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Table 5 Compelling reasons to dismiss

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

Case number

Reason explained by programme director or head of residency training

Respected?

 

Patient safety

 

2013-63209 C

Incident during a weekend shift, concerning patient safety.

Yes

2019-6 C

Three types of incidents such as multiple faults in prescribing medication, not taking concerns of nurses seriously concerning wound care, forgot to attend to a family conversation.

Yes

2017-63269 C

2017-63284 C

Insufficient assessment of the seriousness of patient problems (knowledge from the books not being able to applicate to clinical reasoning and decision making in practice).

Yes

Yes

2017-63281 H

Two incidents risking patient safety on the ICU.

No

2016-63263 H

Complaints and missed diagnosis, behaviour during shifts.

No

2019-4 H

A pattern of dysfunctioning discarding continuity and safety of patient care.

No

2013-63211 H

Carelessness with radiation therapy leading to concerns about patient safety.

Yes

 

Unreliability

 

2016-63264 C

Forgery about attending a conference.

Yes

2012-63192 C

No show on an emergency services shift, on top of other professionalism lapses.

Yes

2013-63198 C

Resumé fraud.

Yes

 

Losing support from colleagues or staff

 

2013-63203 C

Level of performance and lack of ability to work independently at the emergency medicine services.

Yes

2013-63212 C

Incidents resulting in interruption of the rotation in emergency medicine.

Yes

2016-63255 H

Severity of deficiencies combined with untrainability regardless of a registration as medical specialist abroad.

Yes

2016-63259 H

No longer having the support of the nursing staff on the ICU after discarding promises of restricting patient contact leading to safety risks.

Yes

  1. Legend: This table shows the arguments used in 15 cases of residents whom were dismissed from residency because of compelling reasons. This concerned reasons other, or on top of illness or untrainability. Although concerns for patient safety were expressed in at least eight cases, we have no evidence that the patents in these cases actually suffered from the reported incidents, because the training staff discovered these incidences in time. The conciliation board respected compelling reasons to dismiss in twelve of the fifteen cases, but refused some arguments about patient safety as a reason, were as the board respected other reasons to dismiss. C = Community-based Practice, H = Hospital-based Specialty