RIVERSIDE METHODIST HOSPITAL MEDICAL EDUCATION DEPARTMENT Columbus, Ohio

RIVERSIDE METHODIST HOSPITAL MEDICAL EDUCATION DEPARTMENT Columbus, Ohio RESIDENT/FELLOW AGREEMENT This Agreement ("Agreement") is made by and between Riverside Methodist Hospital (RMH), ("Hospital"), Columbus, Ohio and Name ("Resident" or Fellow ), effective as of June 16, 2015. In consideration of the mutual promises made below, the Hospital and the Resident agree as follows: SCOPE OF RESIDENCY PROGRAMS I. The Hospital is committed to maintaining graduate medical education programs approved by the Accreditation Council for Graduate Medical Education in the following areas: Family Practice, General Surgery, Preliminary Surgery, Internal Medicine, Obstetrics and Gynecology, Transitional and Preliminary Medicine, Primary Care Sports Medicine Fellowship, and Hospice and Palliative Medicine Fellowship. Each such program has a Program Director and may have a chief resident. II. The Hospital has established a formal affiliation with The Ohio State University for residency training in the following programs: Emergency Medicine, General Surgery, Orthopedic Surgery, Physical Medicine and Rehabilitation, and Plastic Surgery. The Hospital also has a formal affiliation with Nationwide Children s Hospital for the education and training in the care of pediatric patients. TERM AND TERMINATION The term of this Agreement shall commence on June 16, 2015 and end on June 19, 2016. This Agreement shall not be terminated by either party prior to its expiration unless the Resident/Fellow is unable to perform his or her assigned duties or fails to meet the performance standards of the training program in the judgment of the Hospital because of incapacitating illness or if he or she has violated this Agreement, Resident Commitment or the Medical Education Department and Hospital's policies, procedures, rules or regulations. If the decision is made not to renew a resident or fellow s contract, the Program Director must notify the resident/fellow in writing no later than four months prior to the end of the contract. If the decision not to renew occurs within the four months prior to the end of the contract, the Program Director must provide the resident/fellow with as much written notice as circumstances reasonably allow prior to the end of the contract. The Resident/Fellow may appeal a termination action in accordance with the Grievance Procedure as it is stated in this agreement. There is no obligation to extend this Agreement beyond its initial term. APPOINTMENT TO RESIDENCY/FELLOWSHIP PROGRAM The Hospital desires to appoint, and the Resident/Fellow accepts an appointment to the Program residency/fellowship program, subject to the terms and conditions set out in this Agreement. 1. While performing his or her duties at the Hospital or at other locations as directed by the Hospital, the Resident/Fellow agrees to conduct him/herself in accordance with the Rules and Regulations of the Medical Staff, the Medical Education Policies and Procedures, the directions of the Graduate Medical Education Committee, the Designated Institutional Official/Director of Medical Education, and the Program Director of the residency/fellowship program, the Policies and Procedures of the Hospital, the RMH House Staff Handbook, and the Commitment Between Resident and Fellow Physicians and Their Teachers. 1

SALARY 2. If the Resident/Fellow has or becomes aware of any health condition which could have an effect on the Resident/Fellow's ability to practice medicine, or if the performance of essential functions of his or her job requires reasonable accommodation in order to facilitate the Resident/Fellow's continued practice of medicine or essential requirements of his or her job, the Resident/Fellow shall inform the Program Director and the Designated Institutional Official/Director of Medical Education, who together shall determine what accommodations, if any, shall be made. Such conditions include but are not limited to, substance abuse, mental illness, physical disability, or contagious diseases such as HIV or tuberculosis. See RMH Medical Education Policy: Resident/Fellow Physician Emotional and Behavioral Health. 3. In the event of any conflict between the Policies and Procedures of the Hospital and this Agreement, this Agreement shall be controlling. Otherwise, the Resident/Fellow shall abide by all Policies and Procedures of the Hospital. 4. To begin the PGY-1 year, the applicant must have met and completed all the requirements to receive his or her medical school degree. The degree must also be conferred before the applicant begins the Riverside Methodist Hospital residency. 5. Each residency/fellowship program shall be responsible for determining the academic standards required for satisfactory progress through each year of study and for the completion of the requirements. These shall be in accordance with the ACGME requirements for each specific residency/fellowship or Board requirement. 6. The Resident/Fellow shall be responsible for ensuring that he or she is meeting the requirements and expectations of the Medical Education Department and the Hospital by attending assigned responsibilities such as Hospital Committee/Council meetings (see RMH Medical Education policy: Resident Involvement on Hospital Committees), completing all assigned Medical Records, reading and adhering to the appropriate policies and procedures, and by abiding by the cognitive and non-cognitive standards for house staff outlined in the Commitment of Housestaff. 7. Riverside Methodist Hospital and the Department of Medical Education are committed to providing a work environment free of discrimination. See RMH Medical Education policy: Resident Selection Policy, and the OhioHealth Human Resources Policy #1.00: Equal Employment Opportunity. The Hospital maintains a strict policy prohibiting sexual harassment. See the OhioHealth Human Resources Policy and Procedure #3.50: Harassment and Medical Staff Policy #16: Sexual Harassment. Effective June 16, 2015, the annual stipend for PGY 1 level residents/fellows shall be $49,774.40 payable in biweekly installments, 26 times a year. Federal, city, state, and Social Security tax will be withheld. RESIDENT DUTIES AND RESPONSIBILITIES During the term of the Agreement, the Resident/Fellow shall perform the duties described below. Resident/Fellow acknowledges that failure to fulfill any or all of these duties shall be considered a material breach of this Agreement and may lead to corrective action, including but not limited to termination, suspension or probation, or to non-renewal of this Agreement. 1. Participation in New Resident Orientation. 2. Develop a personal program of self-study for life long learning and professional growth. 3. Fulfill the educational and clinical requirements of the training program as specified by the Accreditation Council for Graduate Medical Education. 4. Provide safe, effective, and compassionate patient care under supervision, commensurate with 2

Resident Levels of Advancement. 5. Complete and keep current any and all medical records, progress notes, charts, reports or other necessary documentation. 6. The Hospital s DEA number is restricted for use by the Resident/Fellow only in the course of carrying out clinical duties within their GME training program. If Resident/Fellow is planning to perform any clinical duties outside the training program regardless of location, the Resident/Fellow must obtain a Drug Enforcement Agency number for dispensing controlled substances. 7. Residents/Fellows must be certified as a Provider to perform Advanced Cardiac Life Support (ACLS). Program Directors may make a request to the GME Office to have this requirement exempt if not applicable to the training program. 8. Residents/Fellows must have a National Provider Identification (NPI) number. 9. Participate in the educational activities of the training program and, as appropriate, teach and supervise other residents and students. 10. Participate in institutional committees and councils to which the Resident/Fellow is appointed or invited. 11. Participate in the annual program evaluation and review. 12. Resident/Fellow must dress and carry out his/her duties in a professional and ethical manner in accordance with State and Federal laws and state licensure standards. They must also endorse the Commitment of Housestaff. 13. Residents/Fellows must participate in in-house and where permissible, home call. All duty hours shall conform to institutional policies, program policies and to applicable ACGME requirements. 14. Residents/Fellows agree to participate in any drug and alcohol screen or for cause testing as per Medical Staff policies. All information pertaining to drug screening tests or results will be maintained in a confidential manner. 15. Residents/Fellows will at all times use appropriate infection control measures including hand hygiene which is critical to the prevention of healthcare associated infection. INSURANCE BENEFITS 1. Health, Dental, and Vision Health benefits, including medical, dental and vision are available to residents and fellows and are paid with pre-tax dollars utilizing a Personal Care Account (PCA). Health coverage is available for individuals, families and domestic partners and families. 2. Life Insurance Residents and fellows may elect basic life insurance for yourself and dependents. In addition, you can choose accidental death and dismemberment coverage for yourself and family. Rates depend on the amount of coverage. 3. Disability Insurance OhioHealth provides short term disability up to 90 days for an illness or injury that prohibits you from fulfilling your educational responsibilities. Your full salary will be paid up to 90 days until you are able to return to work or qualify for long term disability. OhioHealth provides long term disability coverage to protect your income if an injury or illness keeps you from working for an extended period of time in accordance with the disability policy. This coverage picks up after you have been disabled for 90 days. The premium for Long Term Disability is paid by OhioHeatlh. Please refer to benefits information for rates and coverage. 4. Professional Liability Insurance a. The Hospital provides professional liability insurance for the acts of all residents/fellows incurred in the performance of their duties in the Hospital or at the direction of the Program Director or the Designated Institutional Official/Director of Medical Education as part of their residency/fellowship program activities. The Hospital will defend and assume the costs of all such claims, regardless of when such claims are made or whether the resident/fellow is still in a Hospital training program. 3

b. The professional liability insurance coverage is limited to actions within the scope of the Hospital's residency/fellowship program. Activities outside the scope of the training program (e.g., moonlighting: internal as well as external) are not covered under this Agreement, and it is the sole responsibility of the resident/fellow to arrange coverage for such activities. c. In consideration of such coverage, the Resident/Fellow agrees to provide the Hospital's Risk Manager or General Counsel with prompt notice of any claim or potential claim of professional liability, and to cooperate with the Hospital's Risk Management Department, General Counsel's office and trial counsel in the investigation and defense of any claim made against the Resident/Fellow or the Hospital due to the Resident/Fellow's delivery of care. MEDICAL AND OTHER SUPPORT SERVICES The Resident/Fellow may seek medical assistance while on duty through the Associate Health Program. Counseling and other mental health services are available as described in RMH Medical Education Policy: Resident Physician Emotional and Behavioral Health. STIPEND A stipend is provided each academic year to help with expenses occurring during training. These expenses may include purchasing food while on duty, travel as it relates to outside rotations, and other expenses occurring as a result of residency training. MEALS Food is available within the hospital 24 hours a day. LAUNDRY The Resident/Fellow will be furnished two lab coats per year, and scrubs as needed, which shall remain the property of the Hospital. Residents/fellows are responsible for cleaning and maintaining their lab coats. CALL ROOMS Safe, quiet, and private call rooms are furnished by the Hospital to be used when residents/fellows are on call or too tired to perform safe patient care or drive home. LEAVES OF ABSENCE / TIME OFF For more detailed information on leaves of absence / time off please see the policy: Leave of Absence for House Staff. Residents/Fellows should be aware that the amount of leave or absence from training taken for any reason may affect your eligibility for certification boards. The Resident/Fellow must consult the Program Director regarding certification requirements in the particular program prior to any extended leave. The various specialty boards have differing requirements regarding the need to make up time missed from a training program. 1. VACATION: a. Residents/Fellows are entitled to three weeks vacation for each PGY level. Vacation will be prorated appropriately for contracts less than one academic year. b. Vacations must be scheduled by submitting the appropriate form with approval of the chief resident and/or program director to the Medical Education office by the 15th of the month prior to the requested vacation month. Individual residency/fellowship programs may have additional scheduling requirements. c. Unused vacation time may not be transferred to subsequent academic years. 4

2. SICK LEAVE: The Resident/Fellow is entitled to five (5) days of paid sick leave during the term of this Agreement. Notification must be given to the Medical Education Department when absent from any service. Illness requiring more than five (5) days of absence will be classified as Disability Leave. 3. PARENTAL LEAVE: (See Medical Education Policy: Parental Leave). Maximum Parental Leave Note: Leave must be taken immediately following the date of the event, except as noted below. Birth Mother (Normal Delivery) disability pay for up to 6 weeks maximum Birth Mother (Cesarean Delivery) disability pay for up to 8 weeks maximum Birth Father disability pay for up to 2 weeks maximum Adoption (Mother) disability pay for up to 2 weeks maximum Adoption (Father) disability pay for up to 2 weeks maximum Residents must coordinate leave of absence requests with their program director to ensure that they meet the ACGME and Board requirements. While the resident or fellow may, with program director approval, use available vacation time or time off without pay during the same academic year in which parental leave is taken, doing so may result in an unpaid extension of the training program. 4. CONFERENCE LEAVE: Residents/Fellows in good academic standing in the PGY-II academic year and above are entitled to five (5) days paid conference time annually. Residents/Fellows may be reimbursed for expenses incurred to attend a conference up to a maximum of $1500 per year. Expenses greater than $1500 are the responsibility of the Resident/Fellow. A request form must be completed and signed by the appropriate Program Director before the conference time may be granted. The Program Director may grant additional conference time/funding at his or her sole discretion. PGY-I residents in some programs may be eligible to attend conferences at the sole discretion of the Program Director. 5. PROFESSIONAL LEAVE: Professional leave will be defined and granted at the discretion of the Program Director. A request for paid professional leave must be approved in advance by the chief resident and Program Director. Adequate service coverage during the proposed leave must be demonstrated before the request can be granted. Any absence must be communicated to the Medical Education office. DUTY HOURS Duty hours are defined as all clinical and academic activities related to the residency program. Residents/Fellows are expected to be on duty from 7:00 a.m. to 5:00 p.m. Monday through Friday. Weekend, holiday, and night coverage will be in accordance with the RMH Medical Education Department policy: Duty Hours and the requirement of the specific residency/fellowship program, as determined by the chief resident or Program Director. Residents and Fellows are expected to know the ACGME duty hour requirements and comply with the Medical 5

Education Duty Hour Policy. MOONLIGHTING Internal and external moonlighting is not permitted, except under special circumstances when the resident/fellow is granted permission by the Program Director. All internal and external moonlighting must be counted toward the 80-hour weekly limit on duty hours. PGY-1 residents may not participate in moonlighting activities. Any resident/fellow participating in moonlighting, internal or external, must be licensed to practice medicine in the State of Ohio, obtain a fee-paid DEA, and must understand that the professional liability insurance given to them by OhioHealth while acting as a resident/fellow physician is NOT in effect during moonlighting activities. (See Medical Education Policy: Moonlighting). ACCOMMODATION FOR DISABILITIES OhioHealth provides equal employment opportunities and reasonable accommodation for qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) of 1990. OhioHealth prohibits discrimination in regards to job application procedures, hiring, advancement, discharge, compensation, benefits, job training and all other terms, conditions and privileges of employment, including resident/fellow physicians. (See Human Resources Policy: Disabilities and Reasonable Accommodations). PHYSICIAN IMPAIRMENT It is the responsibility of each member of the Medical Staff to voluntarily report when he/she or any other Practitioner suffers from a temporary or chronic health condition or impairment that may adversely affect rendering patient care. In addition, any other person may report such a condition or impairment. Indication of possible impairment while on duty is considered an immediate threat to patient safety. The person(s) receiving this report shall arrange for an immediate interview and assessment of the situation. (See Medical Staff Policy: MSP- 23 Impaired Practitioner). HARASSMENT It is the policy of the Medical Staff of Riverside Methodist Hospital to create and support a hospitable, cooperative and non-coercive environment in which all persons may work. Harassment of any kind is unacceptable and unprofessional. (See Medical Education Policy: Harassment). OFF-DUTY PROFESSIONAL ACTIVITIES Appointment and acceptance to the residency/fellowship program is a full-time responsibility. Any professional activity outside the purview of the residency/fellowship program must not interfere with the Resident/Fellow's performance of his or her Hospital duties. The resident/fellow will participate in these activities only with the prior knowledge and permission of the Program Director. LICENSURE The Department of Medical Education will provide all house staff with a State of Ohio Training Certificate for the duration of their residency training. Training certification is limited to the resident's professional activities in the course of his or her residency program. Residents who wish to obtain a permanent Ohio State Medical License during their training can do so by following the guidelines as outlined by the State Medical Board of Ohio. Expenses incurred for the permanent license will be the responsibility of the resident. See RMH Medical Education Policy: Resident Licensure. 6

EXAMINATIONS In-Training Examination Residents are expected to satisfactorily participate in the relevant In-Training Examination. Residents in a Preliminary or Transitional program are not required to participate in the In-Training Examination. Specialty Board Examination To become certified in a field of Medicine, a physician must complete the requisite predoctoral education, satisfactorily meet the graduate medical education training requirements, demonstrate clinical competence in the care of patients, meet licensure and procedural requirements, and pass the Certification Examination by the Specialty Board. Information on eligibility and application for Certification Examination requirements can be found on each Specialty Board s website. GRIEVANCE PROCEDURE AND DUE PROCESS 1. Prior to the initiation of a formal grievance request in any dispute or controversy involving the interpretation or application of this Agreement or any policies and practices of the Hospital (including but not limited to policies on gender and other forms of harassment), the Resident/Fellow is encouraged to pursue an informal approach, using communications with mentors, counselors, and the Program Director to resolve the dispute. The resident/fellow must transmit a written grievance request to the Designated Institutional Official/Director of Medical Education within three working days of the incident and/or the effective date of the Administrative Academic Action (See OhioHealth Medical Education Policy: Corrective Action, Grievance, and Due Process). This time period will not be extended due to informal resolution efforts unless specifically extended in writing by the Program Director or Designated Institutional Official/Director of Medical Education. 2. Upon receipt of a grievance, the Designated Institutional Official/Director of Medical Education will notify the Graduate Medical Education Committee (GMEC) and the Program Director. The Designated Institutional Official/Director of Medical Education shall consult with the Program Director and determine whether to recommend rescission of the Administrative Action to the GMEC or to proceed to the next step. 3. If the Designated Institutional Official/Director of Medical Education and the Program Director uphold the original decision, then the Designated Institutional Official/Director of Medical Education will appoint a panel and deliberate the action as described in the Medical Education policy: Due Process. The resident/fellow shall not be represented by legal counsel at this hearing. 4 During the grievance appeal and until the final determination is made, the Administrative Academic Action will remain in effect; but if relieved of duty, the resident/fellow will continue to receive salary and benefits until the final determination or for thirty (30) days, whichever occurs first. The final decision on the appeal shall be made by the Designated Institutional Official/Director of Medical Education and there shall be no appeal from this decision. SUSPENSION For more information, please refer to the RMH Medical Education Policy: Due Process and House Staff Grievance Policy. The Resident/Fellow may be suspended with or without pay by the Program Director or Acting Program Director for failure to perform his or her duties or infraction of established policies and procedures. Written notice of the suspension will be provided to the resident/fellow by the Program Director in advance of the effective date if practicable; otherwise, such notice will be provided at the initiation of the suspension. The notice will include the effective date of the suspension, the reasons for it and, if known, the date on which the suspension will end or the conditions which must be satisfied to end the suspension. A copy of the notice will be sent to the Designated Institutional Official/Director of Medical Education. If there are conditions which must be satisfied in order to end 7

the suspension, the Program Director must identify them as soon as possible after the effective date, but in no case later than three (3) working days after the effective date. It is the responsibility of the resident to demonstrate satisfactory completion of such conditions. For more information, please see OhioHealth Medical Education Policy: Corrective Action, Grievance, and Due Process. HOSPITAL RESPONSIBILITIES The Hospital agrees to provide an environment wherein both the teaching staff and residents/fellows continually strive to improve their knowledge and medical skills. Residents/fellows will be incorporated into medical staff programs related to medical education and patient care in a true cooperative and educational relationship. In addition, the Hospital agrees to provide training programs that meet the essentials of accredited residencies as required by the Accreditation Council of Graduate Medical Education, American Osteopathic Association, Residency Review Committees, and Specialty Boards. If it becomes necessary for the Hospital to reduce the size of a residency/fellowship program or to close a residency/fellowship program, the Hospital will inform the resident/fellow as soon as possible and make every effort to allow residents/fellows already in the program to complete their education. If any residents/fellows are displaced by the closure or reduction of a residency/fellowship program, the Hospital and the Department of Medical Education will make every effort to assist the residents/fellows in identifying a program in which they can continue their education. CONDITIONS FOR REAPPOINTMENT Promotion of a resident to the subsequent year of training requires satisfactory cumulative evaluations and satisfactory progress in professional growth and knowledge. Demonstrated proficiency in each of the ACGME competencies (patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, systems-based practice), conference attendance and punctuality, satisfactory clinical evaluations, completion of teaching evaluations, appropriate residency advisory committee input, and adherence to medical staff policies and procedures at Riverside Methodist Hospital and at each training site assigned, and proficiency of program-specific levels of care, all provide the basis for promotional decisions. IN WITNESS WHEREOF, the Hospital and the Resident/Fellow sign this Agreement and make it effective as of the date indicated. Resident/Fellow Signature Date GME Training Program Director Date Sara Sukalich, MD Designated Institutional Official Date 8