Indian Pediatrics

, Volume 56, Issue 1, pp 53–59 | Cite as

Approach to Handling a Problem Resident

  • Jaya Shankar KaushikEmail author
  • Kausalya Raghuraman
  • Tejinder Singh
  • Piyush Gupta
Medical Education


Many medical postgraduate teaching programs have residents with professional and personal problems that may limit their performance. A Problem resident is the one who does not meet the expectations of the training program owing to deficits in knowledge, skill or attitude. Medical administration and faculty of every institution must have a system that is sensitized to handle a difficult learner. Problems need to be addressed before they escalate or result in compromise of patient care. The present review discusses a broad approach to recognizing a Problem resident and provides suggestions on remedial measures.


Attitudes Competency based medical education Postgraduate training Professional competence 


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  1. 1.
    Modi JN, Gupta P, Singh T. Competency-based medical education, entrustment and assessment. Indian Pediatr. 2018;52:413–20.CrossRefGoogle Scholar
  2. 2.
    Mahajan R, Badyal DK, Gupta P, Singh T. Cultivating lifelong learning skills during graduate medical training. Indian Pediatr. 2016;53:797–804.CrossRefGoogle Scholar
  3. 3.
    Nemani VM, Park C, Nawabi DH. What makes a “great resident”: The resident perspective. Curr Rev Musculoskelet Med. 2014;7:164–7.CrossRefGoogle Scholar
  4. 4.
    Yao DC, Wright SM. National survey of internal medicine residency program directors regarding problem residents. JAMA. 2000;284:1099–104.CrossRefGoogle Scholar
  5. 5.
    Reamy BV, Harman JH. Residents in trouble: An in-depth assessment of the 25-year experience of a single family medicine residency. Fam Med. 2006;38:252–7.Google Scholar
  6. 6.
    Steinert Y. The “problem” junior: Whose problem is it? BMJ. 2008;336:150–3.CrossRefGoogle Scholar
  7. 7.
    Steinert Y. The “problem” learner: Whose problem is it? AMEE Guide No. 76. Med Teach. 2013;35:e1035–45.CrossRefGoogle Scholar
  8. 8.
    Yao DC, Wright SM. The challenge of problem residents. J Gen Intern Med. 2001;16:486–92.CrossRefGoogle Scholar
  9. 9.
    Roback HB, Crowder MK. Psychiatric resident dismissal: A national survey of training programs. Am J Psychiatry. 1989;146:96–8.CrossRefGoogle Scholar
  10. 10.
    Hunt DD, Carline J, Tonesk X, Yergan J, Siever M, Loebel JP. Types of problem students encountered by clinical teachers on clerkships. Med Educ. 1989;23:14–8.CrossRefGoogle Scholar
  11. 11.
    Gaiser RR. The teaching of professionalism during residency: Why it is failing and a suggestion to improve its success. Anesth Analg. 2009;108:948–54.CrossRefGoogle Scholar
  12. 12.
    Ramani S, Leinster S. AMEE Guide no. 34: Teaching in the clinical environment. Med Teach. 2008;30:347–64.CrossRefGoogle Scholar
  13. 13.
    Wu JS, Siewert B, Boiselle PM. Resident evaluation and remediation: A comprehensive approach. J Grad Med Educ. 2010;2:242–5.CrossRefGoogle Scholar
  14. 14.
    Lloyd B, Pfeiffer D, Dominish J, Heading G, Schmidt D, McCluskey A. The New South Wales Allied Health Workplace Learning Study: Barriers and enablers to learning in the workplace. BMC Health Serv Res. 2014;14:134.CrossRefGoogle Scholar
  15. 15.
    Bajpai V. The challenges confronting public hospitals in India, their origins, and possible solutions. Advances in Public Health. 2014;898502.Google Scholar
  16. 16.
    Lal P. Whither medical education and healthcare? MAMC J Med Sci. 2015;1: 59.Google Scholar
  17. 17.
    Saini NK, Agrawal S, Bhasin SK, Bhatia MS, Sharma AK. Prevalence of stress among resident doctors working in medical colleges of Delhi. Indian J Public Health. 2010;54:219.CrossRefGoogle Scholar
  18. 18.
    Langenfeld SJ, Cook G, Sudbeck C, Luers T, Schenarts PJ. An assessment of unprofessional behavior among surgical residents on Facebook: A warning of the dangers of social media. J Surg Educ. 2014;71:e28–32.CrossRefGoogle Scholar
  19. 19.
    Garg M, Pearson DA, Bond MC, Runyon M, Pillow MT, Hopson L, et al. Survey of individual and institutional risk associated with the use of social media. West J Emerg Med. 2016;17:344–9.CrossRefGoogle Scholar
  20. 20.
    Chang HJ, Lee YM, Lee YH, Kwon HJ. Investigation of unethical and unprofessional behaviour in Korean residency training. Teach Learn Med. 2015;27:370–8.CrossRefGoogle Scholar
  21. 21.
    Nagler A, Andolsek K, Rudd M, Sloane R, Musick D, Basnight L. The professionalism disconnect: Do entering residents identify yet participate in unprofessional behaviours? BMC Med Educ. 2014;14:60.CrossRefGoogle Scholar
  22. 22.
    Goodman CJ, Lindsey JI, Whigham CJ, Robinson A. The problem resident: The perspective of chief residents. Acad Radiol. 2000;7:448–50.CrossRefGoogle Scholar
  23. 23.
    Al-Eraky MM. Twelve tips for teaching medical professionalism at all levels of medical education. Med Teach. 2015;37:1018–25.CrossRefGoogle Scholar
  24. 24.
    Obadeji A, Oluwole LO, Dada MU, Adegoke BO. Hazardous alcohol use among doctors in a tertiary health center. Indian Psychiatry J. 2015;24:59.CrossRefGoogle Scholar
  25. 25.
    Farrell SE, Hopson LR, Wolff M, Hemphill RR, Santen SA. What’s the evidence: A review of the one-minute preceptor model of clinical teaching and implications for teaching in the emergency department. J Emerg Med. 2016;51:278–83.CrossRefGoogle Scholar
  26. 26.
    Supe A, Singh T. Re-entry NEET (National Eligibilitycum-Entrance Test): Opportunity and concerns. Natl Med J India. 2016;29:158–9.Google Scholar
  27. 27.
    Brenner AM, Mathai S, Jain S, Mohl PC. Can we predict ‘problem residents’? Acad Med. 2010;85:1147–51.CrossRefGoogle Scholar
  28. 28.
    Singh T, Modi JN, Kumar V, Dhaliwal U, Gupta P, Sood R. Admission to undergraduate and postgraduate medical courses: Looking beyond single entrance examinations. Indian Pediatr. 2017;54:231–8.CrossRefGoogle Scholar
  29. 29.
    Ramanan RA, Phillips RS, Davis RB, Silen W, Reede JY. Mentoring in medicine: Keys to satisfaction. Am J Med. 2002;112:336–41.CrossRefGoogle Scholar
  30. 30.
    Yamada K, Slanetz PJ, Boiselle PM. Perceived benefits of a radiology resident mentoring program: Comparison of residents with self-selected vs assigned mentors. Can Assoc Radiol. 2014;65:186–91.CrossRefGoogle Scholar

Copyright information

© Indian Academy of Pediatrics 2019

Authors and Affiliations

  • Jaya Shankar Kaushik
    • 1
    Email author
  • Kausalya Raghuraman
    • 2
  • Tejinder Singh
    • 3
  • Piyush Gupta
    • 4
  1. 1.Department of PediatricsPt BD Sharma Post Graduate Institute of Medical SciencesRohtakIndia
  2. 2.Department of MicrobiologyPt BD Sharma Post Graduate Institute of Medical SciencesRohtakIndia
  3. 3.Department of Pediatrics and Medical EducationChristian Medical CollegeLudhianaIndia
  4. 4.Department of Pediatrics and Medical EducationUniversity College of Medical Sciences (University of Delhi)New DelhiIndia

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