UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE

GRADUATE MEDICAL EDUCATION

RESIDENCY AND FELLOWSHIP POSITION APPOINTMENT (RFPA)

AGREEMENT

2020-2021

UW Graduate Medical Education Office

UW Medicine – South Lake Union

850 Republican St., Box 358047

Seattle, WA 98109-4725

Phone: 206.543.6806 / Fax: 206.685.3314

http://www.gme.washington.edu

University of Washington School of Medicine Residency and Fellowship Position Appointment 2020-2021

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Contents

PREAMBLE ..................................................................................................................................................... 4

PARTIES SUBJECT TO THIS AGREEMENT AND THEIR RESPONSIBILITIES ....................................................... 4

A. Resident and Fellow Responsibilities .................................................................................................... 5

B. Program Director Responsibilities ........................................................................................................ 5

D. Department Chair Responsibilities ....................................................................................................... 5

E. Participating Site Responsibilities ......................................................................................................... 5

F. UW School of Medicine/UW School of Dentistry Responsibilities ....................................................... 6

EQUAL ACCESS AND REASONABLE ACCOMMODATION ............................................................................... 6

CONDITIONS OF APPOINTMENT AND REAPPOINTMENT ............................................................................. 7

A. Appointment and Credentialing ........................................................................................................... 7

B. eLearning .............................................................................................................................................. 7

C. Resident Orientations ........................................................................................................................... 7

D. Electronic Health Record Training ........................................................................................................ 7

E. Orientation Compensation ................................................................................................................... 7

F. Reporting for Duty ................................................................................................................................ 7

G. Conditions of Reappointment and Promotion ..................................................................................... 7

H. Resignation ........................................................................................................................................... 8

I. Non-Compete ....................................................................................................................................... 8

POLICIES AND PROCEDURES ......................................................................................................................... 8

A. Clinical and Educational Work Hours Policy ......................................................................................... 8

B. Drug Enforcement Administration (DEA) Registration Policy ............................................................... 9

D. Immunization Policy and Bloodborne Pathogens (BBP) Exposures: .................................................... 9

E. Licensing Policy ................................................................................................................................... 10

F. Licensure Examinations Policy ............................................................................................................ 10

G. Maintenance of Case/Procedure Logs Policy ..................................................................................... 10

H. Medical Records Policies .................................................................................................................... 11

I. Policy on Working Outside of the Training Program .......................................................................... 11

J. Physician Impairment Policy ............................................................................................................... 11

K. Professional Behavior and Conduct for the Teacher/Learner Relationship ....................................... 11

L. Resident/Fellow Remediation Policy and Grievance Procedure ........................................................ 11

M. Supervision and Accountability Policy ................................................................................................ 12

N. Transitions of Care Policy.................................................................................................................... 12

O. UW Medicine Information Security Policies ....................................................................................... 12

P. UW Medicine Policy on Professional Conduct .................................................................................... 12

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Q. UW Medicine Social Media Policy and Guidelines ............................................................................. 13

R. UW Patent, Invention and Copyright Policy ....................................................................................... 13

S. UWSOD Code of Professional Conduct ............................................................................................... 13

T. Vendor Interaction Policy ................................................................................................................... 13

U. Well-Being Policy ................................................................................................................................ 13

BENEFITS AND PAYROLL .............................................................................................................................. 13

A. UW Benefits ........................................................................................................................................ 14

B. UW Payroll .......................................................................................................................................... 15

C. UW Risk Services ................................................................................................................................. 15

D. Vacation Leave, Sick Leave and Other Leaves of Absence ................................................................. 16

E. GME Wellness Service ........................................................................................................................ 17

F. Other Resident Resources and Services ............................................................................................. 17

PROGRAM REDUCTIONS AND CLOSURES ................................................................................................... 18

SEXUAL HARASSMENT AND OTHER FORMS OF DISCRIMINATION ............................................................. 18

RESIDENT, PATIENT SAFETY, AND COMPLIANCE CONCERNS ..................................................................... 19

AMENDMENTS ............................................................................................................................................ 19

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PREAMBLE

The primary purpose of the appointment of resident and fellow physicians (including dental residents) is

the completion of a graduate medical/dental education training program in accordance with the current

accreditation standards established by the Accreditation Council for Graduate Medical Education

(ACGME), Council on Dental Accreditation (CODA), or relevant accrediting body. It is clearly understood

that the primary objective of the training programs is education. Appointments will be administered

through the University of Washington School of Medicine (UWSOM)/University of Washington School of

Dentistry (UWSOD), and by the respective Department Chairs, and Program Directors, with the

educational needs of residents and fellows foremost in mind. The UWSOM is committed to exemplary

graduate medical and dental education that facilitates residents’ and fellows’ professional, ethical, and

personal development. To that end, the mission of the UW Graduate Medical Education (GME) Office is

to guide, motivate and enlighten the next generation of physicians.

Residency and Fellowship Position Appointment (RFPA): The purpose of this Residency and Fellowship

Position Appointment Agreement (RFPA) is to outline the terms and conditions of resident and fellow

appointments to a University of Washington training program, including the established educational and

clinical practices, policies, and procedures at training sites to which residents and fellows are assigned.

Wherever possible, a hyperlink to the complete policy or resource is provided.

Duration of Appointment: Resident and fellow appointments are for twelve (12) months, renewed

annually. Appointment dates, training level, and salary are included in the RFPA signature page signed at

the beginning of each appointment by the resident/fellow, program director, and UW GME Designated

Institutional Official (DIO).

UWHA Collective Bargaining Agreement: The collective bargaining agreement (CBA) between the

University of Washington Board of Regents and the University of Washington Housestaff Association

(UWHA) (see

UWHA Contract on UW Labor Relations website) covers salaries/stipends, benefits, and

working conditions including but not limited to: childcare, leave, outside work, professional development

fund, licensing reimbursement, and transportation.

In the event of any inconsistency in subjects covered in the RFPA and CBA, the CBA will supersede the

RFPA. As of the time this RFPA was approved for 2020-2021, the CBA was being renegotiated. Therefore,

updates to the CBA, once renegotiated, may not be reflected in this agreement.

Residency and Fellowship Appointment Agreement Grievance Policy and Procedure

: Any controversy or

claim arising out of an alleged violation of any subject covered in the RFPA, excluding matters covered

under the

Resident/Fellow Remediation Policy and Grievance Procedure, may be addressed through the

Grievance Policy and Procedure. Claims related to terms and conditions addressed in the CBA can be

grieved according to the Grievance Procedure outlined in Article 7 within the collective bargaining

agreement.

PARTIES SUBJECT TO THIS AGREEMENT AND THEIR RESPONSIBILITIES

This agreement applies to the individual residents and fellows (hereafter referred to as “Residents”)

training in ACGME, American Board of Medical Specialties (ABMS) board recognized, and Commission on

Dental Accreditation (CODA)-accredited graduate medical and dental education programs sponsored by

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the UWSOM, UWSOD, or other accrediting body. This includes residents appointed under the following

titles and job profiles: Resident (Job Profile 10328), Resident/Senior Fellow Trainee (Job Profiles

10328/10442), Fellow (Job Profile 10439), Fellow/Senior Fellow Trainee (Job Profiles 10439/10442)

and

Chief Residents (Job Profiles 10329). Residents working at the UW who are employed and paid-direct by

an outside entity are subject to certain (but not all) terms of the RFPA. Questions about these terms

should be directed to the GME Office. This agreement further applies to:

 Program Directors;

 Department Chairs;

 Participating Sites; and

 UWSOM and UWSOD

All parties to this agreement are expected to abide by the framework of the Core Values

of UW Medicine.

A. Resident and Fellow Responsibilities: Each Resident is expected to accept the duties, responsibilities,

and rotations assigned by the Program Director or designee; to abide by established educational and

clinical practices, policies, and procedures of the hospitals and other training sites assigned, to the

extent these are not inconsistent with this policy; to conduct all discourse and interactions ethically

and professionally in keeping with the position of physician; and to abide by UW GME policies and

procedures, as well as the conditions and general responsibilities outlined below. As a part of an

appointment at UWSOM/UWSOD, the Resident will be expected to actively participate in the care of

all types of patients who may present at the assigned hospital or clinic. In addition, the Resident will

be expected to take an active role in the instruction of medical/dental students, junior residents,

residents from other programs, and/or other hospital personnel.

B. Program Director Responsibilities: The Program Director, with the support of the Department and

UWSOM/UWSOD, has responsibility, authority, and accountability for: administration and operations;

teaching and scholarly activity; resident recruitment and selection; evaluation, and promotion of

residents, and disciplinary action; supervision of residents; and resident education in the context of

patient care. Responsibilities are further defined by the

ACGME or relevant accrediting body.

C. Site Director Responsibilities: Each participating site must also have a Site Director designated by the

program director, who is accountable for resident education at that site, in collaboration with the

program director.

D. Department Chair Responsibilities: The Department Chair (or designee, such as section chief or

division head), with the support of the UWSOM/UWSOD and the participating sites, shall provide

clinical and research programs of sufficient quality and duration, to ensure that residents who

successfully complete the graduate medical education program will be qualified to enter into the

specialty and subspecialty board examination and certification process. This provision assumes that

all training program activities will be conducted within the requirements of the ACGME, ABMS, CODA

and/or applicable accrediting and certification bodies.

E. Participating Site Responsibilities: Each participating site, or health care setting, provides educational

experiences or educational assignments/rotations for residents. The clinical learning and working

environment of each site will be monitored by each program. In addition, each site will ensure access

to food while on duty; safe and reasonably convenient parking facilities, hospital and institutional

grounds, and related facilities; safe, quiet, clean, and private sleep/rest facilities accessible for

residents with proximity appropriate for safe patient care; lactation facilities; and accommodations

Job Profile titles and codes subject to change.

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for residents with disabilities. There shall also be sufficient secured storage areas for personal

belongings.

F. UW School of Medicine/UW School of Dentistry Responsibilities: The UWSOM/UWSOD, as the

Sponsoring Institution, will oversee resident assignments and the quality of the learning and working

environment at all participating sites, and will ensure that programs only assign residents to learning

and working environments that facilitate patient safety and health care quality. This responsibility,

which is delegated to the GME Office, shall also include oversight and administration of training

programs, and monitoring of programs to ensure compliance with applicable accrediting body

requirements and implementation of terms and conditions of appointment. In addition, the

UWSOM/UWSOD will provide the necessary financial support for administrative, educational, and

clinical resources, including personnel, to maintain graduate medical education training activities. This

includes ensuring that program directors have sufficient financial support and protected time to

effectively carry out their educational, administrative, and leadership responsibilities. Additionally,

the UWSOM/UWSOD agrees to perform a series of administrative and educational functions for the

benefit of the residents and the participating sites. These include issuing salary/stipend paychecks;

maintaining resident records; administering the benefits outlined below and in the CBA; ensuring

timely and appropriate communications to residents and programs from the parties listed in this

agreement; and providing mechanisms for coordination of the program among the participating sites,

the UWSOM/UWSOD, and the various clinical services. Lastly, the UWSOM/UWSOD will provide a

learning and working environment in which residents have the opportunity to raise concerns and

provide feedback without intimidation or retaliation and in an appropriate and confidential manner.

Graduate Medical Education Committee

: The UWSOM, through the Graduate Medical Education

Committee (GMEC), which is composed of program directors, faculty, medical directors, quality officers,

residents, fellows, program administrators, and GME administration, is responsible for overseeing:

 the ACGME accreditation status of the Sponsoring Institution and its ACGME-accredited

programs;

 the quality of the GME learning and working environment within the Sponsoring Institution, its

ACGME-accredited programs, and its participating sites;

 the quality of educational experiences in each ACGME-accredited program that lead to

measurable achievement of educational outcomes as identified in the ACGME Common and

specialty/subspecialty Program Requirements;

 the ACGME-accredited programs’ Annual Program Evaluation (APE) and self-studies

 Clinical Learning Environment Review (CLER) reports

 processes related to reductions and closures of ACGME-accredited programs, major participating

sites, and the Sponsoring Institution.

 the provision of summary information of patient safety reports to residents, fellows, faculty

members and other clinical staff members.

Additionally, the GMEC Policy Committee advises GMEC on all GME-related policies. These policies include

but are not limited to the particulars of this appointment agreement, which is reviewed by the Policy

Committee and GMEC annually.

EQUAL ACCESS AND REASONABLE ACCOMMODATION

The University of Washington is committed to providing equal access in its services, programs, activities,

education and employment for individuals with disabilities (see

UW Administrative Policy Statement 46.5:

Policy on Reasonable Accommodation of Employees with Disabilities). Residents who have a disability

and require an accommodation must submit a request to the UW Disability Services Office. In the event

that such an accommodation is requested, the UW Disability Services Office will work with the GME Office

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and the program, or the program will notify the GME Office of the request in order to facilitate a

reasonable accommodation.

CONDITIONS OF APPOINTMENT AND REAPPOINTMENT

A. Appointment and Credentialing: Residents agree to comply with appointment and credentialing

requirements, as outlined in the Resident and Fellow Appointment and Credentialing Policy, both at

initial appointment and annually during reappointment. A resident will neither be permitted to begin

the training program nor be eligible to receive benefits under this agreement without having met such

appointment and credentialing requirements.

B. eLearning: Residents are required at initial appointment and annually to complete a series of

eLearning modules in the UW Medicine Learning Hub. Modules are launched annually in June and

October and address ACGME, state, federal, UW Medicine Compliance, and University requirements.

C. Resident Orientations: Incoming residents who are new to UW GME training programs are required

to attend an in-person UW GME Orientation, either immediately prior to or after their appointment

start date, based on their program. Residents who start off-cycle will have alternate arrangements

made for orientation by their program. Residents are also expected to attend program-specific

orientations arranged by their training program.

D. Electronic Health Record Training: Residents, either during Orientation or at a later time scheduled by

their program, will be required to attend in-person training on the electronic health record (EHR)

systems utilized at the participating sites and other training sites. Residents may not be provided with

access to these systems until the defined training requirements have been met. This includes but is

not limited to training on the respective EHR systems at UWMC, HMC, SCCA, SCH and the VA.

E. Orientation Compensation: Residents will be paid a daily rate appropriate to their level of training to

attend UW GME Orientation, EHR training, and for completion of eLearning modules, if the

requirements are met prior to commencement of training. Residents who attend a pre-appointment

orientation sponsored by the training program will be paid the daily rate for these orientation days.

F. Reporting for Duty: Residents must report for duty and attend required didactic and other educational

activities as specified by the program and training schedule. Residents who are unable to report for

duty due to illness or other events must report their absence to their Program Director or designee.

Residents with scheduled clinical responsibilities who are unable to report for duty during inclement

weather must maintain appropriate communication with the Program Director and/or designee, and

may be allowed to complete other academic endeavors during this time with advance approval by the

Program Director (see the UW Inclement Weather Policy and the UW Suspended Operations Policy

Residents reporting for duty will be provided with appropriate accommodations during such events.

Disaster Preparedness: In the event of a disaster, or other event that disrupts the normal operations

of training sites, residents may be required by their training site to report for duty or be available by

pager or cell phone, as outlined in the Continuity of UW Graduate Medical Education and

Administration in the Event of a Disaster Policy.

G. Conditions of Reappointment and Promotion: Residents are first and foremost learners and are

expected to pursue the acquisition of competencies that will qualify them for careers in their chosen

specialties. In addition, residents must adhere to standards of professional conduct appropriate to

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their level of training. Program appointment, advancement, and completion are not assured or

guaranteed to any resident. Promotion to the next level of training is based on the achievement of

program-specific competence and performance parameters via evaluation, including specialty-

specific Milestones, as determined by the Program Director and/or program Clinical Competency

Committee (CCC). Unsatisfactory resident performance can result in required remedial activities,

temporary suspension from duties, non-promotion, non-reappointment, or termination of

appointment and residency education.

H. Resignation: Residents who desire to voluntarily leave the program prior to completion of the training

necessary for board certification in the specialty or program completion may do so at any time but

are expected to discuss this action with their Program Director at the earliest possible time. In this

circumstance, residents are expected to complete the training year of their current appointment,

unless an earlier resignation is mutually agreed upon by the Resident and Program Director.

I. Non-Compete: Residents are not required to sign a non-competition guarantee or restrictive covenant

by the UWSOM or any of its ACGME programs as a condition of appointment.

POLICIES AND PROCEDURES

Residents must comply with the policies and procedures of the participating sites and other training sites,

in addition to UWSOM/UWSOD policies and procedures.

Policies outlined throughout this agreement may be found in their entirety in the Policies and Procedures

section on the GME website.

A. Clinical and Educational Work Hours Policy

: Clinical and Educational Work Hours are defined as all

clinical and academic activities related to the training program. This includes inpatient and outpatient

clinical care, in-house call, short call, night float and day float, transfer of patient care, and

administrative activities related to patient care such as completing medical records, ordering and

reviewing lab test, and signing orders. This also includes time spent doing clinical work while on home

call, all outside work activities, and other scheduled activities, such as conferences. Clinical and

Educational work hours do not include reading done in preparation for cases, studying, and research

done away from the duty site. In-house call is defined as those work hours beyond the normal work

day when residents are required to be immediately available in the assigned institution.

Program Policies: Each program shall maintain a program work hours policy that meets the

educational objectives and patient care responsibilities of the training program and must comply with

work hour limits according to ACGME requirements and the Institutional Clinical and Educational

Work Hours Policy.

Fatigue Mitigation: Programs must educate all faculty members and residents annually to recognize

the signs of fatigue and sleep deprivation. All incoming residents are required to complete a Physician

Well-Being module that addresses fatigue management and mitigation via the UW Medicine Learning

Hub.

Compliance: Residents are required to report their daily work hours in the MedHub Residency

Management System and have access to two-week blocks for documenting their time for the prior

and current weeks. Blocks are available on a one-week rolling cycle (Sunday – Saturday), after which

residents will be locked out from reporting work hours.

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B. Drug Enforcement Administration (DEA) Registration Policy: Residents who prescribe, order,

administer, or handle controlled substances are required to obtain an individual DEA registration.

Registrations may be obtained on a fee-exempt basis while in training in a UW GME training program;

however, such registrations are restricted to activities within the scope of the training program

(including internal moonlighting and extra pay for extra duty activities). Residents who engage in

external moonlighting may not use their fee-exempt registration for this purpose. Residents who are

not eligible for an individual DEA registration (e.g., those training with an Idaho permit) must use the

institutional DEA numbers of their respective training sites.

C. Resident and Fellow Evaluation Policy

: Each resident shall be provided with frequent feedback by

faculty during each rotation or educational assignment, as well as access to written evaluations of

performance in the MedHub Residency Management System at the completion of each rotation or

educational assignment in the training program. For residents whose block rotations are greater than

three months in duration, evaluation will be documented at least every three months. Longitudinal

experiences will be evaluated at least every three months and at completion. In addition, the Program

Director or designee shall meet with and review with each resident their documented semi-annual

and final evaluations of performance in the program. The Program Director or designee will assist

residents in developing individualized learning plans and develop plans for residents failing to

progress.

The program director will appoint a Clinical Competency Committee (CCC)

according to ACGME

policies to review all resident evaluations at least semi-annually. The CCC will garner resident

performance evaluation data from multiple evaluators, synthesize the data, determine each

resident’s progress on achievement of the specialty-specific Milestones, and advise the program

director regarding each resident’s progress prior to the residents’ semi-annual evaluations. The semi-

annual meeting discussions and Milestone reports shall be documented in writing and maintained in

the Resident’s academic file, which is accessible for review by the Resident.

D. Immunization Policy and Bloodborne Pathogens (BBP) Exposures:

During initial onboarding, all

incoming residents must submit documented proof of current immunization and/or positive

serological status for measles, mumps, rubella, varicella-zoster virus, hepatitis B, tetanus, pertussis

and diphtheria, and TB screening for review by UWMC or HMC Employee Health prior to

commencement of training. Participating sites may also have additional requirements.

a. Residents are required to comply with the annual UW Medicine Influenza Prevention Program

requirements. Compliance with the program includes influenza vaccination at UWMC/HMC,

documentation of vaccination at an outside facility, or signing a formal declination.

b. Annual TB screening and N-95 fit testing/PAPR clearance as required by the applicable training

site.

c. Residents with chronic hepatitis B, hepatitis C or HIV infection will have their results referred

by Employee Health to the UW Medicine Bloodborne Pathogen Committee. All referred cases

are confidential, and recommendations of the committee are oriented to maintaining the

usual practice scope of the referred individual while maintaining patient safety.

d. In the event of a bloodborne pathogen exposure (e.g., needlestick, cut, puncture, mucous

membrane, or open wound exposure to human blood or other potentially infectious materials

such as: body fluids, HIV/HBV/HBC containing cultures, HIV/HBV/HBC infected animals,

human cell and/or tissue lines), residents should immediately seek medical attention. Wash

the exposed area for 15 minutes; inform the attending; seek medical treatment from

Employee Health (if after hours, go to the Emergency Departments) and bring patient’s label.

See

Policies on Infection Control Procedures, with Special Emphasis on Health Care

Practitioners Infected with Bloodborne Pathogens for more information.

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E. Licensing Policy: All residents must hold an active Washington state provider license or permit in the

state where they are training (e.g., Alaska or Idaho). It is the Resident’s responsibility to comply with

licensure requirements at all participating training sites, as well as any additional licensure

requirements while participating in educational experiences outside of UW Medicine and

participating sites. Residents must submit all application materials and supporting documentation to

the Washington Medical Commission or other applicable licensing body prior to commencement of

training. Residents shall be reimbursed by programs for the payment of license fees as outlined in the

CBA.

F. Licensure Examinations Policy

: To meet appropriate educational standards and national quality

standards in preparation for medical licensure and certification by the ABMS, residents must

successfully pass specified steps of national licensing examinations by a given training year.

 USMLE Steps 1 and 2 (CK and CS) or equivalent examinations (COMLEX-USA or MCCQE): Must be

completed within 6 months of commencement of training in a UW residency or fellowship

program, regardless of training level.

 USMLE or COMLEX Step 3: Must be completed within 6 months of starting PGY-3, or earlier, if

indicated by the training program. Residents entering a UW program after their PGY-3 year must

pass USMLE or COMLEX Step 3 prior to commencement of training.

Residents must be provided with reasonable accommodations by the program to sit for their required

exam and may use Professional Leave for these days. Residents may be reimbursed for examination

fees as outlined in the CBA.

Residents enrolled in CODA-accredited dental residency training programs must have successfully

passed the National Board of Dental Examinations (NBDE) Part I and Part II and any other applicable

licensing exams (written or clinical) as defined by the training program.

G. Maintenance of Case/Procedure Logs Policy

: The case/procedure logs maintained by residents to

document their clinical experience requirements must be protected and kept secure so that only

authorized individuals have access to patient information.

 Each Program Director is responsible for establishing and communicating a standardized process

and documentation requirements for residents to maintain case/procedure logs, which may

include use of the ACGME Resident Case Log System, the MedHub Residency Management

System, or national society or board case log system.

 Any written (paper) documentation generated in preparation for database entry or any other

documentation pertaining to cases (e.g., sketched pictures) that are unsuitable for database entry

that contain PHI must be physically secured in a location that cannot be accessed by non-UW

Medicine workforce members.

 Each program must designate secure locations at each the training sites to maintain

case/procedure logs. If the paper documentation must leave the site, it must remain in the

possession of the resident at all times. Any patient information kept on a mobile device before

being entered into a case log system or at any time, must be stored on an encrypted device only.

 Residents are responsible for safeguarding patient information and must be familiar with the UW

Medicine Information Security Policies, which require password protection and encryption

of any

mobile device, including a laptop, notebook, tablet, and smartphone, that is used to store,

maintain, or transmit confidential information, including protected health information (PHI). This

requirement applies to University-owned and personal mobile devices. UW Medicine policy

requires that appropriate sanctions be applied, up to and including dismissal from the program,

to residents who fail to comply with institutional polices and established procedures related to

privacy, confidentiality, and information security, as outlined in

Corrective Actions COMP .006.

All UW Medicine Compliance Policies are located at:

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http://depts.washington.edu/comply/policies/. Residents must also comply with information

security policies at other participating sites where they rotate.

H. Medical Records Policies: Residents shall be responsible for complying with timely documentation

and medical records policies of the hospital or clinic to which they are assigned. These policies include

requirements regarding the preparation of a complete and legible medical record for each patient.

Discharge summaries, operative reports, and other key portions of the medical record must be co-

signed by a supervising physician in accordance with Medicare teaching supervision rules. Medical

records must be completed according to the timelines outlined in the relevant hospital or clinic’s

Medical Records Policy. In general, residents will continue to have access to medical records at UW

Medicine sites for 48 hours following completion of training in order to complete required

documentation. Residents are subject to the terms of the hospital or clinic’s Medical Records Policy

for delinquent medical records.

I. Policy on Working Outside of the Training Program

: Work outside of the training program (“Outside

Work”) is defined as any voluntary, clinical or non-clinical work that is outside of a trainee’s regularly

scheduled program duties and done for additional compensation. Outside work includes (1) Internal

Moonlighting, (2) External Moonlighting, (3) Extra Pay for Extra Duty, and (4) Additional Non-Clinical

Work. Residents from all departments are permitted to engage in Outside Work provided that they

are eligible, and that such activities do not interfere with the responsibilities, duties or assignments

of their training program or their stipend-supported research, if applicable. Outside Work must be

approved in writing by the trainee’s Program Director and the GME Office prior to engaging in any

Outside Work activities. Approval is also contingent on Outside Work activities complying with all UW

policies and Washington State law. A Resident who wants to participate in any type of Outside Work

must complete the Request for Approval of Work Outside of the Training Program form and submit

to the GME Office.

J. Physician Impairment Policy

: Program Directors and faculty must monitor Residents for the signs of

impairment. Burnout, mood disorders, suicidality, substance abuse, and behavioral disorders are

examples of conditions that may result in practice impairment. Further, it is the responsibility of every

individual—including Program Directors, faculty and residents—licensed by the Washington State

Department of Health (DOH) to report any licensed healthcare practitioner who may not be able to

practice with reasonable skill and safety as a result of a physical or mental condition according to

Washington Administrative Code

WAC 246.16.220.

K. Professional Behavior and Conduct for the Teacher/Learner Relationship: The UWSOM is committed

to maintaining the highest standards of academic performance, professional behavior, personal

integrity, and respect for each other as individuals. These standards apply to all individuals associated

with the educational experience, and it is expected that the teachers and learners will be on their

honor to maintain the highest standards of professional behavior in all aspects of training. Residents,

in their role as teachers of medical students and other residents, are responsible for adhering to the

guidelines for Professional Behavior and Conduct for the Teacher/Learner Relationship as outlined in

the

UWSOM Student Handbook (p.64).

L. Resident/Fellow Remediation Policy and Grievance Procedure

: Process and appeals related to

academic and professional conduct matters are governed by the Resident/Fellow Remediation Policy

and Grievance Procedure. This includes claims addressing evaluation of academic or clinical

performance or professional behavior, a non-reappointment decision, or any other matters regarding

a Resident’s failure to meet the educational objectives or requirements of the training program

The process described in the Resident/Fellow Remediation Policy and Grievance Procedure is the

exclusive means of review of such actions within the UWSOM and is designed to ensure that actions

that might adversely affect a resident’s status are fully reviewed and affirmed by neutral parties while

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ensuring patient safety, quality of care, and the orderly conduct of training programs. In the case of

non-renewal of appointment, non-promotion to the next training level, or dismissal for cause, the

program will provide the Resident with notice of its intent promptly, and in the most expeditious

manner possible.

M. Supervision and Accountability Policy

: Residents must comply with the supervision standards outlined

in the Institutional Supervision and Accountability Policy and program specific policies. Residents are

given graded and progressive clinical responsibility according to their clinical experience, judgment,

knowledge, and technical skill. The specific clinical responsibilities of each resident varies with PGY-

level, clinical rotation, experience, duration of clinical training, the patient's illness, and the clinical

demands placed on the team and the availability of support services.

Each resident must know the limits of their scope of authority and the circumstances under which

he/she is permitted to act with conditional independence. Residents are responsible for asking for

help from the supervising physician (or other appropriate licensed practitioner) for the service they

are rotating on and complying with the supervision standards of their clinical assignments. Residents

must report any complication, near miss, or patient problem/safety issue to the supervising faculty.

The attending physician is responsible for assuring the quality of care provided and for addressing any

problems that occur in the care of patients and thus must be available to provide direct supervision

when appropriate for optimal care of the patient and/or as indicated by individual program policy.

N. Transitions of Care Policy

: Residents are required to adhere to general institutional policies and to

their program-specific policy for transitions of care. All residents must be trained and systematically

assessed for competency in the transition of care process, which includes hand-off skills and

communication with team members during the hand-off process. Programs are responsible for

having a documented, structured, and monitored hand-off process in place for ensuring the

effectiveness of transition and patient safety.

All residents must demonstrate responsiveness to patient needs that supersedes self-interest. This

includes the recognition that under certain circumstances, the best interests of the patient may be

served by transitioning that patient’s care to another qualified and rested provider. Under such

circumstances, residents must follow the program-specific procedure to transfer their patient care

responsibilities to another provider.

O. UW Medicine Information Security Policies

: All residents must be educated about privacy,

confidentiality, and security of patient, confidential, restricted and proprietary health information.

Residents are required to read and sign the UW Medicine Privacy, Confidentiality, and Information

Security Agreement (PCISA) at initial appointment, at reappointment each year, and prior to using

their UW Medicine Accounts.

 HIPAA Online Training must be completed within 30 days of a resident’s start date.

 Residents training solely at one of the VA training sites (Seattle or Boise) must complete VA HIPAA

compliance training using the VA “Mandatory Training for Trainees” course, are exempt from

completing the UW Medicine training, and are also subject to the privacy and security policies of

the VA.

P. UW Medicine Policy on Professional Conduct

: UW Medicine is committed to high standards of

professionalism in patient care, research and education among our faculty, staff, residents, and

students. Professionalism is integral to our mission of improving health, and includes demonstrating

excellence, respect, integrity, compassion, altruism, and accountability in all endeavors and creating

an environment supportive of diversity in ideas, perspectives and experiences. All individuals in our

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UW Medicine community are responsible for creating an inclusive environment where every person

is valued and honored.

All members of the UW Medicine community are expected to conduct themselves in a professional

and ethical manner with colleagues, patients, and the public. Leaders in our community are expected

to model, promote, and advocate for a strong and visible culture of professionalism.

Q. UW Medicine Social Media Policy and Guidelines

: Use of social media is prohibited while performing

direct patient care activities or in unit work areas, unless social media in those areas has been

previously approved by the supervisor. Residents should limit their use of social media in hospital or

clinic space to rest or meal breaks, unless social media use for business purposes has been previously

approved by a supervisor.

R. UW Patent, Invention and Copyright Policy

: Residents are considered employees for purposes of, and

are required to comply with, the UW Patent, Invention, and Copyright Policy. The policy requires

among other things that residents disclose to the University all inventions and discoveries conducted

during their UW appointment, using UW time and resources, and that residents agree to assign to the

University all inventions in which the University has an interest.

S. UWSOD Code of Professional Conduct

: The Code of Professional Conduct is a set of principles that

has been developed to ensure that all students (graduate students and residents included), staff,

faculty, and volunteers in the School of Dentistry share a collective responsibility for maintaining the

highest ethical standards and professional conduct in their relationships with each other and with

patients.

T. Vendor Interaction Policy

: Resident behavior and professional judgment should not be compromised

by vendor influence, either through vendor interactions with the training program or the individual

resident. Residents are professionally accountable to their patients and colleagues, and as such,

should avoid interactions with vendor representatives that have the appearance of compromising

impartiality in clinical or academic practices.

U. Well-Being Policy

: Well-being of residents and faculty members is a key element of a positive learning

and working environment. Each program, in partnership with the UWSOM, has the responsibility to

address clinicians’ psychological, emotional, and physical well-being, and all members of the health

care team share responsibility for the well-being of others. The UWSOM and each program must offer

appropriate infrastructure, services, resources, and leave from training when needed.

BENEFITS AND PAYROLL

The benefit program outlined below is designed for Residents (Job Profile 10328), Fellows (Job Profile

10439), and Chief Residents (Job Profile 10329) paid by the University of Washington and is administered

through the UWSOM/UWSOD. Some of these benefits, including but not limited to the UW Retirement

Plan (UWRP), may not apply to residents who hold a title of Senior Fellow Trainee (Job Profile 10442) and

receive stipends from training grants. UWSOM also provides a number of benefits that are unique to

residents, which are included below under Other Resident Resources and Services. Policies related to

these benefits are subject to change during the academic year. In the event of a change in benefits policy,

the GME Office will notify residents. More information about each of these benefits may be found on the

GME website or by contacting the GME Office. Residents may also contact UW

Human Resources at (206)

543-4444 for questions regarding UW benefits.

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Residents required by their program to participate in in-house overnight call or to perform other duties

related to their residency program past midnight on their last night of service will receive pay and all

benefits (including health insurance, professional liability coverage and workers’ compensation) for hours

worked past the end date of their appointment agreement. Programs must notify the GME Office of such

extensions by March 30 of each academic year.

A. UW Benefits

1. Medical, Dental, Basic Life and Long-Term Disability Insurance Benefits: As new employees,

residents have 31 days from their initial eligibility date to select and enroll in the medical and

dental plan of their choice. Benefits options are outlined in the

Summary of Benefits for Residents

and Fellows on the Benefits website. Residents will receive their benefits information packets

and new hire benefits orientation at UW GME Orientation. Benefits enrollment will be completed

in Workday, the cloud-based human resource and payroll system for the University of

Washington.

a. Benefits Options: Residents appointed at least 50% FTE (full-time equivalent) for a minimum

of six consecutive months and receive their salary/stipend from UW are eligible for insurance

through the Public Employees Benefits Board (PEBB) through the Washington State Health

Care Authority (HCA). Insurance consists of:

 Medical insurance: University and Resident share the cost of insurance premiums

 Dental insurance: Premiums fully paid by UW

 Life, Accidental Death and Dismemberment Insurance: Basic insurance provided at no

cost, with option to purchase addition coverage

 Long-term disability (LTD) insurance: There are two LTD insurance options for residents.

Residents may enroll qualified dependents in their health plan. Additional information about

Benefits enrollment is available on the UW Integrated Service Center

website.

b. Start of Benefits Coverage: UW is subject to the State PEBB eligibility requirements as defined

in Washington Administrative Code (WAC) Section 182-12-114, which specifies that basic

insurance benefit coverage for eligible residents begins on the first day of the month following

their date of appointment, or on the first day of appointment for those starting on the first

business day of the month, and is effective through the end of the last month of appointment.

For residents starting at the end of June, benefits will therefore not take effect until July 1st.

c. Interim Coverage Options: Residents who recently completed medical school, another

training program, or position of employment and have a gap in insurance coverage may also

be eligible for

COBRA through their former school or employer. Refer to the health insurance

options section on the UW Benefits website for a list of alternate coverage options.

2. UW Retirement Plan (UWRP)

: Residents appointed at least 50% FTE in an eligible job title at the

time of hire, and for a minimum of six consecutive months, are eligible to participate in the UW

Retirement Plan (UWRP). Eligible titles include Resident (Job Profile 10328), Fellow (Job Profile

10439), and Chief Resident (Job Profile 10329). Senior Fellow Trainees (Job Profile 10422) are

not eligible to participate in the UWRP. Residents who hold a title of Senior Fellow Trainee

together with another title may participate in the UWRP only on the eligible title. Eligible

residents may start participating in the UWRP on their first day in a UWRP-eligible appointment.

The contribution rate is a percentage of a Resident’s gross salary and determined by age. Each

dollar contributed is fully matched by the UW. Both the UW and the Resident’s contributions are

immediately vested, and the plan is 100% portable when the Resident leaves the UW. If the

Resident has not enrolled in the UWRP by the end of their two-year anniversary, they will

automatically be enrolled in the plan. Changes to the UWRP may occur as authorized by the UW

Board of Regents.

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3. Voluntary Investment Program (VIP)

: Residents may participate in the Voluntary Investment

Program, a tax-deferred retirement savings plan, operating under Section 403(b) of the Internal

Revenue Code. Participants may choose their contribution amount (up to the IRS-defined limit).

4. Dependent Care Assistance Program (DCAP)

: Residents are eligible to participate in the DCAP,

which allows participants to take a deduction from their pay for eligible dependent care expenses

before taxes are calculated.

5. Medical Flexible Spending Account (FSA)

: Residents are eligible to establish a medical FSA, which

is an IRS-approved, tax-exempt account that allows the account holder to use pre-tax dollars to

pay for eligible medical expenses.

6. UW CareLink

: UW CareLink is the employee assistance program for PEBB benefits-eligible UW

employees, their dependents, and other household members, and includes confidential

counseling, financial and legal services, eldercare assistance, and other work-life solutions.

7. Whole U

: The Whole U connects faculty, staff and students with holistic wellness and year-round

programming offered across campus.

B. UW Payroll: UW payroll is managed through Workday. Payday

is the 10th and 25th of each month,

with exceptions made on weekends and holidays. Incoming residents will receive a new hire checklist

from Workday during the onboarding process. The following actions must be completed by residents

in Workday prior to their hire/appointment start date:

 Initiate I-9

 Current Address

 emergency contact information (required for correct benefits elections and tax withholding)

 Direct Deposit

 Withholding elections

Residents are further responsible for keeping their contact information up to date in Workday

throughout their appointments.

C. UW Risk Services

1. Professional Liability Coverage: Professional liability coverage is provided by the University of

Washington at no cost to residents. This insurance covers the residents’ good faith performance

of duties assigned in the training program, which may also include program-approved volunteer

activities and off-site rotations. For international rotations, coverage is not guaranteed and will

vary based on requirements of the country. Programs must work with UW Office of Risk Services

to determine insurance requirements in the country where the rotation will occur. Visit the

Risk

Services website for more information.

Questions regarding professional liability coverage, including terms and conditions of coverage,

should be directed to the Office of Risk Services at rmcerts@uw.edu

. Liability coverage terms and

conditions and request forms for provider certificates are available on the Risk Services website.

Exemptions from Coverage: Professional liability coverage will not apply to actions, claims or

proceedings arising out of acts taken in bad faith. Examples of types of conduct which will

normally be deemed to have been taken in bad faith include: an act committed with the willful

intention of causing injury or harm, or that was reckless or malicious in nature; an act committed

in willful violation of law or University regulations; or an act committed while under the influence

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of alcohol or a controlled substance (as defined in RCW 69.50.101 as now or hereafter amended).

(UW Policy: Indemnification of University Personnel).

 Volunteer Activities: Coverage may be provided for medical volunteer activities when

approved in advance by the Program Director and the GME Office. The Resident should

consult with their Program Director for clarification of coverage for proposed volunteer

activities in advance of undertaking such activities.

 Outside Professional Work: Professional liability coverage is not provided by the University

of Washington for external moonlighting activities, as these activities are outside the scope

of the residency program. Professional liability coverage may be provided for some internal

moonlighting activities and is determined on a case-by-case basis. Residents should direct

questions to the GME Office.

If the University is defending an action involving a Resident, whether the School or the Resident

are or are not individually named as defendants, the Resident shall cooperate fully with the

University and its counsel in handling or defending the action, claim or proceedings. This

obligation shall continue after the Resident leaves the residency program.

2. Workers’ Compensation: The University of Washington’s workers’ compensation program is

state-insured. The Washington State Department of Labor and Industries (L&I) manages all the

workers’ compensation claims. Residents are insured for injuries or illnesses that occur while

acting within the course and scope of their duties for the University of Washington (see

Administrative Policy Statement 14.1.4: University Risk Management and Insurance Programs),

and includes coverage during any out of state and international rotations. Employees who are

injured at work or who believe that their illness is related to their job can file an L&I claim through

a physician’s office, clinic, emergency room or hospital. Questions regarding workers’

compensation and how to file a claim should be directed to the

Office of Risk Services at (206)

543-6744 or [email protected].

D. Vacation Leave, Sick Leave and Other Leaves of Absence: Residents must comply with program

requirements for requesting and reporting the use of vacation, sick and other leaves of absence. The

amount of available vacation and sick leave is governed by the CBA. When the need/desire for the

leave of absence is foreseeable, the request should be submitted as soon as possible and ideally at

least thirty (30) days prior to the leave. When the need for the leave is unforeseeable, the request

should be submitted as soon as possible. Residents are eligible for several additional leave benefits

as described in the CBA.

Effects of Leave on Program Completion and/or Board Eligibility: Program Directors must provide their

residents with the program’s policy on leaves of absence, including the effects of leaves of absence,

for any reason, on the ability to satisfy the requirements for program completion and information

related to eligibility for specialty board examinations.

Coverage during Leave: Each program must allow an appropriate leave of absence for residents

unable to perform their patient care responsibilities, without fear of negative consequences. It is

ultimately the responsibility of the Program Director to assure that appropriate coverage of patient

care by colleague residents and/or faculty of the respective departments is provided as required

during the Resident’s leave of absence. In arranging such coverage, the principles of the RFPA and

specific departmental policies concerning clinical and educational work hours for residents shall apply.

Extended Leave: Except for extended military service leaves, approved leaves of absence without pay

should not exceed twelve (12) months in duration. Extensions of leaves beyond the twelve (12) month

limitation must be approved by the GME Office.

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E. GME Wellness Service

: The GME Wellness Service is devoted to supporting a positive learning

environment for residents, and to improve the quality of life for residents and their families.

Confidential counseling, therapy and referral services for residents dealing with specific concerns such

as stress, anxiety, depression, burnout, relationship issues, grief/loss, and interpersonal conflicts are

available for free. Referrals to behavioral health services are available. In case of urgent need,

services may be provided over the phone or via video conference. In addition to providing confidential

counseling, the GME Wellness Services arranges community building events for residents,

mindfulness-based stress reduction training, and other activities.

F. Other Resident Resources and Services

1. Husky Card

: The Husky Card is the official identification card for members of the UW community.

The Husky Card serves as the UW library card, enrollment card for the U-PASS program,

membership card for the Intramural Activities Building (IMA), and discount card to arts and

sporting events. It also serves as the “prox” card for restricted areas at UWMC. Residents are

issued Husky Cards at the beginning of their initial UW appointment.

2. U-PASS

: The U-PASS provides residents with a variety of low-cost transportation options - from

buses, commuter train service, and light rail - to discounts and special offers at many local

businesses. Participation in the U-PASS program requires a valid Husky Card, which all residents

receive.

3. Shuttles: Residents are encouraged to use available transportation methods such as the

Shuttles (includes Health Sciences Express, NightRide, South Lake Union, SCCA, Fred Hutch/SLU

shuttle) and the SCH shuttles when commuting between clinical sites.

4. Emergency/Safe Ride Home Program

: If a situation arises where a resident is unable to safely get

home at the end of or during a shift due to extreme fatigue, illness or the late hour, the resident

may use the Emergency/Safe Ride Home Program. This program would provide transportation to

the resident’s place of residence via taxi or rideshare from an approved training site. The GME

Office will reimburse 100% of the meter fare (does not include tip) under eligible circumstances

as defined in the policy.

5. Security Escort Services: Residents who would like a security escort to their parked car may

contact the Public Safety Office at the applicable training site to request a public safety escort.

• UWMC-Montlake: Public Safety (206) 598-5555

• UWMC-Northwest: (206) 668-2795

• HMC: Security Dispatch Center (206) 744-3193

• SCH: (206) 987-2030

• SCCA: (206) 288-1111

• VAPSHCS: Non-emergent needs call ext. 62899 or 63113 from any internal phone, or present

to the security front desk (near the ER)

• Boise VA: (208) 422-1122.

Also available is the Husky NightWalk service (206) 685-WALK, which provides a UW security

escort to anywhere within the UW campus.

6. Sleep Facilities: Residents are provided with appropriate sleep facilities at each participating

training site that are safe, quiet, clean, and private, in order to mitigate fatigue at any time.

Sleep/rest facilities are accessible for residents with proximity appropriate for safe patient care.

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Locations and access to sleep facilities are provided by programs. Residents should contact the

local site director for further information on sleep quarters at other training sites.

7. Lactation Facilities

: Residents will be provided with clean and private facilities for lactation that

have refrigeration capabilities with proximity appropriate for safe patient care.

8. Meals

: Residents must have access to healthy, appropriate food services 24 hours a day while on

duty at all institutions. Meals will be provided to residents while serving at UWMC, HMC, SCH,

and the VA under the following circumstances:

UWMC and HMC: Consistent with the UW GME Meals Policy.

SCH: Meals are provided to residents when working a 12-hour day or night shift, when on a swing

shift, and when on 24-hour in-house call, and must present their SCH badge to the cashier. See

the

SCH Meals Policy for details.

VA: Fresh meals including soups and salads (as well as fruit, drinks, and other miscellaneous items)

are provided for residents when on-call or when required to stay at the hospital after 7 p.m., when

food services are not available.

PROGRAM REDUCTIONS AND CLOSURES

As specified in the Program Reduction and Closure Policy

, in the event of a UW GME program reduction

or closure, or closure of the institution, UWSOM/UWSOD and the training program will work

collaboratively to ensure that residents currently enrolled in the program are able to complete their

education within the program or will assist the residents in enrolling in another ACGME or CODA-

accredited program in which they may continue their training. UWSOM/UWSOD and the Program Director

will consider such issues as transfer of funding and board-specific requirements of residents and will make

every attempt to phase out the program over a period of time to allow all residents currently in the

program to complete their training. In all cases, UWSOM/UWSOD and the program will fulfill the terms

of the current appointment (e.g., stipend, benefits) as described in this agreement and in the CBA.

Similarly, the UWSOM/UWSOD and the Program Director are responsible for ensuring continuity of the

educational experience of residents in training programs in the event of a disaster. The plan for

Continuity

of UW Graduate Medical Education and Administration in the Event of a Disaster addresses how lines of

communication will be administered, the temporary or permanent transfer of residents if necessary, and

continuation of resident stipends and benefits.

SEXUAL HARASSMENT AND OTHER FORMS OF DISCRIMINATION

University policy (see UW Executive Order No.31: Nondiscrimination and Affirmative Action

) prohibits

discrimination or harassment against a member of the University community because of race, color,

creed, religion, national origin, citizenship, sex, pregnancy, age, marital status, sexual orientation, gender

identity or expression, genetic information, disability, or veteran status; prohibits any member of the

University community, including, but not limited to, academic personnel, staff, temporary staff, academic

student employees, student employees, and students at all University campuses and locations, from

discriminating against or unlawfully harassing a member of the public on any of the above grounds while

engaged in activities directly related to the nature of their University affiliation; and prohibits retaliation

against any individual who reports concerns regarding discrimination or harassment, or who cooperates

with or participates in any investigation of allegations of discrimination, harassment, or retaliation under

this policy, or any individual who is perceived to have engaged in any of these actions. This policy further

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defines the following terms: discrimination, harassment, retaliation, sexual harassment, and veteran

status.

RESIDENT, PATIENT SAFETY, AND COMPLIANCE CONCERNS

Complaint Resolution: The University of Washington encourages prompt investigation and resolution of

complaints about the behavior of its employees (see UW Administrative Policy Statement 46.3: Resolution

and Complaints Against University Employees), and encourages employees to seek resolution assistance

regarding behaviors that include but are not restricted to: harassing, discriminatory or threatening

behavior; violation of University policy; or mistreatment of members of the public. Residents who believe

they are being harassed or discriminated against should seek help from their Program Director or

Department Chair and may also seek assistance from the GME Office. A comprehensive list of additional

complaint resolution resources, if needed, is available through

UW Human Resources.

Resident Concerns: Several mechanisms have been established for residents to report concerns regarding

harassment/discrimination, attending issues, personal issues, co-residents, or program issues. Refer to

the

How to Report a Concern in a Confidential Manner diagram for reporting options. Residents may also

contact the GME Office anonymously or confidentially through the Concern Reporting Form.

Patient Safety Concerns: Each participating site has an online incident reporting tool, accessible from the

hospital desktops, which should be used to report adverse events, near misses and unsafe conditions at

the hospital. Residents should report any event or condition that could cause or has caused injury or illness

to a patient, staff member, or visitor. These reporting tools generally provide real-time event notification

to managers, faculty, and other identified subject matter experts. Incident report entries, and any follow-

up, are part of each hospital’s quality improvement programs and are subject to quality improvement

privilege and confidentiality laws.

UW Medicine Compliance Office: The UW Medicine Compliance Office

is responsible for establishing

institutional policy, standards and expectations pertinent to research, clinical billing, privacy, information

security, employment, personal and environmental safety, purchasing, ethics and records retention. The

office provides safe mechanisms for reporting compliance concerns, including hotlines that enable

anonymous reporting. Concerns may be reported confidentially to the anonymous Compliance Hotline at

(206) 616-5248 or (866) 964-7744.

AMENDMENTS

Amendment to the RFPA agreement for the following academic year shall be approved by GMEC and the

Dean by January 15th.

In the event of unforeseen or critical circumstances, the Dean may propose alterations of this agreement.

Such alterations will be referred to the Policy Committee and GMEC for consideration prior to

implementation. Critical or unforeseen circumstances shall be generally defined as grave, pressing, and/or

unusual circumstances of sufficient import and urgency as to necessitate the modification of this

agreement in a manner which could not reasonably be construed as arbitrary or capricious. The

Housestaff Advisory Committee (HAC) will be notified as soon as possible for their comment and input

regarding such unforeseen or critical circumstances.