Procedural due process in the dismissal of residents.

Legal commentators and court decisions have defined, generally, procedural due process for students and faculty in institutions of higher learning. Dental residents (GPRs, oral surgery residents, etc.) occupy a unique niche in this educational structure. On the one hand they are students pursuing advanced training; on the other, they are employees and instructors in a hospital or similar institution. As advanced student-clinicians, residents have significant autonomy in patient care. Those who are charged with monitoring a resident's care can be held liable for the resident's negligence. Hospital administrators and residency program directors have concerns about minimizing the chances of malpractice liability, while simultaneously having to observe procedural due process guarantees when a resident's performance mandates dismissal or suspension. This article will briefly review procedural due process issues concerning dismissal or suspension of students and faculty. Court decisions involving dismissal of medical and dental residents will be analyzed to see if the courts follow the student model or faculty model. The cases will demonstrate that the courts generally follow the faculty due process model when residents are suspended or dismissed. Key administrative law decisions will briefly be reviewed that point out the differences of opinion existing over the student/employee status of residents. Also, it will be shown that when patient safety is at stake, procedural due process guarantees can be modified to allow immediate suspension or dismissal of the resident.