive notification or access to the medical record the attending physician of record will be responsible for completing the record. If the resident does not report within the five (5) day period, he/she will be subject to suspension. Each day of suspension will be counted as one day of annual leave; if there is no available annual leave, the resident will be placed on leave without pay. Extended lengths of suspension may require added time at the end of resident's original program end date.
DISCRIMINATION & HARASSMENT - COMPLAINT & INVESTIGATION PROCEDURE (ETSU POLICY)

IR IV.I.5./IV.I.3.) - ETSU Policy PPP-80
(Approved 11/15/2012, Revised/Approved 3/24/2016, Reviewed/Approved 8/23/2018 by GMEC, Reviewed/Approved 8/24/2023 by GMEC)

ETSU and Quillen College of Medicine prohibit faculty, staff, residents, and fellows from engaging in sexual harassment, discrimination, and retaliation, and inform members of the graduate medical education community how to report potential violations of this policy.

ETSU prohibits discrimination, harassment, or sexual misconduct based on any federally or state protected classes and includes race, color, or ethnicity; sex, sexual orientation, gender, gender identity, or gender expression; national origin; marital or parental status; religion; age; disability; veteran's status; and/or genetic information in education programs, activities, and employment.

This policy is not intended to infringe upon academic freedom or censor or punish members of the university community who engage in activity protected by the First Amendment.

This policy applies to all levels and areas of university operations and programs, undergraduate and graduate students, administrators, faculty, staff, volunteers, vendors, and contractors.

Individuals may report discrimination or harassment without fear of adverse consequences, and East Tennessee State University and Quillen College of Medicine will be responsive to reports.

Important: Other Available Complaint Procedures
An aggrieved individual may also have the ability to file complaints with external agencies such as the Equal Employment Opportunity (EEOC), the Tennessee Human Rights Commission (THRC), the Office of Civil rights (OCR), and the courts. Please note that the deadlines for filing with external agencies or courts may be shorter than the deadline established for filing a complaint under this Guideline. Examples of shorter deadlines include, but are not limited to 180 days to file a complaint under Title VI & Title IX, as well as 300 days to file a complaint under Title VII.

General Statement
It is the intent of the Tennessee Board of Regents that the Board and all of the institutions within the Tennessee Board of Regents System (including East Tennessee State University) shall fully comply with the applicable provisions of federal and state civil rights laws, including but not limited to, Executive Order 11246, as amended; the Rehabilitation Act of 1973, as amended; the Americans with Disabilities Act of 1990, as amended; the Vietnam Era Veterans Readjustment Act of 1974, as amended; the Equal Pay Act of 1963, as amended; titles VI and VII of the Civil Rights Act of 1964, as amended: Title IX of the Educational Amendments of 1972, as amended; the Age Discrimination in Employment Act of 1967; the Age Discrimination Act of 1975; the Pregnancy Discrimination Act; the Genetic Information Nondiscrimination Act of 2008; and regulations promulgated pursuant thereto. The Board of Regents and ETSU will promote equal opportunity for all persons without regard to race, color, religion, creed, ethnic or national origin, sex, sexual orientation, gender identity/expression, disability, age (as applicable), status as a covered veteran, genetic information, and any other category protected by federal or state civil rights law.

Campuses and the Central Office affirm that they will not tolerate discrimination against any employee or applicant for employment because of race, color, religion, creed, ethnic or national origin, sex, sexual orientation, gender identity/expression, disability, age (as applicable), status as a covered veteran, or genetic information, nor will they tolerate harassment on the basis of these protected categories or any other category protected by federal or state civil rights law.

Similarly, the campuses shall not subject any student to discrimination or harassment under any educational program and no student shall be discriminatorily excluded from participation nor denied the benefits of any educational program on the basis of race, color, religion, creed, ethnic or national origin, ex, sexual orientation, gender identify/expression, disability, age (as applicable), status as a covered veteran, genetic information, or any other category protected by federal or state civil rights law.

TBR Policy

Reports or complaints of Discrimination or Harassment may be filed with ETSU's Office of Compliance, Located in Burgin-Dossett Hall, Room 309, 1276 Gilbreath Drive, Johnson City, TN. (423) 439-8545or email compliance@etsu.edu.

Reports can be made anonymously using the online reporting form posted at Anonymous Reporting
DRUG- FREE CAMPUS POLICY
IR III.B.7.c. - ETSU PPP-26
(Approved 7/1/2002, Revised/Approved 9/22/2016, Reviewed/Approved 12/5/2019, Reviewed/Approved by GMEC)

I. Policy
It is the policy of this university that the unlawful manufacture, distribution, possession, use of alcohol and illicit drugs on the ETSU campus in the workplace (on or off campus), on property owned or controlled by ETSU, or as part of any activity of ETSU is strictly prohibited. All employees and students are subject to applicable federal, state and local laws related to this matter. Additionally, any violation of this policy will result in disciplinary action

II. Legal Sanctions
Various federal, state and local statutes make it unlawful to manufacture, distribute, dispense, deliver, sell or possess with intent to manufacture, distribute, dispense, deliver or sell, controlled substances. The penalty imposed depends upon many factors which include the type and amount of controlled substance involved, the number of prior offenses, if any, whether death or serious bodily injury resulted from the use of such substance, and whether any other crimes were committed in connection with the use of the controlled substance. Possible maximum penalties for a first-time violation include imprisonment for any period of time up to a term of life imprisonment; a fine of up to $4,000,000 if an individual; supervised release; any combination of the above; or all three. These sanctions are doubled when the offense involves either: 1.) distribution or possession at or near a school or college campus or, 2.) distribution to persons under 21 years of age. Repeat offenders may be punished to a greater extent as provided by statute. Further, a civil penalty of up to $10,000 may be assessed for simple possession of personal use amounts of certain specified substances under federal law. Under state law, the offense of possession or casual exchange is punishable as a Class A misdemeanor; if there is an exchange between a minor and an adult at least two years the minors senior, and the adult knew that the person was a minor, the offense is classified a felony as provided in T.C.A. Section 39-17-417. ( 21 U.S.C. Section 801, et. seq.; T.C.A. Section 39-17-417)

It is unlawful for any person under the age of twenty-one (21) to buy, possess, transport (unless in the course of his employment), or consume alcoholic beverages, wine, or beer. Such offenses are classified as Class A misdemeanors punishable by imprisonment for not more than 11 months, 29 days, or a fine of not more than $2,500, or both (T.C.A. Sections 1-3-113, 57-5-301). It is further an offense to provide alcoholic beverages to any person under the age of twenty-one (21), such offense being classified as a Class A misdemeanor (T.C.A. Section 39-15-404). The offense of public intoxication is a Class C misdemeanor punishable by imprisonment of not more than 30 days or a fine of not more than $50, or both (T.C.A. Section 39-17-310).III. Institutional/School Sanctions East Tennessee State University will impose the appropriate sanction(s) on any employee or student who fails to comply with the terms of this policy.

A. Employees
As a condition of employment, each employee, including student employees, must abide by the terms of this policy, and must notify the Office of Human Resources of any criminal drug statute conviction for a violation occurring in the workplace (on or off campus) no later than five days after such conviction. A conviction includes a finding of guilt, a plea of nolo contendere, or imposition of a sentence by any state or federal judicial body. Possible disciplinary sanctions for failure to comply with this policy, including failure to notify of conviction, may include one or more of the following depending on the severity of the offense:
- Termination
- Suspension
  mandatory participation in and satisfactory completion of drug/alcohol abuse program, or rehabilitation program
- Recommendation for professional counseling
- Referral for prosecution
- Letter for prosecution
- Letter of warning
- Probation
Moreover, the following certification and notification requirements apply (responsibility of Research and Sponsored Programs in coordination with Human Resources): A certification statement will be placed in all federal grant requests that the institution is complying with the Drug-Free Workplace Act of 1988 and the Drug-Free Schools and Communities Act Amendments of 1989.

All employees involved in the performance of federal contracts and grants will be furnished a written copy of this policy statement. In addition, they must certify that they will abide by the terms of the policy.

Upon receiving notice of a drug conviction by an employee involved in the performance of a federal contract or grant, the appropriate federal agency will be notified (upon approval by the University President) within ten (10) days of the notice of conviction.

B. Students
Possible disciplinary sanctions for failure to comply with the terms of this policy may include one or more of the following depending on the severity of the offense:
- Expulsion
- Suspension
- Mandatory participation in, and satisfactory completion of a drug/alcohol abuse program, or
  rehabilitation program
- Referral for prosecution
- Probation
- Restriction of privileges
- Educational project
- Assignment of volunteer work hours
- Referral to the University Counseling Center
- Written warning
- Reprimand
IV. Health Risks Associated With the Use of Illicit Drugs and the Abuse of Alcohol
There are many health risks associated with the use of illicit drugs and the abuse of alcohol including organic damage; impairment of brain activity, digestion, and blood circulation; impairment of physiological processes and mental functioning; and, physical and psychological dependence. Such use during pregnancy may cause spontaneous abortion, various birth defects or fetal alcohol syndrome. Additionally, the illicit use of drugs increases the risk of contracting hepatitis, AIDS and other infections. If used excessively, the use of alcohol or drugs singularly or in certain combinations may cause death.

V. Available Drug and Alcohol Counseling, Treatment, Rehabilitation Programs, and Employee Assistance Programs.

The university and local community provide a variety of educational programs and services to respond to the problems associated with alcohol and drug abuse. The Campus Alcohol and Other Drug (AOD) Program at East Tennessee State University is designed to serve university students by providing information related to alcohol awareness and chemical dependency. The Office of the Vice President for Student Affairs offers several educational programs which seek to involve university student organizations.

Below is a list of campus and community agencies which also provide referral, information, and/or counseling to students and/or employees:

ETSU Counseling Center (students only) 423-439-3333
ETSU Police Department 423-439-4480
ETSU Employee Assistance Program 423-439-5825
State of Tennessee Employee Assistance Program 1 (877) 237-8574
Alcoholics Anonymous 423-928-0871
Comprehensive Community Services
(Alcohol & Drug Counseling & Prevention Center) 423-928-6581
Woodridge Hospital 423-928-7111
Watauga Mental Health Center 423-232-6200
APPOINTMENT OF RESIDENT/FELLOW POLICY (Eligibility and Selection)
IR IV.B.1.
(Approved 7/12/2007, Revised/Approved 1/28/2016, Reviewed/Approved 8/23/2018, Reviewed/Approved 3/9/2023 by GMEC)

Purpose
The eligibility and selection policy is designed to ensure fair and consistent consideration and decision-making for all applicants to East Tennessee State University Quillen College of Medicine GME residency and fellowship training programs. Recruitment and selection of program applicants are performed by the respective program director, responsible faculty, and department leadership under the oversight of the Office of Graduate Medical Education and the Graduate Medical Education Committee (GMEC).

Policy
Residents/fellow are selected on a fair and equal basis without regard to sex, race, age, religion, color, national origin, disability, veteran status, or any other applicable legally protected status. The GME office will monitor programs for compliance with this policy on recruitment and appointment.

ELIGIBILITY
Applicants with one of the following qualifications are eligible for appointment to residency or fellowship programs, subject to additional qualifications as may be specified in specialty/subspecialty programs:
- Graduates of medical schools in the United States or Canada accredited by the Liaison Committee on Medical Education (LCME).
- Graduates of colleges of osteopathic medicine accredited by the American Osteopathic Association (AOA).
- International Graduates of medical schools outside of the United States or Canada who have valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG) or who have completed a Fifth Pathway program provided by an LCME-accredited medical school.
- To meet eligibility requirements, an international medical school's admission standard must meet or exceed those of medical school accredited by LCME. The Tennessee Board of Medical Examiner's policy on the determination of standards for international medical schools and graduates of unapproved foreign medical schools provide a list of accrediting bodies used to determine medical school compliance. QCOM Graduate Medical Education residency and fellowship programs may not accept graduates from schools that do not comply with this policy, which can be accessed online at Foreign Medical School Policy https://www.tn.gov/content/dam/tn/health/documents/Foreign_Medical_School_Policy.pdf
- All prerequisite postgraduate clinical education required for initial entry or transfer into ACGME-accredited residency programs, AOA-approved residency programs, or in Royal College of Physicians and Surgeons of Canada (RCPSP)-accredited or College of Family Physicians of Canada (CFPC)- accredited residency programs located in Canada, or in residency programs with ACGME International (ACGME-I) Advanced Specialty Accreditation.
- Fellowship programs must receive verification of each entering fellow's level of competency in the required field using ACGME Milestones assessments fro the core residency program.
- A resident/fellow in our program must be a U.S. citizen, lawful permanent resident, or possess the appropriate documentation to legally train in the U.S.
- GMEC may allow for exceptions of exceptionally qualified fellowship applicants for only those programs who routinely are not successful during the Match. Eligibility exceptions must be documented in each fellowship program's eligibility and selection policy, and requests for exceptions must be submitted by the fellowship program director in writing to the GMEC for review and approval prior to an offering of a position or ranking of an applicant. The requests must address the criteria for exception and verify that the fellowship program's Clinical Competency Committee will complete an evaluation of the applicant's performance within 12 weeks of matriculation.
An ACGME-accredited fellowship program may accept an exceptionally qualified international graduate applicant who does not satisfy the eligibility requirements as previously stated, but who does meet all of the following additional qualifications and conditions set forth by the GMEC.
- Evaluation by the fellowship program director and selection committee of the applicant's suitability to enter the program, based on prior training and review of the applicant's summative evaluation of this training, and
- Review and approval of the fellowship applicant's exceptional qualifications by the GMEC including:
  - A minimum of 3 months of clinical experience confirmed
  - First-time board pass of USMLE Steps 1, 2, and 3 equivalent examinations
  - Minimum score of 220 or above required on USMLE Step 2 CK or equivalent examinations. Examinations are required to have been taken within the last five years of application
  - Evidence of scholarly activity; poster, presentation or abstract
  - Verification of ECFMG certification.
Selection
- All applications will be processed through the Electronic Residency Application Service (ERAS) except in those programs in specialty matches or those fellowship programs which handle their own application process.
- Opportunities for interviews will be extended to applicants based on their qualifications as determined by USMLE scores, medical school performance, and letters of recommendation.
- East Tennessee State University programs participate in the NRMP Match. All senior medical student applicants must participate in the NRMP Match or another national matching plan to be considered.
- All interviewed applicants will be considered for ranking in the Match in order of preference based on the following criteria: USMLE scores, medical school performance, letters of recommendation, residents and faculty perceptions during interviews, determination of communications skills, motivation, and integrity via interviews.
- Characteristics such as gender, age, religion, color, national origin, disability or veteran status or any other applicable legally protected status will not be used in the selection procedure. (East Tennessee State University is an EEO/AA/Title VI/Title IX/ Section 504/ADA/ADEA employer.)
- Recommendations fo all interviewing faculty and residents will be considered in determining the rank order of the interviewed applicants.
- All applicants invited to interview for a resident/fellow position must be informed, in writing or by electronic means, of the terms, conditions, and benefits of appointment to the ACGME-the accredited program, either in effect at the time of the interview or that will be in effect at the time of his or her eventual appointment.
- A program director may not appoint more trainees than approved by their respective ACGME Residency Review Committee.
- All applicants invited to interview, and residents/fellows accepted into or enrolled in a program with a status of Probationary Accreditation must be notified in writing of the probationary status.
APPOINTMENT

Resident/fellowship programs at East Tennessee State University are under the oversight of the Office of Graduate Medical Education, in the Quillen College of Medicine. Residents and fellows are trainee employees of ETSU, an entity of the State of Tennessee, and are not employees of any affiliated hospital, clinical site, or private practice group. Appointments will be issued to all matched applicants who meet eligibility requirements and pass a criminal background check.
- Following the release of the Match results, attempts will be made to fill any vacant positions in accordance with the terms of the ETSU QCOM Institutional Agreement with the NRMP. If an applicant is unable to fulfill a Match commitment, the program will not recruit another candidate until NRMP has granted a wavier.
- The Program Director may not appoint more than residents than approved by their ACGME Review Committee complement.
- Agreements of appointment for all positions will be issued through the Graduate Medical Education Office following a review of eligibility.
- All applicants must meet all institutional, hospital systems, departmental, and specialty eligibility requirements for their respective programs.
- A copy of the resident agreement of appointment (contract) will be made available to all interviewed applicants.
Individual program policies will specify additional specialty-specific eligibility and selection criteria.
EVALUATION POLICY

CPR V.
(Approved 7/12/2007, Revised/Approved 12/7/2017, Reviewed/Approved 12/5/2019, Revised/Approved 12/5/2024 by GMEC)

Residents are evaluated in writing at the end of each clinical rotation by their attending faculty. In addition, at least twice per year, formal meetings will be held with each resident to review rotational evaluations and other evaluative data relating to individual residents.

PROCEDURES:
Each residency program will have stated goals for the entire residency which are compatible with the ACGME special requirements and the appropriate specialty board.

Specific objective and performance standards will be defined for each rotation or curriculum segment of each residency program.

Each residency program will have a defined curriculum.

The residency program director for each program will be responsible for developing and implementing an on-going evaluation process of the program and of the individual residents in the program. The evaluation process will ensure that each resident is evaluated on a regular basis. This should include monthly rotation evaluations or periodic evaluations at a suitable interval of specific curriculum segments. Evaluations will be performed in writing and retain on file by the program director.

All faculty members will be expected to review their evaluations of a residents performance with that resident and to provide appropriate feedback and comments to the residents.

Periodically, formal meetings will be held with each resident to review rotational evaluations and other evaluative data relating to individual residents, such as results of in-training examinations. These feedback sessions should occur at a minimum of twice per year. These meetings will be conducted by the program director or by another faculty member designated by the program director and will be documented in writing. Such documentation will be signed by both the resident and the program director/designated faculty.

Evaluations will include cognitive, psychomotor and affective (or professional) domains of the residents experience.

The evaluation process will solicit residents to provide evaluations of their rotations, services, faculty and the institution, as well as other appropriate educational processes as deemed relevant by the program director.
GRADUATED MEDICAL EDUCATION COMMITTEE POLICY
IR I.B.
(Approved 7/1/2010, Revised/Approved 2/1/2018, Reviewed/Approved 12/1/2022 by GMEC)

Purpose
Per the ACGME requirements, the Sponsoring Institution with multiple ACGME-accredited programs must have a Graduated Medical Education Committee (GMEC) which is responsible for the oversight and administration of their program and ensuring compliance with the ACGME Institutional, Common and specialty-subspecialty specific Program Requirements.

Policy
The Graduate Medical Education Committee is a standing committee of the Quillen College of Medicine.

All residency and fellowship programs at Quillen College of Medicine are overseen by the Associate Dean for Graduate Medical Education/Designated Institutional Official, Chair of the GMEC.

Voting members of the GMEC include the Assistant Dean/Dean's of GME, all residency program directors, one fellowship program director, four peer-selected resident/fellows from the Resident Leadership Committee, the Chair of the Resident Leadership Committee, one peer-selected program coordinator, and a Quality Improvement officer from the main training site.

Responsibilities of the GMEC must include oversight of:
- ACGME accreditation and recognition statuses of the Sponsoring Institution and each of its ACGME-accredited programs.
- The quality of the GME learning and working environment within the Sponsoring Institution, each of its ACGME-accredited programs, and its participating sites.
- The quality of educational experiences in each ACGME-accredited program that lead to measurable achievement of education outcomes as identified in the ACGME Common and specialty-/subspecialty-/specific Program Requirements.
- The ACGME accredited programs' annual program evaluations and Self-Studies.
- ACGME's-accredited programs' implementations of institutional policy(ies) for vacation and leaves of absence, including medical, parental, and caregiver leaves of absence, at least annually.
- All processes related to reductions and closures of individual ACGME-accredited programs, major participating sties and the Sponsoring Institution.
- The provision of summary information of patient safety reports to residents, fellows, faculty members and other clinical staff members. At a minimum, this oversight must include verification that such summary information is being provided.
  
  GMEC must review and approve:
- Approval of and review of institutional GME policies and procedures at a minimum every five years or on an as-needed basis in response to changing accreditation standards.
- Review and approval of GMEC subcommittee actions that address required GMEC responsibilities.
- Annual recommendations to the Sponsoring Institution's administration regarding resident/fellow stipends and benefits.
- Applications for ACGME accreditation of new programs.
- Request for permanent changes in resident/fellow complement.
- Major changes in each of it's ACGME-accredited programs' structure or duration of education, including any change in the designation of a program's primary clinical site.
- Additions and deletions of each of its ACGME-accredited program's participating sites.
- Appointment of new program directors.
- Progress reports requested by a Review Committee
- Responses to Clinical Learning Environment Review (CLER) reports.
- Requests for exceptions to clinical and educational work hour requirements.
- Voluntary withdrawal of ACGME program accreditation or recognition.
- Requests for appeal of an adverse action by a Review Committee, and,
- Appeal presentations to an ACGME Panel, and,
- Exceptionally qualified candidates for resident/fellow appointments who do not satisfy the Sponsoring Institution's resident/fellow eligibility policy and/ or resident/fellow eligibility requirements in the Common Program Requirements.
GMEC must demonstrate effective oversight of the Sponsoring Institution's accreditation through an Annual Institutional Review (AIR).

GMEC must demonstrate effective oversight.
GMEC SPECIAL REVIEW POLICY
IR I.B.6
(Approved 7/1/2015, Reviewed/Approved 9/15/2021 by GMEC)

To ensure effective oversight of underperforming Graduate Medical Education programs by the Sponsoring Institution, via the Designated Institutionial Official (DIO) and the Graduated Medical Education Committee (GMEC). The purpose of this policy is to establish criteria for identifying underperformances that includes, at a minimum, program accreditation statuses of Initial Accreditation with Warning, Continued Accreditation with Warning, and adverse accreditation statuses as described by ACGME policies, and address the procedure to be utilized when a residency/fellowship program undergoes a Special Review.

An individual program may be selected for Special Review based on underperformance, by request of its' Program Director or at the direction of the GMEC or DIO. Any program with an ACGME accreditation status of continued accreditation with warning or probationary accreditation will undergo Special Review.

Criteria used in identifying underperformance may include, but are not limited to:
- Program Attrition
- Change in Program Director more often than once every two years.
- Decrease in core faculty >10% each year for two years.
- Residents/fellows withdrawing, transferring, or dismissed >10% for two consecutive years.
- Program Changes
- A major participating site has been added or removed.
- Consistently incomplete resident/fellow complement for two years.
- Major curricular changes.
- Scholarly Activity
- Identified inadequate scholarly activity for either core faculty or residents/fellows.
- Board Pass Rates
- Falling below the accepted specialty threshold over a three year period.
- Clinical Experience
- Any significant changes in adequacy of clinical or didactic experience.
- ACGME Surveys
- Poor response rate.
- Poor resident/fellow or faculty overall evaluation of the program.
- Problematic survey items.
- New or repeated problematic survey items previously identified.
- ACGME Responsibilities
- Incomplete or inaccurate reporting of milestones or annual updates.
- Inability to meet common and program specific requirements.
- Inability to demonstrate success in the CLER focus areas.
- Incomplete or inaccurate annual program evaluation reports.
The DIO will convene a panel for each Special Review. The panel will consist of the DIO, the Institutional Coordinator, the Assistant Deans(s) in GME, and a team of participants from another program. Those individuals from another program will consist of a Program Director or associate Program Director, program manager, and resident/fellow member.

Based on the identified concern, the program being reviewed may be asked to submit documentation prior to the Special Review visit that will help the panel gain clarity. Information used in the review process may include:
- The current ACGME common, specialty/subspecialty-specific program, and institutional requirements.
- Letters of notification from the most recent ACGME review and any progress reports submitted to the RRC.
- Reports from previous Special Reviews and old internal reviews.
- Previous Annual Program Evaluations.
- Results from ACGME resident/fellow and faculty surveys.
- Other materials the panel considers necessary and appropriate.
The Special Review panel will conduct interviews with the Program Director, key faculty members, selected residents/fellows from each year of training, and other individuals deemed appropriate. The panel will submit a written report to the program leadership and GMEC with the panel's recommendations that include quality improvement goals, the corrective actions, and the process for GMEC monitoring outcomes and timelines for follow-up reviews. The DIO and GMEC will work with the Program Director on making necessary improvements, and continuing to monitor outcomes to ensure the program is meeting expectations.

The Program Director will provide an initial response to the report with specific details to demonstrate how the program is progressing in addressing concerns. Subsequently, the DIO may request additional reports from the program at future GMEC meetings as the program continues to make improvements based on individual program needs and the amount of progress made with action plans.
HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACTS OF 1966 (HIPAA)
HIPAA TRAINING, VIOLATIONS AND DISCIPLINARY ACTION
(Approved 7/12/2007, Revised/Approved 9/22/2016, Reviewed/Approved 10/24/2019, Reviewed/Approved 10/24/2024 by GMEC)

The Health Insurance Portability and Accountability Act ("HIPAA") is federal law which protects the health information of individuals. This information is called Protected Health Information ("PHI"). During residency, residents will routinely be exposed to PHI. As part of their orientation, residents will receive HIPAA training which will be required to be completed annually thereafter. HIPAA violations can result in significant federal penalties for both individuals and organizations. Quillen College of Medicine and the Department of Graduate Medical Education regard HIPAA violations as serious offenses. Residents who do not know if a particular use or disclosure of PHI is appropriate should ask their supervisor or contact the ETSU HIPAA Compliance Officer for guidance.

Examples of HIPAA Violations:
- Accessing your own medical records.
- Unauthorized copying of medical records.
- Leaving PHI in a public area.
- Discussing PHI in a non-secure area.
- Posting PHI on any social networking site.
- Removing medical records from a hospital or clinic without proper authority.
- Unapproved accessing of PHI when the Resident is not involved in the care of that particular patient.
- Intentionally assisting another person in gaining unauthorized access to PHI.
- Inappropriate sharing of ID/Password with another person.
- Unauthorized delivery of PHI to any third party.
- Use of PHI for research with IRB approval.
These examples represent varying levels of severity.

Disciplinary actions for HIPAA violations can range from verbal counseling through dismissal from the residency program based on the severity of the violation. Each violation is evaluated on a case by case basic. Suspected violations should be reported to the HIPAA Compliance Office immediately.

ETSU HIPAA Compliance
HOSPITAL SUSPENSION OF A RESIDENT

IR IV.C.I.
(Approved 7/12/2007, Reviewed/Approved 12/7/2017, Reviewed/Approved 12/5/2019, Revised/Approved 12/5/2024 by GMEC)

The affiliated hospital administration and the Associate Dean for Graduate Medical Education may find cause to suspend a resident/fellow for clinical activities. When such a suspension occurs, the hospital administration will immediately notify the appropriate departmental chair and program director. The resident/fellow will be placed on paid Administrative Leave. Within five (5) working days the program director will convene a committee of two (2) departmental faculty selected by the program director and two representatives from the involved hospital selected by the hospital administration. This committee, chaired by the program director, will investigate the incident and recommend appropriate action to the departmental chair. Such action will also be communicated to the hospital administration representative in charge of graduate medical education. If the hospital administration is not agreeable with the committees recommendation to the chair, the issue will be submitted to the Executive Associate Dean for Graduate Medical Education. If an agreement can still not be reached with the hospital administration, the issue will be referred to the Dean of the College of Medicine and the CEO of the appropriate hospital. The ultimate decision regarding resident clinical privileges shall be made by the Hospital. The program director will report this to the Clinical Competency Committee to determine action for lack of professionalism.
IDENTIFICATION, INTERVENTION, ASSISTANCE AND RESOLUTION OF UNSATISFACTORY PERFORMANCE BY A RESIDENT
Impairment - IR IV.I.2. Dismissal - IR IV.D. Due Process -IR IV.D.1.b)
(Approved 8/1/2015, Revised/Approved 12/7/2017, Reviewed/Approved 8/23/2018, Reviewed/Approved 8/24/2023 by GMEC)

Purpose: This policy provides guidelines for proper response to problems by resident physicians associated with poor performance, failure to progress academically, alleged or actual non-professional behavior, substance abuse, physical disability, mental illness, or emotional impairment. An impaired resident physician shall be defined as any resident who, by virtue of substance abuse, physical disability mental illness, or psychological impairment, is unable or potentially unable to care for patients with reasonable safety and skill. The definition includes behavioral problems or unprofessional behavior which may or may not be readily attributable to substance abuse, physical disability, mental illness, or psychological impairment. If any ETSU or MEAC employee, medical staff member or resident has knowledge, substantiated concerns, or convincing reasons to suspect that patient care is, or may be, affected by any resident due to the resident being impaired, it is his or her duty to report this expeditiously to the program director.

Policy: In all that follows, when the term “resident” is used the policy is meant to apply to all residents and fellows. Residents shall abide by the rules and regulations set by the program directors, the hospitals and the Office of Graduate Medical Education. Failure of a resident to perform his/her duties or to abide by the College of Medicine's and the affiliated hospitals' rules and regulations shall be reported to his/her program director. The program shall then institute appropriate disciplinary action. If this rises to the level of written disciplinary or remedial actions, the following policy applies.

UNSATISFACTORY PERFORMANCE BY A RESIDENT; DOCUMENTATION REQUIREMENTS FOR ESTABLISHING THE PROVISION OF DUE PROCESS
Residents who evidence a deviation from their expected performance will be identified in a timely manner and reported to the Program Director. The program director has the authority for managing the residency and maintaining accreditation standards. The program director may be advised by the Clinical Competence Committee (CCC) or other GME faculty at any point in this process, but the program director is responsible for making the decisions and supervising the policy process as outlined below unless otherwise specified. Any instance of a resident being removed from his/her clinical duties requires the office of the Associate Dean for Graduate Medical Education to be notified as soon as possible.

Any resident may benefit from a focused improvement plan to assist in progressing along the milestone continuum and achieving clinical competence. It is highly recommended that focused improvement plans be a routine part of residency education; however, a resident who is deemed to be deviating from expected performance levels by the Program Director. (With consultation when indicated by GME faculty or the CCC) in any aspect of his/her performance will be given verbal or, depending on the severity of the deficiency, written notification and may be given a notice of focused improvement. When action is required, the program director will inform the resident/fellow in writing by giving him/her a letter of focused improvement that should include the following elements:
- Notice of the performance deficiency
- A description of the focused improvement outlined in behaviorally-specific terms with examples
- The program's general expectations for achievement in that competency or competencies
- Defined goals, including points of assessment
- Specific methods in which the program will assist the resident
- A timeline for appropriate completion
- Consequences of success or failure
- Signature of the Program Director and the resident/fellow (copy kept by program)
Departmental-focused improvement is utilized when it is anticipated that there will be a successful outcome on the part of the resident. The program director may skip the letter of focused improvement and proceed to probation (next paragraph) if circumstances warrant. The length of focused improvement will be left to the discretion of the Program Director but generally will be 3 to 6 months.

When necessary, this approach will include the appointment of one or more faculty to work with the resident regularly using a planned, individualized format. The resident's progress in successfully improving said deficiencies will be reviewed by the program director (with advisement by the CCC if necessary) at the end of a defined period outlined in the letter of focused improvement.

If the resident/fellow satisfactorily achieved the goals outlined in the letter of focused improvement, no further action is necessary, but a signed notice of successful completion should be placed in the resident's file. If the resident does not satisfactorily achieve the goals during the focused improvement period and/or if, in the Program Director's opinion, the resident's original deficiency may result in termination, the resident will be placed on probation, generally not to exceed 3 months. Again, the resident must be given written notification with the elements outlined above included in a letter of probation and the additional element:
- The resident/fellow must also be notified in the probation letter of the possibility that the deficiency may lead to termination from the program.
A copy of the signed letter of probation should be sent to the GME office. Probation is an official action taken against a resident/fellow, and it is entered into the record of the resident/fellow for subsequent reporting/credentialing purposes.

At the end of the probationary period, the resident/fellow's performance will be reassessed and the resident will be notified in writing as to his/her status. The resident may be removed from probation if the stated deficiencies have been remediated or the probation may be continued if the resident's performance has improved but deficiencies remain or new deficiencies are uncovered, or the resident may be terminated.

TERMINATION OF A RESIDENT
Termination of a resident may occur based on either of two situations: 1) Failure to meet academic standards despite a carefully planned focused improvement program; 2) Unacceptable personal behavior serious enough to call for immediate suspension. This action may be taken when the resident’s performance is grossly negligent, unprofessional, and/or imminently endangers the health or safety of others. The resident will be suspended with pay while his/her performance is being investigated. After an investigation that includes asking all personnel, including the resident, that have direct knowledge of it for their perception of the resident’s performance, the program director may decide that the resident should be terminated. Under either scenario, the program director must obtain approval from the Associate Dean for Graduate Medical Education and ETSU legal counsel before terminating a resident. The resident is given written notification of termination and the reasons for this action. The written notification must also inform the resident of his/her due process rights.

IMPAIRED RESIDENT PHYSICIAN POLICY
Residents should be evaluated based on performance as outlined above. Sometimes a resident’s GME faculty, co-workers, program director, or others may suspect that a resident’s performance is being affected by an impairment.
The purpose of this policy is to identify and provide assistance to an impaired resident. The policy to correct an academic deficiency can be employed concurrently (in parallel), with the investigation of possible impairment, and either policy may be followed or discontinued depending on whether an impairment is admitted/diagnosed or not.

Step 1. Program Director receives work-related performance problem information.
In the event the Program Director receives reports of alleged impairment-related work performance problems, the following policy applies. Confidentiality is extremely important in suspected impairment. Notwithstanding the foregoing, the Program Director will consult the Associate Dean for GME after receipt of such allegations, and keep the Associate Dean for GME informed of interventions, if any occur, and outcomes during a treatment process. In the event that a resident voluntarily identifies impairment-related work performance problems to anyone in the work environment, the Program Director will be notified and will follow the procedures outlined in this policy beginning with Step 4.

Step 2. Program Director discusses work-related performance problems with the resident.
The Program Director will meet with the resident to discuss the allegations of impairment, framing the discussion in the context of information received related to work performance problems. The Program Director may determine that an impairment problem does not exist and if any, further action is warranted. See UNSATISFACTORY PERFORMANCE BY A RESIDENT; DOCUMENTATION REQUIREMENTS FOR ESTABLISHING THE PROVISION OF DUE PROCESS (above). If the resident indicates a desire to terminate discussions of this nature with the Program Director, he or she may do so at any time. The Program Director will document the resident meeting(s) and /or document unsuccessful attempts to meet with the resident to discuss work-related performance problems. Depending on the acceptance or denial of the alleged impairment, Step 3 or Step 4 is then followed as appropriate.

Step 3. Program Director will notify the Associate Dean for GME.
A. For behavioral and professional problems that are not impairment related, the resident will be provided with documentation outlining the relevant concerns as outlined in the foregoing unsatisfactory performance by a resident. Expectations for improvement will be clearly outlined with a timeline for continued assessment. The Program Director will provide timely progress updates to the resident on performance and whether expected outcomes are being met. At the discretion of the Program Director, resources may be identified and provided to the resident to assist in remediation. Such assistance is limited and cannot disrupt the financial, academic, or healthcare delivery services of the program.
B. In cases of impairment, the Program Director, in consultation with the Associate Dean for GME and ETSU legal counsel, will require the resident to follow all impairment, self-reporting requirements as stipulated by the Tennessee Medical Foundation (TMF) Physician’s Health Program (PHP).
     1.Resident seeks and receives the intervention. If not covered by medical insurance, the residency   will not bear expenses incurred by the resident in the treatment process.
     2. Program Director makes work re-entry decisions. The Program Director may decide whether or not to allow the resident to return to the residency program contingent upon considerations such as the nature of the work-related performance problem, assurance of patient safety, and evidence from the treatment program that the resident is safe to return to work and interact with patients. The Program Director must present documentation to the Associate Dean for Graduate Medical Education that the resident’s treatment has been effective, that the Program Director has received reports on the resident’s progress in the treatment program, that the resident is in compliance with the treatment program, and that the resident is willing to adhere to an after-care program, as necessary.
     3. Program director monitors the resident’s compliance with the after-care program. The program director monitors the resident’s compliance with all components of the after-care program, as set forth by the prescribed treatment plan.
     4. Resident compliance with after-care program and/or recurrence of impairment-related work performance problems. The program director may terminate the resident’s training if the resident does not comply with all components of the after-care program and/or if impairment-related work performance problems persist.

Step 4.
A. The Program Director documents the discussion with the resident including the resident’s denial that a problem exists.
B. The Program Director provides copies of all relevant information to the Associate Dean for GME.
C. The GME program does not have a policy of mandatory diagnostic testing in cases of suspected impairment. Any exceptions would have to be made with the prior approval of the Dean for GME and ETSU legal counsel.
D. Program Director Follows policy: UNSATISFACTORY PERFORMANCE BY A RESIDENT/FELLOW; DOCUMENTATION
E. Program director makes employment decisions.

Step 5. Program Director determines if the resident should be terminated.

Step 6. Resident’s Training is Terminated.
If the Program Director wishes to terminate the resident’s training, the Program Director must notify and receive prior approval from the Associate Dean and ETSU legal counsel. The resident will be afforded due process as outlined below. See TERMINATION OF A RESIDENT, above.

Step 7. Resident’s Training is not Terminated.
Program Director monitors work-related performance. If the resident has denied the existence of an impairment problem and the Program Director does not have sufficient grounds to request entry into a treatment program or termination, no further action will be taken. However, the Program Director will continue to monitor the resident’s work performance and follow the policy outlined above.

UNSATISFACTORY PERFORMANCE BY A RESIDENT; DOCUMENTATION REQUIREMENTS FOR ESTABLISHING THE PROVISION OF DUE PROCESS.
If suspected impairment-related work performance problems persist or if further allegations emerge the Program Director will return to Step 2.

APPEAL OF ADVERSE ACTION, INCLUDING TERMINATION, FOR LACK OF DUE PROCESS
This outline of Due Process is applicable to any resident who wishes to appeal an adverse decision by his/her program. Adverse actions include non-renewal of contract; suspension from residency program; termination from residency program; imposition of formal disciplinary action (probation); or actions taken resulting from a violation of residency policy or procedure which may delay promotion and/or extend the period of residency/fellowship training. In the case of an adverse action taken by the program following one or more attempts at remediation, “due process” refers specifically to whether the resident was provided remediation in substantial compliance with the policies outlined in this document. In the case of imposition of an adverse action as a result of a resident’s performance being judged grossly negligent, grossly unprofessional, and/or imminently endangering the health or safety of others, the “due process” committee will provide a recommendation concerning whether the imposition of the adverse action by the program is justified by the behavior and circumstances that led to it.

A resident/fellow who wishes to appeal an adverse decision by his/her program director or department chair may appeal the decision of the department and request a due process hearing before an ad hoc committee. The resident must provide a written request to the GME office for a due process hearing within 4 weeks of the adverse action taken. This committee shall consist of not less than five (5) faculty members and two (2) residents to be appointed by the Associate Dean for Graduate Medical Education. The five faculty members will be from programs other than the resident/fellow's program and will have little or no personal involvement with the resident's instruction or evaluation. One of the two resident representatives will be selected by the Associate Dean for Graduate Medical Education from a list supplied by the resident making the appeal and the other selected by the Associate Dean for Graduate Medical Education from the Chief Residents' Committee, but this resident shall not be from the appellant's program. The Associate Dean for Graduate Medical Education will appoint a member of the GME faculty outside of the resident/fellow's discipline to be chair of the committee. In the event that the actions of the Associate Dean for Graduate Medical Education are a factor in the hearing, the Dean will appoint the chair. The committee shall convene a hearing at a date agreeable to all parties but in no case more than four (4) weeks after receiving the written request for the appeal.

Committee witnesses will include those on a list provided by the resident/fellow to speak on his/her behalf. The committee will also request testimony from those in the program responsible for the evaluations and decisions which led to the adverse action. The ad hoc committee may request from the department copies of all evaluations and documents leading to adverse action. The resident making the appeal has the right to have an advocate present with whom the resident may consult during the hearing. The advocate cannot address the committee or question witnesses. The resident has the right to hear all witnesses and to ask any questions under the direction of the chair of the ad hoc committee. An electronic recording of the proceedings may be made, but only for the purpose of producing a written transcript, at which time all recordings will be destroyed. This transcript and all other records related to the appeal will be available to the appellant upon request. The chair of the committee will not have a vote in the committee's decision but will create and submit his/her recommendation along with the committee's recommendation in a written report to the Dean. The report must include a numerical statement describing the result of a vote taken on whether to recommend upholding (i.e., the appellant received adequate due process via remediation plans or the adverse action was justified by behavior that was grossly negligent, unprofessional and/or imminently endangered the health or safety of others), or recommend overturning the adverse action taken against the resident/fellow, and it may include a narrative of considerations the committee used in reaching that conclusion. In addition to the committee report, the Dean has access to the transcript of the hearing. The decision of the Dean is final.

Departmental-focused improvement is utilized when it is anticipated that there will be a successful outcome on the part of the resident. The program director may skip the letter of focused improvement and proceed to probation (next paragraph) if circumstances warrant. The length of focused improvement will be left to the discretion of the Program Director but generally will be 3 to 6 months.

When necessary, this approach will include the appointment of one or more faculty to work with the resident regularly using a planned, individualized format. The resident’s progress in successfully improving said deficiencies will be reviewed by the program director (with advisement by the CCC if necessary) at the end of a defined period outlined in the letter of focused improvement.

If the resident/fellow satisfactorily achieved the goals outlined in the letter of focused improvement, no further action is necessary, but a signed notice of successful completion should be placed in the resident’s file. If the resident does not satisfactorily achieve the goals during the focused improvement period and/or if, in the Program Director's opinion, the resident's original deficiency may result in termination, the resident will be placed on probation, generally not to exceed three (3) months. Again, the resident must be given written notification with the elements outlined above included in a letter of probation and the additional element:
The resident/fellow must also be notified in the probation letter of the possibility that the deficiency may lead to termination from the program.
A copy of the signed letter of probation should be sent to the GME office. Probation is an official action taken against a resident/fellow, and it is entered into the record of the resident/fellow for subsequent reporting/credentialing purposes.

PROCEDURE FOR PLACING A RESIDENT ON PROBATION
The GME policy, “Identification, Intervention, Assistance and Resolution of Unsatisfactory Performance by a Resident” outlines the requirements for placing a resident on probation. Probationary status is an adverse academic status of a serious degree, wherein the resident has experienced clear failure to achieve academic requirements of the program, and in which the possibilities of remediation and failure (termination or non-renewal of a resident’s training agreement) coexist. The following steps describe the procedure used to place a resident on probation.
1. The PD, most often in conjunction with the CCC, will determine if there is/are sufficient reason(s) to place a resident on probation. In addition, the CCC may make recommendations to the PD to place a resident on probation.
2. A PD considering the implementation of Probationary status for a resident will present the matter to the DIO for review and guidance prior to informing the resident. The PD will provide all written communications provided to the resident intended to improve his/her performance, including letters of focused improvement.
3. Once the DIO reviews the documentation and agrees with the plan for probation, the PD will write a letter to the resident explaining all reasons for the probation and providing specific requirements the resident must meet during the probationary period. The letter will have an end date of the probation. The letter will state that the probation can be extended or result in termination depending on meeting the requirements set forth in the probation letter. The letter will state that the resident will receive a response in the form of a letter given to the resident at a meeting with the PD within two weeks after the probationary period ends.
4. The PD and resident will meet to go over the letter and discuss the reason for probation. Both the PD and resident will sign the letter. The resident signs the letter as an attestation that she or he received the letter.
5. At the end of the probationary period, the CCC and/or the PD will determine if the probation ends, continues, or results in termination. If the decision is a continuation of the probation or termination, the PD will discuss the decision with the DIO for review and guidance prior to informing the resident.
6. The PD will write the letter and then coordinate a meeting with the resident to discuss the decision. The meeting will occur within two weeks of the end of the probationary period. The PD and resident will sign the letter. The resident signs the letter as an attestation that she or he received the letter.
7. A resident/fellow who wishes to appeal an adverse decision by his/her program may appeal the decision and request a due process hearing before an ad hoc committee as described in the “Identification, Intervention, Assistance and Resolution of Unsatisfactory Performance by a Resident” policy within the time frame described.
8. The PD will provide all signed letters between him/her and the resident to the GME Office within a week of the meeting.
LEAVE OF ABSENCE
IR:IV.H
(Approved 7/1/2022, Approved 6/16/2022, Revised/Approved 12/10/2022, Revised/Approved 7/1/2023, 8/24/2023, Revised/Approved 7/25/2024 by GMEC)

Policy
This policy and procedure reviews East Tennessee State's GMEC's guidelines for accreditation-mandated resident and fellow parental, medical, or caregiver leave.

Per ACGME regulations, starting with their first day of employment, every resident and fellow in an ACGME accreditation residency program is entitled to one, singular six-week (or two three-week) block(s) of paid leave at any time during their residency or fellowship program for parental, medical, or caregiver leave.

This leave must be for a medical, parental, or caregiver leave of absence and must be approved by the Program Director and must be submitted following the standard ETSU GME processes. Supporting documentation will be required.

During this leave period, trainees will be paid 100% of their salary. Health and disability insurance benefits for residents/fellows and their eligible dependents will continue.

If this is a parental leave and a trainee has more than one child during their training the first leave will be covered under this policy. Subsequent parental leave eligibility will follow the standard leave and FMLA processes.

Some or all portions of leaves may fall under the Family Medical Leave Act (FMLA).

This six-week leave may be divided into two three-week blocks with the exception of maternity leave which must be a continuous six week block. The six weeks of leave is inclusive of any holidays that should occur during the six or three week blocks.

To align with East Tennessee State University's Parental Leave Policy, a resident's six (6) weeks of ACGME paid parental, medical, caregiver leave is available in addition to annual and sick leave and should be used (if applicable) prior to remaining annual and sick lave. Paid medical and caregiver leave is part of the same six week benefit and not in addition to the paid six weeks of parental leave.

Our goal is for our trainees who take leave to graduate on time. However, these leaves may impact a trainee's ability to graduate on time or impact board eligibility in the following ways:
- If a trainee is not in good standing in their residency or fellowship and is not meeting ACGME milestones, Program Directors and Clinical Competency Committees may require additional time in program to meet milestones required for successful graduation.
- The trainee on leave's accrediting board will have clear guidelines on how many weeks of training are required to qualify for their board-certifying examination. If leave exceeds time or educational limits required by a particular board, these leaves may impact the ability to take board examinations or become board certified and could require additional months of training to take certifying exams and become board certified. The impact of an extended leave of absence upon the criteria for satisfactory completion of the program and upon a resident's/fellow's eligibility to participate in examinations by the relevant certifying board(s) must be discussed and documented by the Program Director with the trainee before the trainee's leave begins.
- Though all efforts will be taken to minimize impact to clinical assignments resulting from leaves of absence, trainees taking leave may be required to complete service blocks that are required for successful residency completion or to ensure equity between a program's trainees. Additional weeks of leave beyond a trainee's "once in training program" six weeks (or two three-week blocks) of leave will not be covered under this policy.
- Additional weeks of leave beyond a trainee's "once in training program" six weeks (or two three-week blocks) of leave will not be covered under this policy.
Process
- The trainee will inform their Program Director and Program Coordinator in writing to notify them that they require a leave of absence. Though the trainee may share the details of their request with their Program Director, they are only required to disclose the category of their leave (medical, parental, or caregiver) to their program.
- The trainee's Program Director or Program Coordinator will contact GME Assistant Dean in writing to inform them that a trainee is requesting a leave of absence under the ACGME six-week leave requirement. The Program Director is only required to disclose the category of the trainee's leave (medical, parental, or caregiver) to the Assistant Dean.
- The Assistant Dean will connect the trainee with the ETSU HR FMLA Specialist if applicable to their leave request, who will walk the trainee through the leave process. The ETSU FMLA HR Specialist will require appropriate documentation from the trainee to support their leave request including physician notes, etc. Additional documentation may be required beyond initial physician notes or other supporting materials. The trainee is obligated to fulfill all communication requirements with the leave administration contractor and is required to provide them with all requested documents.
- Once the ETSU HR FMLA Specialist approves the leave, they will contact the Assistant Dean to inform them of the leave approval (or disapproval) and dates of the leave.
- The GME Assistant Dean will inform the Program Director and Program Coordinator in writing of the decision and dates.
- The Program Director must meet with the trainee, review their planned leave dates, and review potential impact on the trainee's ability to graduate on time and/or take certifying exams as outlined above. The Program
- Director will review clinical assignments the trainee will be required to make up, if any, as described above. All discussions will be documented by the Program Director and placed in the trainee's personnel file.
- At least one week before the end of an approved leave, the trainee must email their Program Director to confirm their return-to-work date and must additionally communicate with the leave administration contractor as required to ensure their process is properly completed. The Program Director or Program Coordinator will confirm the trainee's return to work with the GME Assistant Dean on their first day back in writing.
- Residents and fellows must be provided with a minimum of one week of paid time off reserved for use outside of the first six weeks of the first approved medical, parental, or caregiver leave(s) of absence.
MEDICAL LICENSES, EXEMPTIONS, and PRESCRIBING

(Approved 7/12/2007, Revised/Approved 7/1/2017, Reviewed/Approved 12/5/2019, Revised/Approved 10/1/2022 by GMEC)

License Exemption
In accordance with Tennessee Code Annotated Section 63-6-207(d)(2), The Tennessee Board of Medical Examiners will exempt residents/fellows from the requirement of a Tennessee Medical License while participating in an accredited clinical training program in the State of Tennessee. Some programs may require residents/fellows to obtain a special training licenses. All residency programs will request and maintain the records of exemption.

Residents/fellows who moonlight must obtain a full licenses in the state in which the moonlighting occurs.

Prescribing
Since ETSU QCOM residents are exempted from the requirement of having an unrestricted Tennessee medical license, they cannot obtain individual DEA numbers that are required for prescribing controlled substances. However, they may dispense, administer, and prescribe controlled substances under the registration of the individual teaching hospital in which the patient care is being provided. The GME Office will provide each resident with a specific unique identifier number (DEA number suffix) to be used along with the appropriate hospital's institutional number. These unique identifiers will be supplied to Tenn Care and are available to law enforcement agencies upon request for the purpose of verifying the authority of the prescribing individual practitioner. Residents are provided the hospital's institutional numbers and are responsible for using them appropriately. The institutional numbers are only valid for patients within that facility and cannot be used for any other purpose. The DEA number should only be used on prescriptions for controlled substances. The hospital institutional DEA numbers and individual suffixes can only be used for residency education rotations. Residents are responsible for immediately reporting any incidents that suggest a compromise to the GME Office and/or hospital pharmacy. Misuse of an institutional DEA number could result in disciplinary action up to and including dismissal from the training program. Residents who have an unexpired personal DEA number and an unrestricted Tennessee Medical should use their personal DEA number on all prescriptions. If moonlighting, a resident must obtain an individual federal DEA number (requires an unrestricted state medical license).
**Residents must utilize the DEA of their attending if prescribing in the ETSU Health clinics.

NPI
All residents must obtain a National Provider Identifier (NPI) number. Information on obtaining the NPI number is located on the GME website. The NPI must be included on all prescriptions including those requiring a DEA number.

Electronic Prescribing of Controlled Substances (EPCS) at Ballad Health
Activating and Access
1) To activate and access EPCS you must first activate your Ballad email address.
2) Activate your Ballad Health email account as soon as possible. Should you need assistance, please contact the Ballad Health Help Desk at (423) 431-6290, and select the "Physician Line" for expedited service.
3) As soon as the Ballad Health IT department completes your account, you will receive an email with instructions for downloading Duo and activating dual authentication for EPCS.
4) The links are time sensitive therefore your prompt attention to activate is imperative.
5) Failure to complete this process will impede your efficiency in completing hospital discharges during your hospital rotations.
MOONLIGHTING POLICY (OUTSIDE EMPLOYMENT)

IR IV.K.1
(Approved 6/18/2002, Revised/Approved 12/7/2017, Reviewed/Approved 12/1/2022 by GMEC)

Purpose

Moonlighting must not interfere with the ability of the resident to achieve the goals and objectives of the educational program and must not interfere with the resident's fitness for work nor compromise patient safety.

Policy
Moonlighting (outside employment) refers to voluntary, compensated medically related work undertaken by a resident outside the context of the residency program. Resident/fellows may not engage in moonlighting activities that interfere with the responsibilities to their program, especially in the context of clinical educational work hour limitations. Program Directors may establish a "no moonlighting" policy based on academic, workload, and/or work hour considerations. PGY I residents and residents holding a J1 Visa are not permitted to moonlight.

Residents may not engage in any outside employment or professional medical activity without first completing the QCOM Institutional Moonlighting Acknowledge Form, and obtaining written approval of the program director. A copy of the form must be sent to the GME Office. The Program Director is responsible for assuring there are no conflicts between their moonlighting schedule and requirements of the program. The program director is responsible for monitoring the health and program performance of the moonlighting resident and must take corrective action if these are adversely affected by the moonlighting activity. Additionally, the resident/fellow must enter moonlighting hours (both internal and external) as part of his/her duty hour log in New Innovations. Time spent moonlighting must be counted towards the 80-hour maximum weekly hour limit.

Program Directors reserve the right to deny moonlighting activities. Any resident/fellow failing to comply with moonlighting guidelines is subject to departmental disciplinary action. Any resident not in good standing may not moonlight.

Any resident/fellow engaged in moonlighting must be licensed for unsupervised medical practice in the state where the moonlighting occurs. It is the responsibility of the institution where moonlighting occurs to determine whether medical licensure is in place, whether adequate liability coverage is provided, and whether the resident/fellow has the appropriate training and skills to carry out assigned duties.

Professional liability insurance coverage provided by the QCOM DOES NOT extend to any medical practice or activities outside the medical education program of the University.

The QCOM does not encourage its' residents/fellows to engage in outside employment. QCOM accepts no responsibility for the financial consequences to residents who engage in moonlighting.
NON- RENEWAL OF RESIDENT CONTRACT (TIMELY)

IR IV.D.1.b
(Approved 7/12/2007, Revised/Approved 3/24/2016, Revised/Approved 8/23/2018, Reviewed/Approved 8/24/2023 by GMEC)

Appointments are made on a year-to-year basis. Reappointment for subsequent years is dependent on the resident's satisfactory progress as monitored according to evaluation and promotion policies, the availability of training positions at the University, and funding. Should the University decide not to renew the appointment, the physician will be notified by the program in as timely a manner as possible with the consent of the DIO.
OTHER LEARNER POLICY

CPR I.E.
(Approved 1/1/2016, Revised/Approved 8/23/2018, Revised/Approved 8/24/2023 by GMEC)

The presences of other learners (including, but not limited to residents from other specialties, subspecialty fellows, medical students, pharmacy students and nursing students) must not interfere with the appointed residents' education. The program director should discuss the presence of other learners with the DIO to ensure the availability of adequate resources for resident education.

The presence of other learners must be included in the program's Annual Program Evaluation (APE) and reported to the Office of Graduate Medical Education.
PROFESSIONAL LIABILITY / MEDICAL MALPRACTICE INSURANCE

IR IV.F.
(Approved 4/1/1980, Revised/Approved 9/22/2016, Reviewed/Approved 10/24/2019, Reviewed/Approved 10/24/2024 by GMEC)

All residents/fellows are covered under the State of Tennessee for professional liability coverage by the Tennessee Claims Commission Act (TCA 9-8.301 et sq). The limits of liability are $300,000 per plaintiff/$1 million dollars per occurrence. State law provides that residents/fellows have absolute immunity from liability for acts or omissions within the scope of their employment, unless the acts or omissions are willful, malicious, criminal, or done for personal gain.

The immunity of resident/fellows under Tennessee law has no mandatory effect in the courts of other states. Residents who participate in rotations out of Tennessee must have additional malpractice. Please consult with your residency coordinator when planning an out of state rotation.

If you should receive a summons and complaint naming you or East Tennessee State University as a defendant in a civil lawsuit arising out of your residency with the University, please have them delivered to the University Legal Office.. Do not discuss the suit with anyone other than the University Legal Counsel or the Attorney General’s Office. Do not talk to the plaintiff or the plaintiff’s attorney. Refer all requests for documents to the University Legal Counsel or the Office of Graduate Medical Education.

The coverage does not extend to any medical practice or activities outside the medical education program of the University (moonlighting). Claims made after termination of training will be covered if based on acts or omissions of the resident within the course and scope of their assignments during training, therefore residents will not need to purchase tail coverage.
PROFESSIONAL CONDUCT POLICY
CPR VI.B.
(Approved 3/27/2014, Revised/Approved 12/7/2017. Revised/Approved 12/1/2022, Revised/Approved 4/25/2024 by GMEC)

Purpose

QCOM Graduate Medical Education program strive to prepare physicians for practice in their chosen medical subspecialty, focusing on the development of clinical skills, professional competence, and acquisitions of key knowledge through organized education programs with guidance and supervision. All members of the QCOM community are responsible for sustaining the highest ethical standards of excellence, integrity, honesty, and fairness and for integrating these values into teaching, research, patient care, business practices, and other services. Residents must adhere to the principles of professionalism, personal responsibility, and ethical principles.

Policy
Principles of Professionalism:
- displaying compassion, integrity and respect for others;
- providing responsiveness to patient needs that supersedes self-interest;
- showing respect for patient privacy and autonomy;
- exhibiting accountability to patients, society, and the profession;
- demonstrating sensitivity and receptiveness to a diverse population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation;
- exhibiting awareness in addressing inequalities in the availability of health care;
- committing to the development and continued maintenance of clinical competence in themselves, colleagues, and students;
- respecting collegial teamwork in the provision of health care;
- recognizing and reporting impairment, including illness and fatigue, in themselves and others;
- fulfilling any and all obligations hospitals, training programs, and governing bodies deem necessary to begin and continue duties as a trainee;
- avoiding all forms of harassment, illegal discrimination, threats, intimidation, bullying or violence;
- displaying honest and accurate reporting of duty hours, patient outcomes, and clinical experience data;
- maintaining a professional appearance including apparel and grooming that is acceptable to their program and the facilities to which they are assigned;
- rendering services within the scope of federal, state and professional licensure guidelines and applicable by-laws;
- acting with integrity in dealing with adverse outcomes, accepting responsibility, taking corrective action, and learning from the event;
- adopting the practice of continuous self-improvement and lifelong learning;
- considering how personal actions reflect upon the university, institution, and profession including behavior outside the workplace including social media;
- adhering to the institutions' guidelines and policies.
Dress Code:
- adherence to proper clinical attire and compliance with the dress code policy of each applicable program is mandatory.
- appropriate attire at all times in patient care settings is Business Casual unless scrubs are required in a hospital setting.
- (Business Casual does not include jeans, shorts, skirts more than three inches above the knee, tube tops, tank tops, t-shirts, midriff tops, sundresses without a blazer/jacket, transparent clothing, sweatsuits).
- wearing of scrubs is at the discretion and direction of the individual program; however, in general, scrubs are not appropriate for ambulatory clinics unless the physician is on call to an area where scrubs are expected. In this case, scrubs should be clean of stains or fluids and always covered with a white jacket.
- CDC requires that fingernails be kept clean and short for patient care and for the proper fit of gloves or other protective equipment. Artificial nails are not permitted.
- acceptable personal hygiene and grooming are expected at all times.
- proper precautions should be taken to avoid odors related to perfume, smoking, or lack of deodorant.
- ETSU name badge is required to be clearly visible at all times.
- trainees are responsible for dressing appropriately for the workplace to foster confidence and trust in patients, families, visitors, and staff through professional behavior and appearance.
Violations of any of the above policies, rules, and standards may result in academic action, including warning letters, probation, non-renewal, or termination from the residency program.
PROMOTION and REAPPOINTMENT OF RESIDENTS and FELLOWS

IR IV.D.
(Approved 7/12/2007, Revised/Approved 12/17/2017, Reviewed/Approved 12/5/2019, Reviewed/Approved 12/5/2024 by GMEC)

Reappointment is not automatic. Residents/Fellows are promoted from one year to the next based upon meeting the academic standards and curricular requirements as determined by the ACGME, the Review Committee of the Program, the Program Director and the Clinical Competency Committee. Reappointment and promotion of a resident to the subsequent year of training requires satisfactory cumulative evaluations by faculty that indicate satisfactory progress in scholarship and professional growth. Individual programs must establish criteria for promotion and completion of the program. This includes demonstrated proficiency in each of the six ACGME competencies: Patient Care, Medical Knowledge, Practice-Based Learning, Interpersonal and Communication Skills, System Based Practice, Professionalism. Promotion also requires the ability to teach others, ability to undertake increasing levels of responsibility for patient care and supervision of junior residents and medical students, attendance, punctuality, and availability. The resident/fellow must adhere to rules and regulations in effect at ETSU Quillen College of Medicine and each healthcare entity to which assigned. Other examples include satisfactory scores on examinations if designated for that purpose by specialty, research, participation, etc.

The passage of USMLE Step 3 / COMLEX 3 is mandatory to advance to the next PGY level as designated by each specific program. Please refer to the GME USMLE Step 3 / COMLEX 3 Policy as well as the applicable program policy.

The decision regarding the promotion is to be submitted to the GME Office. A non-renewal is considered an adverse academic action and will therefore follow the GME Non-Renewal of Resident/Fellow Contract Policy.
QUALITY IMPROVEMENT / PATIENT SAFETY POLICY
IR III.B.2. IR I.B.4.a)
(Approved 7/1/2017, Revised/Approved 1/25/2018, Reviewed/Approved 12/1/2022 by GMEC)

East Tennessee State University, following the Institutional Requirements of the Accreditation for Graduate Medical Education (ACGME), requires each program to participate in safety event investigation and analysis on a routine basis. Programs must ensure that residents are integrated and actively participate in interdisciplinary clinical quality improvement and patient safety programs. Programs must incorporate Quality Improvement/Patient Safety Conferences into its curriculum.

Trainees must demonstrate the ability to investigate and evaluate their care of patients, as well as, the care provided by other healthcare workers. Trainees must be able to review records and analyze care based on careful assimilation and appraisal of scientific evidence, established standards of care, and institutional policies. Trainees must be able to recognize system issues that contribute to sub-optimal patient care. Trainees must demonstrate the ability to continuously improve patient care based on constant self-evaluation and life-long learning.

Quality and patient safety improvement is accomplished through the identification and effective use of opportunities to improve the overall quality and safety of care within the institution, as well as, the correction of problems when identified. This may be accomplished through:
- Hospital and medical staff department participation in the development, implementation, and evaluation of the quality and patient safety assessment and improvement plans and initiatives.
- Actions taken to achieve the organization's priorities and meet quality and patient safety goals.
- Allocations of resources to support quality and patient safety activities and implementation of best practices.
- Provision of support that fosters a non-punitive environment for reporting adverse events and near misses.
- Leadership and representation on quality and patient safety teams and committees.
- Participation in Root Cause Analysis teams to address patient safety opportunities.
Each program must have a process to ensure that quality improvement and patient safety are part of the daily educational structure of the residency. This may be accomplished in many ways including M & M conferences, morning reports, pre-operative conferences, participation in root-cause analysis, and other methods. Education programs and resident involvement in patient safety and quality improvement must be carefully documented and will be reviewed both during the Annual Program Evaluation and RRC site visits.

Programs must be able to demonstrate that residents in their training program can:
- Identify strengths, deficiencies, and limits in their own or in others' knowledge and expertise.
- Establish learning and improvement goals for their own identified deficiencies and identify and perform appropriate learning activities.
- Systematically analyze their practice and that of other healthcare providers using quality improvement methods, and implement changes with the goal of practice improvement.
- Be able to incorporate formative evaluation feedback from quality and patient safety activities into daily practice.
- Locate, appraise, and assimilate evidence from scientific studies related to patients' health problems.
- Use information technology to optimize learning.
All residents shall receive instruction in and must participate in appropriate components of the institution's quality assurance and improvement program.

East Tennessee State University's Office of Graduate Medical Education has purchased a group subscription for the America Medical Association's (AMA) GME Competency Education Program which provides modules to augment each residency/fellowship program's curriculum on patient safety and quality improvement initiatives. All residents/fellows are required to complete the GME-assigned online courses.
RESIDENT INITIATED GRIEVANCES

IR IV.E. ETSU PPP-27
(Approved 5/21/2013, Revised/Approved 10/20/2016, Revised/Approved 9/23/2021, Reviewed/Approved 10/24/2023 by GMEC)

It is desirable for residents' concerns to be resolved within the departmental structure. When resolution is not obtained the residents grievance regarding the residency program should be expressed to his/her preceptor, program director, department chair, or any other faculty member or administrative officer of the College of Medicine who will help to resolve the issue or agree on further action. If not resolved, the problem then will be brought by the involved resident and appropriate faculty member to the attention of the residents program director and the Executive Associate Dean for Graduate Medical Education. If there is still no resolution of the problem, the Executive Associate Dean for Graduate Medical Education will convene an ad-hoc committee and proceed with the due process. If the residents grievance is against the Executive Associate Dean for Graduate Medical Education, program director, department chair of any clinical department or any other person who might otherwise take part in the process of resolving the problem, the above steps will be structured to exclude the involvement of that person from the judging process.
RESTRICTIVE COVENANT/NON COMPETITION

IR IV.M.
(Approved 7/12/2007, Revised/Approved 11/15/2016, Reviewed/Approved 9/15/2021 by GMEC)

In accordance with the Accreditation Council for Graduate Medical Education (ACGME) institutional requirements, neither the Sponsoring Institution nor any of its ACGME-accredited programs will require a resident/fellow enrolled in an accredited program to sign any type of non-competition guarantee or restrictive covenant in return for fulfilling their educational obligations.

Residents and fellows must immediately notify the QCOM Office of Graduate Medical Education if they are asked to sign such a document.

This policy does not apply to moonlighting.
RESIDENT SUPERVISION
IR IV.J.
(Approved 7/12/2007, Revised/Approved 4/25/2013 by GMEC, Revised/Approved 10/27/2017, Reviewed/Approved 8/25/2022 by GMEC)

Supervision in the setting of graduate medical education has the goals of assuring the provision of safe and effective care to each patient; assuring each resident's development of the skills, knowledge, and attitudes required to enter the unsupervised practice of medicine; and establishing a foundation for continued personal growth. One of the core principles of graduate medical education is the concept of graded and progressive responsibility. As residents gain experience and demonstrate growth in their ability to care for patients, they assume roles that permit them to exercise those skills with greater independence.

Each program is required to establish a written program-specific supervision policy consistent with GME Institutional Policies, ACGME Common and Specialty/Subspecialty-specific program requirements, and applicable ACGME Review Committee requirements. Programs must use the ACGME Levels of Supervision and must demonstrate that appropriate Levels of Supervision are in place. This includes but is not limited to: In the clinical learning environment, each patient must have an identifiable, appropriately credentialed and privileged attending physician (or licensed independent practitioner as approved by each Review Committee) who is ultimately responsible for that patients' care. This information should be available to residents, faculty members, and patients; and the patients should be informed of these roles in their care. The program must demonstrate that the appropriate level os supervision is in place for all residents is based on each resident's level of training and ability, as well as patient complexity and acuity. Supervision may be exercised through a variety of methods, as appropriate to the situation.

The program must use the following classification of supervision:
- Direct Supervision - the supervising physician is physically present with the resident during key portions of the patient interaction; or the supervising physician and/or patient is not physically present with the resident and the supervising physician is concurrently monitoring the patient care through appropriate telecommunication technology.
- Indirect Supervision - the supervising physician is not providing physical or concurrent visual or audio supervision but is immediately available to the resident for guidance and is available to provide appropriate direct supervision.
- Oversight - the supervising physician is available to provide review of procedures/encounters with feedback provided after care is delivered.
The privilege of progressive authority and responsibility, conditional independence, and a supervisory role in patient care delegated to each resident must be assigned by the program director and faculty members. The program director must evaluate each resident's abilities based on specific criteria. When available, evaluation should be guided by specific national standards-based criteria. Faculty members functioning as supervising physicians should delegate portions of care to residents, based on the needs of the patient and the skills of the residents. Senior residents or fellows should serve in a supervisory role of junior residents in recognition of their progress toward independence, based on the needs of each patient and the skills of the individual resident or fellow. Programs must set guidelines for circumstances and events in which residents must communicate with appropriate supervising faculty members, such as the transfer of a patient to an intensive care unit, or end-of-life decisions.

Each resident must know the limits of his/her scope of authority, and the circumstances under which he/she is permitted to act with conditional independence. PGY-1 residents must be supervised either directly or indirectly with direct supervision immediately available. [Every discipline's Review Committee will describe the achieved competencies under which PGY-1 residents' progress to be supervised indirectly, with direct supervision available.] Faculty supervision assignments should be of sufficient duration to assess the knowledge and skills of each resident and delegate to him/her the appropriate level of patient care authority and responsibility.
SECURITY BACKGROUND CHECK POLICY

State of TN statue T.C.A. 63-1-149
ETSU PPP-77
(Approved 11/15/2012, Revised 2/1/2018, Reviewed/Approved 1/26/2023 by GMEC)

Purpose
Quillen College of Medicine is to hiring and educating well-trained physicians who possess the traits of high moral character and standards. All prospective residents/fellows of Quillen College of Medicine must undergo a Criminal Background Check (CBC) as a condition for hire.

Policy
Review and approval of a completed CBC is a precondition to employment for new resident and fellow physicians. Based on requirements mandated by the State of Tennessee (T.C.A § 63-1-149), Quillen College of Medicine will not employ any resident or fellow who appears on any state's sexual offender registry, the national sex offender public registry website coordinated by the United State's Department of Justice, any state adult abuse registry, or the Tennessee Department of Health's elder abuse registry.

The CBC may also reveal information not contained in the above registries that could disqualify one from being considered for employment.
Quillen College of Medicine uses an outside vendor contracted the Tennessee Board of Regents, for the CBC's of employee hires. The CBC will include a record of all arrests and convictions, including those that would lead to inclusion in the registry listings above. A list of the information checked and evaluated in the CBC may change from time to time.

After hiring, all residents and fellows are required to disclose within five (5) working days of their occurrence, any criminal charges or events. Failure of a resident or fellow to notify his/her program director of such events may result in disciplinary action up to and including termination.

If the CBC evaluation identifies any issues that may preclude participation in activities when direct patient contact occurs, the case will be referred immediately to the Criminal Background Administrative Committee (CBAC) for evaluation. All post-hire employee reported events will also be referred to the CBAC. The CBAC is comprised of the Executive Associate Dean for Academic Affairs, Associate Dean for Graduate Medical Education, and the Associate Dean for Student Affairs. This committee is responsible for making recommendations to the Dean who retains the authority to make the decision in all such matters about hiring or employee disciplinary action.

The College reserves the right, at its sole discretion, to amend, replace, and/or terminate this policy at any time.
SEXUAL HARASSMENT POLICY (ETSU POLICY)

IR IV.1.3. ETSU Policy PPP-80
(Approved 7/1/2007, Revised/Approved 10/26/2017, Reviewed/Approved 10/24/2019 by GMEC)

East Tennessee State University desires to maintain an environment which is safe and supportive for students and employees and to reward performance solely on the basis of relevant criteria. Accordingly, the University will not tolerate sexual harassment of students or employees.

Unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature constitute sexual harassment when: (1) Submission to such conduct is made either explicitly or implicitly a term or condition of an individuals employment or academic standing; (2) Submission to or rejection of such conduct by an individual is used as a basis for employment or academic decisions affecting an individual; or; (3) Such conduct has the purpose or effect of unreasonably interfering individuals work or academic performance or creating an intimidating, hostile or offensive working or academic environment.

Recommended actions to be taken by anyone who believes he or she is being sexually harassed:

In circumstances where you think you will not be jeopardizing your personal safety, your job, or your academic status, communicate clearly to the offender that the behavior is not humorous or welcome and should cease immediately.
Keep a record of what happened and when it took place. Should there be any witnesses, ask for their names to include in your documentation of the incident.
If the harassment continues, or if you choose not to confront the offender directly, you many report the situation to the Affirmative Action Officer, Office of the President. You may also report the situation to any of the other persons listed below who will assist you in preparing charges to be reported to the Affirmative Action Officer:

Associate Vice President of Student Affairs
Box 70725, (423) 439-4210

Affirmative Action Officer for ETSU
Office of the President, 206 Dossett Hall (423) 439-4211

Source: Tennessee Board of Regents (TBR) Personnel Policy No: 5:01:02:00; TBR Personnel Guide No. P-080.

Violations will be forwarded to Human Resources for employee incidents or Student Affairs for student incidents. The individual department will handle the progressive discipline for repeat violators. Visitor violations will be forwarded to the ETSU Police Department and contractor violations to the Facilities Office.
SOCIAL MEDIA (ETSU POLICY)

ETSU Policy PPP-44
(Approved 7/12/2007, Revised/Approved 10/26/2017; Reviewed 8/23/2018, Revised/Approved 5/25/2023 by GMEC)

Purpose
The Graduate Medical Education Committee recommends that residents/fellows exercise caution in using social networking sites to include, but not limited to, Facebook, Instagram, Twitter, TikTok, and Snapchat. Items deemed to represent unprofessional behavior posted by residents/fellows on such networking sites are not in the best interest of the University and may result in disciplinary action up to and including termination.

Policy
The ETSU information Technology Code of Ethics can be accessed in its entirety by going to this link: https://www.etsu.edu/human-resources/documents/ppps/ppp44 it code ethics.pdf.

Residents and Fellows are expected to exhibit a high degree of professionalism and personal integrity consistent with the pursuit of excellence in the conduct of his or her responsibilities. They must avoid identifying their connection to the University if their online activities are inconsistent with the values or could negatively impact the University's reputation.

If using social media, residents and fellows must use a personal e-mail address as their primary means of identification. Their University e-mail address must never be used for personal views. Residents/fellows who use these websites must be aware of the critical importance of privatizing their websites so that only trustworthy individuals have access to the websites/applications.

In posting information on personal social networking sites, residents/fellows may not present themselves as an official representative or spokesperson for a residency/fellowship program, hospital, or University. Patient privacy must be maintained and confidential, or proprietary information about the University, hospitals, or patients must not be shared online. Patient information is protected under the Health Insurance Portability and Accountability Act (HIPAA). Residents/fellows have an ethical and legal obligation to safeguard protected health information, and sharing patient photographs or any other information is a violation of the HIPAA statute. Violations could result in immediate suspension and/or termination.

ETSU's name or marks may not be used to endorse any opinion, product, private business, cause, or political candidate. Representation of your personal opinions as being endorsed by the University or any of its organizations is strictly prohibited. Residents should post only content that is not threatening, obscene, a violation of copyright or other intellectual property rights or privacy laws, or otherwise injurious or illegal. Photographs or content should not be posted without consent being provided by all parties.

By posting content to any social media site, the resident represents that he or she owns or otherwise has all the rights necessary to lawfully use that content or that the use of the content is permitted by fair use. Residents/fellows also agree that they will not knowingly provide misleading or false information and that they will indemnify and hold the University harmless for any claims resulting from the content. Each program should provide training and guidance to help residents and fellows understand how University and program policies apply to social media and professionalism.
TOBACCO-FREE CAMPUS
ETSU PPP-53
(Approved 8/11/2008, Reviewed/Approved 9/22/2016, Reviewed/Approved 10/24/2019, Reviewed/Approved 10/24/2024 by GMEC)

Effective October 1, 2019, the James H. Quillen VA Medical Center has a no smoking policy on the VA Campus. This includes no smoking in vehicles, as well as the grounds on the ETSU Quillen College of Medicine areas of the campus.

This policy covers all smoking material, including but no limited to:
- Cigarettes
- Cigars
- Any other combustion of tobacco
- Electronic nicotine delivery systems (ENDS), including but not limited to electronic or e-cigarettes, vape pens, or e-cigars.
August 11, 2008, ETSU is a Tobacco-Free Campus, with smoking and all other tobacco usage permitted only in private vehicles. This policy applies to all university buildings/grounds; ETSU-affiliated off-campus locations and clinics; any buildings owned, leased or rented by ETSU in all other areas; and ETSU facilities located on the campus of the James H. Quillen Veterans Affairs Medical Center at Mountain Home. Tobacco use is also prohibited in all state vehicles. This tobacco-free policy is in effect 24 hours a day year-round.
For purposes of the policy, "tobacco use" means, but is not limited to, the personal use of any tobacco product, whether intended to be lit or not, which shall include smoking tobacco or other substances that are lit and smoked, as well as the use of any electronic cigarette or any other tobacco; smokeless pouches; any form of loose-leaf, smokeless tobacco; and the use of unlit cigarettes, cigars and pipe tobacco.

Background - The university promotes a healthy, sanitary environment free from tobacco smoke and tobacco-related debris. The ETSU community acknowledges that long-term health hazards may accrue to people who use tobacco products or who are subjected to second-hand smoke. The failure to address the use of tobacco products on campus would constitute a violation of the Americans with Disabilities Act, the Vocational Rehabilitation Act and Tennessee law Support

Support - Understanding the addictive nature of tobacco products, ETSU will make every effort to assist those who may wish to stop using tobacco. The university offers current information about available resources via Smoking Cessation Resources page.

Compliance - It is the responsibility of all members of the ETSU community to comply with this Tobacco-Free Campus Policy. Violations of the policy will be dealt with in a manner that is consistent with university procedures. There shall be no reprisals against anyone reporting violations of this policy.

Tobacco Free Campus Enforcement Policy

Violations to the tobacco free policy, particularly reoccurring violations, are to be reported to ETSU Police 423-439-4480

Any violator of the policy that refuses to comply or that becomes abusive toward the responsible party will be handled by ETSU Police.
TRANSFER OF RESIDENT POLICY AND PROCESS
CPR III.C.
(Approved 9/25/2013, Revised/Approved 1/28/2016, Reviewed/Approved 9/15/2021 by GMEC)

According to ACGME Institutional Requirement, the institution and our ACGME accredited programs are at risk for loss of accreditation if non-eligible residents are accepted into our training programs. For that reason, any applicant under consideration for transfer must be reviewed and approved by the Designated Institutional Official in the Office of Graduate Medical Education prior to an offer being extended.

The following documents are required for any resident being considered and must be provided to the Designated Institutional Official for review.

Written or electronic verification of the prior educational experience
Summative, competency-based performance evaluation of the transferring resident based on the Milestone assessment by the Clinical Competency Committee. Verification should also include evaluations, rotations completed, procedural/operative experience. **Please utilize the Transfer Checklist provided below.
- Letter of recommendation from the resident's current program director.
- Obtain confirmation from respective ABMS certifying board of the amount of credit that will be granted from prior program.
- Fellowship programs must receive verification of each fellow's level of competency in the required field usually ACGME or CanMED's Milestones assessments from the core residency program.
For any resident transferring from a QCOM training program to another program prior to completion of training, the QCOM program director must provide:
- Written or electronic verification of residency education.
- Summative, competency-based performance evaluation for the resident.
A resident/fellow transferring out of a residency/fellowship program at Quillen College of Medicine must do the following:
- Notify their program director in a timely manner.
- Must complete all program specific requirements (i.e. call, medical records, documents, etc.) and all program specific exit requirements.
- Must meet with their program director to review and sign the final verification of training form.
Transfer Process and Checklist
Supporting Information:

*ACGME Glossary: "Residents are considered as transfer residents under several conditions including: moving from one program to another within the same or different sponsoring institution; when entering a PGY2 program requiring a preliminary PGY 1 program and the PGY 2 program as part of the match (e.g., accepted to both programs right out of medical school). Before accepting a transfer resident, the program director of the 'receiving program' must obtain written or electronic verification of previous educational experiences and a summative competency-based performance evaluation from the current program director. The term 'transfer resident' and the responsibilities of the two program directors noted above do not apply to a resident who has successfully completed a residency and then is accepted into a subsequent residency or fellowship program."

Direct communication with the ACGME establishes that any resident entering categorical residency from a preliminary year, even if this is occurring within the same department, is a transfer resident and the program must receive the list of previous education experiences and the summative evaluation prior to accepting him.

The ACGME Program Director Guide to the Common Program Requirements (July 1, 2007) also includes clarification of the expectation for documentation of resident transfers: For residents who have transferred into the program, written verification of prior educational experience and a summative competency-based performance evaluation should be available in the resident files for site visitors to review. Examples of verification of previous educational experiences could include a list of rotations completed, evaluations of various educational experiences, procedural/operative experience. Meeting the requirement for verification before accepting a transferring resident is complicated in the case of a resident who has been simultaneously accepted into the preliminary PGY 1 program and the PGY 2 program as part of the match. In this case, the "sending" program should provide the "receiving" program a statement regarding the resident's current standing as of one-two months prior to anticipated transfer along with a statement indicating when the summative competency-based performance evaluation will be sent to the "receiving" program.

An example of an acceptable verification statement is: (Resident name) is currently a PGY (level) intern/resident in good standing in the (residency) program at (sponsoring institution). She/he has satisfactorily completed all rotations to date, and we anticipate she/he will satisfactorily complete his/her PGY (#) year on June 30, (year). A summary of her/his rotations and a summative competency-based performance evaluation will be sent to you by July 31, (year).
TRANSITIONS OF CARE POLICY
IR III.B.3.
(Approved 1/1/2016, Revised/Approved 12/7/2017, Revised/Approved 12/1/2022 by GMEC)

PURPOSE
To establish protocol and standards with the Quillen College of Medicine residency and fellowship Programs to ensure and monitor effective, structured patient handover processes to facilitate continuity of care and patient safety at participating sites.

POLICY
Each residency/fellowship program, in partnership with their Sponsoring Institutions, must design schedules and Clinical assignments to maximize the learning experience for residents/fellows as well as to ensure quality care and patient safety, and adhere to general institutional policies concerning transition of patient care within the context of other duty-hour standards. All programs must design call and shift schedules to minimize transitions of patient care. Schedule overlaps should include time to allow for face-to-face handoffs to ensure availability of information and an opportunity to clarify issues. The transition process may be conducted by telephone as long as both parties have access to an electronic or hard copy version of the sign-out sheet. Patient confidentiality must be observed. The transition process should include, at a minimum the following information in a standardized format that is universal across all services.
- Identification of patient, including name, medical record number and date of birth.
- Identification of admitting/primary/supervising physician and contact information.
- Diagnosis and current status/condition (level of acuity) of patient.
- Recent events, including changes in condition or treatment, current medication status, recent lab tests, allergies, anticipated procedures and actions to be taken.
- Outstanding tasks- what needs to be completed in immediate future.
- Outstanding laboratories/studies- what needs follow up during shift.
- Changes in patient condition that may occur requiring interventions or contingency plans.
Each resident/fellowship program must develop components ancillary to the institutional transition of care policy that integrates specifics from their specialty field. Programs are required to develop scheduling and transition/hand-off procedures to ensure that:
- Residents comply with specialty-specific/institutional duty hour requirements.
- Faculty are scheduled and available for appropriate supervision levels according to the requirements for the scheduled residents.
- All parties involved in a particular program and/or transition process have access to one another's schedules and contact information. All call schedules should be available on department-specific password-protected websites and also with hospital operators.
- Patients are not inconvenienced or endangered in any way by frequent transitions of their care.
- All parties directly involved in the patient's care before, during, and after the transition have opportunity for communication, consultation and clarification of information.
- Safeguards exist for coverage when unexpected changes in patient care may occur due to circumstances as resident illness, fatigue or emergency,
- Programs should provide an opportunity for residents to both give and receive feedback from each other or faculty physicians about their handoff skills.
Each residency/fellowship program must include the transition of care process in their curriculum and ensure continuity of patient care.

Residents must demonstrate competency in the performance of this task. There are numerous mechanisms through which a program might elect to determine the competency of trainees in handoff skills and communication. These include:
- Direct observation of a handoff session by a supervisory level clinician, by a peer, or by a more senior trainee.
- Evaluation of written handoff materials by clinician or by a peer or by a more senior trainee.
- Didactic sessions on communication skills including in-person lectures, web-based training, review of curricular materials and/or knowledge assessment.
- Assessment of handoff quality in terms of ability to predict overnight events.
- Assessments of adverse events in relationship to sign-our quality through:
  A. Survey
  B. Reporting Hotline
  C. Chart Review
Programs must develop and utilize a method of monitoring the transition of care process and update as necessary. Monitoring handoffs by the program to ensure:
- There is a standardized process in place that is routinely followed.
- There is consistent opportunity for questions.
- The necessary materials are available to support the handoff (including for example, written sign-out materials and access to electronic clinical information).
- A setting fee of interruptions is consistently available for handoff processes that include face-to-face communications.
- Patient confidentiality and privacy are ensured in accordance with HIPAA guidelines.
There are circumstances in which residents/fellows may be unable to attend work, including but not limited to fatigue, illness and family emergencies. Each program must have policies and procedures in place that ensure coverage of patient care responsibilities. These policies must be implemented without fear of negative consequences for the resident/fellow who are unable to provide the clinical work.

Residents/fellows must care for patients in an environment that maximizes communication. This must include the opportunity to work as a member of effective interprofessional teams that are appropriate to the delivery of care in the specialty and larger health system.
USMLE STEP III / COMPLEX LEVEL 3 POLICY

(Approved 7/1/2022 by GMEC)

The purpose of this policy is to ensure that all residents complete and pass either the USMLE Step III or COMLEX Level 3 to progress in their residency program. Residents cannot become licensed to practice medicine independently without successfully passing the exam. This policy applies to all residents in categorical ACGME accredited post-graduate training programs at East Tennessee State University.

This policy does not apply to residents in Preliminary Internal Medicine or Preliminary General Surgery programs. All residents must receive a passing score on the USMLE Step III or COMLEX Level 3 examination no later than June 1st of their PGY 2 year of training. If a resident is off-cycle they must pass the exam no later than the end of the eleventh month of training during the PGY 2 year. Failure to pass the examination will result in the non-renewal of their contract and/or failure to advance to a PGY 3 position. This is a non-appealable action.

Transfer residents who enter into a PGY 3 level position or above from another training program must have documentation of successful completion of the USMLE Step III or COMLEX Level 3. An transcript must be submitted to the Program Director and the Office of Graduate Medical Education. Fellowship applicants MUST have passing scores for USMLE Step III or COMLEX Level 3 to be considered for a fellowship position.

Each resident is responsible for contacting the appropriate licensing authority to register for the examination. The resident is responsible to pay all costs associated with taking the exam. Departments may permit the resident to be reimbursed from their educational funds, at the discretion of the program director and if consistent with program policy.

Program Directors are required to notify the GME Office when a resident has failed Step III/Level 3 and is at risk of dismissal under this policy. An individual program may have more stringent deadlines and their policy will supersede this GME policy.
VENDOR INTERACTION AND ETHICAL GUIDELINES POLICY
IR IV.L.
(Approved 4/1/2009, Reviewed/Approved 3/27/2017, Revised/Approved 2/23/2022 by GMEC)

Policy and Guidelines for Interactions between the James H. Quillen College of Medicine, East Tennessee State University, and commercial interests ( i.e.,any entity producing, marketing, re-selling or distributing health care goods or services consumed by, or used on, patients).

Purpose
The purpose of this policy is to establish guidelines for interactions with commercial interests for medical staff, faculty, staff, students, and trainees of the James H. Quillen College of Medicine, East Tennessee State University. The intent of this policy to recognize the potentially positive and important value of many of the interactions with commercial interests while providing a framework for an ethical relationship that avoids conflicts of interest that could influence patient care, research objectivity, the integrity of our education and training programs, or the reputation of individual faculty members or the institution.

Policy Statement
It is the policy of the James H. Quillen College of Medicine that interactions with commercial interests should be conducted so as to avoid or minimize conflicts of interest. When conflicts of interest do arise they must be managed appropriately, as described herein.

Principles for Interaction
As the James H. Quillen College of Medicine and commercial interests both share the goal of improving the health of our population, the following principles should be used in guiding interactions:
- The interactions should serve to enhance the health of the public.
- The interaction should be transparent.
- All of the interactions should involve reciprocal communications, with knowledgeable parties on both sides of the interactions.
- The interactions should support and enable the free exchange of information. In appropriate settings,assuring such exchanges are evidence-based and free of bias to the maximum possible extent.
Scope of Policy and Guidelines for Interaction
This policy addresses many types of interactions with commercial interests, e.g. pharmaceutical and device marketing, training, educational support of students and trainees, and continuing medical education. Its scope includes interactions with commercial interests both on-site and off-site.

1. Gifts to Individuals

Personal gifts from commercial interests may not be accepted anywhere at the Quillen College of Medicine, college clinical offices, or training sites. It is strongly advised that no form of personal gift from commercial interests be accepted under any circumstance.

Examples of prohibited transactions include but are not limited to the following:
- Individuals may not accept gifts or compensation for listening to a sales talk by an industry representative.
- Individuals may not accept gifts or compensation for prescribing or changing a patients prescription.
- Individuals must consciously and actively divorce clinical care decisions from any perceived or actual benefits expected from any company. It is unacceptable for patient care decisions to be influenced by the possibility of personal financial gain.
- Food supplied by a commercial interest is considered a personal gift and is not permitted at the Quillen College of Medicine, college clinical sites, or functions. This does not apply when food is provided in connection with ACGME accredited programming or through unrestricted grants to departments or divisions that follow ACGME guidelines.
- Individuals may not accept compensation from commercial interests, including the defraying of costs, for simply attending a CME or other activity or conference unless the individual is speaking or otherwise actively participating or presenting at the event.
2. Pharmaceutical Sample

Sample medications are centrally managed at all ETSU facilities, in accordance with guidelines outlined by MEAC, ETSU Family Medicine and Associates, and individual departments.

Sample medications may only be dispensed to patients.

3. Site Access by Industry Representatives

Access of the representatives of commercial interests to individuals is limited to non-patient areas ( e.g., private physician offices at a practice location or conference rooms) and must take place by appointment or the invitation of a faculty member, with the following exceptions:
- Access by device manufacturer representatives to patient care areas is permitted by appointment or invitation by faculty members or clinic supervisors.
- Device manufacturer representatives may not be present during patient interactions unless there has been prior disclosure and consent by the patient. Such interactions must be limited to in-service training or assistance on devices and equipment.
- Medical students and trainees may be included for educational purposes.
- These interactions must occur under the supervision of a faculty member.
4. Support for Educational and other Professional Activities

The Office of Continuing Medical Education administers all accredited CME activities to ensure compliance with ACGME standards.

All educational events sponsored by the James H. Quillen College of Medicine and its departments or divisions must be compliant with ACGME Standards for Commercial Support whether or not CME credits are awarded, and whether or not they are held on or off campus.

5. Participation in Programs Sponsored by Commercial Interests

Faculty, staff, students, and trainees are strongly encouraged to avoid attending or speaking at meetings and conferences that are exclusively or primarily organized, underwritten, or presented by commercial interests because of the high potential for perceived or real conflict of interest. This provision does not apply to meetings of professional societies that may receive partial support from commercial interests or to meetings supported by commercial interests governed by ACGME Standards. It also does not apply to special and specific training on the use of new patient care medical devices for which alternate sources of education and training are not available.

Individuals who participate ( e.g., by giving a lecture, organizing the meeting) in meetings and conferences supported in part or in whole by commercial interests and not governed by ACGME Standards should follow these guidelines:
- Financial support by commercial interests is fully disclosed by the meeting sponsor.
- The meeting or lecture content is determined by the speaker and not the commercial interest.
- Participants, including the ETSU participant, are being expected to provide a fair and balanced assessment of therapeutic options and to promote objective scientific and educational activities and discourse.
- The ETSU participant is not required by a commercial interest to accept advice or services concerning speakers, content, etc., as a condition of the sponsor's contribution of funds or services.
- The ETSU participant makes clear that content reflects individual views and not the views of ETSU.
- The use of the ETSU name in non-ETSU events is limited to the identification of the individual by his or her title and affiliation.
6. Sponsorship of Scholarships and Other Educational Funds for Trainees by Commercial Interests

Educational grants that are compliant with the ACGME standards may be received from commercial interests but must be administered by the Office of Continuing Medical Education, departments or divisions and not by individual faculty.

No quid pro quo may be involved for donated scholarship or educational funds.

The evaluation and selection of recipients of scholarships or grants is the sole responsibility of ETSU or of a nonprofit-granting industry, with no involvement by the donor commercial interest.

7. Professional Travel

Direct payments by commercial interests to ETSU faculty, staff, students, and trainees is not allowed other than for reimbursement of direct travel when the faculty, staff, student, or trainee is providing a legitimate service for which the travel is necessary and is reasonable in relation to the services provided.

8. Ghostwriting

ETSU faculty, staff, students, and trainees are prohibited from having publications or professional presentations of any kind, oral or written, ghostwritten by any party, industry or otherwise.

This does not apply to transparent writing collaboration with attribution between academic and industry investigators, medical writers, and/or technical experts.

9. Boards of Directors, Advisory Boards, and Consulting

ETSU faculty, staff, students, and trainees are allowed to interact as members of boards and/or as consultants via professional service agreements, as long as such activities are conducted in full compliance with the ETSU Conflict of Interest Policy and ETSU training program policies.

10. Publications

In scholarly publications, individuals must disclose their related financial interests in accordance with the International Committee on Medical Journal Editors.

11. Purchasing

Individuals having a direct role in making institutional decisions on equipment or drug procurement must disclose any financial interest they or their immediate family have in companies that might substantially benefit from the decision. They must also disclose any research or educational interest they or their department have that might substantially benefit from the decision. This provision does not include indirect ownership such as stock held through mutual funds.
VISAS AND INTERNATIONAL MEDICAL GRADUATES
IV B.2,c).(1)
(Approved 7/12/2007, Revised/Approved 2/1/2018, Reviewed/Approved 1/26/2023 by GMEC)

Purpose
This policy defines the requirements for non-U.S. citizens applying to the Accreditation Council for Graduate Medical Education (ACGME)-accredited residency or fellowship programs at Quillen College of Medicine.

Policy
Definitions:
Educational Commission on Foreign Medical Graduates (ECFMG): ECFMG is a private, non-profit organization established to:
- provide information to and answer inquiries of International Medical Graduates planning to come to the United States for GME;
- evaluate IMGs' credentials, knowledge of medicine, and command of English; and
- certify that IMGs have met certain medical education and examination requirements.
Certification by ECFMG is the standard for evaluating the qualifications of International medical graduates (IMGs) before they enter U.S. graduate medical education (GME), where they provide supervised patient care. ECFMG Certification also is a requirement for IMGs to take Step 3 of the three-step United States Medical Licensing Examination (USMLE) and to obtain an unrestricted license to practice medicine in the United States. (From https://www.ecfmg.org/about/index.html accessed September 4, 2020)
ECFMG also administers the Exchange Visitor Sponsorship Program (EVSP), which sponsors J-1 visas for the purpose of participation in a U.S.- accredited training program. For more information and a complete listing of services provided to assist IMGs, please go the ECFMG website www.ECFMG.org. or contact Kathy Sandman in the GME Office.
Employment Authorization Documents (EAD): A document issued by the United State Citizenship and Immigration Services (USCIS). See https://www.uscis.gov/
International medical graduates (IMGs): A physician who has graduated from a medical school outside of the United States or Canada.

The clinical departments of the Quillen College of Medicine each maintain policies for selecting and accepting candidates into graduate medical education (GME) residency or fellowship training programs. These policies must be followed for international graduates as well as all other eligible candidates.

International graduates who are not permanent U.S. residents or U.S. citizens must be willing to obtain a J-1 exchange visitor visa sponsored by the Education Commission to Foreign Medical Graduates (ECFMG) if they are chosen according to the rules of the NRMP Match, or have a Permanent Resident Card (Green card) or an Employment Authorization Card (EAD). They are also expected to be willing to obtain a J-1 for placement in the unusual circumstance of being accepted outside of the NRMP Match.

All graduates of medical schools outside of the United States or Canada must have a valid ECFMG certificate to train at East Tennessee State University's Quillen College of Medicine's residency and fellowship programs.

If a newly matched trainee experiences a delay in obtaining a visa and cannot begin at the appointed time, the program, in consultation with the Office of GME, and through the NRMP agreement, may choose to terminate the contract at the end of the 45th day or earlier in the case of a final rejection of the visa application through an NRMP waiver. The program and candidate, also in consultation with the Office of GME, may choose to extend the timeframe in the pursuit of a visa if mutually agreed on by all parties.

J-1 physicians should exercise caution when planning international travel, as it comes with some inherent risks. International travel restrictions, security and background checks, along with other security-based initiatives can result in delays in visa issuance at U.S. consulates. These delays can compromise a physician's timely return to the United States. J-1 visas are extended through ECFMG annually for the length of training with a continuation sponsorship application making it unnecessary to leave the United States.

While it is understandable trainees may choose to return to their home country during their residency training, they must be aware of the consequences should there be delays with their visa renewal.

The programs have the authority to require unpaid leave should a trainee's stay be extended due to delays with the visa renewal process. The institutions and programs are under no obligation to retain the position if J-1 physicians travel internationally and experience a delayed return. Should the interruption be more than 30 days, there is a risk of forfeiting the residency position.

The Quillen College of Medicine does not sponsor H1-B visas for the purpose of residency or fellowship training in its GME programs.
VISITING TRAINEES POLICY
(Approved 7/1/2022 by GMEC)

Only Residents from ACGME accredited programs may be considered for approval to participate in temporary rotations in an ETSU Quillen College of Medicine Graduate Medical Education Program. Completion of the following procedure is required before a visiting rotation assignment may begin.

The completed application and supporting documents (items 1-7, below) must be submitted to the ETSU program coordinator at least 90 days before the requested rotation date. The information must be submitted to the appropriate department for approval by the respective ETSU Program Director.

Supporting documents to attach to the application:
- A letter from the applicant's Program Director verifying the applicant is in good standing. This must include a statement the Sponsoring Home Institution will provide the Resident's salary and benefits during the ETSU QCOM rotation.
- A letter from the applicant's home GME Office verifying the resident has passed a background check and has completed HIPAA training.
- A copy of their Curriculum Vitae.
- A copy of their current malpractice coverage or letter verifying the Sponsoring Home Institution will provide the liability coverage during the ETSU QCOM rotation, the minimum is $1 million per occurrence /$3 million aggregate.
- A copy of their immunization record including proof of TB screening and COVID vaccination.
- A copy of their medical license or a copy of the letter of exemption from licensure.
- If applicable, a copy of a valid ECFMG certificate and Visa.
Upon receipt of the signed and completed Application for Visiting Rotation and all required documents, the Program Director will review it. If the Program Director approves the application, she/he will forward to the DIO who will review and notify the ETSU Program Director and Program Coordinator of his/her approval or denial.

The Program Coordinator of the Sponsoring Home Institution must initiate a program letter of agreement (PLA) and provide it to the ETSU program coordinator in the department with which the rotation is located. This PLA must be received at least 90 days before the desired start date. Therefore, communication among the resident candidate, the appropriate people at the Sponsoring Home Institution and the ETSU Program Director must occur well before the desired rotation. The application will not receive final approval and be processed without a signed PLA.

NOTE: The Quillen College of Medicine Graduate Medical Education Program does not offer or provide the opportunity for any externships or observing experiences for physicians not in an ACGME accredited residency or fellowship training.
Medical students enrolled in an LCME or AOA accredited school may apply for M4 electives by contacting the ETSU Office of Academic Affairs at (423) 439-6327.
WELL BEING POLICY
IR III.B.7.
(Approved 7/1/2017, Revised/Approved 2/1/2018, Revised/Approved 1/26/2023 by GMEC)

Purpose
East Tennessee State University, Quillen College of Medicine is committed to ensuring that residents and fellows remain physically and mentally healthy while completing their training program. Recognizing that residents and fellows are at increased risk for burnout and depression, Quillen College of Medicine will prioritize efforts to foster resident well-being while ensuring the competence of its trainees.
Quillen College of Medicine Counseling Services provides individual mental health counseling and psychotherapy utilizing a short-term, problem-oriented, solution-focused model. On occasion, residents and fellows may present with problems that surpass what can be handled in the short-term model. Information provided in this policy defines services available for short-term, extended support, and for those in an emergency or crisis situation.

Policy
Each residency/fellowship program will have policies and schedules in place that define ways in which residents and fellows will be supported in their efforts to become a competent, caring and resilient physician.

These must include but not limited too :
- Ensure protected time dedicated to patient care;
  Provide administrative support;
- Provide oversight of scheduling, work intensity, and work compression that may negatively impact a resident/fellow’s well-being;
- Policies for time away from the residency/fellowship that allow the resident/fellow the opportunity to attend medical, mental health, and dental care appointments, including those scheduled during their working hours;
- Education regarding recognizing the symptoms of burnout fatigue, depression and substance abuse, including recognizing these symptoms in themselves and how to seek appropriate care;
- Education of trainees and faculty to alert designated personnel when they are concerned about a fellow trainee or faculty member who is displaying signs of burnout, depression, fatigue, substance use, suicidal ideation or potential for violence.
- Monitoring workplace safety data to address the safety of residents/fellows;
- Have programs and resources available that encourage optimal resident/fellow well-being;
- Provide access to appropriate self-screening tools;
- Ensure adequate sleep facilities and safe transportation options for residents who may be too fatigued to safely return home
- Residents may also contact the Tennessee Medical Foundation Physician's Health program online at http://www.e-tmf.org at (615) 467-6411 or by clicking below.
All of these must be implemented without fear of negative consequences for the resident/fellow who may be having any issues interfering with their well-being.

Resident/Fellow Benefits

Campus Recreation
East Tennessee State University offers programs in:
- Fitness
- Intramurals
- Non-Credit Instruction
- Outdoor Adventure
- Sport Clubs
The Wayne G. Basler Center for Physical Activity (CPA) is a 120,000 square foot facility that was built by and operates on student activity fees and is staffed by ETSU student workers.

The Basler Center recreational facilities include:
- 19,000 square foot weight room - cardio room
- 1/8 mile indoor track
- Martial arts training area
- 2 Racquetball/squash courts
- 4 Basketball/Volleyball courts
- Outdoor challenge/ropes course
- Indoor swimming pool with 8 lanes
- Aerobic studio
- Yoga studio
- An indoor and outdoor climbing wall
- 2 outdoor intramural and sport club fields
- Locker rooms
- Casual Care child care service
Learn More
Deferred Compensation Program

Residents are eligible to participate in two optional, tax deferred retirement savings plans operated by the State of Tennessee: a 457 (b) plan and a 401 (k) plan. Enrollment in either of these plans is voluntary. If you choose to participate in either or both of these plans, you will make contributions through regular payroll deductions. The Resident is responsible for evaluating and selecting a company and for entering into a contractual agreement with that company. ETSU does not investigate, evaluate, or endorse any of the tax-deferred income investment options.

Residents are not eligible for any matching funds from the State of Tennessee or ETSU.

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Group Insurance

Group health insurance is available for residents and their eligible dependents. Term life insurance, Accidental Death and Dismemberment and long term disability are available for the residents only.

ELIGIBILITY

Insurance benefits are available to full time employees who work at least 30 hours per week. Eligible dependents include spouse (legally married), natural or adopted children, stepchildren, children for whom you are the legal guardian, children for whom the plan has qualified medical child support orders. You will need to provide a government-issued marriage certificate or license as proof of marital relationship.

HEALTH
The resident health insurance is provided through Blue Cross/Blue Shield. Residents may elect single coverage or family coverage. Premiums are shared by the university and the resident. The resident portion is $35.00 for single coverage and $75.00 for family coverage. The premiums are payroll deducted monthly.
Effective 7/1/2025 the resident portion of single coverage will increase to $50 and $100 for family coverage.

DENTAL
The resident dental insurance is provided through Blue Cross/Blue Shield. Residents may elect single coverage or family coverage. Premiums are shared by the university and the resident. The resident portion is covered by the Health Insurance premium at the same coverage.

VISION
If enrolled in the health insurance through Blue Cross/Blue Shield residents also receive vision coverage at no additional premium.

LIFE
A basic life insurance policy is available for each resident in the amount of $50,000. No life insurance is available for dependents. Residents may elect to purchase additional life insurance up to $500,000. Upon termination, residents have the opportunity to convert their life insurance to an individual policy. For additional information on life insurance contact TMA Plan Administrators at (800) 347-1109.

DISABILITY
Individual disability policies with monthly benefits of 60% salary, after 90 days of disability are available for the resident only. Additional coverage may be purchased by the resident.
Impaired Physicians Program

East Tennessee State University, James H. Quillen College of Medicine is committed to supporting the Tennessee Medical Foundation and the Physicians Health Program in regards to our faculty, residents and students.

Counseling services will be available to all residents upon their request or the request of the Program Director. Services will address any issue of professional or personal stress that may be encountered during the training experience which might result in deterioration of performance, medical behavioral problems or substance abuse. Services will function within and follow the guidelines set by the Tennessee Medical Foundation, Physicians Health Program.

When a problem with a resident is suspected, the Program Director or Departmental Chair will contact the Tennessee Medical Foundation, Physicians Health Program in Nashville, Tennessee. The Medical Director or the Assistant Medical Director will require an evaluation and the Physicians Health Program will recommend treatment, if indicated. The resident will be under their complete management and may not be considered for reentry into our program until they have been cleared by the Physicians Health Program.

The Office of the Executive Associate Dean for Graduate Medical Education should be kept informed as to coordinate leave time and disability benefits.
Leave Benefits
Residents/fellows are entitled to several different types of leave. Time away from training due to leave my count against fulfilling board and program requirements. The amount of time a resident can be away from residency/fellowship duties and still meet Board requirements vary among the specialties. It is the resident's responsibility to be aware of his/her specialty requirements. Training may be extended to meet all program and board certification requirements if they are not met.

A leave authorization form must be completed and approved for any type of leave. These must be completed in advance of the leave except for emergency sick leave.
- ACGME Leaves of Absence
- Administrative Leave
- Annual/Vacation Leave
- Education Leave
- Exam Leave
- Family Leave (FMLA)
- Holidays
- Jury Duty
- Military Leave
- Sick Leave
ACGME LEAVES OF ABSENCE
Please refer to the Leaves of Absence Policy for details.

ADMINISTRATIVE LEAVE

Residents/fellows may receive up to five (5) days of administrative leave over the course of their residency/fellowship, depending on their program's policy. Trainees doing a preliminary year or a one year fellowship will be allotted up to two (2) days depending on their program's policy.

ANNUAL/VACATION LEAVE
At the beginning of each contract year, ETSU provides residents/fellows with up to 15 working days (Monday through Friday). Scheduled days off on the weekend (Saturday and Sunday) are at the discretion of the program director and department. Annual leave is scheduled by the Program Director to ensure adequate coverage of educational and clinical responsibilities and must be approved in advance. Unused annual leave may NOT be carried over into a new contract year. Resident/fellows are not paid for any unused annual leave.

EDUCATION LEAVE
Educational leave may be provided to attend conferences and workshops. A maximum of five (5) days per contract year is allotted. The resident/fellow may petition the program director for an additional five (5) days per contract year. These days will not carry over in to a new contract year. Residents/fellows rotating at the Veterans Affairs hospital will only be allotted five (5) days per academic year. A request with required documentation must be submitted for approval at least 30 days in advance for educational leave.

EXAM LEAVE
Residents/fellows who are taking a required exam may take up to two days paid leave for the exam and up to two days for travel (depending on the location) with the approval of the Program Director. Documentation is required to the Program Director.

FAMILY LEAVE
If a resident/fellow is not eligible for FMLA, they still may use any accrued annual or sick leave. Please make an appointment with GME office (423) 439-8023 to discuss.

HOLIDAYS
Official holidays of the University are not automatically observed as time off for medical residents and fellows.

JURY DUTY
Residency/fellowship training has been recognized as an activity that should not be interrupted. However, participation in jury duty is a civic responsibility. In the event that a resident/fellow is called for jury duty, he/she must notify the Program Director. The Program Director must arrange with back-up to release the resident/fellow from clinical activities during the jury duty process if at all possible.

LEAVE OF ABSENCE (Maternity/Paternity/Wellness)

Per ACGME regulations, starting with their first day of employment, every resident and fellow in an ACGME-accredited residency program is entitled to one, singular six-week (or two three-week block(s) of paid leave at any time during their residency or fellowhip program for parental, medical, or caregiver leave.
Please see the Leave of Absence Policy for details and the process.

MILITARY LEAVE
All residents who are members of any reserve component of the armed forces of the United States or of the Tennessee National Guard may be entitled to leave of absence from their duties for all periods of military services during which they are engaged in the performance of duty or training in the service this state, or of the United States, under competent orders as stipulated in the U.S.C. Title 38, 4311-4318 and T.C.A. 8-33-101 through 58-1-106.

Each resident who is on military leave shall be paid his/her salary or compensation for a period, or periods, not exceeding fifteen (15) working days in any one (1) calendar year, plus such additional days as may result from any call to active State duty pursuant to T.C.A. section 58-1-106. The resident must furnish the University certification from competent military authority of the dates of active duty that was actually performed.

SICK LEAVE

At the beginning of each contract year, ETSU provides residents/fellows with twelve (12) days of sick leave which may accumulate to a total of not more than sixty (60) days for continuous service. Accumulated sick leave is forfeited if University service is contratually interrupted. Sick leave can only be used for bona fide illness which prevents the performance of professional duties and cannot be used for vacation, education, exam or other types of personal leave purposes. It is the responsibility of the resident to notify their Program Director of illness which prohibits them from attending to assigned duties. The Program Director has the right to require verification of any illness from a licensed healthcare provider. Residents are not paid for unused sick leave.
Professional Liability Insurance

As a resident physician with East Tennessee State University under the State of Tennessee your professional liability coverage will be provided by the Tennessee Claims Commission Act (TCA 9-8.301 et sq). The limits of liability are $300,000 per plaintiff/$1 million dollars per occurrence. State law provides that residents have absolute immunity from liability for acts or omissions within the scope of their employment, unless the acts or omissions are willful, malicious, criminal, or done for personal gain.

The immunity of residents under Tennessee law has no mandatory effect in the courts of other states. Residents who participate in rotations out of Tennessee must have additional malpractice. Please consult with your residency coordinator when planning an out of state rotation.

If you should receive a summons and complaint naming you or East Tennessee State University as a defendant in a civil lawsuit arising out of your residency with the University, please contact the Office of Graduate Medical Education immediately. Do not discuss the suit with anyone other than the University attorney or the Attorney Generals Office. Do not talk to the plaintiff or the plaintiffs attorney. Refer all requests for documents to the University attorney or the Office of Graduate Medical Education.

The coverage does not extend to any medical practice or activities outside the medical education program of the University (moonlighting). Claims made after termination of training will be covered if based on acts or omissions of the resident within the course and scope of their assignments during training, therefore residents will not need to purchase tail coverage.

Residents working at the VA are covered by the Federal Tort Claims Act during their rotation at the VA.
Resident Assistance Program "RAP"
East Tennessee State University, James H. Quillen College of Medicines Resident Assistance Program (RAP) is a confidential counseling and referral service for East Tennessee State University Medical School residents and their adult family members. The purpose of the program is to encourage self referral so that you can be helped with training issues, personal and marital concerns before they lead to more serious difficulties.

As resident physicians, you should strive to manage professional and personal stress, to maintain your own health and well-being so that you can maximize your ability to provide quality health care to your patients.

Stress is part of everyone's life. It can become overwhelming when it is not managed properly which in turn can lead to physical, mental and spiritual difficulties.

The Resident Assistance Program (RAP) is here to provide you with help in managing stress in both your personal and professional lives through confidential counseling, education, and in some cases medication. This includes assistance with marriages and other relationships.

Below are listed some causes of excessive stress:
- Lack of staff or attending support
- Unresolved bereavement issues
- Too much responsibility
- Culture issues
- Trying to be perfect
- Sexual orientation issues
- Lack of sleep
- Sexual harassment
- Marriage and family issues
- Too many hours on call
- Physical illness
- Both husband and wife are residents
- Excessive anxiety
- Depression
- Social isolation
- Don't feel part of the residency community
Please call the CARES House at (423) 232-0275.
Resident Sick Leave Bank
The purpose of the ETSU Resident Sick Bank is to provide emergency paid sick leave to members of the residency program who have suffered an unexpected personal illness, surgery, injury or disability with complications beyond their control and who have exhausted their personal sick leave.
By definition, "unexpected personal illness", does not include recovery following childbirth. Unforeseen complications during pregnancy would be a qualifying event.

MANAGEMENT
The Sick Leave Bank shall be managed by eleven (11) residents, one from each residency program (Bristol Family Medicine, Johnson City Family Medicine, Kingsport Family Medicine, Internal Medicine, Obstetrics/Gynecology, Orthopaedic Surgery, Pathology, Pediatrics, Psychiatry, and General Surgery) and one (1) fellow, elected to represent all fellowship programs. An election will be conducted annually to choose the peer-selected representatives. Elected resident/fellow representatives must be members of the sick leave bank. The ten (10) residents and one (1) fellow will elect a chairperson from among the eleven (11) elected resident/fellow representatives at their first meeting.

ELIGIBILITY
Membership in the Sick Leave Bank will be available to all Residents/Fellows of the ETSU Quillen College of Medicine. To be eligible for membership, a Resident or Fellow must elect to participate by completing and signing the enrollment form during onboarding or annual open enrollment that is held May 15th to June 15th. Residents/fellows who do not elect membership by agreeing to contribute the assessed number of sick days to the Sick Leave Bank and do not complete and sign an enrollment form will not be eligible to apply for grants from the sick leave bank.

PROVISIONS
All eligible residents/fellows who elect to participate in the Sick Leave Bank will be assessed two (2) sick leave days upon initial enrollment. Sick leave days transferred to the Sick Leave Bank are non-refundable with the following exceptions: the Sick Leave Bank is dissolved due to the membership in the bank falling below twenty (20) participants. Upon dissolution of the bank, the total hours on deposit shall be returned to the participating members at the time of the dissolution and credited to the personal sick leave accumulation in the proportion to the number of days each has been assessed individually.

A bank member may cancel his/her membership at any time by written notification to the trustees. Assessed sick leave days are non-refundable upon cancellation of membership. The effective date of cancellation shall be the date of the written communication from the bank member.

Upon a resident/fellow completing his/her training, their balance of sick leave days will be removed from the Sick Leave Bank. The effective date for the removal will be July 1st.

A bank member shall lose the right to request bank sick leave upon termination of employment, cancellation of bank membership, refusal or inability to honor the trustees assessments, and going on a leave of absence (in a non-pay status) for reasons other than illness, injury or disability.

Grants of bank sick leave shall not be contingent, upon repayment of hours used or waiver of other employment benefits or rights.

Participants must exhaust all accumulated annual and sick leave prior to receiving bank sick leave.

No grant from the Sick Leave Bank shall be made for periods of leave of five (5) days or less.

Bank sick leave shall not be used for: elective surgery, absence to allow for routine childcare subsequent to childbirth (unforeseen complications during pregnancy would be a qualifying event), illness or death of any member of the resident/fellow's family or during any period when the resident/fellow is receiving disability benefits. Participants may be required to provide proof that the above does not apply.

Initial grants of bank sick leave to individual bank members shall not exceed twenty (20) consecutive days for which the applicant would have otherwise lost pay. After receiving twenty (20) consecutive days, requests for an extension, made in writing, may be granted by approval of the trustees. The maximum number of days any participant may receive in any fiscal year is sixty (60) days. The maximum number of days any participant may receive for any one illness is sixty (60) days.

If a bank member is physically or mentally unable to request bank sick leave, or an extension, a family member, or agent for the member may file.

Grants of sick leave from the bank will run concurrently with approved FMLA, as applicable.

All requests of bank sick leave will be approved or rejected within ten (10) calendar days of receipt of the request.

Participation by a quorum (7/11) of the committee is required for each decision.

All denials of sick bank leave must be accompanied by a letter explaining why the member's request was denied.

The decision of the trustees shall not be appealed beyond that body.

All records and official forms of the Sick Leave Bank and minutes of the trustee meetings shall be maintained in the Office of Clinical Affairs. All records shall be subject to audit by administrative officials of East Tennessee State University. All records of the trustees shall remain confidential unless requested access is approved by the 7/11 (quorum) of the committee.

Granting of sick bank days does not relieve the resident/fellow from meeting the required number of days for his/her board eligibility. A resident/fellow who accumulates excessive absences for any reason may have to sign a letter of extension for meeting board eligibility. This will be managed by individual program directors/department chairpersons.

PROCEDURES
All eligible residents/fellows will receive notification of the establishment of the plan, dates of initial enrollment period, and copies of the plan and enrollment forms.

The annual thirty (30) day enrollment period shall be May 15th through June 15th.

All participants in the Sick Leave Bank shall be equally assessed one (2) days (as determined by the committee) as the initial assessment to be deducted from the individual's personal accumulated sick leave.

Subsequent assessments will be determined annually and shall be conducted in order to maintain a positive minimum balance in the bank. Members of the sick bank will be notified of the need for additional assessments and will be granted the option to continue or cancel their membership in the sick bank.

Official forms of the Sick Leave Bank are available in the Office of Graduate Medical Education:
- Enrollment form
- Sick Leave Bank request form
- Sick Leave Bank notice of assessment
All requests to draw upon the Sick Leave Bank must be made with all appropriate signatures upon a sick leave request form and submitted to the trustees within thirty (30) calendar days of the first date Sick Leave Bank usage is requested. A physicians statement, verifying the nature of the illness or injury, and the inability of the resident/fellow to work, must accompany the request form. The committee shall approve or disapprove the application within ten (10) calendar days of receipt of the application.

Upon receipt of a request to draw upon the bank, the committee will examine the bank members sick leave record. If evidence of abuse exists, the committee may deny the request.

When acting upon a request, if additional information is necessary in order to approve or disapprove a request, the committee or Assistant Dean of GME, may contact the attending physician and/or the bank member requesting leave. The resident/fellow requesting the sick leave will provide the appropriate releases for obtaining the information from the physician. Failure to provide such information or release may result in disapproval of the resident/fellows request.

A bank member requesting leave from the Sick Leave Bank will receive a copy of the signed approved/disapproved request form as notification of the committees' action.

AMENDMENTS
Amendments to these guidelines may be made by a majority vote of the policy committee and approval of the Sick Leave Bank committee with final approval required by the Graduate Medical Education Committee (GMEC).
Safe Travels

Taxi service is available to provide a safe way for residents to travel from the hospital to home post call.

All ETSU Quillen College of Medicine residents/fellows are eligible. Any resident who feels that he or she cannot drive home safely due to fatigue or excessive sleepiness should call for a WW taxi.

WW Taxi Company may be reached at (423) 928-8316.

You must present an ID to the taxi driver and the taxi company will invoice the GME Office.
Tuition Assistance

The College of Medicine has set aside $5,000 for tuition assistance for active residents' spouses and eligible dependent children. Tuition assistance will be limited to undergraduate classes at ETSU only and will be on a first-come-first-served basis. Active residents and fellows who wish to pursue coursework toward a Master's Degree are eligible for tuition assistance.

Applications must be completed for each semester and submitted by a defined deadline. Tuition assistance is limited to Fall and Spring semesters only. For application assistance please contact the Office of GME at (423) 439-8023.
Under "Educational Benefits" click on "ETSU Employee Educational Benefit Portal".

The amount of the scholarship may vary depending on the number of applicants for the semester, with a maximum of $500 granted per person, per semester. For more information please contact the GME office at (423) 439-8023.

General Information

Bookstores

The university bookstore is located on the first floor of the D.P. Culp University Center. They carry a supply of new and used text books, supplies, ETSU branding clothing and much more.

View Store

The medical bookstore is located on the lower level of VA Building 34 (the clock tower building). This satellite bookstore carries books for all medical school courses, supplies and equipment.
Completion of Residency Training

Each resident is responsible for completing the resident checkout form. A forwarding address must be provided by each resident.

The programs will issue a certificate of training to each resident completing their program. A certificate will also be issued to residents who have served as a chief resident.

Each program director is responsible for certifying that the resident has satisfied all training requirements of their program and is eligible for the certifying examination of their specialty. Certification of completion of the program will be contingent upon the residents having returned all ETSU and hospital property such as books, keys, equipment; completed all patient medical records at each affiliated hospital; and settled their professional and financial obligations. A checklist for final clearance will be provided which must be cleared prior to release of the last paycheck.
E-mail

It is mandatory for all residents/fellows to obtain and keep current a University e-mail account for e-mail communications. The primary means of communication for all residents/fellows is e-mail. The majority of important/critical communication is done by e-mail via the University e-mail account. University e-mail account is subject to University Information Technology policies and procedures, including but not limited to access, authentication, and password management. Contact your Program Coordinator for instructions on activating your e-mail account.
Graduate Medical Education Committee
CHARGE
The charge to the Committee will be to perform a periodic analysis of each residency training program and recommend appropriate corrective action where necessary and have the responsibility for the oversight and administration of the Graduate Medical Education programs. These analysis will be in compliance with ACGME Essentials to include the following:

The GMEC must establish and implement policies and procedures regarding the quality of education and the work environment for the residents in all programs. These policies and procedures must include:
1. Stipends and position allocation: Annual review and recommendations to the Sponsoring Institution regarding resident stipends, benefits, and funding for resident positions.
2. Communication with program directors: The GMEC must:
  1. Ensure that communication mechanisms exist between the GMEC and all program directors within the institution.
  2. Ensure that program directors maintain effective communication mechanisms with the site directors at each participating institution for their respective programs to maintain proper oversight at all clinical sites.
3. Resident duty hours: The GMEC must:
  1. Develop and implement written policies and procedures regarding resident duty hours to ensure compliance with the Institutional, Common, and specialty/subspecialty-specific Program Requirements.
  2. Consider for approval requests from program directors prior to submission to an RRC for exceptions in the weekly limit on duty 11 hours up to 10 percent or up to a maximum of 88 hours in compliance with ACGME Policies and Procedures for duty hour exceptions.
4. Resident supervision: Monitor programs supervision of residents and ensure that supervision is consistent with:
  1. Provision of safe and effective patient care;
  2. Educational needs of residents;
  3. Progressive responsibility appropriate to residents level of education, competence, and experience; and,
  4. Other applicable Common and specialty/subspecialty-specific Program Requirements.
5. Communication with Medical Staff: Communication between leadership of the medical staff regarding the safety and quality of patient care that includes:
  1. The annual report to the OMS;
  2. Description of resident participation in patient safety and quality of care education; and,
  3. The accreditation status of programs and any citations regarding patient care issues.
6. Curriculum and evaluation: Assurance that each program provides a curriculum and an evaluation system that enables residents to demonstrate achievement of the ACGME general competencies as defined in the Common and specialty/subspecialty-specific Program Requirements.
7. Resident status: Selection, evaluation, promotion, transfer, discipline, and/or dismissal of residents in compliance with the Institutional and Common Program Requirements.
8. Oversight of program accreditation: Review of all ACGME program accreditation letters of notification and monitoring of action plans for correction of citations and areas of noncompliance.
9. Management of institutional accreditation: Review of the Sponsoring Institutions ACGME letter of notification from the IRC and monitoring of action plans for correction of citations and areas of noncompliance.
10. Oversight of program changes: Review of the following for approval, prior to submission to the ACGME by program directors:
  1. All applications for ACGME accreditation of new programs;
  2. Changes in resident complement;
  3. Major changes in program structure or length of training;
  4. Additions and deletions of participating institutions;
  5. Appointments of new program directors;
  6. Progress reports requested by any Review Committee;
  7. Responses to all proposed adverse actions;
  8. Requests for exceptions of resident duty hours;
  9. Voluntary withdrawal of program accreditation;
  10. Requests for an appeal of an adverse action; and,
  11. Appeal presentations to a Board of Appeal or the ACGME.
11. Experimentation and innovation: Oversight of all phases of educational experiments and innovations that may deviate from Institutional, Common, and specialty/subspecialty-specific Program Requirements, including:
  1. Approval prior to submission to the ACGME and/or respective Review Committee;
  2. Adherence to Procedures for "Approving Proposals for Experimentation or Innovative Projects" in ACGME Policies and Procedures; and,
  3. Monitoring quality of education provided to residents for the duration of such a project.
12. Oversight of reductions and closures: Oversight of all processes related to reductions and/or closures of:
  1. Individual programs;
  2. Major participating institutions; and,
  3. The Sponsoring Institution.
13. Vendor Interactions: Provision of a statement of institutional policy (not necessarily GME-specific) that addresses interactions between vendor representatives/corporations and residents/GME programs.
STRUCTURE
The composition of the Committee will be the Executive Associate Dean for Graduate Medical Education, the Assistant Dean for Graduate Medical Education, representatives of medical affairs from participating hospitals, one peer selected resident representative from each residency program, and other appropriate individuals involved in furthering graduate medical education as appointed by the Dean. The Executive Associate Dean for Graduate Medical Education will Chair the Committee.
Identification Badges

An I.D. badge will be made for each residents at orientation. Residents are required to wear these badges at all times in the hospitals and clinics, making sure that the picture, name and department can be seen at eye level. If the badge is lost, please call ID services at (423) 439-8316 for a replacement. There is a $10 charge to replace an ID badge. Badges are the property of ETSU and must be relinquished upon completion or termination from the residency program.
Loan Deferments

The Office of Graduate Medical Education will complete deferments, forbearance, and hardship forms. That office will also send letters verifying training periods to loan companies when requested. Please contact Renee McNeely at mcneely@etsu.edu for assistance. The current PSLF form can be found under the "Forms" tab. Information regarding Public Service Loans can be found at this website: Public Service Loan Forgiveness
Mandatory Deduction

Withholding Taxes - Federal withholding taxes are deducted from your salary at a rate determined by the amount of your salary and the number of personal exemptions claimed. All residents participate in the Social Security system at the established rate, currently the rate is 6.2% OAB and 1.45% FICA-MED.
Medical Library

The Medical Library is located in building #4 on the Veterans Affairs campus. Residents are eligible to check out materials but must obtain a library I.D. card at the Circulation Desk.

Library Hours:

Monday-Saturday:
8:00 a.m. - 12:00 a.m.

Sunday:
12:00 p.m. - 12:00 a.m.

Changes in hours or holiday hours are posted at the library.

A Computer Lab is available during regular library hours. There are three Apples and three IBM computers. Information is available at the Circulation Desk.

Medical Library
Medical License and License Exemptions

All residents must hold either a Tennessee medical training license or a license exemption from the State of Tennessee. Both must be renewed annually. Check with your program for their requirements.
National Provider Identifier (NPI) Number

All residents must obtain a National Provider Identifier (NPI) number. Please contact your Program Coordinator for information on obtaining a NPI number.
Notary Public

There are Notary Publics on campus including the Office of GME. For assistance please contact the GME office at (423) 439-8023.

ALL DOCUMENTS TO BE NOTARIZED MUST BE SIGNED IN FRONT OF THE NOTARY AND IDENTIFICATION MUST BE PROVIDED TO THE NOTARY.
Orientation

Orientation is held during the portion of June for all new residents. Dates will be determined annually. University policies, procedures, benefits and responsibilities are covered at this time. All new residents are required to attend.
Payday

Residents are required to have salaries paid through direct deposit. A voided or canceled check must be submitted to the Office of Graduate Medical Education for processing. All residents are paid on the last working day of each calendar month.
Safety & Health

The University strives to provide the safest possible environment for all residents. Residents must comply with safety and health regulations and report to appropriate supervisors any condition which appears to be hazardous. Residents should report any unsafe working conditions to the Human Resources Office. Residents have the right to expect such conditions to be explained and/or improved. If the residents does not feel that the condition has been satisfactorily improved, the residents has the right to request further inspections without any fear of dismissal or discrimination because of the action.
Traffic and Parking Regulations

All residents who intend to park a motor vehicle on the ETSU Campus or VA Campus must register with the Parking Services Office (423) 439-5650. Residents should purchase faculty/staff decals. Information about the regulations and prices can be obtained in the Business Office at Dossett Hall. You will receive further instructions concerning parking through ETSU e-mail.

Traffic & Parking Regulations
Work Related Injuries

All ETSU Quillen College of Medicine Residents and Fellows must follow this process:

All workplace injuries, including needle sticks, must be reported to the State of Tennessee Worker's Compensation Program through CorVel.
Residents must contact the Workplace Injury Call Center at 866-245-8588. Please select option 1 to speak to a nurse for immediate care.
Select option 2 for First Notice of Loss reporting.

Failure to contact CorVel within three (3) business days of the injury will result in a $500 penalty to the University and will be assessed to the appropriate department.

If you have issues with your CorVel claim and need assistance please contact Renee McNeely in the Office of Graduate Medical Education at mcneely@etsu.edu or (423) 439-8293.

The failure to contact CorVel within a reasonable time will result in denial of claim.

Salary | Policies & Procedures | Resident/Fellow Benefits | General Info