National Survey of Internal Medicine Residency Program Directors Regarding Problem Residents

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Abstract
Since 1972, the American Board of Internal Medicine (ABIM) has relied on residency programs to evaluate the readiness of eligible candidates for certification. Accordingly, attempts have been made to standardize resident evaluation at the program level, and to identify those residents who fail to meet the evaluation norms. The ABIM defines a problem resident as "a trainee who demonstrates a significant enough problem that requires intervention by someone of authority, usually the program director or chief resident."1 The problem is often manifested in 1 or more of the ABIM's 7 areas that relate to clinical competency: clinical judgment, medical knowledge, clinical skills, humanistic qualities, professional attitudes and behavior, medical care, and moral and ethical behavior. Residency program directors predictably have to work with problem residents and must consider the negative impact they may have on the residency program.