The importance of strong evaluation standards and procedures in training residents.

A strong evaluation process in a residency offers faculty an opportunity to strengthen the educational program, to help residents know what is expected of them, and to remove with minimum difficulties those residents who are not progressing satisfactorily and do not appear to be salvageable. Despite these advantages, the evaluation of residents during their training is often done poorly or not at all. The author describes the kinds of standards and procedures that constitute a sound, strong evaluation process, proposes criteria for academic probation and due process when a resident is performing unacceptably, and describes the role that the medical school administration should play in the evaluation process, one that is flexible enough to allow each program to comply and still have program-specific procedures. The author closes with statistics on how few residents are dismissed for incompetency or unacceptable behaviors, and inquires how many more might be found if strong evaluation processes were more widely used. Even so, in the attempt to evaluate residents and to foster protection from legal problems, residency program directors must keep in mind the importance of letting residents make mistakes and learn from them; a good evaluation system strikes a balance that fosters the learning process and benefits the residents, the medical school, and the community.