Dutch dismissal practices: characteristics, consequences, and contrasts in residents’ case law in community-based practice versus hospital-based specialties

Table 1 Differences in educational law procedures

Training characteristics	Community Practice	Hospital Specialties
Nominal years of training	3 years	4.5–6 years
Programme	2 years of supervision with a GP and 1 year of rotations in between in paediatrics, emergency medicine and psychiatry	Rotations of 6 to 12 months
Nationwide knowledge test	Yes	No
Longitudinal mentorship	Yes	Optional
Reflection classes	Yes	No
Conditional passing	Optional	No
Supervisor disconnection	Optional in GP	Exceptional
Dismissal procedure
Actor of dismissal	Head of residency training	Programme Director
Timing of dismissal	Flexible at any time in residency because of conditional passing or compelling reasons (such as untrainability)	Fixed moment determined to assess aptitude, unless critical safety incident or other compelling reason
Mediation initiated by	Institution with external mediator	Centralized Educators Committee

Legend: this table shows noticeable differences of design and regulation of training programmes for residents in Community Practice (general practitioner and nursing home doctor residents) and Hospital-based Specialties [10, 12, 29,30,31]
Reflection classes: classes designed to teach the residents to reflect on difficulties experienced during independent practice. Conditional passing: the training programme lets the resident in training pass to the next year of training, however, this allowance is conditional. The resident needs to fulfil certain conditions within a limited period of time, mostly within 3 to 6 months, or else the training program will be terminated. Supervisor disconnection: both the supervisor and the supervisee are entitled to disconnect their master-apprentice relationship prematurely. In such case the supervisee is entitled to continue the training at another general practitioners office with a new supervisor

ISSN: 1472-6920